A preschooler recently started attending school. The teacher is worried because the young student is often very angry. The parents also wonder what is going on and report to the youth mental health clinic. The father himself is also under treatment because of his sometimes violent outbursts. In contact with his child he is very controlling and reacts irritated when things do not go the way he wants. This situation is one of many examples from Stolper's research that underscore the importance of a family-centered approach.
In practice, parents and children are usually treated separately. Previous research shows that children of parents with mental problems are twice as likely to develop symptoms. Young children are especially vulnerable. According to Stolper, you miss a piece of the puzzle when you only treat the adult or the child. ''Family-centered treatment helps parents and child break negative interactions and patterns,'' the psychologist says. ''Yet in practice, treatment now often focuses on the complaint in an individual because that's how the systems in the mental health system are set up. That leads to context blindness.''
Social context
The researcher emphasizes that mental problems often arise in conjunction with the social context. But what if you include that social context, including the family situation, in the treatment? That is the central question in the thesis of Stolper, who also works as a clinical psychologist at Dimence Groep. She looked at the effect of Contextual Treatment, an integrated family approach in mental health treatment. Instead of treating only the adult or child, this approach focuses on the entire family: the parent's psychological symptoms, the parental role, the young child and the parent-child relationship. In addition, it is important to address social stressors, which requires close collaboration with other organizations.
Video observations show progression
To examine the success factors of this approach, several interviews were conducted with practitioners and parents. A special feature of the study is the use of video observations. These were used as part of the treatment and analyzed to measure progress. This clearly showed that the quality of parent-child interaction improved. The results of the questionnaires and interviews showed increased satisfaction among the parents about their relationship with their child, as well as confidence in their parenting. In addition, parents appeared to be better able to empathize with their child.
All these aspects, according to Stolper, protect the mental health of both parent and child. A good example of success is the family with the short-tempered father. The family was filmed several times for the study. ''When the father saw the footage back, he realized that he was constantly directing his little son and giving him very little space,'' Stolper says. ''He learned to empathize more with his son and gained more control over his anger.''
''The mental health system can help prevent the intergenerational transmission of mental problems''
Hanna Stolper
PhD Candidate
Treatment is not a 'car wash'
This family-centered approach led to significant improvement at the group level, but it requires a different way of working in practice. For example, it requires a family-oriented focus from all caregivers involved. This requires consultation between practitioners from both adult and youth mental health services. A certain flexibility is also needed to provide customized services. Stolper: ''The father indicated this with an apt metaphor. He was afraid that treatment would feel like 'going through a car wash' where the program is predetermined. Instead, there was a constant reassessment of what was needed at that moment for me, my child and our whole family,' he told me.''
Of course, there are challenges with this method of treatment. Youth and adult care in the mental health system are typically different organizations with their own work processes, language and therapeutic vision. This approach requires a culture change, or a turnaround from individual to context-oriented. The workload and waiting lists in the mental health sector are high. Stolper: ''Our experience is that treatment can often be faster this way. Parenthood is often a powerful motivator to want to benefit from treatment. And more importantly, mental health care can help prevent the intergenerational transmission of mental problems.''
- PhD student
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