Mental Health Professionals' Exposure to Clients with Problematic Internet Experiences

ABSTRACT

This paper examines clients' exposure to problematic Internet experiences among a national sample of 2,098 social workers, psychologists, marriage and family therapists, and other mental health professionals. This analysis finds that mental health professionals are working with clients experiencing a range of problems related to Internet use. However, these professionals have generally not been exposed to training or information in the professional literature on the topic of working with clients with problematic Internet experiences. We identify several areas in which additional training is needed and review practical implications for mental health professionals.     

Disclosure of Child Sexual Abuse Among Adult Male Survivors

Men who were sexually abused during childhood are a stigmatized, under-studied, and marginalized population that is at risk for long-term mental health problems. However, many mental health practitioners feel under-prepared and ill-equipped to effectively treat male survivors of child sexual abuse. Furthermore, little is known about factors that may impact the mental health of male survivors such as disclosure of the sexual abuse. The purpose of this study was to (a) describe the disclosure process of male survivors using a lifespan approach, (b) identify disclosure differences based on age and type of abuser, and (c) explore relationships between disclosure attributes and current mental health. Using a large, purposive sample of male survivors (N = 487), the study found that, on average, men delayed telling (M = 21.38 years) and discussing the abuse (M = 28.23 years) for many years. Older age and being abused by a family member (i.e., incest) were both related to delays in disclosure. Most participants who told someone during childhood did not receive emotionally supportive or protective responses and the helpfulness of responses across the lifespan was mixed. Several variables (e.g., timing of disclosure, discussing with a spouse, response to disclosure) were related to current mental health problems. These findings are helpful for clinical social workers who practice with clients from this population. Specific suggestions for improving clinical practice (e.g., assessment, treatment, professional training) are discussed.     

The mental health problems of mothers experiencing the child protection system: identifying needs and appropriate responses

This article presents the findings of a small pilot study which examined the needs of 13 mothers with severe mental health problems whose children were involved in the child protection system. The use of the diagnosis of ‘personality disorder’ in relation to this group of women is discussed and the finding that all these women had experience of domestic violence is considered in the context of other research findings. The extent to which child protection social workers and mental health professionals worked together on these cases was explored and only limited evidence of good communication and collaboration was found. The need for effective inter‐professional and inter‐agency coordination is argued, but differing conceptions of maternal mental health problems and their relationship to children's needs may make for difficulties in professional communication and decision‐making. The article seeks to identify the differing approaches to maternal mental health problems which appear to be developing out of different groups of research studies and argues that practitioners need to be explicit in identifying their perspectives on the associated issues of maternal mental health problems and child protection. Copyright © 1999 John Wiley & Sons, Ltd.     

Preliminary Validation of an Online DSM-Based Mental Health Referral Inventory

A brief online inventory was developed as a much needed corrective for the hundreds of unscientific tests that are used now by millions of people to self-diagnose mental health problems. The primary purpose of the new inventory is to refer people to mental health professionals for further evaluation when they are experiencing problems that might be diagnosable under DSM guidelines; it is not designed to diagnose, however. The inventory was found to be a valid and reliable measuring instrument based on analysis of data obtained from 3,403 subjects. The 54-item checklist looks for 18 common problems identified in the DSM-IV and takes from 5 to 10 min to complete. Test scores proved to be good predictors of a variety of self-reported criterion measures, including happiness, personal and professional success, history of hospitalization, history of therapy, current participation in therapy, employment, and level of education. Females were found to have slightly more mental health problems than males, but no differences in scores were found by race or ethnicity.     

You Can't Recover From Suicide: Perspectives on Suicide Education in MSW Programs

Suicide is a profound worldwide public health problem that has received increased attention in recent years. The major federal response, the National Strategy for Suicide Prevention, calls for more suicide education for mental health professionals, including social workers. Little is known about the amount of suicide education in MSW curricula nationwide. This study presents quantitative findings from 2 national surveys of MSW deans and directors and of MSW faculty on suicide education and qualitative findings from a series of faculty focus groups. Results suggest that MSW students receive 4 or fewer hours of suicide education in graduate school, and most deans and faculty do not have plans to increase suicide content. Barriers include lack of faculty expertise, crowded curricula, and other educational priorities. Implications are discussed.     

Impact of client suicide on social workers and counselors

Recent studies on the impact of client suicide on mental health professionals focus on psychiatrists and psychologists, while,in the current mental health system in our country, most clients receive services from other clinicians. This research focuses on the impact of client suicide on social workers and counselors as well as organizational responses to client suicide/attempt. Data were collected via interviews and survey of 121 clinicians. Client suicide impacts clinicians adversely in many ways. Many participants felt their agency/practice could have done more to support them during post-suicide management. Data presented in this report have the potential to aid in the creation of needed workforce development initiatives.     

Training Mental Health Professionals on Ethical Issues and HIV/AIDS

This report describes the importance of ethics training for mental health professionals working with persons infected or affected by HIV/AIDS. We first describe three major ethical dilemmas (confidentiality, duty to warn, and suicide) faced by mental health providers serving persons with HIV/AIDS, and the legal and clinical aspects of these dilemmas. We present data from the South Texas AIDS Training Project describing the types of mental health professionals who have attended workshops on ethical issues and HIV/AIDS. Finally, we report observations about the impact of the ethics training sessions on the participants' knowledge and attitudes.     

Group therapists' countertransference reactions to multiple deaths from aids

Group therapists for those with HIV Related Diseases are becoming the “professional” survivors of this world-wide epidemic. From their experiences we may learn a great deal more about the effects of multiple deaths on mental health care professionals. As therapists they are constantly eliciting and listening to the fears, hopes, agonies and terrors of those with this disease. They become the bereaved. Witnesses to the deaths of many of their group members, they struggle with a wide range of emotional responses while at the same time assisting surviving group members in their struggle to live with these deaths. Mourning reactions and countertransference phenomena are in abundance as these therapists grapple with these group processes. This article identifies and examines these therapists' responses by focusing on clinical illustrations drawn from their bi-weekly supervision sessions.     

Mental Health Conditions Among North Korean Female Refugee Victims of Sexual Violence

The study aims to examine the negative effects of sexual violence on North Korean (NK) female refugees in South Korea. Although the prevalence of sexual violence victimization is extremely high and mental health problems are serious among these refugees, little to no research has been done on the relationship between sexual violence and mental health among these women. The mental health conditions of two groups of women (sexual violence victims and those who have not experienced sexual violence) were compared using ANCOVA analyses. The results show that suicidal ideation and alcohol use are significantly more prevalent in the sexual violence group than in the non‐sexual violence group. The women who had experienced sexual violence in particular should be provided with more professional and sustained treatment and management services. The government must improve the effectiveness of existing policies related to suicide and the drinking culture in South Korea.     

Does self-help increase rates of help seeking for student mental health problems by minimizing stigma as a barrier?

Objective: This study examined whether self-help (books, websites, mobile apps) increases help seeking for mental health problems among college students by minimizing stigma as a barrier. Participants and Methods: A survey was conducted with 200 college students reporting elevated distress from February to April 2017. Results: Intentions to use self-help were low, but a significant portion of students unwilling to see mental health professionals intended to use self-help. Greater self-stigma related to lower intentions to seek professional help, but was unrelated to seeking self-help. Similarly, students who only used self-help in the past reported higher self-stigma than those who sought professional treatment in the past. Although stigma was not a barrier for self-help, alternate barriers were identified. Conclusions: Offering self-help may increase rates of students receiving help for mental health problems, possibly by offering an alternative for students unwilling to seek in-person therapy due to stigma concerns.     

Mental health professionals in children's advocacy centers: is there role conflict?

Two recent chapters in professional books have criticized children's advocacy centers for creating role conflict for mental health professionals because of their work with criminal justice and child protection professionals in children's advocacy centers as part of a coordinated response to child abuse. This article argues that these critiques misunderstand children's advocacy center practice and overestimate the risk of role conflict. Children's advocacy center standards set a boundary between forensic interviewing and therapy, which in most children's advocacy centers are done by separate professionals and never by the same professional for a given child. Many mental health professionals serve children's advocacy centers as consultants with no treatment role. Children's advocacy center therapists are rarely involved in investigation, and their participation in multidisciplinary teams focuses on children's interests and well-being.     

Strategies for improving education

1. An extensive curriculum is required to prepare mental health professionals to adequately assess, plan, and implement the necessary comprehensive treatment plan and to sufficiently develop relevant social policy. 2. A majority of professionals believe they were not adequately trained in the care of the chronically mentally ill; this may be a result of the trend of integrating the teaching of mental health nursing concepts into the baccalaureate curriculum. 3. Frequently there is a lack of mental health professional role models. Nursing faculty are in an excellent position to implement innovative practice models. 4. Learning from a multidisciplinary team may increase the likelihood that students will apply these approaches to the chronically mentally ill.     

Ethical Issues in Child Custody and Dependency Cases

Abstract

The emotional and psychological risks to children of high conflict divorce have led to the increased involvement of mental health professionals in child custody cases. Numerous service models (Greenberg & Gould, 2001; Johnston, 2000; Johnston & Roseby, 1997) have been developed to assist divorcing families in minimizing family conflict and supporting children'S needs. This underscores the need for judges and attorneys to understand the ethical and professional standards that underlie competent mental health practice in forensic cases. The practices of mental health professionals providing court-related services may have a substantial impact on the validity of their professional opinions, the effectiveness of services provided to children and families, and children'S development and adjustment. The authors suggest core ethical and clinical issues to be considered by all psychologists who work in the context of custody disputes. It is hoped that these professional practice suggestions will also be useful to attorneys and judicial officers in assessing the quality of mental health professionals' opinions.     

Secondary victimization of rape victims: insights from mental health professionals who treat survivors of violence

Rape victims may turn to the legal, medical, and mental health systems for assistance, but there is a growing body of literature indicating that many survivors are denied help by these agencies. What help victims do receive often leaves them feeling revictimized. These negative experiences have been termed "the second rape" or "secondary victimization." If indeed secondary victimization occurs, then these issues may be raised in rape survivors' mental health treatment. In the current study, probability sampling was used to survey a representative sample of licensed mental health professionals about the extent to which they believe rape victims are "re-raped" in their interactions with social system personnel. Most therapists believed that some community professionals engage in harmful behaviors that are detrimental to rape survivors' psychological well-being. Implications for future research on secondary victimization are discussed.     

Supporting families with a mentally ill parent: European perspectives on interagency cooperation

This paper reports on the findings of a cross-country comparison of cooperation between services for community mental health and child protection in 11 states. The authors consider the implications of the findings for English practice. When children have a parent with mental health problems, they have needs over and above those of other children. Often these needs are met by the family, but this is not always possible. There are increasing numbers of these children, and they feature disproportionately in the case loads of child welfare professionals, health visitors and social workers. The cross-country comparisons demonstrate the ways in which differences in structures, resources, expectations and attitudes affect professional responses and the experiences of families. The findings provide information on several levels. A comparison of commonalities and differences highlights the problems that are shared across countries, and alternative ways of responding to them at ground level are discussed. The factors that facilitate a good outcome are analysed in relation to English practice and service structures. The research findings are relevant for British social welfare strategies, and the paper highlights the implications of the findings for policy and practice. Copyright © 2001 John Wiley & Sons, Ltd.     

Striving to help college students with mental health issues

Mental health problems in the college population appear to be increasing in number and severity. University counseling services are limited in the number of counselors they can hire to meet the increasing demands. In addition, it is believed that many students do not actually seek much-needed counseling services due to lack of knowledge about mental health problems or services, stigma, or denial of the severity of the problem. Left unrecognized and untreated, mental health problems may lead to students dropping out or failing out of college, attempting or committing suicide, or engaging in other risky, dangerous behaviors that may result in serious injury, disability, or death. Mental health nursing faculty can help address this problem on college campuses by offering courses on mental health issues and skills, becoming involved with NAMI-on-Campus groups, and seeking grant opportunities that can be used to help develop and enhance services for the college community. Information about how to establish a NAMI-on-Campus group can be obtained by accessing http://www.namioncampus.org or http://www.nami.org.     

Attitudes of mental health professionals about changing ages of legal majority

Questionnaires were sent to mental health professionals surveying their attitudes toward legal age limits which govern the rights of the young to make decisions for themselves. Inquiries were also made about respondents' opinions of the impact that increasing those rights might have on their professional interactions with young people. Responses were received from 69 predominantly young professionals and reflected a fairly libertarian outlook toward the rights of minors. Discussion emphasized the value of consulting with mental health professionals who work with children when shaping and interpreting new standards of autonomous decision making.     

Social Psychopathy,Social Distress,Family Breakdown,and Custody Disputes in the 1990s: Implications for Mental Health Professionals

The decade of the 1990s will probably contain more challenges to the role of the mental health practitioner in child custody cases than ever before in history. Because of increasing social stress and family disintegration, custody disputes are destined to become more frequent, bitter, and traumatic for all parties. Mental health professionals, in particular, need to develop a coherent structure regarding their own participation in this process. Issues of moral changes among our leadership and our citizenry are examined and guidelines for the behavior of the mental health practitioner in the courtroom are formulated and illustrated as they pertain to custody decisions. Parlicular attention is paid to custody decisions as an a11 rather than a science, the role of empirical research, the need to anticipate certain unintended circumstances, the need for the application of mental health principles on an individual case-by-case basis, the nature of the mental health professional’s expertise, and the problems with the concepts of “parental unfitness” and the use of psychiatric diagnosis as a way of defining such alleged unfitness.