Search

In mental health settings, we often meet traumatized and volatile youth who resist treatment and do not respond to engagement attempts. For such patients, the treatment refusal may be a representat...

Objective: ADHD in adolescents and low level of parental monitoring have been associated with increased risk-taking behavior. The present study examined whether parental knowledge of the child’s whereabouts mediates the correlations between adolescent ADHD symptoms and risk-taking behavior. Method: Ninety-two adolescents and their parents completed questionnaires assessing perceptions of parents’ monitoring, engagement in risk-taking behaviors, and ADHD symptoms. Results: Greater engagement in risk-taking behavior correlated with higher levels of ADHD symptoms and decreased parental monitoring. Mediation analysis revealed both direct effect of ADHD symptoms on risk-taking behavior and an indirect effect mediated by level of parental knowledge. Conclusion: These findings suggest that parental knowledge is negatively affected by the presence of ADHD symptoms, and may in turn lead to risk-taking behavior. The findings emphasize the need to target parenting and in particular parental knowledge of the child’s whereabouts to reduce risk-taking behaviors among youth with ADHD.

The development of mindfulness parenting programs in recent years offers a promising direction for targeting parental emotional dysregulation in families of children with attention deficit hyperactivity disorder (ADHD). Nevertheless, research on the effectiveness of mindfulness parenting programs is limited, and little is known about the contribution of mindfulness skills to parenting when integrated with parent training (PT). The present study evaluated a mindfulness skills augmentation to PT for ADHD. We hypothesized that mindfulness-enhanced PT would improve parental emotion regulation and reduce hostile and coercive parenting. We developed a 90-min mindfulness skills protocol and integrated it with a nonviolent resistance (NVR) PT program addressing ADHD and behavior difficulties. A total of 79 families were randomly assigned to PT or mindfulness-enhanced PT. Forty-three families completed intervention. We used multilevel modeling to evaluate parental emotion regulation, hostile and coercive parenting, and child behavioral symptoms across treatments and over time. Across treatment conditions, mothers’ negative feelings, escalating behaviors, and capacity for emotion regulation improved significantly following treatment. Fathers in the mindfulness condition reported greater improvement in the capacity for emotion regulation, reduced negative feelings, and reduced parental submission compared with fathers in the PT condition. We found no differences in child externalizing symptoms, which decreased significantly in both groups. Study results suggest that PT in NVR is effective in improving maternal capacity for emotion regulation and in reducing hostile and coercive parenting. For fathers, a mindfulness-based skills augmentation may be important for enhancing treatment benefits.

Objective: The aim of this study is to examine the role of parental emotion regulation (ER) and parental mentalization as possible contributors to hostile and coercive parenting in families of children with ADHD. Method: Seventy-four Israeli families (64 mothers and 48 fathers) seeking parent training for child ADHD completed measures during the intake session. Measures included parental ER; parental mentalization; hostile, coercive, and submissive parenting; and child symptoms. Results: Findings suggested a relationship between parental ER and coercive parenting independent of child age, symptom level, and parental mentalization. Parental mentalization appeared to buffer against hostility specifically among parents with low ER capacities. Patterns were parallel for mothers and fathers. Conclusion: Study findings highlight the importance of evaluating and addressing parental ER in interventions attempting to reduce coercive parenting. The findings also highlight the potential role of parental mentalization as a protective mechanism against hostile parenting in families of children with ADHD.

This article provides an insight into the work of a child clinical psychologist in Sderot, a small city in the south of Israel that suffered for several years from rocket attacks from the adjacent Gaza Strip. The article discusses the intersection between clinical work and politics as it manifests in the diagnosis and treatment of post-traumatic stress disorder in the city. Using a clinical vignette, the article raises two questions regarding the responsibility of clinical psychologists. First, it invites them to consider political meanings during their clinical work, and second, to consider the role they play in creating a trauma-focused national narrative that preserves rather than tempers political conflicts. Copyright © 2014 John Wiley & Sons, Ltd.