1
|
Jackson KT, Mantler T, O'Keefe-McCarthy S, Davidson CA, Shillington KJ, Yates J. "Breaking through the Brokenness": An Arts-Based Qualitative Exploration of Pregnant Women's Experience of Intimate Partner Violence while Receiving Trauma- and Violence-Informed Antenatal Care. Creat Nurs 2024; 30:195-209. [PMID: 38860523 DOI: 10.1177/10784535241256872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
Intimate partner violence (IPV) is a pervasive, worldwide public health concern. Risk of IPV may elevate during the perinatal period, increasing maternal and fetal health risks. Trauma- and violence-informed care shows promise among interventions addressing associated mental health sequelae. As a secondary analysis, the purpose of this study was to employ a qualitative arts-based exploration to better understand pregnant women's experiences of trauma and violence-informed perinatal care in the context of IPV. Using an arts-based qualitative methodology, different art forms were used to analyze, interpret, and report data, resulting in a layered exploration to represent phenomena. From this, four themes were reflected in four poetic pieces: Black Deep Corners, Triggering my Thoughts, Breaking through the Brokenness, and Now Perfectly Imperfect. Nine pieces of visual art were created reflecting these themes, creating a layered, embodied, artistic way to empathically explore and translate phenomena.
Collapse
Affiliation(s)
- Kimberley T Jackson
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Tara Mantler
- School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Sheila O'Keefe-McCarthy
- Faculty of Applied Health Sciences, Department of Nursing, Brock University, St. Catharine's, Ontario, Canada
| | - Cara A Davidson
- Health and Rehabilitation Sciences, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
| | - Katie J Shillington
- Health and Rehabilitation Sciences, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
| | - Julia Yates
- Health and Rehabilitation Sciences, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
| |
Collapse
|
2
|
Sullivan KS, Ancharski K, Wortham W, Okosi M, Kaplan D, Urquiza A, Timmer S, Cloitre M, Chemtob C, Lindsey MA. Feasibility and Preliminary Impact of a Community-Based Intervention for Maternal PTSD and Parenting: Parenting-STAIR Pilot. JOURNAL OF CHILD AND FAMILY STUDIES 2023; 32:481-497. [PMID: 36685737 PMCID: PMC9842206 DOI: 10.1007/s10826-023-02534-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
Trauma exposure and post-traumatic stress disorder (PTSD) impact emotional and physical well-being, social functioning, and parent-child relationship quality. The effect of parental trauma on parenting and child maltreatment is often overlooked by current child welfare (CW) services. The novel intervention, Parenting-STAIR, was created to address maternal mental health, parenting skills, and child well-being outcomes. Parenting-STAIR is a combination of Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative Therapy and Parent-Child Care (PC-CARE). This open pilot study aimed to examine the feasibility and preliminary impact of Parenting-STAIR in reducing maternal PTSD and increasing positive parenting skills for mothers and families involved in the child welfare system. Parenting-STAIR was delivered to 111 mothers receiving family preservation services in New York City. Of these, 70 completed treatment; statistical and clinically significant changes were observed for maternal PTSD and depression as well as in parenting stress, parenting skills, and child behaviors. These findings provide encouraging initial evidence for the feasibility and impact of this novel PTSD intervention. An evaluation of maltreatment recidivism is needed, as well as implementation of a randomized controlled trial to establish efficacy of the intervention.
Collapse
Affiliation(s)
| | - Kelly Ancharski
- McSilver Institute for Poverty Policy and Research, Silver School of Social Work, New York University, New York, NY USA
| | - Whitney Wortham
- Silver School of Social Work, New York University, New York, NY USA
| | - Mercedes Okosi
- McSilver Institute for Poverty Policy and Research, Silver School of Social Work, New York University, New York, NY USA
| | - Debra Kaplan
- McSilver Institute for Poverty Policy and Research, Silver School of Social Work, New York University, New York, NY USA
| | - Anthony Urquiza
- CAARE Diagnostic & Treatment Center, Department of Pediatrics, University of California, Sacramento, CA USA
| | - Susan Timmer
- CAARE Diagnostic & Treatment Center, Department of Pediatrics, University of California, Sacramento, CA USA
| | - Marylene Cloitre
- Institute for Trauma and Stress, New York University Langone Medical Center, New York, NY USA
- National Center for PTSD Dissemination and Training Division, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA USA
| | - Claude Chemtob
- McSilver Institute for Poverty Policy and Research, Silver School of Social Work, New York University, New York, NY USA
- Grossman School of Medicine, New York University, New York, NY USA
| | - Michael A. Lindsey
- Silver School of Social Work, New York University, New York, NY USA
- McSilver Institute for Poverty Policy and Research, Silver School of Social Work, New York University, New York, NY USA
| |
Collapse
|
3
|
Ponting C, Urizar GG, Dunkel Schetter C. Psychological Interventions for Prenatal Anxiety in Latinas and Black Women: A Scoping Review and Recommendations. Front Psychiatry 2022; 13:820343. [PMID: 35370831 PMCID: PMC8965279 DOI: 10.3389/fpsyt.2022.820343] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/03/2022] [Indexed: 12/02/2022] Open
Abstract
Anxiety symptoms are common among pregnant women worldwide. In the United States, prenatal anxiety symptoms tend to be elevated among Black and Latin American women as compared to non-Latina White women. Despite the high prevalence of anxiety and associations with adverse maternal and offspring outcomes, interventions have not been developed or tailored sufficiently to Black women or Latinas who need efficacious treatment. This article provides a scoping review of articles published since 2017 that test the effects of randomized and non-randomized psychological interventions designed to reduce prenatal anxiety in samples comprised primarily of ethnic/racial minority women. We also review published protocols of planned psychological interventions to reduce prenatal anxiety in order to highlight novel approaches. In addition to summarizing intervention efficacy and participant acceptability, we highlight gaps in the literature which, if addressed, could improve perinatal mental health equity. Finally, we discuss future directions in prenatal anxiety intervention science beginning preconception including intervention design and prevention models.
Collapse
Affiliation(s)
- Carolyn Ponting
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Guido G. Urizar
- Department of Psychology, California State University, Long Beach, Long Beach, CA, United States
| | | |
Collapse
|
4
|
Mantler T, Jackson KT, Walsh EJ, Jackson B, Baer JR, Davidson CA, Shillington KJ, Parkinson S. Promoting Attachment Through Healing (PATH): Results of a retrospective feasibility study providing trauma-and-violence-informed care to pregnant women. J Adv Nurs 2021; 78:557-568. [PMID: 34837410 DOI: 10.1111/jan.15117] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/01/2021] [Accepted: 11/04/2021] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the impact of a trauma and violence-informed cognitive behavioural therapy (TVICBT) intervention, compared with standard care on mental health, coping, bonding and maternal-infant attachment among pregnant women with a history of intimate partner violence and who displayed symptomatology consistent with anxiety, depression or post-traumatic stress disorder (PTSD). DESIGN A mixed-methods case study design was employed, where women either received standard perinatal care or were referred to a specialized TVICBT program. METHODS Data were collected through a retrospective obstetric medical chart audit in 2017 at an Ontario hospital in a large urban centre. Multiple choice and 'yes/no' questions were analysed using measures of central tendency and dispersion, in addition to frequency counts. Qualitative data from clinical notes were subjected to an inductive content analysis approach to identify key concepts. RESULTS In total, 69 women participated (intervention group = 37, standard care group = 32). Prevalence of mental illness between groups was consistent, apart from the TVICBT group having a significant increase in PTSD. In the TVICBT group, 83.8% of women (n = 31) expressed perinatal concerns, compared with only 37.5% (n = 12) of the standard care group. More women in the intervention group (94.6%, n = 35) coped successfully in the intrapartum period than the standard care group (78.1%, n = 25). However, more women in the standard care group (97.0%, n = 31) exhibited appropriate bonding behaviours than the TVICBT group (88.6%, n = 31). CONCLUSION The TVICBT intervention was effective in assisting women to identify triggers during their pregnancy journey, develop appropriate coping strategies and advocate for their needs to best cope. IMPACT TVICBT offers an effective, individualized, trauma and violence-informed approach to optimize the health outcomes of perinatal women and their infants by promoting positive coping and maternal-infant bonding, thus filling an existing practice gap of a lack of individualized, trauma-informed care.
Collapse
Affiliation(s)
- Tara Mantler
- School of Health Studies, Western University, London, ON, Canada
| | - Kimberley T Jackson
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Edmund J Walsh
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Brianna Jackson
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Jessi R Baer
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Cara A Davidson
- School of Health Studies, Western University, London, ON, Canada
| | | | | |
Collapse
|
5
|
Jackson KT, Mantler T, Jackson B, Walsh EJ, Baer J, Parkinson S. Exploring mothers' experiences of trauma and violence-informed cognitive behavioural therapy following intimate partner violence: a qualitative case analysis. J Psychosom Obstet Gynaecol 2020; 41:308-316. [PMID: 31902267 DOI: 10.1080/0167482x.2019.1707799] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
PURPOSE Intimate partner violence (IPV) is a pervasive public health issue impacting one in three women, worldwide. Broadly defined as any act of coercive control within the context of an intimate relationship, IPV often results in significant negative health outcomes. Cognitive Behavioral Therapy (CBT), a mainstay treatment for relational trauma, has particular relevance for women undergoing the many transformations associated with the perinatal period. The findings of this case analysis build upon existing literature supporting the positive impact of Trauma and Violence- Informed CBT (TVICBT) for women who have experienced IPV and are living with mental health challenges. METHODS As part of a larger mixed-methods study, three women who experienced IPV and received TVICBT during pregnancy participated in in-depth, semi-structured interviews to determine the perceived value and acceptability of this intervention. FINDINGS Insights gained herein, serve to enrich current evidence, suggesting that TVICBT provided during pregnancy may hold promise for the treatment of IPV-related mood and anxiety disorders. CONCLUSIONS Given that improved perinatal mental health has been linked to enhanced maternal resiliency and quality of life, greater maternal-infant attachment, and positive child health outcomes, this research has the potential to bridge the critical knowledge gap at the intersection of motherhood, trauma, and mental health.
Collapse
Affiliation(s)
| | - Tara Mantler
- School of Health Studies, Western University, London, Canada
| | - Brianna Jackson
- Arthur Labatt Family School of Nursing, Western University, London, Canada
| | - Edmund J Walsh
- Arthur Labatt Family School of Nursing, Western University, London, Canada
| | - Jessi Baer
- Arthur Labatt Family School of Nursing, Western University, London, Canada
| | | |
Collapse
|