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The purpose of this article is to delineate the current state-of-the-knowledge of peer support following the framework employed in the 2004 article (Solomon, Psychiatr Rehabil J. 2004;27(4):392-401 1). A scoping literature was conducted and included articles from 1980 to present. Since 2004, major growth and advancements in peer support have occurred from the development of new specializations to training, certification, reimbursement mechanisms, competency standards and fidelity assessment. Peer support is now a service offered across the world and considered an indispensable mental health service. As the field continues to evolve and develop, peer support is emerging as a standard of practice throughout various, diverse settings and shows potential to impact clinical outcomes for service users throughout the globe. While these efforts have enhanced the professionalism of the peer workforce, hopefully this has enhanced the positive elements of these services and not diluted them.

BACKGROUND Youth and young adults face barriers to mental health care, including a shortage of programs that accept youth and a lack of developmentally sensitive programming among those that do. This shortage, along with the associated geographically limited options, has contributed to the health disparities experienced by youth in general and by those with higher acuity mental health needs in particular. Although intensive outpatient programs can be an effective option for youth with more complex mental health needs, place-based intensive outpatient programming locations are still limited to clients who have the ability to travel to the clinical setting several days per week. OBJECTIVE The objective of the analysis reported here was to assess changes in depression between intake and discharge among youth and young adults diagnosed with depression attending remote intensive outpatient programming treatment. Analysis of outcomes and the application of findings to programmatic decisions are regular parts of ongoing quality improvement efforts of the program whose results are reported here. METHODS Outcomes data are collected for all clients at intake and discharge. The Patient Health Questionnaire (PHQ) adapted for adolescents is used to measure depression, with changes between intake and discharge regularly assessed for quality improvement purposes using repeated measures t tests. Changes in clinical symptoms are assessed using McNamar chi-square analyses. One-way ANOVA is used to test for differences among age, gender, and sexual orientation groups. For this analysis, 1062 cases were selected using criteria that included a diagnosis of depression and a minimum of 18 hours of treatment over a minimum of 2 weeks of care. RESULTS Clients ranged in age from 11 to 25 years, with an average of 16 years. Almost one-quarter (23%) identified as nongender binary and 60% identified as members of the lesbian, gay, bisexual, transgender, queer (LGBTQ+) community. Significant decreases (mean difference –6.06) were seen in depression between intake and discharge (t967=–24.68; PPF2,958=0.47; P=.63), gender identity (F7,886=1.20; P=.30), or sexual orientation (F7,872=0.47; P=.86). CONCLUSIONS Findings support the use of remote intensive outpatient programming to treat depression among youth and young adults, suggesting that it may be a modality that is an effective alternative to place-based mental health treatment. Additionally, findings suggest that the remote intensive outpatient program model may be an effective treatment approach for youth from marginalized groups defined by gender and sexual orientation. This is important given that youth from these groups tend to have poorer outcomes and greater barriers to treatment compared to cisgender, heterosexual youth.

Objective: The International Classification of Functioning, Disability, and Health (ICF) is a comprehensive and universally accepted framework for describing functioning and disability in a...

Objectives This study examined whether trajectories of depressive symptoms of one spouse are associated with the other spouse’s memory. Methods Longitudinal data from the Health and Retirement Study (2004–2016) were used ( N = 5690 heterosexual couples). Latent-class growth analysis and structural equation models examined the actor and partner effects of depressive symptom trajectories on memory. Results Four depressive symptom trajectories were identified (i.e., persistently low, increasing, decreasing, and persistently high). Compared to the low trajectory group, the increasing and persistently high trajectories were associated with worse memory for both men and women. While none of the wives’ depressive symptom trajectories was significantly associated with husbands’ memory ( p > .05), husbands’ decreasing trajectory was linked to wives’ better memory (β = 0.498, 95% CI = 0.106, 0.890). Discussion Older adults with increasing and persistently high depressive symptoms may experience worse memory. Psychosocial interventions targeting depressive symptoms among older men may be beneficial to their spouses’ memory.

Smoking continues to be a major health concern among persons with mental illnesses.This pilot study compared smoking outcomes between wellness-coaching for smoking cessation and a control group.Thirty-one individuals were enrolled in an educational group on smoking cessation and 23 completed an eight-session manualized education. Following this educational group, 11 of 23 participants were randomly assigned to wellness coaching for four months and 12 to a control condition. ANCOVAs were used to compare group differences in smoking outcomes.Fagerström Nicotine Dependence Index (FTND) score of the participants who received the wellness coaching intervention decreased significantly as compared to the control group, indicating a lower level of nicotine dependence. The outcomes of average number of cigarettes smoked daily and breath carbon monoxide level showed tendencies towards reductions for wellness coaching, although not statistically significant compared to the control condition.Suggestions are shared about the feasibility of wellness coaching as well as barriers and challenges learned in implementing such an intervention to assist individuals with mental illnesses in quitting or reducing smoking.

To perform a systematic review and meta-analysis of CBT for individuals diagnosed with cancer across a broad range of outcome domains, i.e., functional health, psychological health, health behaviors, social relational, and general wellness.A comprehensive search of 7 databases, 91 published reviews, and 4 professional websites was performed on August 30th, 2021. English-language clinical trials of CBT for cancer patients/survivors were included. Studies were independently screened, and data were extracted by 2 reviewers, and discrepancies were resolved by consensus among the investigative team. A total of 151 clinical trials (154 articles) published between 1986 and 2021 were included in the analysis.CBT was overall effective for cancer patients/survivors in the domains of functional health, g = 0.931, p 0.001, psychological health, g = 0.379, p 0.001, and general wellness, g = 0.257, p 0.001, but ineffective in domains of health behaviors, g = 0.792, p 0.05, and social relational outcomes, g = 0.319, p 0.05. Additional subgroup and moderator analyses further revealed CBT's differential treatment effect for different within domain outcomes, across different cancer disease stages, and CBT delivery format.Findings of the study showed that CBT is an effective treatment for individuals diagnosed with cancer. However, treatment effects differ by important disease- and intervention-related factors, which should be considered when recommending CBT for cancer patients/survivors.

Purpose: To systematically review and meta-analyze all published studies, written in Chinese and published in China, focusing on mindfulness-based interventions for Chinese breast cancer patients’ mental health and quality of life outcomes. Methods: Following the Cochrane guideline, this study searched across five electronic debases, two professional websites, two major Chinese oncology journals, and reference lists of existing reviews and included studies. Meta-analysis was conducted using meta-regression with robust variance estimation. Publication bias and risk of bias were assessed and evaluated in the final analysis. Results: A final of 35 clinical trials included 126 effect sizes and 3,100 participants. Studies reported an overall large and statistically significant treatment effect, g = 0.963, p < .001. Conclusions: Mindfulness-based interventions were significantly effective for Chinese breast cancer patients and are recommended for oncology social workers. Moderator analyses identified group-based mindfulness interventions as significantly more effective than individual-based interventions, and mindfulness-based interventions delivered as therapeutic treatment were significantly more effective than ones delivered as supportive treatment.

Using a nationally representative sample of U.S. older adults (50+), this study investigates gender-based depression trajectories following heart disease onset and associated risk of disability and mortality over an 8-year period.Six waves of longitudinal data from the Health and Retirement Study (2006-2016) were used (Three distinct depression trajectories were identified, including persistent minimal depression (men: 68.65%; women: 60.17%), moderate depression (women: 29.70%; men: 17.97%), and chronic depression (women: 10.12%) or emerging depression (men: 13.38%). Younger age and depression status at baseline were associated with women's chronic depression and men's emerging depression. Chronic/emerging and moderate depression were associated with higher disability risks than was minimal depression among both women and men (hazard ratios [HR] ranged from 2.12 to 3.92,Longitudinal course of depression following onset of heart disease is heterogeneous in later life. Unfavorable depression trajectories (i.e. moderate, chronic, and emerging) were associated with higher disability risk compared to the minimal depression trajectory. Study findings characterize risk stratification regarding depression after heart disease onset, which can inform the development of interventions to improve health outcomes among older adults with heart conditions.

This study was conducted to investigate how adults with serious mental illness learn and utilize an illness self-management framework for pursuing recovery through a program called Wellness Recovery Action Plan (WRAP). The researchers employed an interpretive descriptive methodology with thematic analysis. Data were collected from three focus groups ( n = 26) and in-depth interviews with follow-up member checks with 10 participants ( n = 20 interviews). Findings aligned with main constructs of self-determination theory (SDT) to explain how an autonomy-supportive environment created opportunities for participants to build competency, implementing personalized recovery strategies that are socially endorsed by peers, resulting in internalized motivation for continued application of WRAP’s framework. SDT appears to explain mechanisms of change for WRAP. Recommendations for mental health organizations include broadly ensuring autonomy-supportive environments and services that maximize opportunities to build competence in recovery strategies in collaboration with peers. Future research may utilize SDT as the theoretical basis for investigating self-management programs.

The objective of this community-based participatory research project was to develop a clinically useful, psychometrically-sound scale to measure community integration for adults with severe mental illness. Two researchers and an administrator of a behavioral health agency (BHA) recruited a group of providers, half with lived-experience of severe mental illness. Through a series of five focus groups, provider participants guided identification of four major domains of community integration and the development of 95 scale items; items and domains were reviewed by three external researchers with subject matter expertise. Initial pilot: BHA providers administered the scale to clients (n = 51) with 19 completing it twice to investigate internal consistency, test-retest reliability, and restricted variance and collinearity of items. Further piloting: providers at two BHAs administered the scale to clients (n = 178) to conduct exploratory factor analysis and analyze internal consistency. After initial pilot, 50 items remained post item reduction for restricted variance and collinearity, with Cronbach's alpha of .95 and test-retest reliability of .90. After a larger pilot, a four-factor solution emerged, aligning conceptually with the four domains as anticipated; 33 items loaded (factor loadings ≥ .4), with RMSEA of .069 and overall Cronbach's alpha of .89 (subdomains ranging .78-.86). The scale has good preliminary psychometric properties and appears to be feasible for use in BHAs for the purposes of research and evaluation, with clinical utility for assessment and treatment planning.

Major depressive episode (MDE) and alcohol use disorder (AUD) often co-occur and the presence of one doubles the risk for the other, which brings disabling social and health consequences. Increasing evidence supports integrated treatment of co-occurring MDE and AUD, including combined medications for both conditions as well as behavioral therapies. While young adults suffer disproportionately from these co-occurring conditions, little is known about their treatment utilization. Using nationally representative data from the National Survey on Drug Use and Health (NSDUH), 2011-2019, this study examined temporal trends and disparities in the prevalence and treatment use for co-occurring MDE and AUD among young adults aged 18-25 in the U.S. Across the survey time, an increasing trend of MDE was revealed, whereas the prevalence of AUD decreased significantly. Meanwhile, the prevalence of co-occurring MDE and AUD remained steady. Among young adults with co-occurring MDE and AUD, while treatment use for MDE increased from 2011 to 2019, treatment use for AUD and co-occurring conditions remained stable. Observed widening disparities in co-occurring treatments utilized among young adults ages 18-25 are further perpetuated by gender, emerging adulthood, and socioeconomic status, warranting immediate action. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

This study aimed to examine the rate at which persons with psychiatric disorders were victims of violence by reference relatives and the extent to which victimization and perpetration co-occurred in this population.A total of 523 adults with a psychiatric disorder completed an online survey. Chi-square and Fisher's exact tests were computed.Since first diagnosis, 25% and 26% of respondents reported having been a victim of violence by reference relatives and having committed violence toward reference relatives, respectively. Thirteen percent of respondents reported having been a victim of violence by reference relatives, and 12% reported having committed violence toward reference relatives in the past 6 months. Victimization and perpetration often co-occurred.The risk of victimization and perpetration of family violence among persons with psychiatric disorders should be acknowledged. Assessing for risk of perpetrating family violence and intervening in such cases should entail assessing for and/or addressing victimization, and vice versa.

Objective: We examined the extent to which judges’ personal or family history with psychiatric disorders influenced their perception of violence risk among criminal defendants diagnosed with/withou...

This is a post-peer-review, pre-copyedit version of an article published in Psychiatric Quarterly. The final authenticated version is available online at: https://doi.org/10.1007/s11126-020-09717-6., This pilot study evaluated a video-based educational program for improving communication skills and reducing family violence between parents and their adult children with schizophrenia. We used a one group pretest-posttest design. The program included a main 90-min video and six stories, each 20–30 min long. We made assessments at baseline and program completion (three months after baseline). Sixty-six parent participants completed the intervention. The average frequency of acts of family violence significantly decreased from 11.4 (SD = 26.2) at pretest to 5.1 (SD = 13.2) at posttest (p = 0.016). Our findings showed significant improvements regarding expressed emotion, psychological distress, family empowerment, and hope, demonstrating preliminary positive results for this video-based educational program. The program was shown to be feasible for support/educational groups of family members of adults with mental disorders to deliver and may also be useful for practitioner-led educational groups for families in public health centers or medical settings to offer.

Stigmatized attitudes towards people with mental illness from healthcare providers continues to be a problem affecting recovery in people with mental illness. The process of recovery was explored through digital stories created by service users, with support from nursing students. Stigmatized attitudes in nursing students and stigma resistance in service users were also investigated.A quasi-experimental, mixed-methods, pilot study in which service users/nursing student teams created digital stories. Surveys testing stigmatized attitudes and stigma resistance were employed.Statistical significance was not found, however, qualitative analysis revealed recovery elements and greater appreciation of individuals with mental illness by the nursing students.Digital story-telling assists service users in doing the internal work of making meaning from experience. Nursing students benefit from involvement in the activity.

Intergenerational service-learning programs are an effective and frequently used training modality in undergraduate education and are often examined using qualitative methods. It is less common to qualitatively examine two such programs to compare their outcomes. This study reports qualitative findings from a mixed-methods study comparing two intergenerational service-learning programs in an undergraduate Psychology of Aging class. The longer, more relational intervention, the Lives Well Lived program, matched students and older adults exemplifying “successful aging” in a mutual interviewing, life review project utilizing documentary film, photography, and memoir creation. The comparison intervention, the Meals That Connect/Lunch Bunch program, also exposed students to older adults exemplifying successful aging, but in a shorter, less relational way. A convenience sample of 128 students (65 in the intervention group and 63 in the comparison group) answered post-intervention open-ended questions about what they liked/disliked about the program in which they participated, as well as any viewpoints about aging they felt changed or were reinforced by the project. Thematic analysis revealed students in both groups experienced decreased ageism and improved attitudes about aging. However, those participating in the Lives Well Lived program had closer relationships with the older adults participating in the project, expressed more positivity about their own aging process, and indicated more willingness to engage in future intergenerational relationships. Use of a comparison project in qualitative examination of intergenerational service-learning adds greater insight into such programs’ outcomes, enhancing quantitative effectiveness examinations.

Intergenerational service-learning has been established as an effective pedagogical strategy for undergraduate gerontology education but can challenge students and instructors alike if an older adult participant dies during such a program. Currently, there is a lack of literature to provide guidance to instructors about how to address such an event. Examination of a case study of such an occurrence during the Lives Well Lived intergenerational service-learning program seeks to advance the field by describing an example of such an event and how an instructor might seek to address it. Grief literature, including theories such as Kübler-Ross’ stage model, Worden’s TEAR model, and Wortman and Silver’s approach, as well as Doka’s concept of disenfranchised grief are examined and applied to this challenging situation. Applying these theories as a framework, recommendations are given for addressing death and grief in service-learning including: (1) assessment of the course, instructor, student, and situation; (2) creating opportunities for grief processing and (3) resources for on and off campus grief and instructor support. Providing education on death, grief and grieving as integral course content and allowing student choice in how to proceed with the project should a death occur are key recommendations to consider. Implications call for more research related to this topic.

There are a variety of educational interventions for families who have a relative with a mental health disorder. However, for those with one or more emotion dysregulation disorders, there are limited options. This article reports on the results of a pilot project using a quasi-experimental design with a sample of 270 (intervention = 217, control = 53) to assess an intervention, Getting Off the Emotional Roller Coaster Skill-Building Family Education Course (GOER Family Course), for families coping with and managing emotion regulation disorders in a loved one which are often misdiagnosed or co-occurring. This intervention was effective in reducing caregiver burden [F(1, 120) = 12.25, p = 0.001], while improving attitudes, knowledge, and skills [F(1, 170) = 6.16, p = 0.014]. It fills an important gap in available resources for families faced with challenges and responsibilities that these disorders can present, especially when inaccurately diagnosed or receiving ineffective treatment. While there is a need for further research and adaptation to virtual learning, the preliminary results show positive effects.Existen varias intervenciones educativas para las familias que tienen un familiar con un trastorno de salud mental. Sin embargo, para aquellos que padecen uno o más trastornos de desregulación emocional, existen pocas opciones. En este artículo se informan los resultados de un proyecto piloto usando un diseño cuasiexperimental con una muestra de 270 personas (intervención=217, de referencia=53) para evaluar una intervención llamada Bajarse de la montaña rusa emocional: curso de capacitación familiar para el desarrollo de habilidades (Curso familiar GOER, por sus siglas en inglés), orientado a familias que enfrentan y manejan trastornos de regulación emocional en un ser querido, los cuales generalmente están mal diagnosticados o son concomitantes. Esta intervención fue eficaz para reducir el agobio de los cuidadores [F (1,120 )=12.25, p=.001] y a la vez mejorar las actitudes, el conocimiento y las habilidades [F (1,170)=6.16, p=.014]. Además, llena un vacío importante en los recursos disponibles para las familias que enfrentan las dificultades y las responsabilidades que estos trastornos pueden presentar, especialmente cuando tienen un diagnóstico impreciso o reciben un tratamiento ineficaz. Si bien es necesario continuar investigando y adaptarse a la enseñanza virtual, los resultados preliminares indican efectos positivos.对于亲属患有精神健康障碍的家庭有各种教育干预措施。然而，对于那些有一种或多种情绪失调障碍的人来说，选择则是有限的。本文报告了一个试点项目的研究结果，使用的是一项针对需要应对和管理亲人情绪调节障碍的准实验设计(干预=217，对照=53)来评估GOER家庭课程的干预效果（即get Off the Emotional Roller Coaster技能建设家庭教育课程）。他们的亲人的精神障碍疾病经常被误诊或与物质滥用是同时发生的。这种干预措施可以有效地减轻护理人员的负担 [F (1,120 )=12.25, p=.001]，同时改善态度、知识和技能 [F (1,170)=6.16, p=.014]。面临这些精神疾病带来的挑战和责任的家庭，特别是在疾病诊断不准确或病人接受无效治疗时，有哪些可用资源，此研究填补了针对这个话题研究方面的空白。虽然虚拟学习还需要进一步地去研究和适应，但初步研究结果显示有积极的效果。.

Objective: Adults with serious mental health conditions (SMHC) experience higher rates of disengagement from treatment. Factors associated with engagement in treatment in general for this population include therapeutic alliance, provider empathy, and perceived coercion. This cross-sectional exploratory study addressed the question: To what extent do client perceptions of therapeutic alliance, therapist empathy, and perceived coercion explain the degree of engagement in outpatient therapy for adults with SMHC? Method: An anonymous online survey measuring study variables was completed by 131 participants. The relationship between variables was tested using multivariate regression analysis with hierarchical blocks. Results: After separating therapeutic alliance and therapist empathy in the analysis due to multicollinearity and accounting for the influence of control variables, therapeutic alliance (B = .43, p < .01) and therapist empathy (B = .25, p < .01), but not perceived coercion, were associated with the degree of client engagement. Conclusions and Implications for Practice: For adults with SMHC enrolled in outpatient therapy, therapeutic alliance explained the greatest variation in the degree of engagement. Participants appeared to use outpatient therapy as a main strategy for pursuing recovery, and engagement in therapy may be increased if providers utilize strategies to strengthen expressions of empathy and bolster alliance. Additional research is needed to enhance understanding of engagement in therapy for this population and to develop more sensitive measures for evaluating these constructs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A randomized controlled trial was conducted to examine the effectiveness of an Internet-based educational intervention plus a peer support-moderated listserv for improving parenting skills and coping and reducing parental stress among mothers with serious mental illnesses. The analyses examined whether positive results achieved immediately after the intervention were improved upon during the 18-month postbaseline period.Mothers with serious mental illnesses (N=131) were randomly assigned to an experimental or an active control condition. Outcomes were assessed over time by using a repeated-measures analysis of variance.Participants in the experimental condition experienced statistically greater reduction in parental stress at the 18-month follow-up than those in the active control condition.This relatively low-cost intervention, along with the Internet's advantages of accessibility, anonymity, and insulation from child care issues, suggests potential utility for reducing parenting stress for busy mothers. These results provide a foundation for enhancing this intervention to achieve other targeted outcomes related to parenting.

NIMH requires intervention research to utilize an experimental therapeutic approach, identifying mediators to examine causal mechanisms of change. The authors propose utilizing self-determination theory (SDT) to guide research design for self-management interventions, using Wellness Recovery Action Plan (WRAP) as an exemplar. To delineate the theory's relevance to self-management interventions and recovery outcomes, the authors describe the main constructs of SDT and demonstrate its applicability to WRAP and recovery. Suggestions for research design and measurement strategies are provided.

Relational challenges often associated with interpersonal trauma may hinder survivors’ abilities to fully benefit from group therapy. This quasi-experimental study compared clinical outcomes of a 16-week version of the Trauma Recovery and Empowerment Model (TREM) for women and an attachment-informed adaptation (ATREM). Prior findings of TREM are extended by demonstrating that both group conditions can facilitate comparable clinical outcomes, creating options for group facilitators. Only ATREM resulted in statistically significant improvement in individual attachment avoidance, and it trended toward a slightly higher completion rate. This study provides insight into the emerging concept of group attachment.

Violence committed by patients with mental illness is mostly perpetuated against family members, not strangers. The present study aimed to clarify the rate of violence that is experienced and/or witnessed by siblings of patients with schizophrenia and factors related to sibling’s experiencing and/or witnessing violence committed by patients. A self-administered survey was completed by family members of patients with schizophrenia, including siblings. The final sample consisted of 113 siblings. Of the 113 siblings, 52 (46.0%) had experienced and 56 (49.6%) had witnessed physical violence at some point. A logistic regression revealed that siblings tended to experience physical violence by patients with younger age of onset of the disorder. Witnessing physical violence was significantly related to being a female sibling, a male patient, younger age of patient, and younger age of onset of schizophrenia. Crisis intervention and respite services for female siblings in particular need to be developed in ...

This study evaluated the efficacy of a 10-hour intergenerational service-learning program administered to undergraduates to determine if it would increase knowledge about aging, improve attitudes about older adults, and reduce ageism more than a course with less service-learning activity. Making maximum impact on students in these areas in a short amount of time is particularly relevant in short, quarter-based university programs. A quasi-experimental design using a convenience sample compared pre-test and post-test scores between an experimental intervention (N=68) and a comparison (N=71) group on The Facts on Aging Quiz Multiple Choice version, Aging Semantic Differential, and Fabroni Scale on Ageism. Qualitative data via open-ended survey questions was also collected. The experimental intervention, the Lives Well Lived project, was based on a documentary film by the same name, which incorporates themes of successful aging. During the project students and older adults interviewed one another about living a life well lived, participated in a photo shoot, and created a Memoir for the older adult. The comparison group included two social visits to a congregate meal program. Results from multiple regression analysis showed that students in the intervention group had less ageist stereotypes and less negative bias about aging at post-test and qualitative data indicated they were more inclined to participate in intergenerational relationships in the future. Programs like this one that are longer and more relational may be useful for consideration in undergraduate gerontology courses in reducing ageism and promoting intergenerational relationships which benefit those of all ages.

Previous research indicates that one’s identity relates to one’s use of specific coping strategies. Exploring the relationship between self and coping in military wives is crucial to understanding how they manage military lifestyle-related stressors. The researchers hypothesized that identity status, self-concept clarity, self-monitoring, mastery, and role conflict will be related to choice of emotion-focused coping or problem-focused coping strategies. Two hundred two participants completed an anonymous online survey containing standardized scales. Ordinary least squares (OLS) regression analyses revealed that emotion-focused coping had positive relationships with achieved identity status and role conflict. Problem-focused coping had positive relationships with moratorium status, self-concept clarity, self-monitoring, and mastery. Findings provide preliminary support that sense of self is important in understanding how military wives choose to cope with particular challenges.

This is a non-final version of an article published in final form in Kageyama, Masako RN, PHN, PhD; Solomon, Phyllis PhD. Characteristics of Parents With High Expressed Emotion and Related Factors, The Journal of Nervous and Mental Disease: December 2018 - Volume 206 - Issue 12 - p 955-961 doi: 10.1097/NMD.0000000000000902., This study aimed to clarify characteristics of parents with high expressed emotion (EE) and related factors among parents of adults with schizophrenia. In total, 73 (25.3%) of the 289 parents had high EE (Family Attitude Scale [FAS] score ≥60), and 216 (74.7%) had low EE (FAS score

It is widely documented that persons with mental illness (MI) experience much stigma, contributing to undesirable outcomes for persons with MI and posing barriers to their psychosocial rehabilitation. It is our argument that stigma and violence have a reciprocal relationship. In particular, stigma increases the risk of violence by this population by acting as a barrier to treatment participation and by increasing criminogenic risk factors among this population. Discrimination in social relationships, housing, and employment increases the likelihood that persons with MI will experience substance abuse, unemployment, stressed family relationships, antisocial characteristics, and less engagement in prosocial activities, all of which are known to increase the risk of criminal behavior. It is well documented that family members are the most common victims of violence by persons with MI. However, many family victims do not report acts of violence to authorities due to fear of exacerbating the stigma of MI. As such, not only does stigma increase the risk of violence by persons with MI, it also decreases the likelihood that family victims will report violence, preventing them from receiving victim services and other valuable supports. Reduction in stigma may be an essential element of a comprehensive approach to decreasing the risk of violence by persons with MI and increasing reporting and service use among family members who have been victims by persons with MI.

The link between interpersonal trauma and negative biopsychosocial outcomes has been well-documented. Integrated treatments that address trauma, mental health, and substance use among women with trauma histories have been found to be more effective than treatments that focus separately on these concerns. Since the early 2000s, the Trauma Recovery and Empowerment Model (TREM) has been described as a “promising” integrated trauma group therapy for women. Despite widespread recognition and implementation of TREM, its effectiveness has not been clearly established. The present scoping review is the first systematic effort to describe the extant literature on TREM and aims to provide an understanding of TREM’s effectiveness by organizing and synthesizing the available empirical data. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, a systematic search was conducted using PubMed, PsycINFO, SW Abstracts, Scopus, Embase, and Web of Science. Quantitative dissertation findings not published elsewhere and peer-reviewed journal articles published in English that reported outcomes from TREM intervention research with adult women were included. Twelve of the initial 385 publications identified met the inclusion criteria and reported data from nine studies. TREM demonstrated statistically significant effects on posttraumatic stress disorder, anxiety, psychological/psychosomatic distress, and substance use. A more limited set of findings suggests that TREM may also be associated with additional gains, including self-esteem, relationship power, social support, attachment, and spiritual well-being. Future research should replicate findings, use random assignment to groups, involve larger sample sizes and more representative samples, examine optimal duration, and identify components that facilitate change.

Two diametrically opposed positions predominate discourse for the care and treatment of persons with severe mental illness: anti-deinstitutionalization and anti-institutionalization. Both share the same goal of ensuring best quality of life for those with severe psychiatric disorders, but pathways to achieving this goal are very different and have resulted in much contention. Supporters of each position espouse a different belief system regarding people with psychiatric disorders and their presumed capabilities, placing varying emphasis on maximizing protection of the community versus protection of individual rights, and result in contrasting mental health policies and practice orientations. The authors delineate the history from which these positions evolved, consequent views, and policies and practices that emerged from these differing attitudes. The article culminates in a proposed practice approach that offers a more balanced approach to serving adults with mental illness -navigating risk management by preserving freedom and opportunities of risk while affording mutually satisfactory "risk control."

BackgroundDespite a sizable minority of persons with serious mental illness (SMI) acting aggressively toward family members, little is known about this topic. The objectives of the present analyses are to examine the association of offenders' SMI status with offender behaviors and victim outcomes and to compare the immediate contextual characteristics of incidents involving offenders with and without SMI.MethodsUsing a cross-sectional design, all incidents of domestic violence to which police were called between adult children and their parents in Philadelphia, PA, in 2013 (N = 6191) were analyzed. Additionally, incidents in which the offender was indicated to have SMI (n = 327) were matched with a sample of incidents in which the offender was not indicated to have SMI (n = 327).ResultsOffenders having SMI was not associated with using a bodily weapon or gun, threatening victims, or damaging property. Offenders having SMI was associated with a decreased risk of offenders using a non-gun external weapon and victims being observed to have a complaint of pain or visible injuries. When offenders had SMI, conflict was less likely to focus on family issues and more likely to focus on offenders' behaviors and to involve contextual characteristics related to mental illness.ConclusionsEfforts to prevent gun and other violence between non-intimate partner family members should target factors more strongly associated with violence than SMI (e.g. history of domestic violence, substance abuse). Intervening in family aggression by persons with SMI likely requires addressing unique circumstances these parties experience.

Background Previous studies have found that suicide rates are likely to increase after the occurrence of earthquakes. Most existing studies that examined the relationship between PTSD and suicidality focus on risk factors. It remains unclear whether protective factors, such as post-traumatic growth (PTG) and social support, play a role in this relationship. Objectives The aim of this study was to investigate the role of PTG and social support in the association between PTSD and suicidality, using data from a cross-sectional study conducted in China. Methods 1,369 participants were recruited from two study sites that were severely affected by the Wenchuan earthquake. Univariate and multivariate regression analyses were conducted to examine the relationship between PTSD, PTG, social support, and suicidality. Results The results indicate that the prevalence of suicidal ideation, suicide plans, and suicide attempts among adult survivors were 9.06%, 2.97% and 3.31%, respectively, even after 8 years following the Wenchuan earthquake. Furthermore, the findings show that PTSD was significantly associated with suicidality (OR = 1.96; 95% CI = 1.53, 2.52). Additionally, individuals reporting lower levels of social support and the acquisition of PTSD (OR = 5.99; 95% CI = 1.66, 21.56) were significantly related to suicidality. Moreover, compared to individuals who reported no presence of PTSD and high PTG, those who lived with PTSD and lower levels of PTG (OR = 2.33; 95%CI = 1.00, 5.42) were more likely to report suicidality. Limitations The cross-sectional design of this study limits our ability to determine causal relationships. Effects of other related factors, such as cultural and life events, were not examined in this study. Conclusions Suicidality is a long-term health issue among survivors of the Wenchuan earthquake. PTG and social support play important roles on the association between PTSD and suicidality and are important contributing factors to understanding this relationship. These results contribute new knowledge of suicidal risk for a number of years after an earthquake and have implications for further mental health promotion following earthquakes.

Background: Although breastfeeding is a major public health priority and provides numerous benefits, women veterans encounter many barriers to initiating and sustaining breastfeeding. Women veterans are a growing population with unique health care needs related to exposures and injuries experienced during military service. These military experiences are linked to health diagnoses known to impact postpartum health behaviors, such as breastfeeding. Research aim: The aim of this study was to identify factors associated with breastfeeding at 4 weeks postpartum among women veterans. Methods: We used 2016-to-2018 survey data from women veterans ( N = 420), interviewed before and after delivery, who were enrolled in maternity care coordination at a national sample of Veterans Health Administration facilities. Using the social ecological model, logistic regression was employed to explore the relationship between breastfeeding at least 4 weeks and postpartum and maternal/infant characteristics, interpersonal dynamics, community influences, and system factors. Results: The rate of breastfeeding at 4 weeks postpartum was 78.6% among this sample of veterans. Self-employed participants were 2.8 times more likely to breastfeed than those who were employed outside the home. Participants who had been deployed at any point in their military career were twice as likely to breastfeed compared with those who never deployed. In this study sample, race independently predicted lower rates of breastfeeding, with African American participants being 48% less likely to breastfeed as compared with white participants. Conclusion: Our analysis suggests significant racial disparities in breastfeeding within veteran populations utilizing Veterans Health Administration, despite access to multiple sources of support from both the Veterans Health Administration and the community.

OBJECTIVE Wellness Recovery Action Plan (WRAP), an illness self-management intervention used internationally, enhances perceived recovery for adults with psychiatric disabilities, but the magnitude of positive change is modest at best. As part of a larger study about how adults with serious mental illness learn and use illness self-management strategies through WRAP, this paper reports on an investigation of the relationship between problem-solving and perceived recovery for WRAP users and addresses the question: To what extent is the degree of problem-solving confidence associated with the degree of perceived recovery for WRAP users? METHOD An anonymous online survey was administered to adults with serious mental illness (N = 82) who had completed the Wellness Recovery Action Plan in the previous 6-24 months, with standardized scales to measure perceived recovery, problem-solving appraisal and confidence, self-reflection and insight, symptoms, and social support. Data were analyzed using multiple regression. RESULTS Problem-solving confidence (p = .013) and social support (p < .001) were associated with degree of perceived recovery, and the model accounted for 40% of the variance. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Whereas WRAP alone is modestly efficacious, it may be that adding a problem-solving intervention for small groups of adults with serious mental illness will increase the magnitude of change in perceived recovery by enhancing problem-solving confidence and increasing ongoing social support through group processes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Mental Health Recovery Model is an empowering service philosophy which has been transforming the field of mental health. An important service approach to actualizing this model is hirin...

In this period of post-deinstitutionalization, much of the care for people with severe psychiatric disorders (PD) is provided by their families. A primary stressor for caregivers is fears regarding their own safety and that of others, which has been virtually unexplored. To fill this gap, factors in three domains were assessed: (1) relatives with PD, (2) family caregivers, and (3) interactions with each other. This investigation was a secondary analysis of data obtained from a national survey of caregivers of adults with mental illness conducted by the National Alliance for Caregiving. A subsample of 1,505 was used in the present study. Fear of harm was positively associated with the following factors: relatives with PD-serious mental health problem, alcohol and substance abuse, receipt of crisis mental health treatment, history of arrest; interaction-greater difficulty getting relative to take medications as prescribed; and fear that relative would be hurt by others or die by suicide. Social workers need to be cognizant of risk of potential violence against caregivers and ensure the safety of these family members, even if they may not be their primary clients. The article includes recommendations for family inclusion in the treatment of people with PD.

Given the critical role of parental care for pediatric cancer patients, this pilot study evaluated the feasibility and effectiveness of a hospital-based solution-focused brief therapy (SFBT) intervention for reducing psychological distress among parents of pediatric cancer patients in China. Differences between treatment and active control (AC) groups were assessed on dimensions of psychological distress. Parents’ level of hope was also assessed. Participants (N = 44) were randomly assigned to SFBT or AC. Parents received four sessions of SFBT twice a week delivered by graduate-level hospital social workers. Pre- and post-intervention assessments measured change in distress (depression, anxiety, and somatization symptoms) of parents as well as their level of hope. Analysis of covariance (ANCOVA) indicated the SFBT group had better outcomes than the AC group on overall distress of somatic, anxiety, depression symptoms and level of hope. Within- and between-group treatment effects reported significantly greater effect of the SFBT group than of the AC group. Considering the inherent limits of a pilot feasibility study, results suggest that SFBT is a feasible, culturally compatible, and promising intervention for alleviating distress among Chinese parents of children with cancer. Additional comprehensive trials are needed to draw more definitive conclusions. SFBT may be beneficial for improving the critical support systems of parents of pediatric cancer patients. Thus, SFBT may have the potential to enhance children’s well-being during cancer treatment and recovery.

Chinese parents of children with congenital heart disease (CHD) experience significant psychological distress due to the child's illness and hospitalization. Unfortunately, there are few psychosocial interventions for parental distress in China. This pilot study aimed to examine the efficacy of solution-focused brief therapy (SFBT) in a Chinese hospital for parental distress using a randomized controlled trial design. The participants included 40 Chinese parents of a currently hospitalized child diagnosed with CHD who were assessed to have psychological distress. Parents were randomized into either the intervention (n = 25) or the hospital medical social work treatment as usual (TAU) (n = 28) group. The Chinese Brief Symptom Inventory-18 and Chinese version of Herth Hope Index were administered before and after the interventions. Results of the intent-to-treat analysis indicated a significant decrease in parental distress and increase in parents' levels of hope in the intervention group compared with the TAU group. This study supported SFBT administered in a hospital setting as a promising intervention for reducing distress among Chinese parents with children diagnosed with CHD.