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Home-based treatment for children and families affected by HIV and AIDS. Dealing with stigma, secrecy, disclosure, and loss.
Gewirtz A; Gossart-Walker S
July 30, 2000
Unique Identifier : AIDSLINE MED/20230621

The compelling needs of HIV-affected children and families sometimes appear to represent human struggles under the magnifying glass. The multiple assaults on the healthy psychologic development of children through disruptions in caregiving, loss, and abandonment require interventions that are mindful of their mental health needs and longer-term developmental trajectories. An ongoing relationship with a clinical team who can understand and respond to the vicissitudes of the illness and provide calibrated psychotherapeutic and case management services can aid both children and parents in the painful tasks that AIDS presents. Whereas clinically informed case management services can offer respectful and thoughtful concrete help, psychotherapy can offer the opportunity for children to pull together the often fragmented narratives of their family lives and integrate object loss to be free to continue on a normative developmental path. Comprehensive, wraparound home-based services of the type described in this article represent a mostly new tradition in psychiatry, but one that ensures that mental health services are provided to the most vulnerable children and families. For those affected by HIV or