Exploring changes in family functioning when a child participates in a School-Based Filial Therapy program

Child focus is a central construct within Bowen family systems theory (Bowen theory). A clinical implication is that mental health treatment focusing on a child may unwittingly reinforce the operation of child-focused processes, which undermine rather than enhance child well-being. The concept of child focus in Bowen theory presents significant implications for professionals working in school settings and in fields such as children's mental health, which are inherently child-focused. Bowen theory is the guiding theoretical framework for School-Based Filial Therapy (SBFT). SBFT is a play therapy intervention that was initially established in remote and outer-regional New South Wales, Australia in response to the low availability of children's mental health services and the significant barriers associated with caregiver engagement in children's mental health treatment. It involves trained school personnel facilitating therapeutic play sessions with children experiencing emotional–behavioural problems. The intervention occurs on school grounds, during school hours, and children's family members do not participate in the intervention. This mixed-methods study examines the impact of children's participation in SBFT upon family functioning. Interviews with caregivers (n = 10) of children who participated in 10 SBFT sessions were analysed using content analysis. Quantitative data were collected using the Differentiation of Self Inventory – Short Form and Visual Analogue Scale – Family Functioning. A Wilcoxon signed rank test was used to analyse the pre- and post-data. Qualitative outcomes indicated changes in the categories of child functioning, caregiver functioning, and extended family functioning, whilst child-focused processes remained dominant but changed in intensity and valence following SBFT.     

The effect of social anxiety,generalized anxiety,depression and substance abuse on child support payment compliance among non-custodial parents

Millions of children live with custodial parents (CPs) who have child support court orders for the non-custodial parent (NCP) to provide payments to the CP for care of the children. Unfortunately, less than half of CPs receives full child support. A key issue influencing the failure to pay child support is NCP unemployment. Despite a clear association between unemployment and several mental disorders, the nature and prevalence of mental disorders has not been investigated in the NCP population. The purpose of this study was to explore the association between mental health and substance use problems among non-custodial parents and their payment of child support. The study also investigated whether unemployment mediated the relationship between these variables.Surveys that included validated screening instruments to assess for generalized anxiety, social anxiety, depression, and substance use disorders were administered to a convenience sample of 633 NCPs. Survey respondents were matched with state support payment information.The results indicated that depression, generalized anxiety, social anxiety and substance use problems were present at a much higher rate than 12-month rates of these conditions found in the general population. This study also confirmed the strong association between child support payments and employment. Employment mediated the relationship between mental health problems and child support payments. The findings suggest that non-compliant NCPs, particularly those who are also unemployed, may experience clinically significant mental health conditions that contribute to unemployment and potentially, payment non-compliance. Future studies could explore if providing mental health assessment and employment-focused treatment for mental health-related barriers to employment may increase employment and child support compliance for NCPs, thereby improving children's economic stability and well-being.     

Program evaluation of trauma-informed yoga for vulnerable populations

BackgroundTrauma is highly prevalent among vulnerable populations, including those who are incarcerated, in treatment for substance use, or seeking mental health services. Trauma-informed yoga seeks to create a safer yoga practice for individuals with a trauma history and may improve emotional and physical wellbeing. Thus, we conducted an evaluation of a trauma-informed yoga program to gain insight into participant experiences.MethodsTrauma-informed yoga classes were led by trained volunteers and held in three sectors that work with vulnerable populations: corrections and reentry, substance use treatment and recovery, and community and mental health. Data were collected via anonymous survey using a retrospective pre-post design. The survey instrument captured reasons for student participation and perceived effects of yoga on emotional and physical wellbeing.ResultsStudents were motivated to participate in yoga classes by expectations of physical, mental, and spiritual benefit. Students reported perceived improvements in emotional and physical wellbeing and greater use of self-regulation skills after starting yoga.ConclusionOur findings suggest trauma-informed yoga is perceived as beneficial by vulnerable individuals, especially those in the correctional system or recovering from substance use. Our results support the value of offering trauma-informed yoga in institutionalized and community settings. Improvements in emotional and physical wellbeing warrant formal study.     

Efficacy of a Web‐based Intervention for Concerned Spouses of Service Members and Veterans with Alcohol Misuse

Concerned partners (CPs) of service members and veterans who misuse alcohol face help‐seeking barriers and mental health problems. We used multiple regression to evaluate the efficacy of Partners Connect, a four‐session web‐based intervention (WBI) to address military CPs’ mental health and communication. We randomized 312 CPs to the WBI or a control group. Five months later, WBI CPs reported significant reductions in their anxiety and increases in their social support compared to control CPs. Intervention dose was also associated with improved WBI CP outcomes. Partners Connect appears to fill a need for families who face help‐seeking barriers and provides an alternative to traditional care for those who may not otherwise seek help.     

Quality of life in workplace trauma victims seeking treatment for posttraumatic stress disorder

Traumatic events at work can have debilitating effects on employees. This pilot study aims to describe the trauma exposure, posttraumatic stress disorder (PTSD) severity, functioning level, and general and work-related quality of life of employees who experienced a workplace trauma and consequently developed PTSD. Forty-four participants with current PTSD were recruited and assessed using semistructured interviews and questionnaires. ANOVAs were performed to assess differences in outcomes between employees from different work settings. Specific types of traumatic events appear to occur in particular types of occupations. Participants manifested severe PTSD, low levels of current functioning, and poor general and work-related quality of life. Overall, these results did not significantly differ between employees in different occupations. Unemployed participants showed poorer outcomes than those who were still working despite their current difficulties. PTSD severity and the presence of comorbid major depression significantly predicted several quality-of-life outcomes. In conclusion, PTSD stemming from workplace trauma appears to have major consequences for employees. Clinical implications are discussed.     

The Buffering Effect of Relationships on Combat Exposure,Military Performance,and Mental Health of U.S. Military Soldiers: A Vantage Point for CFTs

This study examined the role of cumulative combat experiences with regard to military performance and conduct and mental health among a sample of young soldiers from the Army STARRS dataset (N = 5,283). Higher levels of cumulative combat experiences were directly related to poorer performance and conduct and a greater likelihood of anxiety, depression, and post-traumatic stress disorder (PTSD). Military performance and conduct served as a linking mechanism between combat experiences and mental health. Using moderated mediation structural equation modeling, relationship disruptions were found to exacerbate the adverse effects of combat experiences; conversely, unit cohesion buffered the impact of combat experiences. Implications for military helping professionals include identifying leverage points for intervention, particularly strengthening the social connections of service members within and outside the military.     

No Fear,Just Relax and Play: Social Anxiety,Alcohol Expectancies,and Drinking Games Among College Students

Abstract

Objective: The authors examined the association between social anxiety and drinking game (DG) involvement as well as the moderating role of social anxiety–relevant alcohol outcome expectancies (AOE) in social anxiety and DG involvement among college students. Participants: Participants were 715 students (74.8% women, M _age = 19.46, SD = 1.22) from 8 US colleges. Methods: Data were collected via self-report survey from Fall 2005 to Spring 2007. Results: Tension Reduction and Liquid Courage AOE moderated the association between social anxiety and DG participation. Tension Reduction AOE and DG participation were positively related among those with high social anxiety, but were associated negatively for those with low social anxiety. Liquid Courage AOE were associated with increased DG participation for those with low social anxiety, but not for those with high social anxiety. Conclusions: Findings suggest that social anxiety acts as a protective or a risk factor for DG participation among college students, depending upon AOE.     

Analyzing free-text survey responses: An accessible strategy for developing patient-centered programs and program evaluation

Despite widespread availability of yoga in the Veterans Health Administration (VA), it remains unclear how to best evaluate yoga programs. This is particularly problematic for programs aimed at veterans with mental health concerns, as evaluation typically focuses narrowly upon mental health symptom severity, even though program participants may have other health-related priorities. We analyzed responses to free-text questions on 237 surveys completed by veterans with mental health concerns enrolled in a yoga program at six VA clinics in Louisiana to characterize veteran participants’ experiences with yoga. Qualitative analysis resulted in 15 domains reflecting veterans’ individual health-related values and priorities. We use results to illustrate the potential for analysis of free-text responses to reveal valuable insights into patient experiences, demonstrating how these data can inform patient-centered program evaluation. The approach we present is more accessible to those responsible for decision-making about local programs than conventional methods of analyzing qualitive evaluation data.     

Discrimination,mental health,and body image among transgender and gender-non-binary individuals: Constructing a multiple mediational path model

The purpose of the current study was to examine the relationships among discrimination, mental health, and body image in a national sample of transgender adults. Participants (N = 78) identified as transgender, genderqueer, or other gender-non-binary identities and were recruited via a national online survey. Harassment/rejection, work/school, and other discrimination explained 10.4% of the variance in body appreciation, while satisfaction with life, anxiety, self-esteem, and depression explained 60.7%. Within these models, harassment/rejection was inversely associated with body appreciation, while self-esteem and satisfaction with life were positively associated. A series of path models moving from a measurement model to a more parsimonious and excellent-fitting model found that the effect of harassment/rejection on body appreciation was fully mediated by self-esteem and satisfaction with life, resulting in a multiple mediation.     

I'm going back to work: back injured clients' perceptions and experiences of their worker roles

This study aimed to elicit perceptions and experiences of facilitators and barriers that affected individuals who received back rehabilitation and their ability to resume their worker roles. Qualitative research methods were used in order to explore the research question. Participants were selected by means of simple random sampling and the data were collected by means of semi-structured focus groups. Some factors that were seen as facilitatory in maintaining the worker role of an individual who received back rehabilitation included injury management strategies, a positive work culture and having meaningful/satisfactory work experiences. Factors or barriers that prevented individuals from resuming their worker roles included physical and psychosocial stressors of the job, a lack of education by the employer and inadequate workplace policy. The results indicated that occupational therapists need to reassess their role within the wider context of the helping professions where they should become more involved in on-the-job evaluations, work placements and training of individuals who received back rehabilitation.     

An equality of condition framework for user involvement in mental health policy and planning: evidence from participatory action research

Discussions about user involvement in the mental health services tend to throw up four major areas of concern: the capacity of service users to participate, their lack of participation skills, the need for a positive organisational culture and the need for arenas of participation. This article presents evidence from participatory action research with Irish mental health service users which explored how they could more equally participate in advisory committees. Participants identified barriers to their equal participation due to unequal cultural, physical, mental and economic resources, time, power, ‘stigma’(prejudice) and lack of respect for their experiential knowledge and emotional expression. These barriers fall within the ‘equality of condition framework’ developed by Baker and colleagues. Enabling equal user involvement in strategic decision‐making requires more than arenas of participation – it requires comprehensively addressing service users’ structural disadvantages throughout the process of involvement.     

The Impact of Low Socioeconomic Status and Perceived Discrimination on Parental Perceptions of the Well-Being of Latino Children

This exploratory study examined the impact of low socioeconomic status (SES) and perceived discrimination on Latino parents’ perceptions of their children’s mental health issues. Anti-immigrant policies and negative public discourse lead to perceived discrimination among Latinos, which may impact mental health. Participants (106), surveyed in 2011, were Latino, predominantly female, had a mean of 14 years living in the United States, and less than 9 years of education. The results of multivariate ordinary-least-squares regressions indicated that participants with lower levels of SES had significantly greater (p < .05) perceptions that their children were angry, had separation anxiety from parents, were fearful, and avoided social situations. Higher levels of perceived discrimination were significantly related (p < .05) to participants’ perceptions of fear among their children. Social service providers must assess for possible mental health issues and develop culturally appropriate intervention strategies to effectively address these issues with parents and children.     

Facilitating the Welfare-to-Work Transition for Women with a Mental Health Work Barrier

SUMMARY

Since the 1996 PRWORA welfare reform act requiring workforce participation in order to receive services, evidence has emerged that many welfare recipients experience mental health work barriers. Yet, little is known about effective approaches for assisting women with a mental health work barrier in the welfare-to-work transition. This paper addresses this gap by first surveying the empirical research on mental health work barriers among welfare recipients. Second, I propose a comprehensive service provision model to identify and assist welfare recipients with a mental health barrier. Third, I review outcome data from several promising intervention strategies.     

Dialectical Behavior Therapy as a catalyst for change in street-involved youth: A mixed methods study

The current study implemented and evaluated a 12-week Dialectical Behavior Therapy (DBT) intervention across two Canadian service agencies providing drop-in, shelter and transitional housing to street-involved youth in order to alleviate mental health challenges and to strengthen resilience. A quasi-experimental mixed methods design with a wait-list comparison was used. Overall results demonstrate that youth who received the DBT intervention (N = 60) demonstrated significant improvement in mental health challenges (e.g. depression, hopelessness, and anxiety), as well as significant improvement in resilience, self-esteem, and social connectedness immediately post-intervention. Participants in the wait-list control did not demonstrate significant improvement on any of the study outcome measures. Furthermore, the gains attained for the intervention group were sustained at four and 10 weeks post-intervention. The qualitative data substantiates these findings; further shedding light on youth's perspectives regarding the impetus for engaging in DBT, the experience of DBT and the impact DBT had on their lives. Results of this study suggests that DBT implemented by front-line clinicians shows promise in meeting the needs of street-involved youth in the community. Moreover, this study demonstrates that it is possible, with the right approach and support, for an interdisciplinary team of youth workers, nurses, and social workers to implement an evidenced-based treatment with youth at community agencies thereby increasing access to needed services to support youth in ultimately exiting the street.     

Interactive association between negative emotion regulation and savoring is linked to anxiety symptoms among college students

Abstract

Objective: This study tested the interactive relationships between college students’ perceived capability of regulating negative emotions and savoring positive emotions on mental health outcomes, including anxiety and depressive symptoms. Participants: Participants were healthy undergraduates (n?=?167) recruited from two universities in Hong Kong. Methods: Students completed four scales assessing their perceived capability of using strategies to regulate negative and positive emotions and their anxiety and depressive symptoms. Results: Findings revealed that both anxiety and depressive symptoms were negatively linked to perceived capabilities of regulating negative emotions and savoring positive emotions. Furthermore, regulating negative emotions interacted with savoring positive emotions to predict anxiety symptoms. Conclusions: The need to simultaneously perform negative and positive emotion regulation is highlighted. The results suggest the priority of regulating negative emotions over savoring positive emotions in alleviating anxiety symptoms. Nevertheless, enhancing positive emotion shows greater benefits for those who are less adept at regulating negative emotions.     

Effectiveness of mindfulness-based coloring for university students’ test anxiety

Abstract

Objective: This study compared the effectiveness of mindfulness coloring (mandala), free drawing/coloring, and a noncoloring control activity for university students’ test anxiety, and assessed the relationship of dispositional mindfulness and response to intervention on mindfulness and test anxiety states. Participants: University students (n?=?167; 81.4% female; M_age = 21.29?years, SD?=?4.46) were randomly assigned to a mandala (n?=?57), free draw/coloring (n?=?58), or noncoloring condition (n?=?52). Methods: Participants completed standardized measures assessing test anxiety and state mindfulness pre–postactivity before completing a test, and two dispositional mindfulness measures. Results: Participants in both coloring conditions reported significant decreases in test anxiety and significant increases in state mindfulness pre–postintervention, and participants in the control condition reported significant increases in test anxiety. Reports of preintervention state mindfulness and test anxiety fully mediated relations between dispositional mindfulness and postintervention state mindfulness and test anxiety. Conclusions: Implications for research and practice on mindfulness coloring and test anxiety are discussed.     

Development and piloting of a mother and child intervention to promote resilience in young children of HIV-infected mothers in South Africa

This paper describes the process of developing a parallel intervention for HIV-positive mothers and their young children (6-10 years) with a view to strengthening the relationship between them. Strong mother-child relationships can contribute to enhanced psychological resilience in children. The intervention was developed through action research, involving a situation analysis based on focus group discussions; intervention planning, piloting the intervention and a formative evaluation of the intervention. Participants supplied feedback regarding the value of the intervention in mother-child relationships. The findings obtained from the formative evaluation were used to refine the intervention. Two parallel programmes for mothers and children (15 sessions each) were followed by 10 joint sessions. The intervention for mothers focused on maternal mental health and the strengthening of their capacity to protect and care for their young children. The intervention for children addressed the development of their self-esteem, interpersonal relationships and survival skills. The formative evaluation provided evidence of good participation, support and group cohesion. Qualitative feedback indicated that the activities stimulated mother-child interaction. A similar intervention can easily be applied elsewhere using the detailed manual. The insights gained and lessons learnt related to mother and child interaction within an HIV-context that emerged from this research, can be valuable in other settings, both in Sub-Saharan Africa and elsewhere.     

Development and piloting of a mother and child intervention to promote resilience in young children of HIV-infected mothers in South Africa

This paper describes the process of developing a parallel intervention for HIV-positive mothers and their young children (6–10 years) with a view to strengthening the relationship between them. Strong mother–child relationships can contribute to enhanced psychological resilience in children. The intervention was developed through action research, involving a situation analysis based on focus group discussions; intervention planning, piloting the intervention and a formative evaluation of the intervention. Participants supplied feedback regarding the value of the intervention in mother–child relationships. The findings obtained from the formative evaluation were used to refine the intervention. Two parallel programmes for mothers and children (15 sessions each) were followed by 10 joint sessions. The intervention for mothers focused on maternal mental health and the strengthening of their capacity to protect and care for their young children. The intervention for children addressed the development of their self-esteem, interpersonal relationships and survival skills. The formative evaluation provided evidence of good participation, support and group cohesion. Qualitative feedback indicated that the activities stimulated mother–child interaction. A similar intervention can easily be applied elsewhere using the detailed manual. The insights gained and lessons learnt related to mother and child interaction within an HIV-context that emerged from this research, can be valuable in other settings, both in Sub-Saharan Africa and elsewhere.     

The Indirect Effect of Child Maltreatment Severity on Adult PTSD Symptoms through Anxiety Sensitivity

Although the rate of posttraumatic stress disorder (PTSD) among survivors of child maltreatment is high, individuals differ in symptom severity and many do not experience clinically significant levels of psychopathology. The present study tested the indirect effects of child maltreatment severity on adult PTSD, suicidal ideations, and alcohol dependence via anxiety sensitivity. A sample of 336 participants (mean age of 22.81 years, SD = 8.93; 70.2% female) completed an online survey of child abuse and neglect, anxiety sensitivity, PTSD symptom severity, suicidal ideation severity, and alcohol dependence severity. The results revealed significant indirect effects of child maltreatment on PTSD symptom severity through cognitive and social concerns, but not physical concerns. No direct or indirect effects were demonstrated for suicidal ideations or alcohol dependence severity. These findings elucidate mechanisms in the robust relationship between child maltreatment and adult PTSD symptoms and can potentially inform future research on mechanisms of change in psychotherapy.