Video feedback combined with coordination meetings in school to reduce early disruptive behaviour problems (DBP)-A 1-year follow-up randomised controlled trial.

AIM: To compare long-term effects of a systemic school-based intervention, Marte Meo and Coordination Meetings (MAC), targeting 3- to 12-year-old children displaying disruptive behaviour problems (DBP) in preschool or school, and service as usual (SAU). In addition, to examine whether social status (SS) affected the outcomes. METHODS: In a randomised controlled design, teachers' and parents' ratings of 99 children's DBPs and mental health were collected before intervention and 1 year after post-test. RESULTS: A significant time effect in school was found in both interventions, notably larger than at post-test in an earlier study. There was no difference between groups, SAU catching up with MAC. From teachers' reports, 53-70% of the children showed a positive change. SS did not affect the outcomes. CONCLUSION: School provides an already established setting to detect and intervene when young children begin to display DBP. Even if a long-term positive change in MAC did show more rapidly than in SAU, both interventions were equivalent for children from diverse social backgrounds.

An upbringing with substance-abusing parents: Experiences of parentification and dysfunctional communication.

AIM: To increase understanding of the consequences of growing up with substance-abusing parents, including how this can influence the experience of becoming a parent. METHODS: In-depth interviews were conducted with 19 parents who had participated in an Infant and Toddler Psychiatry Unit intervention programme and who had experienced substance-abusing parents in their family of origin. Directed qualitative content analysis was used to analyse the data. RESULTS: Analysis of the interview material revealed both a high incidence of parentification and a conspiracy of silence concerning the substance abuse that helped generate symptoms of cognitive dissonance in the children. As parents they experience a high degree of inadequacy, incompetence and stress. CONCLUSION: A majority of the children who had grown up with substance-abusing parents responded by taking a parenting role for themselves, their siblings and their parents. These children, often well-behaved and seemingly competent, need to be identified and offered support as they risk developing significant psychological and emotional difficulties that can extend into adulthood. They form an extra sensitive group who may need special support up to and including the time when they become parents themselves. This finding underlines the importance of further research on parenting among those who have grown up with abusive parents.

Struggling with one's own parenting after an upbringing with substance abusing parents.

AIM: To add to our knowledge concerning the key elements involved in the individual's experience of growing up with substance abusing parents and the resulting challenges this involved for their own parenthood. METHODS: In-depth interviews were conducted with 19 parents who had participated in a mental health intervention programme. All had experienced substance abusing parents in their family of origin. Qualitative content analysis was used to analyse the data. They also completed a self-report questionnaire assessing their attachment style. RESULT: Participants reported a high incidence of emotional abuse and neglect coupled with inadequate support from the community. Their own parental role was influenced by high parental stress and a majority had an insecure attachment style. CONCLUSIONS: All participants had experienced a very difficult childhood which was reinforced by the fact that they received little support from society. Their childhood experience and the resulting challenges that this created in their own parenting role could negatively influence their own children's ability to form a secure psychosocial development. It is therefore important to develop instruments that can help to identify children who were raised in misuse families in order to accommodate the transgenerational effects of growing up with substance abusing parents.

The development of a systemic school-based intervention: Marte Meo and coordination meetings.

Antisocial behavior is often persistent, and in addition to causing suffering to children and their families, it also poses considerable costs for society. Children who display externalizing behavior in their early years run a high risk of having severe problems later in life. There is a need for treatment methods that may be used in various settings because these children constitute a group that is hard to reach with conventional treatment methods. In addition, the dropout rate from ordinary treatment is often high. In the present study, a systemic school-based model for early detection and intervention among 4-12-year-old children who displayed externalizing behavior problems was developed and examined in a nonrandomized study in the county of Skaraborg in Sweden. The intervention was collaborative and included a combination of the Marte Meo model and coordination meetings based on systemic theory and practice. Treatment effects in the group who had received the intervention were compared with a group who had received treatment as usual in their ordinary school setting. Assessments were carried out before, and 2 years after, the intervention. For the intervention group (N = 33), there was a significant decrease in the children's reported symptoms in school and in the home. No decrease in externalizing behavior was found in the comparison group (N = 16). There were no dropouts in the intervention group after the intervention had begun. The results are promising; the study demonstrates that it is possible to work effectively with many children who display externalizing behavior problems in a nonclinical setting.

Introduction to medical family therapy.

The onset of illness and/or disability in children may also create difficulties at psychosocial levels--for the child, the family, her network and even in relations between them and the medical team. Medical family therapy, coupled with salutogenic theory and Marte meo offers specific ways of working with such difficulties so that the family and the medical team can work together in a mutually supportive manner.

[Supervisor training in psychosomatic approach to work--a successful pilot project. Communication increases trust in the professional]. / Handledarutbildning i psykosomatiskt arbetssätt--ett lyckat pilotprojekt. Samtal ger ökad professionell tillit.

A question from the Director of Health and Social Security--"What happens when so many patients seek help, and apparently don't get any?"--resulted in an enquiry, which mapped how the medical staff thought about "psychosomatic" problems. One consequence was the pilot project discussed in this article: a training programme with two aims--to increase knowledge of psychosomatic illness, and to offer training in a method for supervision. The training included theory and practise. The course lasted for one and a half years, two days once a month. Participants (n = 18) included physicians, physiotherapists, nurses, medical social workers and occupational therapists. The course evaluation showed that working on different levels (theoretical, practical, personal) was appreciated, meeting the needs of working with complex health issues. The evaluation of the supervision given by the course participants that reached about 85 persons showed that the supervision brought increased trust to professional ability with the participants in the supervision groups.