"Although the benefits of psychological consultation in the pediatric setting are well established, a gap often exists between the demand for these services and funding. We have embarked on our longstanding goal to develop a group-based intervention model for parents of premature infants, adapting our manual of individual trauma-focused cognitive behavioral therapy to help reduce feelings of parental isolation. This book describes a more global approach to psychological consultation in the NICU integrating interventions that begin prior to the infant's conception and extend well beyond the NICU hospitalization. Chapter 1 provides a context and review of the medical aspects of the NICU environment and the neurodevelopmental consequences of prematurity. In Chapter 2 reviews the common psychological reactions of mothers of premature infants, including specific risk factors associated with maternal psychological distress. It also discusses the relationship between parental posttraumatic stress and infant outcomes as it relates to such issues as breastfeeding, maternal-infant interaction, attachment, and infant development. Chapter 3 describes the form and prevalence of symptoms of paternal psychological distress and outline a curriculum for a group-based intervention specifically designed to address fathers' concerns. Chapter 4 addresses developmental care interventions that overlap with interventions more narrowly focused on parental psychological distress. Chapters 5 and 6 describe our intervention model in both the individualand group therapy formats. Chapter 7 addresses vulnerable child syndrome, which is associated with adverse developmental outcomes in children as well as overutilization of health care resources. Application of the trauma model to the concept provides a framework to understand how parental behavior is altered in the context of trauma. Finally, Chapter 8 discusses how to implement a psychological intervention program in the NICU that includes screening the parents of premature infants for symptoms of psychological distress"--

The increasing prevalence of preterm birth in the United States is a complex public health problem that requires multifaceted solutions. Preterm birth is a cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, sociodemographic and neighborhood characteristics, environmental exposure, medical conditions, infertility treatments, and biological factors. Many of these factors co-occur, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. While advances in perinatal and neonatal care have improved survival for preterm infants, those infants who do survive have a greater risk than infants born at term for developmental disabilities, health problems, and poor growth. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems. Preterm Birth assesses the problem with respect to both its causes and outcomes. This book addresses the need for research involving clinical, basic, behavioral, and social science disciplines. By defining and addressing the health and economic consequences of premature birth, this book will be of particular interest to health care professionals, public health officials, policy makers, professional associations and clinical, basic, behavioral, and social science researchers.

Decades of research have demonstrated that the parent-child dyad and the environment of the familyâ€"which includes all primary caregiversâ€"are at the foundation of children's well- being and healthy development. From birth, children are learning and rely on parents and the other caregivers in their lives to protect and care for them. The impact of parents may never be greater than during the earliest years of life, when a child's brain is rapidly developing and when nearly all of her or his experiences are created and shaped by parents and the family environment. Parents help children build and refine their knowledge and skills, charting a trajectory for their health and well-being during childhood and beyond. The experience of parenting also impacts parents themselves. For instance, parenting can enrich and give focus to parents' lives; generate stress or calm; and create any number of emotions, including feelings of happiness, sadness, fulfillment, and anger. Parenting of young children today takes place in the context of significant ongoing developments. These include: a rapidly growing body of science on early childhood, increases in funding for programs and services for families, changing demographics of the U.S. population, and greater diversity of family structure. Additionally, parenting is increasingly being shaped by technology and increased access to information about parenting. Parenting Matters identifies parenting knowledge, attitudes, and practices associated with positive developmental outcomes in children ages 0-8; universal/preventive and targeted strategies used in a variety of settings that have been effective with parents of young children and that support the identified knowledge, attitudes, and practices; and barriers to and facilitators for parents' use of practices that lead to healthy child outcomes as well as their participation in effective programs and services. This report makes recommendations directed at an array of stakeholders, for promoting the wide-scale adoption of effective programs and services for parents and on areas that warrant further research to inform policy and practice. It is meant to serve as a roadmap for the future of parenting policy, research, and practice in the United States.

Depression is a widespread condition affecting approximately 7.5 million parents in the U.S. each year and may be putting at least 15 million children at risk for adverse health outcomes. Based on evidentiary studies, major depression in either parent can interfere with parenting quality and increase the risk of children developing mental, behavioral and social problems. Depression in Parents, Parenting, and Children highlights disparities in the prevalence, identification, treatment, and prevention of parental depression among different sociodemographic populations. It also outlines strategies for effective intervention and identifies the need for a more interdisciplinary approach that takes biological, psychological, behavioral, interpersonal, and social contexts into consideration. A major challenge to the effective management of parental depression is developing a treatment and prevention strategy that can be introduced within a two-generation framework, conducive for parents and their children. Thus far, both the federal and state response to the problem has been fragmented, poorly funded, and lacking proper oversight. This study examines options for widespread implementation of best practices as well as strategies that can be effective in diverse service settings for diverse populations of children and their families. The delivery of adequate screening and successful detection and treatment of a depressive illness and prevention of its effects on parenting and the health of children is a formidable challenge to modern health care systems. This study offers seven solid recommendations designed to increase awareness about and remove barriers to care for both the depressed adult and prevention of effects in the child. The report will be of particular interest to federal health officers, mental and behavioral health providers in diverse parts of health care delivery systems, health policy staff, state legislators, and the general public.

This practical guide offers mental health professionals a detailed, step-by-step description on how to conduct Parent-Child Interaction Therapy (PCIT) - the empirically validated training program for parents with children who have disruptive behavior problems. It includes several illustrative examples and vignettes as well as an appendix with assessment instruments to help parents to conduct PCIT.

How we raise young children is one of today's most highly personalized and sharply politicized issues, in part because each of us can claim some level of "expertise." The debate has intensified as discoveries about our development-in the womb and in the first months and years-have reached the popular media. How can we use our burgeoning knowledge to assure the well-being of all young children, for their own sake as well as for the sake of our nation? Drawing from new findings, this book presents important conclusions about nature-versus-nurture, the impact of being born into a working family, the effect of politics on programs for children, the costs and benefits of intervention, and other issues. The committee issues a series of challenges to decision makers regarding the quality of child care, issues of racial and ethnic diversity, the integration of children's cognitive and emotional development, and more. Authoritative yet accessible, From Neurons to Neighborhoods presents the evidence about "brain wiring" and how kids learn to speak, think, and regulate their behavior. It examines the effect of the climate-family, child care, community-within which the child grows.

The emotional impact of having a newborn hospitalized in an intensive care unit is immense. The parents' perceptions of the child's fragility and of their role in the vulnerable child's life represent important facts of the crisis in which the infant and the parents are involved. Such early stress marks the child's later development which may include chronic ailments and learning disabilities. This book explores a whole spectrum of psychological questions raised by the birth of medically fragile infants, from the parents' ability to restore a sense of meaning and mastery in the face of the profound challenges confronting them, to the importance of social support and coping strategies, and finally, to the crisis of newborn intensive care in the context of the marital relationship.