Adolescent Pregnancy and Parenting: Reducing Stigma and Improving Outcomes

This book focuses on the impact of social stigma on adolescents who are at high risk of teen pregnancy. It describes and discusses personal and social factors that predispose them to becoming pregnant and having babies; factors that may subsequently protect or more often, compromise outcomes for both parents and children.  The authors, who represent a range of social roles and perspectives, describe the pathways from stigma and its unfounded beliefs about disadvantaged adolescents, to the ways stress burdens teen parents and their children.  They note that successful teen parents often go unrecognized and wonder how many more are hobbled by stigma.  They recognize the lifespan impacts of stress as described in the ACE studies; stress that has psychological, health and economic implications at individual and social levels. They examine the impact of stigma on parent-child relationships and the attachment system, a stress management system, learned in infancy and persisting into adulthood. The book describes how stigma finds its way into daily interpersonal encounters, systemic policies and practices, and even into healthcare research and services.

This sets the stage for an in-depth look at attachment systems within stress management, interventions, and recommendations for professionals whose work is impacted by these issues.  Written by experts in the field, this text is the first to cover the current understanding of the risk factors, advanced understanding of developmental issues, and the key intervention tactics for the most positive outcome for adolescent parents and their families.

Adolescent Pregnancy and Parenting is an excellent resource for psychiatrists, psychologists, physicians, social workers, educators, researchers, and policy makers working with youths at risk for teenage pregnancies.

 

The first updated text to examine the mental health impacts of stress and stigma on teen parenting

Proposes interventions for positive outcomes

Written by experts in the field

 

Introduction

·         The old GAP report; why we need a new one

·         Concepts of stigma and its effects

·         Concepts of stress and its effects

·         Demographics and trends in N. America and internationally; subgroups

·         Social attitudes, government social support and health policy in N. America and internationally

Part I Developmental Aspects of Teen Pregnancy and Parenthood

1.      Adolescent development

·         Relationship needs and development in adolescence; the impact of stigma

·         Impact of pregnancy on adolescent health and development

·         Pregnancy as a result of assault or abuse

·         Adolescent capacity to deal with stress

·         Adolescents as parents

2.      Infant and child development

·         Critical influence of the first 1000 days and beyond

·         Life span outcomes

·         Stress in infancy and the attachment system as a stress management system

Part II Interventions

1.     Pregnancy prevention programs

2.     Interventions to support teen parents

·         Social support programs (professional and peer)

·         Educational support programs

·         Medical care programs (e. g. Young Families Clinic at Sickkids)

·         Psychotherapeutic interventions incl’g parent-infant psychotherapy, family therapy, etc

·         Psychopharmacology

3.     Interventions to support infants, toddlers and preschool children of teen parents.·        Developmental support

·        Educational support and readiness

·        Medical care

<·        Parent-infant psychotherapy

Part III. Conclusions- Recommendations for Research, Clinical Care and Social Policy

1.      Review of evidence to support the adverse impact of stigma

2.      Recommendations for social policy – effecting significant social change; changing power differentials

·         Recommendations for healthcare providers

·         Recommendations for educators

·         Recommendations for interventions and research

 

 

Daniel F. Becker, M. D

Psychiatrist, Clinical Professor of Psychiatry

University of California San Francisco

Medical Director, Behavioral Health Services

Mills-Peninsula Medical Center

Burlingame, California

 

Lois Flaherty, MD

Child and adolescent psychiatrist

Lecturer on Psychiatry

Harvard University

 

Jean-Victor Wittenberg, M. D.

Infant, child and adolescent psychiatrist

The Hospital for Sick Children

Associate Professor of Psychiatry

University of Toronto

Co-Chair, Infant Mental Health Promotion

Dr. Daniel F. Becker is Professor of Clinical Psychiatry at the UCSF School of Medicine where he serves as Vice Chair for Strategy in the Department of Psychiatry and Behavioral Sciences. He specializes in adolescent psychiatry and addiction psychiatry. He received his bachelor’s degree in Humanities from Stanford University and his medical degree from the University of Wisconsin, then completed residency training at Yale University. Dr. Becker’s research interests are primarily in the areas of adolescent and young adult psychopathology, and include substance use disorders, eating disorders, personality disorders, the psychiatric sequelae of trauma exposure, and gender and ethnic differences in the expression of psychopathology.

Dr. Lois T. Flaherty is a child and adolescent psychiatrist and part-time Lecturer on Psychiatry at Harvard University, where she is affiliated with Cambridge Health Alliance in Cambridge, Massachusetts.

She was a leader in developing innovative programs in training for child and adolescent psychiatrists at the University of Maryland where she was an Associate Professor and served as head of the Division of Child and Adolescent Psychiatry. Her trailblazing work in developing school mental health programs in Baltimore led to the formation of the National Center for School Mental Health, and the dissemination of the Baltimore models throughout the US. Throughout her career she has focused on working with underserved populations in school and community settings, with a particular interest in adolescents and she has published widely in these areas.

For more than a decade, Dr. Flaherty utilized her expertise in adolescent psychiatry to provide editorial direction to Adolescent Psychiatry, the official journal of The American Society for Adolescent Psychiatry. She has been recognized by Cambridge Who's Who for showing dedication, leadership and excellence in editorial vision.

Dr. Flaherty earned an MD at Duke University and completed an internship in internal medicine at the Georgetown University Division of DC General Hospital. Having developed an interest in psychiatry while attending medical school, she went on to complete residencies in general psychiatry at Georgetown and child and adolescent psychiatry at The Johns Hopkins Hospital. She is a Distinguished Life Fellow of the American Psychiatric Association, and a Past-President of the American Society for Adolescent Psychiatry as well as and the International Society for Adolescent Psychiatry and the Group for the Advancement of Psychiatry, and also has held leadership positions in the American Academy of Child Adolescent Psychiatry. In 2010, Dr. Flaherty was honored with a Distinguished Service Award from the American Psychiatric Association, and she has recently been recognized by the American Academy of Child and Adolescent Psychiatry for outstanding achievement in the school-based study or delivery of intervention for learning disorders and mental illness.

Dr. Jean-Victor Wittenberg is a staff psychiatrist specializing in infant psychiatry at the Hospital for Sick Children in Toronto. He is an Associate Professor at the University of Toronto.  His primary interest is in the influence of relationships and stress on psychological development and health in infants, children and youth.  He has worked in Canada and internationally to develop, evaluate and teach treatment interventions that promote children’s mental health.  He consulted with Tel Aviv University to develop a network of infant psychiatry clinics across Israel. He was first head of the Child and Family Psychotherapies Program at the University of Toronto, Division of Child Psychiatry. He specializes in work with highly stressed populations including infants and young children with serious medical problems, those in child protection, infants and children of teen mothers and infants, children, youth and families in First Nations communities. He led an advocacy initiative that resulted in the federal government’s creation of the Compassionate Family Care Benefit to support families in which a child, spouse or parent is gravely ill.  More recently he has focused on stigma, misinformation and disinformation as causal and perpetuating factors in the social gradient leading to severe skews in health outcomes for those at the lower end of the social gradient. The most recent focus of this work is on the huge disparity of First Nations children and families in the child protection system.

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