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Introduction to the special issue.

This special issue of Best Practices in Mental Health: An International Journal focuses on the field of children's mental health and how, over the last quarter-century, the field has been profoundly changed by the increasing influence and advocacy of family members who care for children with serious mental health disorders. The papers in this issue explore the mechanisms that have served to enhance family members' influence and power and describe how the field has evolved as a result of families' increasing impact on areas from individual services to national policy. At the same time, the articles in this special issue describe how the Research and Training Center on Family Support and Children's Mental Health (RTC) has contributed to this remaking of the field through its research about how family voice is developed and supported. The six articles in this issue report on research about family and youth participation in a variety of roles and venues, and illustrate how these new forms of participation have created opportunities for family members and youth to shape a children's mental health service system that is more responsive, culturally centered, and family-driven.

The first paper in this collection lays the conceptual groundwork for thinking about the mechanisms through which family members have gained and exerted influence within the developing field of children's mental health. The authors (Friesen, Koroloff, Walker, & Briggs) provide a framework based on the classic work on interpersonal influence by French and Raven (1959) and use it as a basis for understanding how it is that family members--and, more recently, youth and young adults--have developed influence and become empowered. The paper then works through a series of examples using the conceptual framework to explain the dynamics that have driven the evolution of family participation and influence in practice, policy, and research.

The second article begins by describing how broad intellectual and cultural currents in the United States have created a profound change in people's perceptions regarding the nature of authority and expertise. The public has become much more skeptical of scientific authority and professional expertise, and this in turn has given greater legitimacy to other forms of knowledge. Within the field of children's mental health, this shift has supported the idea that family members have important and unique knowledge and expertise about their children and that they should therefore play a primary role in making treatment-related decisions. Walker, Bruns, Conlan, and LaForce use the example of wraparound--a team-based care-planning and delivery process--as an example of a treatment planning approach that seeks to balance family and professional expertise in order to achieve improved outcomes for children with high levels of mental health and related needs. The authors go on to describe how the inclusion of family perspectives in wraparound at the treatment level has contributed to a dynamic that reinforces family influence in the design of systems and services. Specifically, the authors focus on how collaboration between family members and professionals has been a hallmark of the work of the National Wraparound Initiative as that organization has worked to refine the practice model and build the research base for wraparound.

The third article draws attention to the importance of considering parents' perspectives when planning early childhood and primary education transition services for at-risk families with young children entering elementary school. Malsch, Green, and Kothari describe their work to prepare families whose small children have challenging behaviors for their children's entry into kindergarten. The experiences of families are examined and used to form the foundation of practice guidelines that reinforce how essential it is that staff members in early childhood settings prepare parents to know what to expect and to advocate for their children in school systems.

Rosenzweig, Malsch, Brennan, Huffstutter, Stewart, and Lieberman discuss the key communication competencies that human resource personnel need to employ as they work with employees who have children with serious emotional or behavioral disorders. The authors offer insight into ways that human resource personnel can structure the work environment and communicate with families so that the workplace is free of stigma and helps employees to balance work and family demands.

Cross, Friesen, Jivanjee, Gowen, Bandurraga, Matthew, and Maher described a culturally centered method for measuring the effectiveness of culture-specific services for Native American youth. Developed from the ground up in partnership with an urban Indian community agency and a national Native American center that focuses on training, technical assistance, and research, the approach is grounded in principles of community-based participatory research. A series of focus groups with elders, youth, parents, staff, and community partners were used to arrive at a community-based definition of success for Native youth and to define measurable milestones and outcomes. The cultural adaptations necessary to conduct the focus groups and collaboratively analyze the results are examined. Results of this study provide support for a broader and more culturally appropriate definition of success and services in programs serving Native youth.

Jivanjee and Kruzich describe the experiences and attitudes of transition-age youth and their families as they negotiate the mental health system and strive to maintain a satisfying and productive life in the community. The results of the study illustrate the importance of having staff members with the skills and capacities to respond effectively to the unique needs of transition-age youth. The study highlights the importance of providing family and peer support, and reinforces how essential it is for providers to be able to interact with youth in a compassionate manner.

Taken together, these six articles are a reflection of the diversity of ways in which the field of children's mental health has been affected by the growing influence of family, youth, and other lay perspectives. The articles provide tangible evidence of the ways that the inclusion of these perspectives has stimulated profound changes, not just in practice but also in the policies and systems that provide structure to the children's mental health system today.

References

French, J. R. P. Jr., & Raven, B. H. (1959). The bases of social power. In D. Cartwright (Ed.), Studies in social power (pp. 150-167). Ann Arbor, MI: Institute for Social Research.

Harold E. Briggs, PhD, is professor in the School of Social Work, Portland State University in Portland, Oregon. Nancy M. Koroloff, MSW, PhD, is professor and principal investigator at the Research and Training Center on Family Support and Children's Mental Health, Portland State University in Portland, Oregon. Janet S. Walker, PhD, is research associate professor in the School of Social Work, Portland State University in Portland, Oregon. Barbara J. Friesen, MSW, PhD, is research professor and director, Research and Training Center on Family Support and Children's Mental Health, Portland State University in Portland, Oregon. This research was supported by the National Institute on Disability and Rehabilitation Research, U.S. Department of Education, and the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services (Grant No. H133B040038). The content does not necessarily represent the views or policies of the funding agencies.
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Author:Briggs, Harold E.; Koroloff, Nancy M.; Walker, Janet S.; Friesen, Barbara J.
Publication:Best Practices in Mental Health
Geographic Code:1USA
Date:Jan 1, 2011
Words:1161
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