Treating mental health problems in primary care: Discrepancies between therapist expectations and clients’ attendance

ABSTRACT

Models of collaborative primary health care were introduced in Ontario in 2005 with the goal of providing comprehensive care, including that of mental health, to patients. While the success of this model of health care delivered through Family Health Teams (FHT) has been established, evidence based guidelines to guide mental health therapists regarding the number of sessions needed to treat common issues such as depression and anxiety seen within this model is lacking. The goal of this study was to gain a better understanding of how therapists conducted therapy, including type of intervention, under a physician determined eight session cap. Questionnaires completed by the therapists after the first session and again when therapy ended, a focus group and a chart review were conducted over an eight month period involving a total of 147 patients. Several key findings were identified including the unanticipated outcome of a discrepancy between how many sessions were initially thought to be required by the mental health therapist compared to how many sessions were determined helpful by the patient. Conversely, it was also identified that eight sessions was insufficient to treat more severe mental health issues such as trauma. Such results suggest that the treatment of mental health issues within Family Health remains a little understood and explored issue, with the authors suggesting better ways of negotiating session caps reflective of mental health issues addressed within this model of care.     

Diet of the crowned eagle (Stephanoaetus coronatus) in an urban landscape: potential for human-wildlife conflict?

Urban Ecosystems - The study of diet is pivotal in understanding a species, particularly for quantifying a predatory raptors’ economic niche and potential for human-wildlife conflict. The...     

Mitigating Material Hardship: The Strategies Low‐Income Families Employ to Reduce the Consequences of Poverty*

Despite decades of research, little is known about the contours of material hardship and how the social processes underlying specific domains of hardship are similar and different. We use qualitative interview data to examine five different domains of material hardship: housing, bill‐paying, food, medical, and clothing hardships. While mothers use social program participation, reliance on social networks, and individual strategies to mitigate hardships, the dominance of these strategies and their specific applications differ across hardship domains. These results complement recent research that identifies each domain of hardship as unique and suggest that domain‐specific hardship mitigation approaches are necessary.     

A toolkit for accessible and respectful engagement in research

Social, scientific, and ethical factors underscore the value of respectfully including people with intellectual/developmental disabilities in research despite significant barriers to their research participation. In pursuit of this goal, we worked with two research advisors with intellectual/developmental disabilities to develop a qualitative study toolkit emphasizing accessibility, flexibility, variety, and responsiveness. The toolkit includes procedures and materials for recruitment, consent, interview locations and questions, breaks, and incentives. We recommend that future research utilizes insights of individuals with intellectual/developmental disabilities in research that impacts their lives, and that researchers systematically improve the use of procedures and toolkits.     

Adult well-being of foster care alumni: Comparisons to other child welfare recipients and a non-child welfare sample in a high-risk,urban setting

Research has shown that children placed in foster care fall below population norms on many indicators of well-being. Yet few studies have been designed to distill the effects of foster care from conditions that precede foster care. Based on the available evidence, it is also uncertain whether the purported effects of foster care are lasting. This study used data gathered prospectively from an economically disadvantaged, urban cohort to examine whether foster care is associated with decreased educational and economic attainments as well as increased criminality in adulthood. Individuals who were placed in foster care after an indicated allegation of maltreatment were compared to three naturally occurring groups: (a) maltreatment victims who did not reside in foster care, (b) individuals without an indicated maltreatment allegation who were raised in a household with a Child Protective Services (CPS) record, and (c) individuals without an individual or household record of CPS involvement. Using multiple estimation procedures, we found that all participants with a CPS record fared worse in adulthood than their peers without a CPS record. Despite their poor outcomes, foster children functioned as well as other CPS recipients who did not reside in foster care. Our findings indicate that caution is warranted when attributing dysfunction observed in foster children to the effects of foster care. Implications for prevention and intervention within the context of child welfare are discussed.     

Young children's career aspirations: Gender differences,STEM ambitions,and expected skill use

This study examines young children's career aspirations, gender differences in those aspirations, and children's perceptions of the amount of math and science used in careers. We asked 1634 students in first to third grades what job they wanted in the future and how much they thought they would use math or science in it. Career aspirations were sorted into 27 career categories, of which 12 showed significant gender differences. Notably, boys were more likely to indicate military, manual labor, and math/computer science careers, and girls were more likely to indicate stay at home parent, education, and animal care careers. Students aspiring to science, technology, engineering, and mathematics (STEM) careers thought they would use science, but not math, more than non-STEM-aspiring students did. School counseling interventions focused on specific STEM subfields, and education highlighting links between school subjects and careers requirements may benefit students and reduce gender inequality in STEM fields.     

Swear(ING) ain't play(ING): The interaction of taboo language and the sociolinguistic variable

Swearwords influence social evaluation of a speaker in a variety of ways depending on social context (Jay & Janschewitz (2008), The pragmatics of swearing. Journal of Politeness Research. Language, Behaviour, Culture, 4(2), 267–288). Little attention has been paid to the role of linguistic variation in social perceptions of swearing, however. This paper presents two experiments that test the role of sociolinguistic variation in the social evaluation of swearing. Experiment 1 is a variant categorization task, in which participants categorized acoustically ambiguous swearwords and phonetically matching neutral and nonwords as ending in either “-ing” or “-in.” Results suggest that swearwords led participants to hear “-ing” on ambiguous items. Experiment 2 is a matched-guise task in which listeners heard a passage featuring a mix of swearwords and neutral “-ing” words in one of four conditions: fully velar (All-ing), fully alveolar (All-in), only swearwords as velar (Swear-ing), or only neutral words as velar (Swear-in). Participants rated speakers on Likert scales (Schleef et al. (2017), Regional diversity in social perceptions of (ING). Language Variation and Change, 29(1), 29–56). Participants again displayed a tendency towards hearing “-ing” on swearwords. As a result, responses to the Swear-in guises were similar to those for the All-ing guises. The consequences for our understanding of swearing, sociolinguistic perception and cognition, and style, are discussed.     

Does Wealth Enhance Life Satisfaction for People Who are Materially Deprived? Exploring the Association among the Orang asli of Peninsular Malaysia

Recent studies investigating need theory and the extent to which money can buy happiness have called for more research within culturally homogeneous samples from developing countries to explore this relationship. We examine wealth as a measure of possessions and savings and relate this to subjective well-being (SWB) among poor indigenous farmers in Peninsular Malaysia. With hierarchical multiple regression, we find that the association between wealth and life satisfaction, after controlling for demographic variables, is positive and significant, β = 0.24, p<0.001. This effect is similar to effect sizes reported for other poor samples around the globe and is larger than what has been normally found in Western samples. Our analysis of the Malay translation of the Satisfaction with Life Scale (SWLS) reveals rather low internal reliability and prompts us to explore the potential wealth-SWB relationship in the absence of measurement error. We find a larger effect size when measurement error is removed, r = 0.43. We discuss the use of latent variable analysis to better interpret wealth-SWB effect sizes and recommend its use for future studies that use SWLS translations. Finally, we find that age, education, family size, and recent illness, while weak zero-order correlates of SWB, become significant predictors of life satisfaction when included with wealth in the multiple regression model. Some explanations and implications of these findings are conjectured. Our study contributes a unique sample to the expanding literature in support of need theory, and may be one of the first to examine the relationship between wealth and life satisfaction among a country’s aboriginal people.