Driving for Success in Family Reunification-Professionals' Views on Intervention.

Family reunification is a complex process and is consensually considered the best solution for children in care, as soon as the family has changed the dysfunctional patterns that prevent child safety and well-being. Intervention throughout the entire process is crucial to the success of family reunification. This study aimed to explore and understand child protection professionals' views on factors influencing (un)successful family reunification trajectories. Using a qualitative design, 33 Portuguese child protection professionals participated in five focus groups. The thematic analysis revealed a set of influential factors within three different systemic levels: child, family, and child welfare system. The latter level was clearly predominant, pointing to the powerful role of the intervention as a vehicle for successful family reunification. The results showed the relevance attributed by the professionals to some main intervention guidelines, children-professionals' relationships, multisystemic assessment and intervention, coordinated work of intervention teams, and sufficient time between the court decision and the child's re-entry into the family home. The need for early intervention and its continuity after the child's reintegration into the home also emerged as relevant factors. This study provides in-depth knowledge of professionals' views on the intervention process, thus contributing to a comprehensive understanding of (un)successful family reunification trajectories.

When Emergency Patients Die by Suicide: The Experience of Prehospital Health Professionals.

The suicide of a patient can be a disturbing experience for health professionals. According to literature, a patient suicide is a professional hazard in the path of prehospital emergency professionals. In the emergency context, several factors pointed out in literature as predictors of increased emotional impact and more severe traumatic reactions are present. However, the impact of patient suicide on prehospital emergency professionals is still an understudied subject. The aim of this study was to better understand the impact and emotional reactions of prehospital emergency professionals facing a patient suicide, using a qualitative approach. Semi-structured interviews were conducted with 19 prehospital professionals. Fourteen narratives about a patient suicide experience were obtained. Three main categories emerged from the process of content analyses: (1) emotional impact and related factors; (2) perceptions of impact; (3) emergency context and professional growing. Death by suicide in the prehospital emergency context had a considerable emotional impact on these professionals. Several participants described intrusive thoughts and images as a consequence of attending to the death scene. Regarding the perception of impact, there seemed to exist a variation between the levels of exposed to and affected by suicide. There are specific features of the prehospital emergency context that emerged in the narratives of participants as factors which increased the patient suicide impact, namely attending the death scene, encountering the family or other survivors, and managing the feeling of responsibility for not arriving in time of the rescue. The narratives of prehospital professionals also indicated some negative effects on their professional practice, such as doubts about their competence, training, and limits to liability. The death of a patient by suicide in the prehospital emergency context can be a difficult experience, marked with an intense emotional impact. Nevertheless, it can have some positive effects, such as professional growth and increased awareness for the phenomenon. Specific training appears to be fundamental to promote professional growth and to overcome the negative emotional impact.

Anorexia nervosa: divergent validity of a prototype narrative

The objetive of this paper was to test the divergent validity (degree of discrimination) of an anoretic prototype narrative (i.e., communality of themes in the individual, core autobiographical memories), as well different characteristics of the participants which may be associated with the degree of prototype discrimination. Seventy participants diagnosed with anorexia nervosa participated in the study and were asked to indicate their degree of identification with four different narrative prototypes (depressive, agoraphobia, anorexic, alcoholic and drug addiction prototypes). Results did not confirm the divergent validity of the anorexic prototype narrative. Participants tended to identify primarily with the depressive prototype narrative. No significant differences were found between levels of identification with the anorexic prototype and depression, or agoraphobia and alcoholism prototype. The only significant difference found was between the anorexic and drug addiction prototype. However, severity and duration of the clinical condition were found to be associated with the degree of identification of prototype narrative. Results are discussed in terms of a transdiagnostic versus a prototype approach to the eating disorders psychopathology.