Tel-Hai College and Ziv Medical Center Joint Research Center for Mental Health

Dr. Vered Shenaar-Golan (Tel-Hai College) – Head of Center

Mail: [email protected]

Dr. Uri Yatzkar (Ziv Medical Center in Zefat) – Head of Center

Dr. Tali Bretler (Ziv Medical Center in Zefat) – Researcher

Prof. Rachel Lev-Wiesel (Tel Hai College) – Researcher

Mail: [email protected]

Prof. Snait Tamir (Tel Hai College) – Researcher

Mail: [email protected]

Prof. Meirav hen (Tel Hai College) – Researcher

Mail: [email protected]  

Dr. Omer Horovitz (Tel Hai College) – Researcher

Mail: [email protected]

Dr. Ayelet Gur (Tel Hai College) – Researcher

Mail: [email protected]

Dr. Yossi Yaffe (Tel Hai College) – Researcher

Mail: [email protected]

Dr. Uri Yatzkar, Dr. Vered Shenaar-Golan

Recent literature indicates that components of insecure attachment styles and emotion dysregulation influence the development of emotional difficulties and psychiatric disorders. Additionally, it is known that parents' attachment styles and emotion-regulation strategies can affect their children's attachment styles and emotion-regulation strategies. Therefore, this study aims to evaluate these factors by mapping the attachment styles and main emotion regulation strategies among children and adolescents and their parents seen at the Child and Adolescent Mental Health Center at Ziv Hospital. This study will help to focus interventions on the specific emotional state and psychiatric disorder of each patient, in the context of emotion regulation and attachment styles.
To provide data for this study, parents who come to the center with their children will fill out questionnaires before their first evaluation meeting (intake). Additionally, children who are age 8 or older will also fill out questionnaires themselves. These questionnaires will help evaluate the level of anxiety, depression, and overall functioning in the children, as well as the emotional regulation ability and attachment styles of both the children and their parents. This information will be used to aid clinicians in the evaluation process and the clinic data will be used as the database for this research.
The results of this research will provide insight into the attachment styles and emotion regulation strategies present in both the children and their parents who are seeking help at the center. This understanding will aid in connecting the patients' clinical state with their attachment styles and specific emotional regulation strategies, allowing for more customized and effective treatment for both the children and their parents. 
 

Dr. Uri Yatzkar, Dr. Vered Shenaar Golan and Dr. Ayelet Gur.

When seeking to improve the mental health of children and adolescents, the well-being of their parents must also be addressed. Parenting presents challenges, particularly when parenting a child with mental health issues, which can lead to increased stress and anxiety levels in parents.  One approach to assist parents in reducing anxiety and stress, so they may better support their child, is through emotional regulation. There are several strategies for achieving emotional regulation, some of which have been linked to negative influences on well-being. As an alternative approach to traditional emotional regulation strategies, research was conducted at the Galilee Mental Health Research Center on the effects of self-compassion on emotional regulation in parents of children dealing with mental health issues, produced groundbreaking results. 
Dr. Uri Yatzkar explains the importance of the findings: “Recently, as part of the joint study, data was collected from a large number of parents with children with significant mental health issues. The data indicated self-compassion as a significant factor in subjective well-being and in reducing parental stress and anxiety. Furthermore, the findings indicated that the capacity for self-compassion is even more significant for parental well-being than the severity of the child's clinical condition. These findings were reinforced by another joint analysis showing that working with parents on improving the capacity for self-compassion, rather than emotional regulation, was significant for personal well-being. After this breakthrough was presented at the annual conference of the Association of Child and Adolescent Psychiatry in Israel, many centers in the country reconsidered their entire treatment strategy.” 
 

Dr. Uri Yatzkar, Dr. Vered Shenaar-Golan, Dr. Omer Horovitz and Dr. Tali Bretler

At the Galilee Mental Health Research Center, we are currently conducting research on the relationship between physical activity and mental health in adolescents. Among adults, physical activity has been shown to be a promising treatment for depression and other mental health issues. However, the research on this topic in adolescents is still developing and more research is needed.
Our research team has conducted a scoping review of the literature on the relationship between running and mental health in adolescents. The findings indicate that running is positively associated with mental health outcomes, including reductions in depression and anxiety symptoms.
Building on these findings, we are currently conducting a randomized control trial at our Center to assess the effectiveness of combining group-based running therapy with standard treatment for inpatient and day treatment patients in an adolescent psychiatric ward. This study is the first of its kind and will provide valuable information on the potential benefits of running therapy for adolescent patients with complex and severe mental health conditions.
We believe that the results of this study, and future research on the topic, have the potential to inform policy changes and the integration of running therapy as a routine treatment in adolescent psychiatric care. The study also addresses the lack of evidence on the effects of running therapy on adolescent clinical populations, particularly those with severe mental health conditions. Our team is dedicated to advancing the knowledge in this field and contributing to improve mental health outcomes in adolescents.
 

Prof. Meirav Hen, Dr. Vered Shenaar-Golan and Dr. Uri Yatzkar 

The Galilee Mental Health Research Center is currently investigating the impact of the Covid-19 pandemic on child and adolescent mental health. The study utilizes pre-pandemic data for comparison and is uncovering important insights about the emotional and behavioral effects of the pandemic on young individuals.
Initial findings from the study indicate that a significant percentage of children and adolescents participating in the study reported increased feelings of anger during the pandemic. A comparison of data from before and during the pandemic shows that the overall stress experienced by families at the beginning of the pandemic, specifically with the implementation of initial lockdowns, affected the participants' ability to regulate their emotions. The study also reported increased levels of depression and emotional and behavioral problems.
Interestingly, and contrary to most other studies, the findings did not indicate an overall increase in anxiety levels during the pandemic. However, when stratifying samples by gender and age, significant differences were found between boys and girls, and between children and adolescents. Boys and adolescents reported a significant increase in difficulty with emotional regulation, whereas girls and children reported an increase in behavioral problems.
This research is of paramount importance as it provides a comprehensive understanding of the impact of the pandemic on child and adolescent mental health. The findings will inform the development of effective strategies for addressing the ongoing mental health needs of young people during and after the pandemic, and will be of great value to families, researchers, therapists, and policymakers.
 

Tamir, S., Shenaar-Golan, V., Yatzkar, U., and Lital Kachlon, MA thesis, Department of Nutrition, Tel-Hai Academic College

In recent years, research in the field of emotional regulation has been flourishing. Recent literature suggests that emotional regulation should be considered an extremely important transdiagnostic factor, due to the ample evidence that at the base of most psychopathologies lie problems of emotional regulation. In the case of parenting, the topic is more complex since the parent needs to regulate both themself and their child. If the parent has difficulty with self-regulation, it will be difficult for them to fulfill their role as a caregiver. Thus, the parent's ability to self-regulate affects the child's ability to be regulated by the parent and later on, to internalize this function and regulate themselves. Based on this theoretical background, studies have examined and found a link between parental regulation of their own and their children's emotions, and between the regulation of their own emotions and their children's psychopathology.
A healthy lifestyle has been linked in studies to mood swings and emotional regulation. In light of the positive impact of a healthy lifestyle on physical and mental wellbeing, there are a variety of programs that promote a healthy lifestyle and change harmful patterns. Studies examining the efficacy of such programs have found them effective in improving the home environment and adopting healthier habits.
When parents turn to mental health clinics for assistance with children who experience emotional regulation disorders, in most cases there is no reference to the nutritional component and the effect of a family's healthy lifestyle on the child's emotional regulation. To date, many studies have been conducted on the subject of emotion regulation, but few have mentioned criteria that reflect participants' lifestyle behaviors. The present study aims to bridge the gap in the literature relating to the link between promotion of a healthy lifestyle and emotional regulation in both children and parents by examining the impact of a healthy lifestyle program on the emotional regulation processes of parents whose children have psychiatric disorders.
Following the intake session, parents are asked to complete a questionnaire that assesses their lifestyle and that of their children. The score in this questionnaire is added to the scores obtained in the other questionnaires and documented in the patients' medical file, to serve as the database prior to intervention. Participants are then randomly assigned by computer software to one of two groups - experimental or control. The experimental group receives an intervention lasting six weeks that includes a weekly consultation (phone or zoom, chosen by the family) with the parents on lifestyle promotion at home. A flyer containing general guidelines for promoting a healthy lifestyle is sent to the control group. 
In the six weeks of the study, the parents in the experimental group received six weekly consultations on the topic of nutrition and guidance for a healthy lifestyle, where counselors also provide responses to their questions. The consultations deal with promoting a healthy lifestyle: sleep hours, screen time, physical activity, drinking water, wise nutrition, and eating behaviors. 

Dr. Uri Yatzkar, Dr. Vered Shenaar Golan

Parenting a child with emotional and behavioral problems is a complex and emotionally challenging experience for parents. The continuous stress of managing their child's needs, combined with a lack of understanding and support from others, can leave parents feeling overwhelmed, frustrated, and anxious. In addition, parents may struggle with a range of emotions toward their child, including guilt, sadness, and a sense of helplessness, which can lead to a constant internal dialogue about their parenting decisions. The impact of parental feelings on the parent-child relationship cannot be overstated, as it can have a significant effect on the child's emotional well-being and intensify their sensory and behavioral challenges. Therefore, it is crucial to explore the experiences of parents and the role that their feelings play in shaping parent-child interactions. As part of our research efforts, we conducted a study that examined the relationships between paternal feelings, parent-child attachment, and anxiety symptoms among children and adolescents with emotional and behavioral disorders. The study introduces a path model that links paternal feelings with child anxiety disorders through insecure attachment in the father-child relationship. (To learn more about our research and findings, we invite you to explore the publications section of our website and access the study, "Paternal feelings and child's anxiety: The mediating role of father-child insecure attachment and child's emotional regulation.")

To further explore this crucial relationship, our research laboratory conducted a study to extend the work of Bradley et al (2013), in validating the Parental Feelings Inventory (PFI), which measures parental emotions in the context of the parenting role, in Hebrew. While the original PFI was tested with parents of preschool children, our study aimed to broaden its usage to a broader population of parents of adolescents with various clinical characteristics. Our findings revealed a five-factor structure for the PFI (anxious, angry, satisfied, happy, and sad), which is conceptually similar to the three-factor model that Bradley et al. (2013) identified. This endeavor facilitates expansion of the PFI's usage to older ages of children and adolescents, which may promote the instrument's usage by researchers and clinicians with a more extensive age range and contribute to a better understanding of the role played by parental emotions in parent-child relationships in adolescence. (To learn more about our research and findings, we invite you to explore the publications section of our website and access the study, " Validation of the Parental Feelings Inventory with parents of an adolescent clinical sample.")
 

Shenaar-Golan, V., Wald, N., & Yatzkar, U. (2017). Patterns of emotion regulation and emotion behavior among parents of children with and without ADHD. Psychiatry Research, 258, 494-500. 

Wald N., Tadmor-Zisman, Y., Shenaar-Golan, V., & Carthy T. (2018). Influence of maternal negative emotion reactivity and cognitive reappraisal on child anxiety disorder. Depression and Anxiety, 35(4), 353-359.

Wald, N., Tadmor-Zisman, Y., Shenaar-Golan, V., Yatzkar, U., Carthy, T., & Apter, A. (2019). Child–Mother Reappraisal and Child’s Anxiety Among Anxious and Non-Clinical Groups. Journal of Child and Family Studies, 29(6), 1642-1648.‏ 

Shenaar-Golan, V., Vald, N., & Yatzkar, U. (2021). Parenting a Child with Mental Health Problems: The Role of Self-Compassion. Mindfulness, 12(11), 2810-2819. 

Shenaar-Golan, V., Yatzkar, U, & Yaffe, Y. (2021). Paternal Feelings and Child’s Anxiety: The Mediating Role of Father-Child Insecure Attachment and Child’s Emotional Regulation. American Journal of Men’s Health, 15(6). 

Shenaar-Golan, V., Yaffe, Y., & Yatzkar, U. (2022). Validation of the parental feeling inventory with parents of adolescent. Child and Adolescent Social Work Journal, 1-9.  

Hen, M., Shenaar-Golan, V., & Yatzkar, U. (2022). Children and Adolescents’ Mental Health Following COVID-19: The Possible Role of Difficulty in Emotional Regulation. Frontiers in Psychiatry. 

Shenaar-Golan, V., Gur, A., & Yatzkar, U. (2022). Emotion regulation and subjective well-being among parents of children with behavioral and emotional problems – the role of self-compassion. Current Psychology, 1-12. 

Shenaar-Golan, V., Hen, M., & Yatzkar, U. (2022). Do parents’ internal processes and feelings contribute to the way they report their children’s mental difficulties on the Strength and Difficulties Questionnaire (SDQ)? Child Psychiatry & Human Development, 1-11.