Teaching Social Work Practice in the Shared Trauma of a Global Pandemic
Unique clinical dynamics occur when both clinician and client are exposed to the same community traumatic event or reality. This reflection explores the applicability of the concept of shared trauma for social work educators in the context of the COVID-19 pandemic. The author describes her experiences shifting suddenly to teaching social work direct practice courses online, against the backdrop of a rapidly escalating coronavirus pandemic. Several parallels to the clinical concept of shared trauma are described, including a stronger emphasis on the mutuality of the teaching relationship, heightened emotional identification with students, and blurred professional boundaries in the student-teacher relationship. The author also describes significant differences between her own experiences and those of her students, recognizing that shared trauma is not always shared proportionately in environments of persistent racial and economic inequality. The chapter concludes with implications for educators working in shared trauma contexts, including the importance of self-care and administrative support. Teaching in a shared traumatic reality requires social work educators to stay cognizant of our connections to our students, as well as the disproportionate tolls of this pandemic.
“Don’t Know where to Go for Help”: Safety and Economic Needs among Violence Survivors during the COVID-19 Pandemic
The COVID—19 pandemic and related quarantine has created additional problems for survivors of interpersonal violence. The purpose of this study is to gain a preliminary understanding of the health, safety, and economic impacts of the COVID-19 pandemic on people that are experiencing or have previously experienced violence, stalking, threats, and/or abuse. An online survey, open from April to June 2020, was taken by people with safety concerns from interpersonal violence. Participants were recruited from IPV and sexual assault-focused agencies, state coalitions, and social media. Quantitative data were summarized using descriptive methods in SPSS and coding methods from thematic and content analysis was used to analyze qualitative data from open-ended questions. A total of 53 participants were recruited for the survey. Individuals with safety concerns have experienced increased challenges with health and work concerns, stress from economic instability, difficulties staying safe, and access resources and support. Over 40% of participants reported safety had decreased. Use of social media and avoidance strategies were the most common safety approaches used. Participants reported mixed experiences with virtual services. The COVID-19 pandemic has exacerbated existing structural concerns for survivors of violence like IPV and sexual assault. Increased support and economic resource access, coupled with modified safety planning and improved virtual approaches, would better help meet survivor needs.
“We’re just two people in a relationship”: A qualitative exploration of emotional bond and fairness experiences between transgender women and their cisgender partners
Trans‐including couples experience systemic marginalization impacting their relationships, yet studies on these relationships or narratives of strength are few. The purpose of this qualitative study was to explore emotional bonding and perceptions of fairness between transgender women and their cisgender partners. Interpretative Phenomenological Analysis was utilized to answer the research question: What are the experiences of emotional bond and fairness between transgender women and their cisgender partners? This research was situated within frameworks of minority stress, romantic attachment, and contextual therapy. Seven couples of transgender women and cisgender partners were interviewed. Three themes emerged: Minority Stress Contexts and Relational Strengths; The Experience of Emotional Bond; and Negotiating Balance. Processes of boundary creation, attunement, affirmations, and balance of care were noted. Findings reframe partner relationships as opportunities to construct transphobia‐resistant and resilient narratives. Recommendations for clinicians include prioritizing the couple subsystem as an avenue for building resilience against minority stress.
What Gets Measured in Reentry Research? A Scoping Review on Community Reentry From Jail and Prison for Persons With Mental Illnesses
Research on reentry for individuals with mental illnesses leaving jails and prisons lacks outcome specificity and standardization needed to advance knowledge about the efficacy and effectiveness of interventions. This scoping review aims to provide clarity about reentry outcomes by: (a) ascertaining what outcomes are a focus in reentry research, (b) explicating how outcomes are defined, and (c) identifying commonalities or gaps in outcomes reported. A search of multiple databases yielded 415 articles for potential inclusion. After independent document review by two of the authors, 61 articles were included in the review. Recidivism was the most used construct, accounting for 58% of total outcomes and 95% of criminal legal outcomes. Behavioral health indicators were reported the second most frequently and other outcomes were rarely reported. Increasing the specificity of commonly used concepts while also expanding the breadth of outcomes considered is needed to build an evidence base this area of research.
Parents’ Cannabis-Related Attitudes and Emerging Adult Offspring Cannabis Use: Testing the Mediating Effect of Perceived Parental Approval
Background: Contrary to parental alcohol use and expectancies work, little is known about how parent’s cannabis use (CU) and expectancies influence offspring CU. This is a notable gap in the literature given increasing acceptability and use of cannabis, especially among emerging adults (EA). Moreover, limited work has tested mechanisms of transmission of risk from these parent factors. This study addresses these gaps by testing prospective associations of parental CU and expectancies with offspring CU and CU problems, and perceived parental approval of offspring CU as a potential mediator. Method: A community sample of 314 EA and caregiver dyads completed three annual assessments (mean age = 19.13). The sample was 54% female and majority White/non-Hispanic (76%). Caregivers reported on their cannabis expectancies and use, and EA reported on their CU, CU-related problems, and perceived parental approval of CU. Results: Longitudinal structural equation modeling supported a mediated pathway such that high parental positive cannabis expectancies were associated with perceived parental approval of CU, which in turn, predicted increases in EA CU and CU problems. Parental negative expectancies had a significant indirect effect but in the opposite direction. Indirect effects were found above and beyond parental CU, which was not associated with offspring CU. Conclusions: This is the first study to test prospective indirect effects of parental cannabis expectancies on offspring CU. Findings suggest parents’ attitudes, even in the absence of parental use, confer risk for offspring use by shaping perceived acceptance of CU, suggesting parental expectancies as targets for parent-based CU interventions.
Diverse Spirituality Revisited: Lessons Learned
Chapters included in this volume highlight the vibrancy of research into diverse spiritualities. As shown by many of the book’s chapters, culturally specific measures enhance our ability to explain and understand the complexities of spiritual phenomena and help us appreciate religious traditions other than our own and humanize “the other.” The book includes chapters describing measures of Eastern forms of meditation, spiritual Jihad, afterlife beliefs associated with the three main religious worldviews, spirituality among Latin American youth, and Muslim religiousness. The case for particularism is not in conflict with that for universalism as some of the measures have been used cross-culturally. The challenge is to productively fuse these two research traditions. A second set of chapters explores the complex spiritual terrain of the Western world in the post-1960s era. These chapters illuminate a common theme of spirituality decoupled from traditional religiousness—all measures reflect a belief in interconnectedness between the person and the world at large—and articulate differences dependent on socio-cultural and historic contexts (e.g., the U.S. versus Western Europe) and field of inquiry (e.g., the psychology of religion versus transpersonal psychology). Other chapters demonstrate the empirical utility of assessing spirituality related concepts including spiritual support, modeling, struggle, well-being, as well as, prayer coping, faith, and meaning making. The new tools described in this book expand the understanding of the role played by spirituality in our rapidly changing and interconnected world while, at the same time, highlighting the aspects of spirituality common among all peoples and cultures.
The Interpersonal and Psychological Impacts of COVID-19 on Risk for Late-Life Suicide
Older adults experience increased risk for suicide compared to the general population, and the circumstances surrounding the Coronavirus Disease 2019 (COVID-19) may potentiate this risk. We discuss how current COVID-19 pandemic-related policies are likely to harm older adults disproportionately. COVID-19 pandemic social distancing policies and ethical guidelines for COVID-19 treatment may exacerbate experiences of social isolation, perceived expendability, and exposure to suffering, which are related to the 3 main components of the Interpersonal Theory of Suicide (i.e., thwarted belongingness, perceived burdensomeness to society, and capability for suicide). The COVID-19 pandemic poses a drain on services and has drawn ethical debates about policies around treating younger adults first. These experiences may lead older adults to have reduced access to needed medical and psychiatric services and may convey damaging messages of expendability. Furthermore, the potential prolonged stress associated with the COVID-19 pandemic may affect neurological, immunological, and health functioning—exacerbating suicide risk. Potential venues to increase treatment options and decrease social isolation are discussed. We acknowledge optimistic effects as well, such as “pulling together” as a society and the many valuable ways older adults may contribute during this crisis.
The Perceived Spiritual Support Scale (PSSS): Measuring Support from the Deep Connection with Diverse Sacred Entities
The concept of perceived spiritual support (PSS) centers on an internalized resource derived from perception of an intimate relationship with a higher power, be it God, Jesus, a cosmic force, ancestral spirits, or a psychologically functional equivalent. The literature has indicated the increasing importance of spiritual support in crises and medical care, but previous assessments tended to focus on mainstream religions with inadequate validation. To meet the gap and based on related scientific theories, three crises-based studies were conducted to develop and validate a 12-item scale of perceived spiritual support (the PSSS) for assessing the spiritual resource of individuals with diverse belief systems. This endeavor was also a response to a long-standing call for measuring consciousness-related faith experience and to an assessment problem—the use of simple frequency measures in large-scale epidemiological or sociological surveys. Participants in the three studies reflect varied makeups of age, gender, generation, race, belief systems, and cultural backgrounds. The findings provide the adequate psychometric information for the PSSS and its predictive value for various outcomes. Multivariate analyses demonstrated the indirect mediating or pathway effect of the PSSS, simultaneously evaluated the effects of other established factors, and tested an explanatory mechanism underlying its predictive value. The results suggest that the PSSS, as a short and easy to use tool, can be used to predict important outcomes in crises and across different populations. More cross-cultural studies are warranted for further validation.
“It really presents a struggle for females, especially my little girl”: Exploring father’s experiences discussing body image with their young daughters
Body dissatisfaction in children, particularly young girls, is a growing concern around the world. The home environment can have a strong influence on children’s well-being, and parents may contribute to their children’s positive or negative body image development. Nearly all research on parent influence on body image has focused on mothers, leaving fathers’ attitudes and experiences poorly-understood. To address this gap in the literature, we interviewed 30 fathers (Mage = 40.30; SD = 7.48) of girls between the ages of 5 and 10 about the conversations they have with their daughters regarding body image. Through thematic analysis, we identified three primary themes: barriers to effective communication, combatting negative influences, and strategies for discussing body image. Fathers recognized the importance of talking about body image with their daughters, yet many did not feel confident or competent to do so effectively. They engaged in a variety of strategies to combat adverse cultural influences and encourage self-expression, character development, and mental and physical health in their daughters. However, messages about health were sometimes conflated with messages about thinness or food restriction. Implications for families and future research are discussed.
Methods of visual assessment in children with cortical visual impairment
Purpose of review: Cortical visual impairment (CVI) is the leading cause of pediatric visual impairment in developed countries. Currently, there is no standardized method of visual assessment in these children, who usually cannot participate in tests designed for typically developing children. A reproducible method of visual assessment that accurately reflects the multitude of visual deficits in CVI is critical to evaluate proposed therapies for this disorder. This review analyzes current research on methods of visual assessment in children with CVI. Recent findings: Earlier studies focused on measuring visual acuity in children with CVI. More recent studies have emphasized other aspects of visual function, such as contrast sensitivity, motion detection, and visual search. Current research topics include questionnaires, functional vision assessment (CVI Range), neuropsychological tests of visual perception, and eye tracking. Eye tracking shows promise for visual assessment in both clinical and research settings because it is objective and quantitative, with the ability to assess diverse visual parameters. Summary: Current research on visual assessment in children with CVI focuses on measuring deficits of visual function beyond visual acuity. This research represents an important step toward designing clinical trials to identify effective therapeutics for this increasingly prevalent disorder with heterogeneous manifestations.
The impact of a diversity intervention on White college students’ colour-blind racial attitudes
This research explored the impact a 3-day pre-college diversity intervention had on incoming White college students’ (N = 63) colour-blind racial attitudes (COBRAS), or their unawareness of racial privilege, blatant racial issues, and institutional discrimination. Repeated measures analysis of variance tests indicated that students reported a greater awareness of racial privilege and blatant racial issues immediately after the programme. Students’ awareness of institutional discrimination – a potentially more abstract and complex understanding of racism – did not change after the program. To isolate the effects of the intervention, independent sample t-tests between White college students who did not undergo the intervention and intervention participants were conducted. Results indicated that both samples did not have significantly different COBRAS before the intervention, providing evidence that the intervention likely contributed to changes in intervention participants’ COBRAS. These results suggest that the pre-college diversity intervention impacted forms of COBRAS differently. Implications for diversity interventions on predominantly White college campuses are discussed.
Navigating a Minefield, Meta-Synthesis of Teen Mothers’ Breastfeeding Experience
Teen mothers have lower rates of breastfeeding duration and exclusivity than older mothers. A growing body of qualitative research on teen mothers’ experience helps to explain these disparities. Following a systematic search to identify relevant research, we synthesized the findings from 22 primary studies to conclude that teen mothers navigate a minefield that undermines their intention to breastfeed and their breastfeeding confidence and skill. This metaphorical minefield reflects competing norms for infant feeding and good mothering, as evident in mixed support from teens’ social networks; fragmented and stigmatizing healthcare; and spaces that are inhospitable to teen mothers and breastfeeding mothers in general. In recognition of this minefield, we urge clinicians to: respect teen mothers’ infant feeding decisions; develop collaborative relationships based on the principles of patient-centered and strength-based care; challenge stigmatizing healthcare practices; welcome teen mothers and their significant others to clinical settings; and press health systems to fully implement probreastfeeding policies. We also recommend further study to extend our knowledge about teen mothers’ breastfeeding experiences.
Coping Behaviors Mediate Associations between Occupational Factors and Compassion Satisfaction among the Intimate Partner Violence and Sexual Assault Workforce
The intimate partner violence (IPV) and sexual assault (SA) workforce faces significant occupational stressors yet little is known about positive occupational outcomes associated with this work. Therefore, this study analyzed factors associated with compassion satisfaction among the IPV/SA workforce in one southwestern U.S. state (n = 623). Drawing from the Resilience Portfolio Model (Grych et al. 2015), researchers examined the possible role of coping behaviors in mediating associations between compassion satisfaction and workplace resources / assets, perceived job security, and resilience. Analyses revealed partial mediation in the models that included workload, values, and resilience as independent variables, suggesting that these factors both influence workers’ coping behaviors and have an independent association with compassion satisfaction. Models investigating control, rewards, community, fairness, and perceived job security indicated significant total effects of the independent variables on compassion satisfaction. Overall, IPV/SA workers who engaged more frequently in a range of coping behaviors reported higher levels of compassion satisfaction. The findings point to implications for organizational and employee practice, including building in worktime for key individual coping behaviors, balancing workloads among staff members, and enhancing organizational level coping strategies, such as team supervision and team care planning.
Fatherhood and Racial/Ethnic Differences in the Progression of Romantic Relationships
This study examines the influence of fatherhood on the progression of men’s romantic relationships. High levels of relationship flux have resulted in a partner market increasingly characterized by the presence of children, but little is known about how children influence the progression of men’s romantic relationships. Children could reduce the likelihood of marriage and increase chances of cohabitation for single fathers in dating relationships, just as prior literature has found for single mothers. Given high levels of racial/ethnic assortative mating, and variation in the prevalence of single parenthood across racial/ethnic groups, the influence of prior children on men’s relationships may differ by race/ethnicity as well. The authors use data from adult male respondents of the 2002–2015 cycles of the National Survey of Family Growth aged 18–45 regarding the most recent sexual relationship (n = 9,255). Results of propensity score weighted event‐history analyses show that fathers in sexual relationships transition more often and more rapidly into cohabitation than do childfree men, but this pattern varies by race/ethnicity. Children from prior relationships have a strong influence on the progression of non‐Hispanic White men’s relationships, hastening cohabitation, and decreasing transitions to marriage, but prior children have little association with the progression of romantic relationships among Black or Hispanic men. Although fatherhood shapes the progression of men’s romantic relationships, the influence of fatherhood varies across racial/ethnic groups in the United States.
Working Conditions Supporting Person-Centered Care of Persons Living with Dementia in Long-Term Care Homes
The COVID-19 pandemic has underscored the importance of person-centered dementia care and working conditions that support such care in long-term care (LTC) home settings. Personal support workers (PSWs), known also as certified nursing assistants, provide the most direct formal care for persons living with dementia. However, little is known about the working conditions that enable person-centered care. Accordingly, the purpose of this study was to examine the working conditions and the impact of those conditions on PSWs in LTC homes. PSWs (N=39) employed at one of five LTC homes in southwestern Ontario, Canada participated in a series of one-hour focus groups before, during, and after Be-EPIC, a person-centred communication training program for formal caregivers of persons living with dementia. Using an interpretive description investigative framework, textual data from focus group conversation transcripts were open-coded into categories. Overarching themes were interpreted inductively. Study credibility was enhanced through investigator triangulation. Three themes emerged related to working conditions of PSWs: dementia care is complex, lack of trained staff to provide person-centered dementia care, and residents’ families are not situated in the residents’ care circle. Four themes emerged related to the impact of current working conditions of PSWs: occupational burnout, poor resident care, frustrated and disengaged families, and PSWs leave their role. The findings offer opportunities for employers to ameliorate working conditions to support person-centered care. We conclude with specific workplace recommendations that respond to the complexity of dementia care and the associated occupational stresses PSWs experience in the current LTC environment.
Parental buffering in the context of poverty: positive parenting behaviors differentiate young children’s stress reactivity profiles
Experiencing poverty increases vulnerability for dysregulated hypothalamic–pituitary–adrenal (HPA) axis functioning and compromises long-term health. Positive parenting buffers children from HPA axis reactivity, yet this has primarily been documented among families not experiencing poverty. We tested the theorized power of positive parenting in 124 parent–child dyads recruited from Early Head Start ( M age = 25.21 months) by examining child cortisol trajectories using five samples collected across a standardized stress paradigm. Piecewise latent growth models revealed that positive parenting buffered children’s stress responses when controlling for time of day, last stress task completed, and demographics. Positive parenting also interacted with income such that positive parenting was especially protective for cortisol reactivity in families experiencing greater poverty. Findings suggest that positive parenting behaviors are important for protecting children in families experiencing low income from heightened or prolonged physiologic stress reactivity to an acute stressor.
Addressing the physician-scientist pipeline: Strategies to integrate research into clinical training programs
Introduction Physician-scientists are critical members of the biomedical workforce. Thecombination of rigorous scientific training and clinical skills uniquely positions them tobridge clinical needs with investigational pursuits by identifying important clinical questionsthat drive basic discoveries and translating those into therapeutics that improve patientoutcomes. The impact of physician-scientists on biomedical science has been profound.Indeed, the recipients of the 2019 Nobel Prize in Physiology or Medicine, William Kaelin Jr.,Gregg Semenza, and Peter Ratcliffe, are all physician-scientists. Furthermore, physician-scientists have been well represented as Nobel laureates (including Frederick Banting, CarlCori, Earl Sutherland, Alfred Gilman, Michael Brown, Joseph Goldstein, Bernardo Houssay,Edwin Krebs, Peter Agre, Harold Varmus, Robert Lefkowitz, Brian Kobilka, and RalphSteinman, to name a few). Yet, as the need for novel therapies has grown, the number ofphysician-scientists has declined (1). The reasons for this decline are numerous, includinglength and cost of clinical training, declining funding opportunities, reduced visibility ofphysician-scientist role models, and compensation disparities between academic andprivate practice careers. Residency, fellowship training, and entry into faculty — importantentry points for budding physician-scientists and a period of continuity for those who wish tobuild on their earlier research experiences — are critical junctures where attrition occursalong the physician-scientist training timeline (2–5).
Young transgender women survivors of intimate partner violence: A latent class analysis of protective processes
COVID-19 cases and testing in 53 prison systems
COVID-19 has entered United States prison systems at alarming rates. Disparities in social and structural determinants of health disproportionately affect those experiencing incarceration, making them more vulnerable to COVID-19. Additionally, prisons are sites of congregate living, making it impossible to practice social distancing, and most prisons have relied only on incremental measures to reduce risk and spread of COVID-19. To more fully understand the impact that COVID-19 is having on incarcerated populations, it is critical to have systematic data on testing, test positivity, cases, and case fatality. Using data from the COVID Prison Project, we present data on 53 prison systems COVID-19 testing, test positivity, case, and case fatality by state and compare these data with each state’s general population. We do this for the early stages of the pandemic, utilizing data through July 15, 2020. Many states are not reporting full information on COVID testing with some also not reporting on case fatality. Among those reporting data, there is a wide variation between testing, test positivity, and case rates within prison systems and as compared to the general population. However, when more tests are deployed more cases are identified with the majority of state prisons having higher case rates than their general population. These findings underscore the need for the implementation and study of COVID-19 mitigation and surveillance strategies to flatten the COVID-19 curve in prisons across the country. We call for future research to build on these data from the COVID Prison Project to protect the health of our nations’ often forgotten residents.
Assessment of Pediatric Optic Neuritis Visual Acuity Outcomes at 6 Months
Importance: Optic neuritis (ON) in children is uncommon. There are limited prospective data for visual acuity (VA) outcomes, associated diseases, and neuroimaging findings. Prospective data from a large sample would be useful for counseling families on treatment decisions and prognosis. Objective: To prospectively study children with a first episode of ON, describe VA after 6 months, and ascertain the network’s (Pediatric Eye Disease Investigator Group and Neuro-Ophthalmology Research Disease Investigator Consortium) ability to enroll pediatric patients with ON prospectively. Design, setting, and participants: This nonrandomized cohort study was conducted from September 20, 2016, to July 20, 2018, at 23 sites in the United States and Canada in pediatric ophthalmology or neuro-ophthalmology clinics. A total of 44 children (aged 3-15 years) presented with a first episode of ON (visual loss, pain on eye movements, or both) within 2 weeks of symptom onset and at least 1 of the following in the affected eye: a distance high-contrast VA (HCVA) deficit of at least 0.2 logMAR below age-based norms, diminished color vision, abnormal visual field, or optic disc swelling. Exclusion criteria included preexisting ocular abnormalities or a previous episode of ON. Main outcomes and measures: Primary outcomes were monocular HCVA and low-contrast VA at 6 months. Secondary outcomes were neuroimaging, associated diagnoses, and antibodies for neuromyelitis optica and myelin oligodendrocyte glycoprotein. Results: A total of 44 children (mean age [SD], 10.2 [3.5] years; 26 boys [59%]; 23 White individuals [52%]; 54 eyes) were enrolled in the study. Sixteen patients (36%) had bilateral ON. Magnetic resonance imaging revealed white matter lesions in 23 children (52%). Of these children, 8 had myelin oligodendrocyte glycoprotein-associated demyelination (18%), 7 had acute disseminated encephalomyelitis (16%), 5 had multiple sclerosis (11%), and 3 had neuromyelitis optica (7%). The baseline mean HCVA was 0.95 logMAR (20/200), which improved by a mean 0.76 logMAR (95% CI, 0.54-0.99; range, -0.70 to 1.80) to 0.12 logMAR (20/25) at 6 months. The baseline mean distance low-contrast VA was 1.49 logMAR (20/640) and improved by a mean 0.72 logMAR (95% CI, 0.54-0.89; range, -0.20 to 1.50) to 0.73 logMAR (20/100) at 6 months. Baseline HCVA was worse in younger participants (aged <10 years) with associated neurologic autoimmune diagnoses, white matter lesions, and in those of non-White race and non-Hispanic ethnicity. The data did not suggest a statistically significant association between baseline factors and improvement in HCVA. Conclusions and relevance: The study network did not reach its targeted enrollment of 100 pediatric patients with ON over 2 years. This indicates that future treatment trials may need to use different inclusion criteria or plan a longer enrollment period to account for the rarity of the disease. Despite poor VA at presentation, most children had marked improvement by 6 months. Associated neurologic autoimmune diagnoses were common. These findings can be used to counsel families about the disease.