“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.
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.
Neural Correlates of Smartphone Dependence in Adolescents
Increases in depressive and suicide-related symptoms among United States adolescents have been recently linked to increased use of smartphones. Understanding of the brain mechanisms that underlie the potential smartphone dependence may help develop interventions to address this important problem. In this exploratory study, we investigated the neural mechanisms underlying potential smartphone dependence in a sample of 19 adolescent volunteers who completed self-assessments of their smartphone dependence, depressive symptoms, and sleep problems. All 19 adolescents underwent diffusion MRI that allowed for assessment of white matter structural connectivity within the framework of connectomics. Based on previous literature on the neurobiology of addiction, we hypothesized a disruption of network centrality of three nodes in the mesolimbic network: Nucleus Accumbens, anterior cingulate cortex, and amygdala. Our results showed positive correlations between the node centrality of the right amygdala and self-reported smartphone dependence, between smartphone dependence and sleep problems, and between sleep problems and depressive symptoms. A higher phone dependence was observed in females compared to males. Supported by these results, we propose a model of how smartphone dependence can be linked to aberrations in brain networks, sex, sleep disturbances, and depression in adolescents.
Substantiated allegations of failure to protect in the child welfare system: Against whom, in what context, and with what justification?
Failure to protect (FTP), a sub-type of neglect, is used by child welfare systems to categorize and substantiate allegations of child maltreatment. Scholars and advocates have raised concerns that FTP is disproportionately used to substantiate mothers and people of color for harm perpetrated by others, particularly in the contexts of sexual abuse and domestic violence. Limited data exist about how FTP is used in practice or if substantiation of FTP varies by context across gendered or racialized groups. This study extends our understanding of use of FTP by examining who workers substantiate for FTP, in what context, and the justifications they use. Data for this study were drawn from child welfare records in a large, Midwestern county. Mixed methods were used to analyze data from 150 maltreatment referrals which included at least one substantiated allegation of FTP. Findings indicate that the contexts and rate at which caregivers were substantiated for FTP differed significantly across gendered groups. Mothers were most frequently substantiated for FTP in the contexts of sexual abuse, physical abuse, and domestic violence. Fathers were most frequently substantiated in the context of substance use. In addition, rates of FTP substantiation varied across racialized groups. Black caregivers were substantiated disproportionately across all contexts. White caregivers were overrepresented among those substantiated for FTP in the context of substance use. Notably, justification for substantiation decisions was often not documented in data. Implications for policy and practice are discussed.
The Role of Social Support in the Link Between Economic Abuse and Economic Hardship
More data is needed about the pathways through which intimate partner violence (IPV) impacts the economic well-being of survivors. The current study assesses the moderating influence of social support on the association between economic abuse (EA) and economic hardship. Female participants (n = 435) were recruited to participate in a web-based survey which included standardized measures of EA, other forms of IPV, domains of social support, and economic hardship. Analysis included bivariate and multivariate regression with an investigation into interaction effects.Experiencing EA was significantly correlated with economic hardship, even with extent of physical and emotional IPV controlled. Both tangible and appraisal support had significant negative association with extent of material hardship. Significant interactions between forms of social support and economic abuse were observed. For those at high levels of economic abuse, support had less influence on economic hardship. A mix of direct economic aid, advocacy, education and support could provide a blueprint for addressing the economic hardship experiences of community-dwelling survivors of economic abuse. A comprehensive response to EA requires interventions aimed directly at economically controlling and exploitative tactics, including credit building, individual economic advocacy, and education. Interventions that seek to enhance survivors’ access to social support may be necessary but not sufficient to buffer the impacts of violence on survivors’ economic outcomes.
Organizing as “Collective-Self” Care Among African American Youth in Precarious Times
African American youth have responded with hope and action to protect their well-being in violent political, economic, and social conditions, through organizing. While contemporary organizing frameworks prioritize self-care to promote sustainability, there is little research on the meaning and definition of self-care for African American youth organizers, in their own words. In this paper, findings from interviews with 20 Black youths in navigating organizing spaces in New York City will be presented, highlighting how they destabilize the narrowness of commonly defined self-care to embody “collective-self” care strategies. Implications for community practice, recovery from systemic violence, and historical trauma among African Americans will be explored.
#PrEP4Love: success and stigma following release of the first sex-positive PrEP public health campaign
Pre-exposure prophylaxis (PrEP) is an effective yet under-utilised method for preventing HIV transmission in high-risk groups. Despite ongoing social marketing to increase PrEP awareness, few studies have evaluated public responses. This paper contextualises negative responses to Chicago’s PrEP4Love campaign. In February 2016, a sex-positive ad campaign called PrEP4Love was launched online and throughout public spaces in Chicago. A gender and sexuality inclusive campaign, PrEP4Love is intended to be culturally responsive and sex positive, while retaining a focus on risk reduction. Advertisements prominently feature Black sexual minority men, and Black transgender women, and were strategically placed in diverse Chicago neighbourhoods. In response, there were 212 new callers to the PrEPLine during the two-month study period. Negative responses were concerned with: negatively depicting Black homosexuality (4), general anti-LGBTQ comments (7), adverse effects on children (6), sexually explicit nature (5), and general stigmatisation of racial minorities (4). Discussion focuses on sex-positive frameworks, normalising intimacy, stigma and historical mistrust of medical and pharmaceutical institutions, and the social meanings of biomedical prevention technologies (e.g. PrEP) in relation to dominant norms of sexuality and gender. This study is the first to investigate public responses to a sex-positive PrEP campaign. More studies of PrEP social marketing are needed to evaluate targeted public health campaigns to guide future PrEP promotion strategies.
Examining Caretaker Attitudes Towards Primary Prevention of Pediatric Behavioral Health Problems in Integrated Care
Understanding caretaker attitudes towards the prevention of pediatric behavioral disorders is important for the effective delivery of prevention services. Caretakers of children ages 0–18 (N = 385) read a description of pediatric prevention services in an integrated primary care setting. Attitudes towards these services were assessed. The majority of participants (80%) agreed that prevention is important, 87% reported interest in learning their child’s risk for a behavioral disorder, 84% were interested in learning the results of a screen for behavioral disorders, and 88% were interested in learning parenting strategies. Participants endorsed similarly positive attitudes towards prevention in integrated care. Perceived risks outweighing perceived benefits, younger caregiver age, and identifying as non-Hispanic White predicted less favorable attitudes towards prevention. Other socio-demographic characteristics (e.g., caretaker education) were associated with disorder-specific beliefs about the importance of prevention, but not general attitudes. Findings suggest generally positive attitudes towards preventing behavioral disorders in an integrated care setting.
The Process of Change in Systemic Family Therapy
This chapter provides a comprehensive review of the research on the processes of change in systemic family therapy (SFT). We begin by clearly defining SFT process research including what it fully entails: systemically oriented mechanisms and contexts of change. Our review of the research is uniquely organized according to our view of the evolution of SFT practice (a) beginning with an overview of process findings from the traditional schools of SFT, (b) followed by findings from empirically supported treatments in SFT, and then (c) finalized by an assessment of the research from an integrative perspective of SFT including common and unique change processes (systemic alliances, systemic engagement and retention, systemic reframing, and systemic enactments). Following this overview, we provide directions for future areas of research that will need to be explored in order to more fully articulate the pathways of change in SFT including the need to better clarify the contexts in which certain process are most important. Finally, several implications for SFT training and practice are articulated including how this review points to the need for a potential paradigm shift that squarely places systemically oriented principles of change and client system‐centered integration and at the heart of our work.
The effect of Medicaid expansion on use of opioid agonist treatment and the role of provider capacity constraints
To determine the effect of Medicaid expansion on the use of opioid agonist treatment for opioid use disorder (OUD) and to examine heterogeneous effects by provider supply and Medicaid acceptance rates. Yearly state-level data on methadone dispensed from opioid treatment programs (OTPs), buprenorphine dispensed from OTPs and pharmacies, number of OTPs and buprenorphine-waivered providers, and percent of OTPs and physicians accepting Medicaid. This study used difference-in-differences models to examine the effect of Medicaid expansion on the amount of methadone and buprenorphine dispensed in states between 2006 and 2017. Interaction terms were used to estimate heterogeneous effects. Sensitivity analyses included testing the association of outcomes with Medicaid enrollment and state insurance rates. The estimated effects of Medicaid expansion on buprenorphine and methadone dispensed were positive but imprecise, meaning we could not rule out negative or null effects of expansion. The estimated associations between state insurance rates and dispensed methadone and buprenorphine were centered near zero, suggesting that improvements in health coverage may not have increased OUD treatment use. The effect of Medicaid expansion was larger in the states with the most waivered providers compared to states with the fewest waivered providers. In the states with the most waivered providers, the average estimated effect of expansion on buprenorphine dispensed was 12 kg/y, enough to treat about 7500 individuals. We did not find evidence that the effect of expansion was consistently modified by OTP concentration, OTP Medicaid acceptance, or physician Medicaid acceptance. Gains in health coverage may not be sufficient to increase OUD treatment, even in the context of high treatment need. Provider capacity likely limited Medicaid expansion’s effect on buprenorphine dispensed. Policies to increase buprenorphine providers, such as ending the waiver requirement, may be needed to ensure coverage gains translate to treatment access.
Gender Differences in Intimate Partner Violence Victimization, Help-Seeking, And Outcomes Among College Students
Many college students experience intimate partner violence (IPV). Although receiving help from formal and informal sources may ameliorate possible negative impacts of IPV victimization, the outcomes of help-seeking are not always positive. This study used survey data collected at six universities across the United States (U.S.) to examine gender differences in IPV, help-seeking, and its outcomes (n=3,070). Major variables included IPV victimization, IPV consequences, help-seeking, and outcomes. Descriptive and bivariate analyses revealed higher rates of victimization among females as well as poorer health status, higher levels of depression, and more daily routine problems. Females also used more formal help, and reported it as being useful more often than males. Inversely, more males than females reported that informal supports were helpful. Recommendations include social workers providing tailored services both for male and female survivors, service providers developing educational programs that target informal help sources, and social work education providing relevant trainings.