Karitane Research Summary September 2008

Recently completed projects
Residential Family Care Unit Evaluation
This study evaluated mental health and parenting outcomes associated with admissions at the Karitane Residential Family Care Unit. A consecutive series of 151 clients completed a series of mental health, parenting and psychosocial measures on admission, 4 weeks post discharge and 3 months post discharge.  Results showed the program to be associated with significant and lasting improvements for both children and mothers. An information sheet for clients containing details about the evaluation has been made available to clients and results have also been disseminated at a number of conferences including the World Association for Infant Mental Health (WAIMH) Congress (Paris, July 2006), QEC 4th biennial conference (Melbourne, November 2006) and The Zero to Three National Training Institute conference (New Mexico, December 2006).

Jade House Evaluation
In this study, a retrospective review of Jade House data and a post discharge follow-up of Jade House clients were undertaken with the aims of providing a description of the clients who access Jade House, the clinical services provided, consumer feedback and outcomes. Results of this study were reported in the Journal of the Child and Family Health Nurses Association (NSW) (April 2008).

Karitane Toddler Clinic Evaluation
Parent-Child Interaction Therapy (PCIT) is a short-term, evidence-based parent training intervention used widely in the treatment of behaviourally disordered preschool-aged children. This study aimed to evaluate the effectiveness of PCIT delivered to families in an Australian community-based early childhood clinic (the Karitane Toddler Clinic). Participants included 43 families with children aged 19-52 months who were referred for treatment of disruptive child behaviours and who completed PCIT treatment at the Karitane Toddler Clinic. Parents provided pre and post-treatment ratings of child behaviours, parental stress, parental psychopathology and parental attitudes about therapy. At the end of the program, clinically and statistically significant improvements were seen in child behaviours and parental well-being, and parents reported high levels of satisfaction with treatment. Results of this study were published in the Australian and New Zealand Journal of Psychiatry in August 2008.

Projects in progress
Postnatal depression and anxiety research
This research seeks to further investigate the heterogeneity that is known to exist within postnatal depression (PND). The research aims to determine whether there are subtypes of PND characterised by differences in symptom presentations, psychiatric diagnoses, or risk factors (e.g. cognitive style, personality vulnerability, social support, life event stress and psychiatric history). Preliminary results have been reported in the Australian and New Zealand Journal of Psychiatry (June 2007) and at conferences including the Women and Depression conference (Sydney, May 2007), the Australian Marce Society Conference (Surfers Paradise, June 2007), the World Congress for Cognitive Behavioural Therapists (Barcelona, June 2007), and the International Marce Society Conference (Sydney, September 2008).

Adolescent Mothers in Custody Evaluation
The ‘Adolescent Mothers in Custody - Linking to a New Future for Families’ project is a joint initiative conducted by the Juniperina Juvenile Justice Centre (JCC) and Karitane, funded by the Attorney General’s Department (National Crime Prevention Programme Grant). The project aims to support extended day visits for children of mothers incarcerated at the Juniperina JJC (including support and parenting education), facilitate parenting education & clinical supervision for Juniperina JJC staff and to evaluate existing relevant policy and protocols. Evaluation results will be reported in the final project report.

Emotion in parenting and child behaviour problems
Conducted in collaboration with the University of Sydney, this study aims to investigate the cognitive and emotional dimensions of parenting which influence parent-child interactions and early childhood behaviour problems. Specifically, parents’ perceptions of children’s negative emotions will be explored, and the relationship of these perceptions to parenting style, parents’ management of their own emotions, and the treatment of child behaviour problems will be examined.

Comparison of two infant sleep and settle strategies
Conducted in collaboration with the SSWAHS Infant, Child and Adolescent Mental Health Service, this project will compare two interventions for treating infants with sleep and settling difficulties – ‘comfort settling’ and ‘parental presence’. In addition to comparing the effectiveness of the two strategies, parental preference and ease of compliance will also be examined.

Publications
Nemeth, D. & Sinclair, A. (2004). An example of evidence based practice: Ceasing head elevation in the management of infant Gastro Oesophageal Reflux (GOR). The Australian Journal of Child and Family Health Nursing, 1(1), 11-13.

Phillips, J., Sharpe, L. & Matthey, S. (2007). Rates of depressive and anxiety disorders in a residential mother-infant unit for unsettled infants. Australian and New Zealand Journal of Psychiatry, 41, 836-842.

Phillips, J., Morgan, S., Cawthorne, K. & Barnett, B. (2008). Pilot evaluation of Parent-Child Interaction Therapy (PCIT) delivered in an Australian community early childhood clinic Setting. Australian and New Zealand Journal of Psychiatry, 42, 712-719.

Stuchbery, M., Phillips, J. & Barnett, B. (2008). Jade House: A perinatal mood disorders day unit in South Western Sydney. The Journal of the Child and Family Health Nurses Association (NSW), 9 (1), 13-15.

Nemeth, D. (2008). Learning and working together: The benefits of embracing a multidisciplinary approach to family partnership training. The Journal of the Child and Family Health Nurses Association (NSW), 19 (2), 5-8.

Matthey, S., McGregor, K. & Ha, M. (2008). Developing partner awareness and empathy in new parents: The Great Parents’ Quiz. International Journal of Mental Health Promotion, 10 (3), 5-16.

In-house Publications
Crncec, R., Barnett, B., & Matthey, S. (2008). Karitane Parenting Confidence Scale: Manual. Karitane. Sydney: Australia.

Recent conference presentations
J. Phillips, L. Sharpe, S. Matthey. Postnatal depression and anxiety: An exploration of subtypes of mood disturbance in a sample of postnatal women admitted to a residential parent craft unit. Paper presented at the World Congress of Cognitive Behaviour Therapists, Barcelona, Spain, July 2007.

Nemeth, D.  Review of sleep and settling clinical practice guidelines - What we do and WHY! Paper presented at the NSW Family Care Centres Conference, Sydney, October 2007.

Nemeth, D & Maddox, J. ‘What do we mean when we say....?' Removing confusion and finding common ground in sleep & settling terminology. Paper presented at the CAFHNA AGM and Seminar, Sydney, October 2007.

M. Stuchbury. Mother-Infant relationship improved by addition of mother-infant therapy after postnatal depression. Poster presented at the International Congress of Womens Mental health, Melbourne, November 2007.

L. Lennie & L. Thompson. ‘The Other Half’ Group: The development of a weekly father’s group in a residential child and family health setting. Paper presented at the 5th Australian Family and Community Strengths Conference, Newcastle, April 2008.

Myors, K., Schmied, V. & White, E. Implementation & Sustainability of a Parenting Program: Building Organisational Capacity. Paper presented at the Association of Children’s Welfare Agencies Conference, Sydney, August 2008.

Harrison, I. Mother-Baby Attachment: How can we promote it? Paper presented at the Australian Breastfeeding Association Annual Conference, Sydney, November 2008.

Myors, K., Stein, M., Nemeth, D., Campbell, L., Mejaha, K., Simpson, A., Stancombe, F., Stuchbury, M. The complexities of delivering family care centre services. Paper presented at the International Marce Society Conference, Sydney, September 2008.

Phillips, J., Charles, M. Sharpe, L. & Matthey, S. Confirmation of subscales within the Edinburgh Postnatal Depression Scale (EPDS). Paper presented at the International Marce Society Conference, Sydney, September 2008.

Phillips, J., Charles, M. Sharpe, L. & Matthey, S. Subtypes of postnatal depression based on manifest symptom profiles. Poster presented at the International Marce Society Conference, Sydney, September 2008.

Stuchbury, M., Mares, S. &  Zilibowitz, M. Watching Waiting Wondering. Paper presented at the International Marce Society Conference, Sydney, September 2008.

Wilcox, K.. & Nemeth, D. Working with adolescent mothers in custody – Promoting a new future for families. Paper presented at QEC’s Fifth Biennial International Conference, Melbourne, November 2008.


For more information about research activities at Karitane, please contact: Jane Phillips, ph 9794 2300, email Jane.Phillips@sswahs.nsw.gov.au