Conference Agenda

The complexity of both the structure and dynamics of the lives of multichallenged families, particularly those living in conditions of social injustice and poverty, demands integrated assessments and interventions grounded in sufficiently complex modes of thinking to guide family support practitioners, in the coupling with the family systems, towards positive outcomes, in conditions of high-risks and uncertainty.

Guided by a theoretical framework for the operationalisation of complex thinking, and a model of the family as a complex system, we developed a qualitative visual method- Complexigraphy- to map the complexity of case conceptualisations produced by practitioners conducting assessments and interventions with multichallenged families with at-risk children. We present preliminary results of a qualitative analysis of the maps of 22 conceptualisations produced by 8 interdisciplinary teams (27 practitioners). We discuss the results highlighting the differences between practitioners with and without previous training in an Integrated Family Assessment and Intervention Model. We elaborate preliminary hypotheses about the relationship between different properties of complex thinking in relation to the complexity of the outcomes (e.g. new, creative, abductive hypotheses guiding effective action). Finally, we point to the potential of the method and these results for the training and supervision of practitioners.

Anorexia nervosa (AN) is a mental disorder with the highest death rate and constantly decreasing the average age of patients, which in the most severe cases needs to be treated in a stationary model. During the inpatient treatment of a child with AN, parents are emotionally burdened and, at the same time, responsible for making key medical decisions. Parental experiences, reactions and struggles have not been described in a qualitative approach in this specific context, nor were staff interventions. This research aimed to identify the role of cooperation between medical personnel and the parents of young adolescent patients with AN in stationary treatment. The medical documentation (mostly therapists’ records) of 36 patients under 14 years old was analysed using Consensual Qualitative Research methodology. Both the reactions of parents and the interventions of medical personnel were described. Qualitative analysis allowed two parent groups to be distinguished: those cooperating with medical personnel and those perceived as struggling with collaboration. The analysis of parents’ and personnel’s actions was provided for a whole group, but also the comparison between groups was conducted. The quality of cooperation resulted to be an important factor influencing the patients’ symptomatology.

Becoming a parent is a deep identity transformation. Preterm birth, affecting about ten percent of the families, may provoke a deep crisis within the family. Worries about potential further complications are also present. Mothers’ experiences have been studied extensively, but exploring fathers’ birth-related experiences is a recent theme, although father-infant bonding has a key role in the child’s emotional development. This study is a secondary analysis (Interpretative Phenomenological Analysis) of 10 interviews with preterm babies’ fathers about their experiences. Themes included the recognition of unexpected and immense, often life-threatening risks (between life and death in a liminal space), helplessness/loss of control, attempts to distance positive emotions (“did not even dare to love this child or feel anything”), seeing the baby as most fragile and vulnerable, supported by the equipment in the neonatal intensive care unit (NICU), and unexpected changes in daily life. Meaning making attempts also involved searching for the causes of preterm birth and seeking the ways to help babies in their struggle for life. Most NICUs have introduced alternative practices to alleviate the effects of isolation, stress, and anxiety, but crisis intervention or counselling opportunities are missing.

Suicide is the second leading cause of death for Canadian youth. Most youth who die by suicide have at least one mental health concern and half of them visited emergency in the year preceding their death with increased risks partly because of the lack of continuity in mental health care. This study aims to examine how parents whose youth died by suicide describe systems of care that engaged with their youth prior to the suicide to improve service access, quality of mental health care, and reduce the rates of suicide in youth. Using an interpretative phenomenological analysis, we interviewed 13 parents whose youth under 26 died by suicide in the last 5 years. The following themes emerged from parent statements: youths’ voices often unheard in mental health and school systems due to stigma and biases of mental health concerns not as a health matter, but bad youth behaviour or a parenting problem; and/or racism and rigid gender norms. Across the participants, suicidal youth are often described as too low risk for hospital and too high risk for community agencies, and the participants raised concerns about consent and privacy laws excluding caregivers who are usually the most important source of support.