Individually-Tailored Support for Ethnically-Diverse Caregivers: Enhancing Our Understanding of What Is Needed and What Works

Family caregivers play a crucial role in maintaining older adults in the community, often at great cost to themselves. We discuss a program serving ethnically-diverse caregivers in New York, offering, on average, 11 case-management hr per client. Participants reported statistically significantly reduced stress and burden. Respite was the most requested service, belying an assumption underlying policies and services that families, particularly among minority populations, can and will care for their older members. Thus, services must be carefully tailored to meet actual caregiver needs, including provision of alternatives that reduce caregiver involvement. We discuss practice and policy implications.     

Heterosexism,racism, and mental illness discrimination: Experiences of people with mental health conditions and their families

Experiencing discrimination related to race/ethnicity, sexual orientation, or having a mental health condition is associated with negative outcomes. Research comparing types of discrimination or considering intersectionalities is lacking. This study reports findings from interviews with people with mental illnesses (PWMI) or family members of PWMI; all study participants also are of color and/or lesbian, gay, or bisexual. Findings include the following: participants experienced multiple forms of discrimination, mental illness discrimination shares characteristics with racism and heterosexism, and heterosexuals and people of color reported more mental illness discrimination than their counterparts. Implications for change advocates, mental health providers, and researchers are offered.     

Common Challenges in Conducting Prolonged Exposure Therapy With Active Duty Service Members: Case Discussion and Strategies for Intervention

Prolonged Exposure (PE) Therapy receives most of its empirical support from trials conducted with civilian posttraumatic stress disorder (PTSD) populations. There has been only limited research on its use with military personnel with combat-related PTSD, and as a consequence, there has been less clinical discussion detailing its application with active duty service members. The purpose of this paper is to highlight two challenges that commonly arise when conducting PE with active duty service members: 1) selecting the most appropriate index event to focus on in imaginal exposure out of the numerous traumas an active duty patient is likely to have experienced, and 2) patients’ tendency to engage in “safety behaviors,” which undermine the effectiveness of in vivo exposure. The nature of these challenges is explored from a theoretical perspective, along with two case examples to illustrate their presentation in treatment. Specific strategies for addressing them are reviewed.     

WINNING ARTICLE 1986 ALPHA KAPPA DELTA UNDERGRADUATE PAPER COMPETITION

Using the example of "woman athletes," or more specifically, women basketball players, this is a case study in the management of contradictory essential and relational identities. Two types of data are used. Survey data demonstrates member understanding of the social identity of "female athlete"; observational data illustrates the management of incongruent identities on three stages: the woman athlete on the basketball court, the athletic woman attending a formal dinner, and the metamorphosis of identities in the locker room. The results indicate that even though the identity of female athlete is, by definition, deviant, it offers a positive alternative to the deviant identity of woman. However, this study demonstrates that in order for an actor to achieve this identity of female athlete she must be willing and able to consistently manage the dilemmas and contradictions inherent in the role itself. That is, this study demonstrates how female athletes must simultaneously uphold loyalty to both the essential identity of female as well as to the relational identity of athlete.     

Tobacco,Marijuana, and Alcohol Use in University Students: A Cluster Analysis

Abstract

Objective: Segmentation of populations may facilitate development of targeted substance abuse prevention programs. The authors aimed to partition a national sample of university students according to profiles based on substance use. Participants: The authors used 2008–2009 data from the National College Health Assessment from the American College Health Association. The sample consisted of 111,245 individuals from 158 institutions. Methods: The sample was partitioned using cluster analysis according to current substance use behaviors. The association of cluster membership with individual and institutional characteristics was examined. Results: Cluster analysis yielded 6 distinct clusters. Three individual factors—gender, year in school, and fraternity/sorority membership—were the most strongly associated with cluster membership. Conclusions: In a large sample of university students, the authors were able to identify 6 distinct patterns of substance abuse. It may be valuable to target specific populations of college-aged substance users based on individual factors. However, comprehensive intervention will require a multifaceted approach.     

Gender and Feminization in Health Care Professions

Within health care, there has long been a gender division of professional labor: men have predominated in higher-status, higher-paying professions like medicine and dentistry, while women’s health care work has been clustered in so-called support occupations such as nursing. Historically, health care professions were gendered, and beliefs about gender came to be embedded in professional work. Recently, however, traditional gender divisions of labor are being challenged by the feminization of professions in the United States and Canada. Women’s participation is expanding in traditionally male-dominated professions. This article explores the nature and causes of this feminization and considers whether feminization is changing the significance of gender to health care employment.