The College Student-Athlete: Psychological Considerations and Interventions

Abstract

This article reviews the literature dealing with problems brought by student-athletes to college counseling and mental health centers. Among the issues discussed are fear of success; identity conflict; social isolation; poor athletic performance; academic problems; and career or vocational concerns. In addition, the authors examine the paradox that although athletes experience as much or more psychological distress as non-athletes, research indicates that athletes use professional services less often than nonathletes. Finally, the authors review approaches to psychological intervention, including short-term psychotherapy, very brief interventions, cognitive behavioral therapy, and career/vocational counseling, and discuss special considerations for conducting therapy with athletes.     

Youth outside the labour force — Perceived barriers by service providers and service users: A mixed method approach

BackgroundYoung people who are neither in employment nor in education or training (NEET) have received increasing attention in Western countries. While some young people in the labour force are unemployed because of a shortage of jobs, others would be without employment even in periods of economic growth, when more jobs are available. The latter group is referred to as neither in the labour force nor in education or training (NLFET), and such people need intervention to improve their chances of work participation. However, this group is poorly understood, and more knowledge is needed to develop efficient measures. The purpose of the study is to investigate the NLFET population and to identify barriers to education or employment.MethodInterviews were conducted at all labour and welfare offices in a representative county in Norway, and an internet-based survey among 586 persons aged 18–29 years who met the NLFET criteria was conducted. Sixty case managers of young service users and 30 managers/assistant managers were interviewed at the 25 offices in the county.ResultsThe local labour and welfare offices prioritize young clients, and some have designated follow-up teams for young service users. Three main barriers to education or employment were identified through the interviews at the offices: client motivation, the sense of lack of achievement/defeat, and unrealistic expectations about working life. A survey of the young people revealed other barriers, such as health problems (60%), low education (55%), lack of work experience (41%), the feeling of being exhausted (38%), low self-esteem (36%), feeling depressed (35%), sleeping problems (35%), and very often a combination of these barriers.ConclusionsHealth problems, social and other problems are highly prevalent among the NLFET population. The majority of the population wanted to find a job or to complete their education. We conclude that mental health problems often camouflage social problems. Treatment of complex problems should not be left to mental health services. Given the nature of the barriers identified, follow-up by strong multi-professional teams, including social work and health professions, should be part of the measures allocated to the NLFET population.     

Peer contagion among youth in Medicaid-funded residential mental health treatment programs

This paper examined juvenile justice encounters among youth with mental health needs who received care in residential treatment settings. The focus is on peer effects, and whether delinquent peers negatively affected youth. Matched data from Florida Medicaid and Juvenile Justice were used to examine the association between peer delinquency in a residential treatment setting and juvenile justice encounters during and after the treatment episode. Fifteen percent of youth had justice encounters during residential out-of-home treatment, while the rate was lower in the six months after (23.0%) treatment than the six months before (33%). Support for peer contagion was found as youth treated in Medicaid-funded residential mental health treatment programs were more likely to have JJ encounters when the other youth in the facility had histories of delinquency.     

A Program Evaluation of Los Angeles ACORN's Welfare Case Advocacy

SUMMARY

Bureaucratic confusion and client dissatisfaction since the 1996 changes in welfare policy opened opportunities for third party advocacy on behalf of welfare clients. This paper evaluates Los Angeles ACORN's case advocacy program for welfare clients. Outcomes analyzed include client satisfaction with ACORN's advocacy and effects of the program on welfare clients who later became ACORN members. Ninety-one percent of clients surveyed (N = 99) stated they were satisfied with the resolution of their welfare case complaint. Eighty-eight percent of respondents stated ACORN did a better job resolving their problem compared to the welfare department. Unique aspects of the program include peer advocacy and opportunities for welfare recipients to join ACORN and work on welfare policy changes among other issues.     

The Effect of Graduate School on Identity Issues

Abstract

Objectives: To provide a critical review of the efficacy of brief interventions for alcohol use in college health centers. Methods: Studies were included if (a) they examined brief intervention trials that were conducted in college- or university-based student health centers or emergency departments, and (b) they provided pre–post data to estimate change. Results: Twelve studies suggested that screening and brief interventions in these settings are acceptable, feasible, and promote risk reduction. Conclusions: Findings support continued use of time-limited, single-session interventions with motivational interviewing and feedback components.     

Screening and Brief Intervention for Tobacco Use by Student Health Providers on College Campuses

Abstract

Objective: This study assessed college students’ reports of tobacco screening and brief intervention by student health center providers. Participants: Participants were 3,800 students from 8 universities in North Carolina. Methods: Web-based survey of a stratified random sample of undergraduates. Results: Fifty-three percent reported ever visiting their student health center. Of those, 62% reported being screened for tobacco use. Logistic regression revealed screening was higher among females and smokers, compared to nonsmokers. Among students who were screened and who reported tobacco use, 50% reported being advised to quit or reduce use. Brief intervention was more likely among current daily smokers compared to current nondaily smokers, as well as at schools with higher smoking rates. Screening and brief intervention were more likely at schools with lower clinic caseloads. Conclusions: Results highlight the need to encourage college health providers to screen every patient at every visit and to provide brief intervention for tobacco users.     

A pilot study of Latinos with multiple sclerosis: demographic, disease, mental health, and psychosocial characteristics

In this study the authors present results from a survey of 99 Latinos with multiple sclerosis (MS), including demographic, disease, and mental health characteristics. Four in 10 respondents reported depressive symptoms; half thought they had more worries than other people due to their MS; and about 29?% thought they needed mental health care in the past year. Whereas 76?% of respondents were highly satisfied with their access to MS-focused care, only 61% were highly satisfied with their access to mental health care. These findings highlight the role of mental health and social services in the comprehensive care needed by Latinos with MS.     

Adolescents Seeking Mental Health Services

Summary

Inner-city adolescents receiving mental health services often get inadequate medical care. However, when those who seek counseling are asked about their health concerns, they say they want to discuss them with their therapists. Based on responses to a clinical self-assessment questionnaire (Adquest), adolescent mental health clients reported sleep difficulties, weight and eating concerns, and frequent headaches and stomachaches. Age and gender differences in patterns of vulnerability and willingness to talk were explored.     

The college student-athlete: psychological considerations and interventions

This article reviews the literature dealing with problems brought by student-athletes to college counseling and mental health centers. Among the issues discussed are fear of success; identity conflict; social isolation; poor athletic performance; academic problems; and career or vocational concerns. In addition, the authors examine the paradox that although athletes experience as much or more psychological distress as nonathletes, research indicates that athletes use professional services less often than nonathletes. Finally, the authors review approaches to psychological intervention, including short-term psychotherapy, very brief interventions, cognitive behavioral therapy, and career/vocational counseling, and discuss special considerations for conducting therapy with athletes.     

Frequency and Types of Partner Violence Among Mexican American College Women

Objective and Participants: The authors studied the prevalence of partner violence, by type, among Mexican American college women aged 18 to 35 years (N = 149; response rate = 85%). Results: Twelve percent of women who reported a dating partner in the past year were physically or sexually assaulted, 12.1% were stalked, and 9.1% scored as psychologically abused. Among those experiencing partner violence, almost half experienced stalking and 89% reported psychological abuse. Few women (25%) who experienced physical violence believed violence was a problem in their relationship. Conclusions: Partner violence was prevalent in this population, and participants experienced many forms of violence. Because few women experiencing physical violence report that violence is a problem in their relationship, interventions must address perceptions of violence and its impact on women's mental and physical health in college populations.     

Australian Social Work Reviewers 2010

Abstract

Children placed in out-of-home care are a particularly disadvantaged group in society, who have often been exposed to trauma and socioeconomic disadvantage. As a result, they experience poorer health outcomes than children in the general population, especially mental health outcomes. One health outcome that has yet to be researched thoroughly is overweight and obesity of children placed in out-of-home care. Hence, the overall goal of this paper was to review the extant literature over the last decade on weight-related issues for children in out-of-home care, with particular emphasis on overweight and obesity. The findings of the review revealed that there is a lack of rigorous Australian research in relation to prevalence rates of overweight and obesity in children in out-of-home care; there is a lack of strategies or interventions designed specifically to combat overweight and obesity in children in out-of-home care; and one of the major limitations of Australian research to date is the use of self-report measures to assess the weight status of children in out-of-home care. It was concluded that prevention and intervention strategies are needed that target children as they enter out-of-home care.     

Predictors of Substance Use and Mental Health of Children of Divorce

Abstract

This short-term longitudinal study examined psycho-social influences on substance use and mental health among children of divorced parents. The sample consisted of ethnically diverse fifth and sixth grade students, and compared children of divorced parents (CODPs; N = 176), who were an average of four years post-divorce, with children of married parents (COMPs; N = 213) who had never divorced. CODPs reported more life stress, less problem-focused coping, and more substance-using friends and family members than COMPs. Further, these variables were significantly related to CODPs' greater reported substance use, aggressive behavior, and depression than COMPs cross-sectionally, and longitudinally, four months later. The results suggest the importance of including both substance use and mental health outcomes in preventive interventions for CODPs.     

Comorbid Substance Abuse and Mental Illness

Abstract

Literature concerning assessment and treatment of comorbid substance abuse and mental illness is reviewed. Currently, comorbidity is under-diagnosed and dually diagnosed clients are under-served. Those clients, who are so diagnosed, are most often offered dichotomous parallel or serial interventions. However, research suggests that an integrated approach is preferable. Enhanced training of mental health and substance abuse professionals is urgently needed as is further research concerning the efficacy of various treatment modalities. Improved identification and treatment of comorbidity may reduce the revolving door effect among these individuals and thereby lower health care costs.     

Social work and pastoral counseling: Empowering each other

ABSTRACT

This article addresses the divergent outcomes which can result from counseling services offered pastorally versus clinically. As faith leaders often have greater direct access than social workers to supporting religious populations, it is important to explore the intersection between religious pastoral support and clinical social work. Presenting six scenarios from the author’s own experiences as both a rabbi and social worker, this article processes each scenario first through the pastoral lens of an Orthodox rabbi, followed by the clinical lens of a social worker or other mental health professional. The client outcomes which are produced from each modality are radically different. This contrast demonstrates the distinction between the goals, values, and training of each profession, and highlights importance for future work to be done in linking religious and pastoral training to mental health services, as well as broadening the scope of cultural competence for social workers and therapists who may engage with tight-knit religious populations.     

Social Work in the Emergency Department—Implementation of a Domestic and Family Violence Screening Program

Abstract

Women who have experienced domestic and family violence use health services more frequently than women who have not. Early identification and intervention by the health system may reduce health problems associated with domestic and family violence and lead to savings for the health sector. This study aimed to evaluate the impact of a new domestic and family violence screening program, which was based on an ecological model and introduced by a social work team in the Emergency Department of a major metropolitan hospital. The evaluation method included an audit of social work case files to assess the effect on referral rates and a survey of Emergency Department staff to obtain perceptions of the impact of the program on the staff and clients. In the 3-month period following the introduction of the program, the rate of referral to social work increased by 213%. Staff agreed that the Emergency Department is an appropriate place to ask about domestic and family violence, under certain conditions. Findings suggest that an ecological social work model provides an approach to screening for domestic and family violence that not only contributes to increased identification and supportive client interventions but may also contribute to more sustainable systemic change.     

Including At-Risk Adolescents in Their Own Health and Mental Health Care

Summary

As urban adolescents encounter serious health and mental health risks, they present the allied health professions with important opportunities for health promotion and risk reduction interventions. However, the prevailing emphasis on adolescents' risk behaviors rather than on their vulnerability has limited our capacity to understand and serve them. Further limiting are the widely held myths that adolescents as a whole have few health problems and that they are poor judges of their own needs. This article presents an overview of current theories of adolescent risk and vulnerability and suggests Youth Development as an overarching framework for understanding both. Experience within a comprehensive, adolescent health and mental health center demonstrates how to meaningfully engage adolescents in their own health care from the start.     

Effects of Testosterone Treatment and Chest Reconstruction Surgery on Mental Health and Sexuality in Female-To-Male Transgender People

ABSTRACT. Objectives: This study examined the effects of testosterone treatment with or without chest reconstruction surgery (CRS) on mental health in female-to-male transgender people (FTMs). Methods: More than 200 FTMs completed a written survey including quantitative scales to measure symptoms of anxiety and depression, feelings of anger, and body dissatisfaction, as well as qualitative questions assessing shifts in sexuality after the initiation of testosterone. Fifty-seven percent of participants were taking testosterone and 40% had undergone CRS. Results: Cross-sectional analysis using a between-subjects multivariate analysis of variance showed that participants who were receiving testosterone endorsed fewer symptoms of anxiety and depression as well as less anger than the untreated group. Participants who had CRS in addition to testosterone reported less body dissatisfaction than both the testosterone-only or the untreated groups. Furthermore, participants who were injecting testosterone on a weekly basis showed significantly less anger compared with those injecting every other week. In qualitative reports, more than 50% of participants described increased sexual attraction to nontransgender men after taking testosterone. Conclusions: Results indicate that testosterone treatment in FTMs is associated with a positive effect on mental health on measures of depression, anxiety, and anger, while CRS appears to be more important for the alleviation of body dissatisfaction. The findings have particular relevance for counselors and health care providers serving FTM and gender-variant people considering medical gender transition.     

Meeting Life Challenges

SUMMARY

Mental health and social service providers need to understand the contextual experience of diverse aging populations and the types of life challenges they have encountered. This research examined the life challenges specified by a purposive sample of 75 urban community-dwelling low-income older adults from four high-rise housing facilities. Thirty-four study participants were Jewish American and 41 were African American. Results indicate that many participants of both groups identified personal events such as bereavement and health as stressors, but only the Jewish Americans identified societal events such as World War II. Both groups found social resources moderately valuable in meeting life challenges, but religious resources were frequently identified by African American older adults and personal resources were highly endorsed by Jewish Americans, resulting in a hierarchy of coping styles for each group. Results suggest that mental health and social service providers can create interventions to reinforce and strengthen natural client resources that may vary according to ethnic and racial differences