PO2-19 – xenia halmov
1
Psychosocial Needs and Coping
Strategies in Children and
Adolescents Living with a Family
Member w...
PO2-19 – xenia halmov
2
1. BACKGROUND
The research literature indicates an association between the development
of suicidal...
PO2-19 – xenia halmov
3
1. OBJECTIVE
We present the preliminary results of a qualitative exploratory
study on what adolesc...
PO2-19 – xenia halmov
4
2. METHODS
2.1. Participants
Age Gender Siblings Person
who
made
suicide
attempt
Lives with suicid...
PO2-19 – xenia halmov
5
2.2. Procedure
We conducted semi-structured interviews with seven adolescents and young
adults bet...
PO2-19 – xenia halmov
6
The main themes of the interview were:
(I) The perception of the adolescents of their family situa...
PO2-19 – xenia halmov
7
3.RESULTS
Awareness of the suicide attempt
All but one of the participants, a 15 year old female w...
PO2-19 – xenia halmov
8
The one exception was a girl who did not mention the separation but the
intense impact of her moth...
PO2-19 – xenia halmov
9
Impact of the suicide attempt on the adolescent
All of the adolescents reported experiencing great...
PO2-19 – xenia halmov
10
Coping strategies and social Support
Friends: All participants reported that friends were their p...
PO2-19 – xenia halmov
11
Social-recreational support: The adolescents said that the following
activities helped them get t...
PO2-19 – xenia halmov
12
and friends. What they all wanted most was to have a good relationship with
their family.
All of ...
PO2-19 – xenia halmov
13
4. DISCUSSION
Friends are the main source of support for these adolescents whose parent
attempted...
PO2-19 – xenia halmov
14
5. LIMITATIONS
Since the sample size is small one cannot generalize these findings to
the general...
PO2-19 – xenia halmov
15
6. IMPLICATIONS FOR PRACTICE
The lack of support offered suggests that support should be
systemat...
PO2-19 – xenia halmov
16
opportunity to help the children involved. When professionals and
volunteers working in suicide p...
PO2-19 – xenia halmov
17
7. IMPLICATIONS FOR FUTURE RESEARCH
This is a small exploratory study. It would be interesting to...
PO2-19 – xenia halmov
18
REFERENCES
Beautrais, A. L. (2004). Support for Families, Whanau and Significant Others After a S...
Prochain SlideShare
Chargement dans…5
×

CRISE - IASP 2013 - XÉNIA HALMOV

729 vues

Publié le

The research literature indicates an association between the development of suicidal behaviours of young people and parental suicide behaviours. However, we lack empirical data on what children and adolescents know about their parent's suicidal behaviours and how they cope with the stress of living in a family where a parent has attempted suicide and may be at risk of attempting. We present the results of a qualitative exploratory study to understand what young adolescents know about the suicidality of a suicidal parent, what they thought and felt about it and how they coped with the situation. We conducted semi-structured interviews with eight adolescents between 12 and 15 years old living in a family where a parent had attempted suicide in the past 3 years, in order to obtain information on the perception of the adolescents themselves. In most cases we did not know if they knew or what they knew about their parent being suicidal. A significant number of the adolescents knew or suspected that their parent was suicidal. They used coping strategies like talking to their best friend or listening to music, but were inclined not to confide in adults and not to bring up the subject in the family. All the parents had contacted a community crisis centre for help, the adolescents were generally not offered any support . Support was generally only provided to the suicidal parent who contacted the crisis centre and to other adults involved in the intervention. Support should also be systematically offered proactively to the children and adolescents when their parent has suicidal behaviours in order to help them find efficient strategies to cope with the stresses associated with living with a suicidal parent. Specific approaches to helping children learn to cope better will be presented and discussed.

Publié dans : Santé & Médecine
0 commentaire
2 j’aime
Statistiques
Remarques
  • Soyez le premier à commenter

Aucun téléchargement
Vues
Nombre de vues
729
Sur SlideShare
0
Issues des intégrations
0
Intégrations
31
Actions
Partages
0
Téléchargements
5
Commentaires
0
J’aime
2
Intégrations 0
Aucune incorporation

Aucune remarque pour cette diapositive

CRISE - IASP 2013 - XÉNIA HALMOV

  1. 1. PO2-19 – xenia halmov 1 Psychosocial Needs and Coping Strategies in Children and Adolescents Living with a Family Member with Suicidal Behaviour Presented by Xénia Halmov This research was conducted as part of a Masters Degree programme in Social Work, supervised by Annie Devault, Ph.D, Professor, Université du Québec en Outaouais, Canada.
  2. 2. PO2-19 – xenia halmov 2 1. BACKGROUND The research literature indicates an association between the development of suicidal behaviours of young people and parental suicide behaviours (Fleming, Merry, Robinson, Denny, & Watson, 2007; Fotti, Katz, Afifi, & Cox, 2006; Johnson, Cohen, Gould, Kasen, Brown, & Brook 2002); Johnson, Cohen, Gould, Kasen, Brown, & Brook, 2002); Klimes-Dougan, Free, Ronsaville, Stilwell, Welsh, & Radke-Yarrow, 1998). A suicide attempt has a great impact on family functioning, with heightened feelings of anxiety and fear about further suicidal behaviour and various other emotional responses (Beautrais, 2004). In Quebec, Canada, several papers in suicidology emphasize the importance of meeting the needs of family members of a suicidal person as well as to those bereaved by suicide (Gouvernement du Québec, 1998; 2010). However, we lack empirical data on what children and adolescents know about their parent’s suicidal behaviours and how they cope with the stress of living in a family where a parent has attempted suicide and may be at risk of attempting.
  3. 3. PO2-19 – xenia halmov 3 1. OBJECTIVE We present the preliminary results of a qualitative exploratory study on what adolescents know about the suicidality of their parent, what they thought and felt about it and how they coped with the situation. The main objective is to document the real-life experiences and the psychosocial needs of youth aged 12 - 20 years who live with a family member who has suicidal behavior. We wanted to know how these young people perceive their family, the impact the situation has on them and the way they cope. We also sought to identify which types of psychosocial support that could best help them.
  4. 4. PO2-19 – xenia halmov 4 2. METHODS 2.1. Participants Age Gender Siblings Person who made suicide attempt Lives with suicidal parent Advantaged or disadvantaged environment Studies Work 1 16 F Only child Mother Yes, full time. Sees father occasionally. Advantaged Student 2 16 M Brother 19 Mother Part time (50/50). Father remarried. Advantaged Student 3 19 M Brother 16 Mother Part time (50/50). Father remarried. Advantaged Student Part time 4 20 F Only child Mother Yes, full time. Father absent, mother has boyfriend. Disadvantaged Student 5 14 F Sisters 17 & 19 Father and mother Full time with mother, father visits often. Disadvantaged Student 6 17 F Sisters 14 & 19 Father and mother Full time with mother, father visits often. Disadvantaged Student 7 19 F Sisters 14 & 17 Father and mother Full time with mother, father visits often. Disadvantaged Student Part time
  5. 5. PO2-19 – xenia halmov 5 2.2. Procedure We conducted semi-structured interviews with seven adolescents and young adults between 14 and 20 years old living in a family where a parent had attempted suicide in the past 2 years. In the initial project, we were intending to interview younger adolescents, between 12 and 15 years old. However, most of the crisis centres we initially contacted refused to participate in the study (without explanation), and the parents of the younger adolescents we contacted also refused to participate, mainly because they feared that the interview would reveal to the adolescent the fact that they made a suicide attempt. Finally, we obtained access to a sample of participants in a longitudinal study of suicide attempters who had expressed an interest in being solicited for participating in other research projects. That allowed us to contact adults who had made a suicide attempt. Because, these adults had older children our sample will be a little bit older that what we had previously planned. Although the teenagers and young adults aged between 14 and 20 we interviewed were older than we initially envisioned, the participants had rich experiences that they were able to verbalize in detail.
  6. 6. PO2-19 – xenia halmov 6 The main themes of the interview were: (I) The perception of the adolescents of their family situation in general. (II) The perception of the adolescents of the nature and quality of the relationships between family members. (III) The strategies they use to cope with living with a suicidal family member. (IV) Their perception of their life in general, their values and beliefs. (V) Their perception of the social support they receive and their needs for support. Each interview was transcribed and rendered anonymous and a content analyses was undertaken for each interview.
  7. 7. PO2-19 – xenia halmov 7 3.RESULTS Awareness of the suicide attempt All but one of the participants, a 15 year old female who was not certain if the parent had attempted suicide or not, were aware of the suicide attempt of their parent and talked about it without being directly asked about suicide. Family life in General All of the youth came from families where their parents are divorced, and none of the divorces were recent. They lived with the parent who had made a suicide attempt and they generally had poor relationships with the parent with whom they were not living primarily. All but one felt that their most difficult experience was their parents’ separation and the tense relationship between their parents, more so than the suicide attempt itself.
  8. 8. PO2-19 – xenia halmov 8 The one exception was a girl who did not mention the separation but the intense impact of her mother’s suicide attempt. The positive experiences they described were often family outings and happy times spent with their mother. Warning signs None of the participants reported that their parent made an overt suicide threat before they attempted. However, they noticed behavioural changes, such as withdrawal, apathy, emotional changes and increased conflicts between divorced parents. These behaviours resulted in the adolescents feeling vague concerns. In one case the mother told her daughter that she must not stop her if she attempts suicide. When the daughter returned from school every day she wondered if she would find her mother dead. She always checked each room to make sure her mother had not hanged herself there.
  9. 9. PO2-19 – xenia halmov 9 Impact of the suicide attempt on the adolescent All of the adolescents reported experiencing great stress, and fear that the parent would attempt again. They all watched their parent closely to look for signs of another attempt. For example, three sisters read the text messages their father sent to his ex-wife to see if he threatened suicide. Another asked her mother every day when she returned from school how she was feeling, and she worried whenever her mother was angry or sad. For the participant who was not sure if her mother had made a suicide attempt or not, when one of her mother’s friends committed suicide the adolescent desperately sought her mother to check if she was still alive. Long after the attempts, even when things were going well for their parent, the youths were less worried but continued to fear that their parent would attempt again if things got worse.
  10. 10. PO2-19 – xenia halmov 10 Coping strategies and social Support Friends: All participants reported that friends were their primary source of support. They all either had a best friend (6/7) or a boyfriend-girlfriend (4/7) whom they confided in. They also had friends with whom they did things to distract themselves (5/7), in order to stop thinking about the situation with the parent, but with whom they did not want to talk about the situation and their feelings. Parents: Only one of the adolescents confided in the parent who had attempted suicide, a female who confided in her mother. One male confided in his father concerning his mother’s attempt. Overall, participants confided about other matters more with their mother than their father. Other family members: Although 5 of the 7 mentioned other family members as sources of support, none of them discussed the suicide attempt with them. Formal support: Only one adolescent sought help from a school counsellor and another one was offered help at school but refused it. 6 out of 7 had no one offer to talk to them about the suicide attempt of their parent.
  11. 11. PO2-19 – xenia halmov 11 Social-recreational support: The adolescents said that the following activities helped them get through difficult times: sports (6/7), television (3/7), surfing the internet (3/7), playing video games (2/7), listening to music (2/7), writing (2/7), attending school (2/7) and being at work for the 2 participants who had a job. Three mentioned that having a pet was an important source of comfort. Other coping strategies: 3 of the 7 said that checking up on the parent who had attempted suicide by calling or visiting them was helpful. 6 of the 7 said that they avoided conflicts or ‘opening old wounds’ when in contact with the parent after the attempt. Helping others as a coping strategy: 5 of the 7 said that they helped their friends with their problems by listening and consoling them, and this increased their sense of self-worth, allowing them to think about other things and others rather than themselves. Strengths, values, beliefs and suicidal ideation: The adolescents felt that their strengths are their ability to listen, to not judge others, to be patient and persevering, to want to help others in a gentle way, through valuing the family
  12. 12. PO2-19 – xenia halmov 12 and friends. What they all wanted most was to have a good relationship with their family. All of the participants but one said that they had no suicidal ideation. The youth that had reported considering suicide said that thoughts were several years before the parent’s attempt and she had follow-up afterwards with a therapist. Perceived needs: Above all, every participant wanted their divorced parents to have a better relationship. Two participants wanted to know why their parent attempted suicide. One wanted to be able to be with someone his age who understood what he was experiencing, someone who has experienced the same situation, but not recently, not necessarily to talk about it. One wanted to meet an adult or a professional to discuss the situation and talk about it. One wanted someone to talk to confidentially. IMPACT OF THE INTERVIEW: 6 of the 7 participants said at the end of the interview that they felt good and that the interview helped lessen the burden they felt.
  13. 13. PO2-19 – xenia halmov 13 4. DISCUSSION Friends are the main source of support for these adolescents whose parent attempted suicide, although most of them also confided in adults as well. Only one participant received professional help when she actively sought it out. Only one person received an offer of help, which was refused. However, a number of recreational activities were useful in coping with the situation according to the participants, often with peers. Although 5 of the participants had siblings, no one mentioned a sibling as a source of support. One mentioned not wanting to make things worse by bringing up the subject with his brother. One sister was very protective of the other two younger sisters. None of the youngsters mentioned receiving any information from adults. Several participants said that if an adult had offered to talk about the situation they would have accepted the offer. Overall, they lacked information as well as the opportunity to discuss the situation with an adult in a safe context. Contrary to our expectations, none of the participants reported any false beliefs or information about suicide. We wonder about the benefits of the tendency of the adolescents to be kind and helpful to others. While this may be a source of feeling valued, it could also lead to them neglecting their own needs by focusing on others.
  14. 14. PO2-19 – xenia halmov 14 5. LIMITATIONS Since the sample size is small one cannot generalize these findings to the general population. What is reported is a portrait of how some adolescents react to a suicidal parent, but more extensive research is needed to determine how typical these reactions are. Since we recruited participants whose parent had attempted suicide, but survived the attempt, it is possible that in retrospect the participants may have minimized the seriousness, knowing that the parent had survived. We did not have access to the medical records of the parent who attempted suicide. However, many of these parents suffered from a mental disorder. Consequently, we cannot tell to what extent the reactions are in relationship to the suicidal behaviour and to what extent they may be shared by anyone living with a parent who has a mental disorder.
  15. 15. PO2-19 – xenia halmov 15 6. IMPLICATIONS FOR PRACTICE The lack of support offered suggests that support should be systematically and proactively offered to children and adolescents when their parent has suicidal behaviours in order to help them find effective strategies to cope with the stress associated with living with a suicidal parent. They may also benefit from more information about their parent’s mental disorder (if diagnosed), and information on suicide in general once it is known in the family that the person is suicidal. However, the concerns they expressed suggest that it would be very important to address the problem carefully in order to not dramatize the situation and to make sure that the children and adolescents do not feel that they are responsible for the adult’s safety. It seems that when their parent told them that they did not want to commit suicide anymore, this helped a lot to relieve the stress. A family meeting with a professional after the attempt could be an
  16. 16. PO2-19 – xenia halmov 16 opportunity to help the children involved. When professionals and volunteers working in suicide prevention are aware of the suicidal thoughts of a person even before an attempt is made, it could be useful if they would systematically verify if there are children involved and see that these children get support, especially proper information, access to a helpline 24/7, and emotional support. These children may also benefit from the help of an adult member of the family in whom they could confide and express their worries. Training programs in suicide prevention and intervention should always include a section on how to support the families of suicidal individuals, including the children. Children with suicidal parents need information, help and support to help them cope with a suicidal parent and we suggest that this help should be offered proactively.
  17. 17. PO2-19 – xenia halmov 17 7. IMPLICATIONS FOR FUTURE RESEARCH This is a small exploratory study. It would be interesting to interview more adolescents and children to obtain further data on the impact of the suicidal behavior of their parent, their coping strategies and their needs. We could not interview younger children, so a future study is needed on what younger children know and do not know about their parent’s suicidality, and what they do when they know and everyone around them thinks they do not know.
  18. 18. PO2-19 – xenia halmov 18 REFERENCES Beautrais, A. L. (2004). Support for Families, Whanau and Significant Others After a Suicide Attempt. A literature review and Synthesis of Evidence. Christchurch, Canterbury Suicide Project, Christchurch School of Medicine & Health Sciences, 51 p. Fleming T., Merry S., Robinson E., Denny, S. & Watson, P. (2007). Self-Reported Suicide Attempts and Associated Risk and Protective Factors Among Secondary School Students in New Zealand. Australian and New Zealand Journal of Psychiatry. 41(3), p. 213-21. Fotti, Katz, Afifi, & Cox (2006). The Associations Between Peer and Parental Relationships and Suicidal Behaviors in Early Adolescents.Canadian Journal of Psychiatry, 51(11), p. 698-703. Gouvernement du Québec (Ministère de la Santé et des Services sociaux) (1998). Stratégie québécoise d’action face au suicide : S’entraider pour la vie.Québec : Publications du Québec, 94 p. Gouvernement du Québec (Santé et services sociaux) (2010). Prévention du suicide. Guide de bonnes pratiques à l’intention des intervenants des centres de santéet de services sociaux. Québec : Publications du Québec, 83 p. Johnson, J. G., Cohen, P., Gould, M., Kasen, S., Brown, J. & Brook, J. S. (2002). Childhood Adversities, Interpersonal Difficulties, and Risk for Suicide Attempts during Late Adolescence and Early Childhood. Arch Gen Psychiatry, 59, p. 741-749. Klimes-Dougan B., Free, K., Ronsaville, D., Stilwell, J., Welsh, J., & Radke-Yarrow, M. (1998). Suicidal Ideation and Attempts: A Longitudinal Investigation of Children of Depressed and Well Mothers. Journal of the American Academy of Child and Adolescent Psychiatry, 38(6), p. 651-659. Xénia Halmov, student, Master’s Degree programme in Social Work Supervision: Annie Devault, Ph.D, Professor, Université du Québec en Outaouais.

×