I. Patients of the treatment division of the judge baker guidance center 1

Abstract

There is a growing emphasis in the social work literature that social work's overall mission should be that of social justice and that mental health be relegated as outside of social work's realm. This paper draws upon a constructionist and narrative perspective in developing a general formulation of clinical social work to bridge the gap between social justice and mental health.     

Stigma Management Among Gay/Bisexual Men with HIV/AIDS

People with HIV infection are subjected to prejudice, discrimination and hostility related to the stigmatization of AIDS. To manage the stigma of their disease, they mount complex coping strategies. This paper reports results from a qualitative study that examined gay/bisexual men's experiences of living with HIV infection. Unstructured interviews from a diverse sample of 139 men were analyzed to examine how men coped with AIDS-related stigma. We discerned a variety of stigma management strategies that could be arranged along a continuum from reactive to proactive based on the extent to which they implicitly accepted or challenged the social norms and values that underlie the stigmatization of HIV/AIDS. Reactive strategies to cope with stigma involve defensive attempts to avoid or mitigate the impact of stigma, but imply acceptance of the underlying social norms and values that construct the stigma. Examples of reactive strategies include hiding one's HIV status, presenting one's illness as a less stigmatizing one (e.g., cancer), or distancing one's self from more damaging aspects of AIDS-stigma (e.g., attributing infection to blood transfusion). Proactive strategies challenge the validity of the stigma and imply disavowal and resistance of the social norms and values that underlie the stigma. Examples of proactive strategies include engaging in public educational efforts that address misperceptions about HIV transmission and social activism to change the social and political conditions that affect PWA/HIV.     

Household Headship Among Married Women: The Roles of Economic Power, Education, and Convention

Household headship historically has been equated with being the main economic provider of the household, a position usually occupied by men. This paper uses a change in the United States Census definition of household headship to examine whether headship for married women is associated with being the primary breadwinner in a marriage versus other non-economic explanations. According to microdata from the 1990 United States Census, women who are the main income providers in a marriage are much more likely to be household heads than women in co-provider marriages. There also is support for an egalitarian ideology explanation; that is, when both spouses are highly educated, the wife is more likely than the husband to be household head net of her relative economic independence in that marriage. Yet the force of convention remains strong given the low prevalence of headship among married women. The new census definition was meant partly to reflect the changing economic status of women. However, the reality is that conventional gender behaviors persist in household headship.     

Culture and Co‐residence: An Exploration of Variation in Home‐Returning among Canadian Young Adults*

Cet article s'inscrit dans la lignée des études sur les dimensions culturelles de la cohabitation entre générations en examinant de près le comportement des jeunes adultes canadiens qui retournent vivre chez leurs parents. Nous explorons les rapports mutuels entre la famille et la diversité culturelle, entre le capital financier et le capital social, et entre le rythme et les mécanismes de transitions précoces qui se manifestent au cours d'une vie. Les modéles de hasards proportionnels sont appliqués à un sous‐échantillon de 2 549 jeunes adultes, àgés de 19 á 34 ans, en tenant compte des données de l'Enquete sociale générale, cycle 10, de 1995. L'une des principales conclusions tirées ici indique que les jeunes qui sont de langue maternelle anglaise sont beaucoup plus susceptibles de retourner chez leurs parents après un premier départ que ceux dont la langue maternelle est le français ou une autre langue. Les autres variables qui entrent en jeu sont le niveau d'education du père, le nombre de frères et de soeurs, le sexe, l'âge au moment du depart de la maison et la raison de ce départ. L'article aborde aussi les questions des responsabilités et des rôles des parents autour de la cinquantaine, et de la socialisation au sein de la famille au cours de la vie. This article offers a focussed examination of variation in home‐returning behaviour among Canadian young adults. Framed within the life course perspective, we explore the interrelationships among family and cultural diversity, financial and social capital, and the timing and pathways of early transitions. Proportional hazards analyses are performed on a subsample of 2,549 young adults aged 19–34, using data from the 1995 General Social Survey, Cycle 10. A major finding is that those whose mother tongue is English are significantly more likely to return to the parental home than those with French or “other” mother tongues. Other variables include: father's education, number of siblings, gender, age at home‐leaving, and initial reason for home‐leaving. Implications for midlife parental roles and responsibilities, and for family socialization are discussed.     

Videotaped Life Review: Its Personal and Intergenerational Impact

While the literature reports therapeutic benefits of life review in the elderly, systematic involvement of family members and extensive use of video recording are uncommon. Outcomes of videotaped life reviews with 30 individuals in the general population, conducted in collaboration with family members, are described. Mutually enhanced sense of self and self-esteem were observed. Interviewees felt less fearful of traumatic events after reviewing them in the context of their entire lives. For family members afraid to ask their parents directly about painful events, the camera created safe transitional space and opportunity for more genuine connection. Using examples from popular media and the author’s videotaped work, this paper will define life review, describe the heightened need for life review in the latter stage of life, the value of systematically involving family members, and implications for including life review methods in psychotherapy.     

Letters to the editor

Relatively little attention has been paid to the use and importance of labels used by men who have sex with men to describe insertive or receptive sexual behavior during intercourse. This study examines sexual self‐labels, sexual behavior, HIV transmission risk, and psychological functioning among 205 HIV‐seropositive men who have sex with men. The majority of participants (88%) identified as a “top, “ a “bottom, “ or “versatile. “ Tops were more likely to engage in insertive anal intercourse than bottoms, and bottoms were more likely to engage in receptive anal intercourse than tops, with versatiles reporting intermediate rates of both behaviors. Although the results suggest preliminary evidence regarding the predictive utility of self‐labels, sexual behaviors of self‐label groups were greatly overlapping. Differences were found among self‐label groups in gay self‐identification, internalized homophobia, sexual sensation seeking, and anxiety. Results suggest an added value in assessing self‐labels in addition to asking about sexual behavior.     

The Inability of Self-affirmations to Decrease Defensive Bias Toward an Alcohol-Related Risk Message Among High-Risk College Students

Abstract

Objective: To examine the efficacy of a self-affirmation task in deterring college alcohol misuse and the importance of preexisting beliefs in predicting subsequent behavior change. Participants: Heavy-drinking undergraduates (N = 110) participated during the 2011–2012 academic year. Methods: Participants were randomized to complete an affirmation or control task before reading an alcohol risk message. Alcohol-related beliefs and behaviors were assessed. Participants completed a 2-week online follow-up assessing alcohol-related behaviors. Results: Both groups reported increased perceived problem importance, but neither group displayed changes in personal risk. Follow-up assessment revealed similar, significant declines in peak consumption in both groups, with no significant between-group differences. Preexisting beliefs accounted for 5% to 10% of variance in drinking outcomes. Conclusions: An affirmation task does not seem to decrease defensive processing or alter high-risk drinking behaviors among college students and should not be utilized in lieu of more effective strategies.