Mediational Intervention for Sensitizing Caregivers to Improve Mental Health Outcomes in Orphaned and Vulnerable Children.

Published on Mar 5, 2021in Journal of Clinical Child and Adolescent Psychology
· DOI :10.1080/15374416.2021.1881903
Carla Sharp59
Estimated H-index: 59
(UH: University of Houston),
Paulina A. Kulesz9
Estimated H-index: 9
(UH: University of Houston)
+ 7 AuthorsMichael J. Boivin37
Estimated H-index: 37
(MSU: Michigan State University)
Objective: There is an urgent need to equip community-based careworkers with the skills to address the mental health needs of orphans and vulnerable children (OVC) as an essential response to shortages in human resources for mental health in Sub-Saharan Africa. We conducted a quasi-experimental feasibility trial in South Africa to adapt and evaluate an established year-long semi-structured, manualized video-feedback caregiver intervention (the Mediational Intervention for Sensitizing Caregivers; MISC) for community-based organizations (CBOs).Methods: Following a year-long iterative cross-cultural adaptation of MISC, we recruited 88 OVC (ages 7-11; 45.5% girls) and their CBO careworkers (N = 18; 94.4% female). Two CBOs (45 children; 9 CBO careworkers) received 12 months of MISC, and two CBOs (43 children; 9 CBO careworkers) received treatment as usual. Child mental health and quality of caregiving were assessed at 6 months into the intervention and at completion through multi-informant questionnaires and video-recordings of careworker-child interactions. Qualitative interviews were conducted to evaluate feasibility and acceptability.Results: MISC-CBO was acceptable and feasible in terms of attendance and post-intervention interviews. MISC improved child mental health, as well as the quality of careworker caregiving in terms of interactive effects for affective and cognitive (Expanding) components of MISC, and main effects for the cognitive components of Rewarding and Provision of meaning. MISC components did not mediate the effects of the intervention.Conclusions: The current study shows that laypersons with no tertiary education and virtually no prior training who undergo MISC training can improve caregiving quality and the mental health of OVCs.
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In addition to its contribution to child mortality, HIV/AIDS has a substantial impact on the psychosocial well-being of children across the globe and particularly in sub-Saharan Africa. We conducted a systematic review of the literature in order to identify studies that assess the effectiveness of interventions developed to improve the psychosocial well-being of children affected by HIV/AIDS, published between January 2008 and February 2016. Studies that were eligible for the review included mal...
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The MISC presents a theoretical and practical framework for early intervention. The acronym MISC stands for both the process and the objective of the intervention. Through the process of a Mediational Intervention for Sensitizing Caregivers of infants and young children, these children may stand a better chance of becoming more intelligent and socially competent individuals, ready to benefit new experiences, within their own environment. This chapter presents the basic reasons for implementation...
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Community-based organizations (CBOs) have the potential to provide high quality services for orphaned and vulnerable children in resource-limited settings. However, evidence is lacking as to whether CBOs are reaching those who are most vulnerable, whether attending these organizations is associated with greater psychosocial wellbeing, and how they might work. This study addressed these three questions using cross-sectional data from 1848 South African children aged 9–13. Data were obtained from ...
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Cited By0
#1Carla Sharp (UH: University of Houston)H-Index: 59
OBJECTIVE Based on the well-known principle that the ability to meaningfully relate to others starts in the context of early attachment relationships, the current case illustration uses a recent extension of mentalization-based theory and practice to demonstrate how caregivers can enhance the capacity for optimal social and personality function through the mediational intervention for sensitizing caregivers (MISC). METHODS Case material is presented to demonstrate the implementation of the MISC ...