Understanding and influencing the stigma of mental illness

Life goals and the opportunities that define them are impaired by the stigma of mental illness. Three kinds of stigma may act as barriers to personal aspirations: public stigma, self-stigma, and label avoidance. Challenging mental illness stigm is essential in helping individuals accomplish recovery-related goals. Public stigma may be changed through protest, education, and contact. Self-stigma can be addressed by fostering group identity, changing the perceived legitimacy of stigma through cognitive rehabilitation, and making strategic decisions about disclosing one's mental health history. Stigma change for label avoidance is not as well understood but may include the education and contact approaches used for public stigma. Evidence-based approaches to stigma change need to be substantiated by rigorous investigations.     

Mental illness,partial hospitalization,and the family

Summary When illness is socially defined, the task of therapy is to enable the patient to move from a sick role to one of maximal social functioning. In a day hospital setting, methods are explored to involve a patient with his family both directly and indirectly. Thus the patient is supported both in the treatment milieu and when he is at home. Not only the patient, but the family, is vulnerable at this time and each must be helped to make parallel and complementary shifts in interpersonal behavior. To view the family solely as a resource for the support of the ill member and his treatment is to fail to accept the need of the family as a whole for reorganization and strengthening.     

The impact of the family on home-based work

This article reports on a study of 899 families with at least one member engaged in home-based work. Six work characteristics are examined in relation to family structure and gender of the home-based worker: business ownership, occupation of the home-based work, amount of income generated, location of the work space, number of hours worked, and availability of help with the work. Women in single-parent and full-nest families are found to do the most restructuring of work time and space and women home-based workers generate less income from the work than do men. Male home-based workers experience less conflict between family and work scheduling, are more likely to have an exclusive work space, and tend to have help with the home-based work.This article reports results from the Cooperative Regional Research Project, NE-167, entitled, At-Home Income Generation: Impact on Management, Productivity and Stability in Rural and Urban Families, partially supported by Cooperative States Research Service, U.S. Department of Agriculture and the Experiment Stations at the University of Hawaii, Iowa State University, Lincoln University (Missouri), Michigan State University, Cornell University (New York), The Ohio State University, The Pennsylvania State University, Utah State University and University of Vermont.Her research interests include divorce, work and family, and the economic well-being of women and children. She received her Ph.D. from Oregon State University.He has extensive experience in research, consulting, and training for small business owners and operators, including single parents, disabled veterans, Hispanics, rural and home-based. He received his Ph.D. from New York University.     

Caregiving at night: Understanding the impact on carers

Caregiving research has rarely examined the nature and impact of care provision at night. This paper analyses indepth interviews with 24 older people in England whose sleep had been adversely affected by providing care at night. A framework is proposed that illustrates how six aspects of caregiving can disrupt carers' sleep quality: first, attending to the night-time physical needs of the care recipient; second, anticipation of their night-time care needs; third, ‘monitoring’ their relative at night; fourth, disruption from relatives who are awake for long periods at night, wandering or shouting; fifth, undertaking emotional support, and worries or anxieties related to their relative; and finally, the legacy of caregiving may continue to disrupt sleep after caring ceases, because of painful images of their relative's suffering or feelings of guilt. Adverse effects on carers' sleep are greatest for co-resident carers, especially when caring for a spouse or relative with a life-limiting illness or dementia.     

Understanding the longer-term effects of family group conferences

Few studies estimate the longer-term effects of family group conferences (FGCs), as previous research has been mainly qualitative or has focused only on the shorter-term effects of FGCs. This study analyses, using a randomised controlled design, the longer-term effects of adult FGCs in terms of social support, mental health and re-employment. A total of 149 Norwegian longer-term social assistance recipients were randomly assigned to intervention and control groups. Participants were followed up 12 months after baseline. To gain in-depth knowledge of the FGC process, 15 participants were interviewed. Despite high shares of participant satisfaction and significant shorter-term effects, the one-year follow-up identified neutral effects of the intervention. Qualitative interviews demonstrated that lack of reciprocity in social relationships and lack of follow-up were the main reasons for the stagnation of an initially positive FGC process.     

The impact of mental illness on employment: consumers' perspectives

This paper is based on a qualitative study of employment for people with mental illness. Forty-one consumers of mental health services were interviewed to obtain their perspectives on employment. One of the major issues they discussed was the ways in which mental illness affected their employment experiences. These effects were complex and interrelated and varied between individuals depending on their unique characteristics and circumstances. Participants described effects relating to the need to maintain mental health, difficulties with work performance, and work confidence and work goals. Understanding consumers' perspectives on how mental illness affects employment is necessary for practitioners and researchers seeking to explain or improve consumers' employment outcomes.     

Understanding the experience of Black clients in marriage and family therapy

Past research on Black clients' utilization of therapy focused on the barriers that prevent Black clients from attending therapy and the reasons for these barriers. However, few studies have been conducted that focus on how Black clients attending therapy actually experience these barriers. This study utilized both Likert and open-ended questions to examine the obstacles 16 Black clients face in their attempts to attend family therapy. The most frequently identified obstacles were related to concerns over family member response and cultural barriers to therapy. Participants also reported concerns about racial and/or cultural differences and a lack of understanding by non-Black therapists. The implications of this study addressed how to effectively meet the therapeutic needs of Black clients.     

Disability at work: Understanding the impact of the ADA on the workplace

It has been more than 25 years since the Americans with Disabilities Act (ADA) was passed by Congress. Many supporters of the law hoped that it would improve the employment outcomes for people with a disability, yet many scholars argue that it has fallen short in achieving this goal. Such judgments of success or failure are typically offered with little regard for the complex relationship between law and social change. In this paper, I apply a socio‐legal perspective to scholarly research regarding the impact of the ADA on employment. Socio‐legal studies offer a variety of concepts and perspectives, which better capture the complexity of law's impact on social life, and the various paths through which it might have an impact on social change. From this perspective, studies tend to assume that ADA law will either impact social change directly or indirectly. I discuss the findings of both of these approaches and conclude with some directions for future research.     

Community and individual acceptance: family planning services in the Sudan

The Sudan Community-Based Health Project, initiated by the University of Khartoum in cooperation with the Ministry of Health in 1980, sought to test the proposition that government-trained village midwives could provide maternal-child health and birth spacing services in addition to their ongoing obstetrical duties. The project area encompassed 92,000 people in 93 villages. The 120 midwives serving the project area received training in 4 interventions -- oral rehydration therapy, maternal and child nutrition, immunization, and birth spacing -- and introduced these services by means of 3 rounds of household visits over a 5-month period. Comparison of pre- and post-intervention survey data indicates that village midwives can indeed be used successfully to promote not only contraceptive use, but also health attitudes and practices that are positively associated with fertility regulation. Between the 2 surveys, the percentage of women who ever used contraception increased from 22% to 28%, while the percentage of current users rose from 10% to 13%. Parity was significantly related to current use; each child born multiplied the likelihood of contraceptive acceptance (by a factor of 0.76 in the post-intervention sample). Maternal education was the socioeconomic variable that most enhanced receptivity to contraceptive acceptance after the project's interventions. In terms of community-level variables, village location along the Nile and proximity to a paved road were significant correlates of contraceptive use. When variables related to the project itself were analyzed, women with vaccinated children were found to be twice as likely to contracept as those with nonvaccinated children and women who believed breast feeding should be continued during diarrhea episodes were 1.5 times more likely to use birth spacing than those who did not. Although midwives did not specifically emphasize contraceptive use, it appears women who were encouraged by midwives to take positive steps in the area of child health were also likely to become more innovative in terms of fertility regulation.     

Work and family: Understanding men's role evaluations

Analysis of data provided by a random sample (N=92) of married police officers was used to evaluate the effects of time constraints, job stress, family strengths, family structure, and social networks on men's role evaluations. These men had generally positive evaluations of their income provider, husband, father, and home care roles. Multivariate analysis showed complex relationships between work, family, and network conditions and men's evaluations of their roles. Commuting time, job stress, family strengths, number of children, kin available, friends available and contact with friends effected role evaluations. The centrality of family roles for these men and the patterns of personal gain they received did not support stereotypic images of men's family relationships.This is a revised version of a paper presented at the Annual Meeting of the National Council on Family Relations, November, 1985. I wish to thank Kuo-Liang Lin for his able assistance, and Robert A. Lewis and Fred Piercy for their helpful comments.Karen Altergott received her doctorate in Sociology from the University of Minnesota, and is currently Assistant Professor of Family Studies at Purdue University. Areas of research include family relations and social networks across the life course, comparative family studies, and family gerontology. Send correspondence to Dr. Altergott at Family Research Institute, 525 Russell Street, West Lafayette, IN 47907.     

The impact of family assets and debt on college graduation

This study examines the influence of family financial assets and debt, both measured during the time of youth's college enrollment, on the chances of college graduation. Data come from the National Longitudinal Survey of Youth. Results from analyses controlling for a number of student, parental, and institutional characteristics indicate that family assets are positively related to the chances of college graduation among White and Black students; family debt is negatively associated with the odds of college graduation among Black students, but neither family assets nor family debt is related to the chances of college graduation among Hispanic students. Overall, results indicate that family assets and debt explain a small portion of racial/ethnic gaps in college graduation. Policy implications are considered.     

The impact of initial factors on therapeutic alliance in individual and couples therapy

The study uses 457 clients to investigate the impact of initial client factors on the development of therapeutic alliance. Data were collected longitudinally over the early portion of treatment. Cases included both individual and couple clients, allowing for examination of differences by case type. The study used the Working Alliance Inventory-Shortened Version (Tracey & Kokotovic, 1989) to measure therapeutic alliance. Initial factors considered included age, differentiation levels, prior stress, and depression. Couple clients showed differences from individual clients, and the variability prompted further investigation into relationship satisfaction and commitment as factors influencing the development of therapeutic alliance. Results highlight the increased complexity of developing an alliance with couples, and recommendations are provided for clinicians.     

Foster family acceptance: Understanding the role of foster family acceptance in the lives of LGBTQ youth

LGBTQ youth in the child welfare system have historically received very little attention. The limited research available suggests that they encounter a number of disparities and double standards when compared to straight youth. The current study examines the role that foster family acceptance plays in the lives of LGBTQ youth as they navigate the child welfare system. The experiences of LGBTQ foster care alumni who had accepting foster family experiences are compared to those who had rejecting experiences. Findings suggest that foster family acceptance plays a pivotal role in creating an affirming and inclusive environment for LGBTQ youth. Similarly, findings provide further evidence for the need to educate, train, and recruit affirming and accepting foster families.     

The impact of family structure on the adjustment of adopted children.

Psychological and academic adjustments were assessed in a group of 130 adopted children (six to 12 years of age) living in five different family constellations: only children, children with younger adopted siblings only, children with younger biological siblings only, children with older adopted siblings only, and children with older biological siblings only. Few differences were found from one cluster to another, suggesting that family structure, while complicating the dynamics of adoptive family life, plays a minor role in adoption adjustment.