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Research & Resources
Research at Vanier focuses on
children with special needs and their families, in particular how
mental health problems develop and how to treat them.
Activities include a full range of projects, from working with university professors conducting basic science or applied research, to formal evaluations of our own programs. We are continuously learning about what is working with children and families and using that knowledge to improve our services. We often work with other children's mental health centres and with researchers at universities.
Current research projects
Vanier is currently involved in large projects with university-based researchers and several other children's mental health centres:
"Continuity of Care in Children's Mental Health: Parent, Youth, and Professional Perspectives" A Qualitative Study - Juliana I. Tobon, M.Sc., Psychology; Graham J. Reid, Ph.D., Psychology, Family Medicine, & Paediatrics; Judith B. Brown, Ph.D., Family Medicine; The University of Western Ontario.
Continuity of care, the way in which individuals experience care over time as consistent and connected, is an important value in health care. This experience is important, especially for families seeking children's mental health services in a fragmented "system". Continuity of care was examined in 36 qualitative interviews with 15 parents of children whose children had received services at a children's mental health agency in Ontario, 11 youth, and 10 professionals working at these agencies. We found that parents and youth expected consistency of contact with their workers. Professionals agreed that it was important to have "the same clinician [...] as much as possible." Youth in particular seemed to value relationships with their providers. Nevertheless, gaps in care were usual for families receiving services. Professionals recognized the need to make transitions "as seamless as possible" though there was often "a lack [of] resources, the time to do the ideal." Despite these challenges, families described many instances of their individual workers going "over and above the call of duty." Professionals described situations in which flexibility was used in applying rules in order to serve families better: "...nothing is written in stone [...] Things go based on what makes sense for the client." Transitions, such as discharge from a residential setting, or when there was a change in provider, were key points that families and professionals saw as having the potential for problems with continuity. During transitions, families valued information sharing so they would not have to "repeat myself over and over." The present study is foundational for a larger study in which we will develop a new measure of continuity of care for children's mental health.
We would like to acknowledge the Children's Health Research Institute for funding this study. We would like to thank all of the families and professionals who graciously participated in this study and shared their stories with us.
Predicting and understanding patterns of service utilization within children's mental health agencies Co- Principal Investigators: Graham Reid, The University of Western Ontario, Shannon Stewart, The Child & Parent Resource Institute (CPRI)
Children's mental health (CMH) has been labelled the "orphan's orphan" of Canada's health care system. There is an urgent need to improve the evidence base for Canadian delivery of CMH care. In preliminary analyses of data from a study currently underway, we found 5 patterns of services use among over 6,000 children 3- to 14-years old at the time of their first visit to a CMH agency in Ontario. About one-third of children received services for 2-to-5 years. In addition, one-quarter of the children had 2 or more episodes of care over 5 years. These children might be considered to have a "chronic illness" and need ongoing care. Current models of psychological care are based on an acute-illness model - services are provided in times of extreme need, and treatment is only for a brief period. In contrast, "chronic illness" models (e.g., attending regular clinic appointments for diabetes) have additional important components that can reduce relapse and improve health status. Another significant problem in CMH is children/families that dropout of services prematurely. The proposed study is the second in a program of research with the aims of developing and testing new models of care that can better meet the needs of children/families.
This study will use non-identifying data, from existing client information systems, relating to appointments and attendance as well as other information including presenting problems and services received, to: (1) Examine predictors of service use patterns within CMH Centres as a function of predisposing (e.g., sex, age), enabling (e.g., parent psychopathology), and need (e.g., psychopathology) factors. (2) Examine predictors of repeated episodes of service use within CMH centres as a function of predisposing, enabling, and need factors. (3) Explore differences in the status of children (e.g., dropout) at the end of care (i.e., last few months) and in need of treatment in each of the patterns of service use. (4) Explore predictors of dropout as a function of predisposing, enabling, and need factors.
Long-term Community Adaptation of Children and Families Participating in Residential and Intensive Family Service Children's Mental Health Programs - Created in 2000, the Partnerships for Children and Families Project (PCFP) at Wilfrid Laurier University is a multi-year research project directed at understanding the lives and experiences of families and children who are served by children's mental health agencies and Children's Aid Societies and in Southern Ontario, Canada. Together with Vanier and four other children's mental health agencies, the PCFP has been following how well youth leaving residential treatment and intensive family services programs in Ontario are doing in several areas of their lives- school and employment, social integration, family living and youth well being. There is little information about the long-term life trajectories of children and adolescents after they leave services. How do younger children leaving these programs handle the challenges of adolescence and high school? How do adolescents leaving these programs fare in the worlds of education, employment, and adult relationships? What happens to these families as their children cross major developmental thresholds?
So far what we have learned is that almost all of the 212 youth in this study were struggling with school attendance and performance, delinquency, and disruptions in family life at the time of entry to residential treatment or intensive family service programs. At program discharge, most youth showed significant improvements in how they were doing in these areas. However, the challenge seems to be maintaining these positive changes over time. In our follow up discussions with families and youth, approximately 1 1/2 years and 3 years after program discharge, many youth still faced daily challenges in several life domains. In fact, difficulties with staying in school and getting into trouble with the law were more concerning overall at follow up than at admission to these programs. To view some of the research results or for more information on other research by the Partnerships for Children and Families Project, please visit our website www.wlu.ca/pcfproject.
Evaluation of the Caring Dads Program at Vanier - Caring Dads is an intervention program designed for fathers struggling to develop and maintain healthy relationships with their children. Professor Katreena Scott and Ph.D. student Holly McGinn at the University of Toronto lead an evaluation of the impact of this program on fathers and children at Vanier. In particular, evaluation is focused on change in fathers' parenting attitudes and behaviours from the beginning to the end of group and in the observed quality of interactions between men and their children.
Cognitive Functions and Aggression in Children with Callous-Unemotional Traits (Vanessa Hamil, University of Western Ontario) Researchers have identified two subgroups of children who present with conduct problems: namely, one group of children who display only conduct problems (e.g., are aggressive), and a second group who display conduct problems and present with pre-psychopathic traits, or callous-unemotional traits (e.g., low empathy). Children who present with both conduct problems and callous-unemotional traits are more likely to be in contact with the law, and are more aggressive than children without such traits. These children are also more likely to engage in proactive (e.g., goal directed) and reactive (e.g., impulsive aggression), whereas children without callous-unemotional traits typically engage in reactive aggression only. In addition, studies have found that these children show impairments on measures of cognitive processing (e.g., show little emotional reactivity to distressing stimuli).
The goal of the current study was to examine aggressive behavior and social-cognitive processing in a sample of children with behavioral problems. Children were recruited from Vanier Children's Services and the community of London, Ontario. Children completed several measure of cognitive processing and their parents completed several questionnaires designed to assess personality and behavior. It is hoped that the findings of this study will better inform treatment programs for children who present with callous-unemotional traits.
Frick, P. J., & White, S. (2008). Research Review: The importance of callous-unemotional traits for developmental models of aggressive and antisocial behavior. Journal of Child Psychology and Psychiatry, 49, 359 - 375.
The interRAI Child and Youth Quality of Life Survey (iCYQLS) In partnership with Dr. Shannon Stewart at the Child and Parent Resource Institute, Vanier is involved in a pilot project to examine the psychometric properties of the interRAI Child and Youth Quality of Life Survey, iCYQLS (pronounced "icycles"). The iCYQLS is a measure of client well being and satisfaction while in residence. A variety of domains are assessed, such as satisfaction with the food provided, comfort in the living environment, opportunity for individual expression and community involvement, satisfaction with treatment services and school, as well as quality of relationships with staff, peers, and family while in residence. The iCYQLS will become part of a suite of instruments to be used world-wide by interRAI, a research network comprised of investigators in more than 30 countries (www.interrai.org). Additionally, for our own purposes, this tool will show the areas where we are excelling and where we could improve from the perspective of the children and youth we serve.
Program Evaluation of the RAPP/TAPP-C Program The "Rapp and Tapp-C" programs provides a range of services to children and families dealing with fire involvement and other high risk behaviours that would likely lead to criminal charges if the child was 12 years of age or older. The research component of the program ensures ongoing evaluation of our services and will assist in the evaluation of the "promising practices" utilized over the 3 years of the project. In this way, Vanier hopes to contribute its experience to the growing body of knowledge in this area.
Vanier Children's Services - RAPP/TAPP Program Manual Vanier's program for children ages 7 to 12 years who have a high risk for fire and police involvement, RAPP/TAPP (Referral to Alternative Pathways - The Arson Prevention Project), has demonstrated success. The pilot project was partially funded by the Government of Canada's Crime Prevention Strategy. With support from the Ontario Centre of Excellence for Child and Youth Mental Health, we have developed a program manual. For a free electronic copy for your agency, please contact Karen Allen.
Strongest Families is a program that is being used to help children with behaviour problems in Nova Scotia. Dr. Patrick McGrath, at the IWK Health Centre, in Halifax, NS, and Dr. Charles Cunningham, at McMaster University in Hamilton, ON, are now studying The Strongest Families Program with families in Ontario. Several Children's Mental Health Agencies throughout Ontario, including Vanier Children's Center, are working with Strongest Families by introducing the study to clients who are eligible for study participation.
Strongest Families is a distance treatment program. Parents learn skills in the comfort and privacy of their own homes, at times that are best for their families, and at no cost. Trained coaches give telephone support to families as they work their way through the program. Coaches and parents work together solve problems as parents apply new skills in their daily lives.
This study is funded by Canadian Institutes for Health Research (CIHR).
The ABCs of Mental Health was developed by the Hincks-Dellcrest Centre in response to parent and teacher requests for mental health information that would help them in their everyday interactions with children and adolescents. In consulting with parents, teachers and other school personnel about development of the ABCs Resource, a common theme was that although mental health information regarding children is currently available in books and on the Internet, it was not always easy to understand and not always clear how to apply the information in school settings or at home.
Instead, individuals suggested materials be developed to provide:
- practical suggestions for the prevention of mental health problems;
- information about the common behaviours and mental health problems that concern parents and teachers;
- early intervention strategies to use in the classroom or home;
- appropriate responses to children with more serious mental health problems.
In developing the ABCs of Mental Health, the Centre had the assistance of a team of Centre personnel and consultants, and a number of mental health professionals with specialized expertise in a particular area of children's mental health.
The titles of the current chapters in the ABCs of Mental Health are as follows:
- The Worried Child
- The Sad Child
- The Self-Harmful Child
- The Angry or Aggressive Child
- The Child with Poor Social Relations
- The Defiant or Misbehaving Child
- The Child with Attention Problems
- The Child with Unusual Behaviours
- The Child with Eating Problems
- The Child with Drug and Alcohol Problems
The information provided in each chapter is organized around three headings, each of which contains different levels or concepts: Actions, Beliefs and Course to Follow. For both the Actions and the Course to Follow, content is generally divided into three levels of seriousness, called: Green Light, Yellow Light and Red Light. As certain behaviours might be normal at one stage of development, but could indicate a moderate or serious mental health problem at another stage of development, the Actions and Course to Follow also are generally divided into four different stages of development: Early Childhood, Middle Childhood, Early Adolescence, and Adolescence. The content under the Beliefs heading is generally divided into the following areas: Biological, Congenital, Health; Family; Disabilities; Differences; Culture/Religion; and Trauma, Loss or Turbulent Environment.