Mental health articles

I briefly review core theoretical premises from attachment, ecological, and violence risk prediction theories that undergirded the team assessment approach. Attachment theory provides a rich basis for understanding the centrality of parenting, the bonds of love that bind parent and child to each other, and the reasons why a mother parents her children in the particular way she does. This theory also provides a framework for understanding a child’s attachment to his or her caregivers, how these bonds influence the child’s ability to explore and to form relationships with others, and the effects of separation and loss on a child’s bonds and his or her well-being . According to attachment theory, the task of parenting is to protect a child from harm. As a child develops, a parent must be able to provide changing levels and forms of protection depending on the unique needs of each individual child as he or she develops. Parenting is made easier or more difficult depending on a mother’s ability to form and maintain supportive relationships with others and depending on her ability to balance competing demands, including her own need for help. Attachment theory also emphasizes that a mother’s feelings for and behavior with her children are deeply influenced by experiences she has had and may still have with her own parents or caregivers. If a mother’s own attachment needs were not met in childhood or if she was traumatized, she may feel helpless in the parenting role and may doubt that others will support her. In this context, she may turn to her child for support, ignore her child’s needs as her own are so great, and/or may redirect anger at a child . Current life stresses and the attitudes of a woman’s partner are other important contributors to parenting. Ecological theory provides a framework for understanding the dynamics of parenting breakdown and for isolating factors at various levels (individual, family, cultural, and societal) that contribute to parenting risk and competency. It underscores the influences of a variety of environmental and familial contexts that interact with each other over time to influence parenting.An important facet is the consideration the theory gives to protective factors that can ameliorate risk and promote more healthy parenting pathways. Violence risk prediction research provides a theoretical framework for understanding when an individual with mental illness who has been violent in the past poses a substantial risk of harming others either currently or in the future . It emphasizes the importance of assessing an array of empirical and theory-based risk factors in multiple domains of functioning, including a parent’s own childhood experiences, their current disposition (anger, impulsiveness), and situations that could evoke risk behaviors. This theory also emphasizes the importance of looking at how specific mental illness symptoms, such as hallucinations, delusions, or violent fantasies can lead to violence, as well as at the course and prognosis of the illness, and the individual’s responsiveness to treatment. Risk is viewed not as something static, but as something that can change over time and in different contexts. A risk assessment involves an estimation of probabilities: how likely it is that harm will occur now or in the near future. In the next sections, I describe and use clinical vignettes to illustrate the four modes and the assessment process. All case examples were modified to protect confidentiality.

Tags: assessment approach