Carol M. Anderson

Women in families : a framework for family therapy

This comprehensive book, ideal as a basic text in family therapy and womens studies, addresses the question of how women experience family life from a variety of perspectives. It covers gender issues in family therapy theory, practice, and training; women in context (ethnicity and life cycle issues, marriage, motherhood, sisterhood, women alone, lesbian couples), and such special issues as work, addiction, and mental illness.

Designing websites for persons with cognitive deficits: Design and usability of a psychoeducational intervention for persons with severe mental illness.

The purpose of this study was to develop an understanding of the design elements that influence the ability of persons with severe mental illness (SMI) and cognitive deficits to use a website, and to use this knowledge to design a web-based telehealth application to deliver a psychoeducation program to persons with schizophrenia and their families. Usability testing was conducted with 98 persons with SMI. First, individual website design elements were tested. Based on these results, theoretical website design models were used to create several alternative websites. These designs were tested for their ability to facilitate use by persons with SMI. The final website design is presented. The results indicate that commonly prescribed design models and guidelines produce websites that are poorly suited and confusing to persons with SMI. Our findings suggest an alternative model that should be considered when designing websites and other telehealth interventions for this population. Implications for future studies addressing the characteristics of accessible designs for persons with SMI and cognitive deficits are discussed.

A Clinical Trial to Test the Feasibility of a Telehealth Psychoeducational Intervention for Persons With Schizophrenia and Their Families: Intervention and 3-Month Findings

OBJECTIVE To evaluate the feasibility of a telehealth psychoeducation intervention for persons with schizophrenia and their family members. STUDY DESIGN Randomized controlled trial. PARTICIPANTS 30 persons with schizophrenia and 21 family members or other informal support persons. INTERVENTIONS Web-based psychoeducation program that provided online group therapy and education. MAIN OUTCOME MEASURES Measures for persons with schizophrenia included perceived stress and perceived social support; for family members, they included disease-related distress and perceived social support. RESULTS At 3 months, participants with schizophrenia in the intervention group reported lower perceived stress (p = .04) and showed a trend for a higher perceived level of social support (p = .06). CONCLUSIONS The findings demonstrate the feasibility and impact of providing telehealth-based psychosocial treatments, including online therapy groups, to persons with schizophrenia and their families.

Quality of Life for Persons Living with Schizophrenia: More Than Just Symptoms.

Quality of life is an important outcome for persons living with schizophrenia and for the treatment of schizophrenia. However, studies of quality of life among persons living with schizophrenia have focused primarily on the symptoms experienced by the individual. This study sought to determine the influence of unmet need and social support on the quality of life of individuals with schizophrenia. Thirty-two persons living in the community with schizophrenia or schizoaffective disorder were assessed on quality of life, psychopathology, unmet need and social support. Hierarchical regression analyses indicated that unmet need and social support are important contributors to the quality of life of a person with schizophrenia, even after controlling for symptoms. Implications for schizophrenia treatment are discussed.

Use of the Child Behavior Checklist as a Diagnostic Screening Tool in Community Mental Health.

Objective: This study examines whether the Child Behavior Checklist (CBCL) can be used as an accurate psychiatric screening tool for children in community mental health settings. Method: Associations, logistic regression models, and receiver operating characteristic (ROC) analysis were used to test the predictive relationship between the CBCL and structured interview-derived diagnoses. Results: Associations between CBCL subscales and specific diagnoses were found, replicating results of previous research. Multivariate models and ROC scoring led to correct diagnostic predictions in a large majority of participants. Corresponding sensitivities, however, were deemed inadequate as they indicated that the screen would miss an unacceptably high number of cases. Conclusions: Using the CBCL as a diagnostic screening tool would result in a large number of cases being missed by the screen. Although the CBCL is unlikely to accurately identify children with specific diagnoses, it could be used as a triage tool to inform practitioners if an in-depth structured diagnostic interview is necessary.

Effects of structural family therapy on child and maternal mental health symptomatology

Objective: This pilot study examined the effect of structural family therapy (SFT) on children’s impairment and depressive symptomatology and mothers’ depressive symptomatology and anxiety for 31 families served by a community mental health clinic. Method: A one group predesign/postdesign, with a baseline and two follow-up time points, was used. Results: A series of repeated measures analyses of variance showed significant improvement for mothers’ depression, F(2, 36) = 6.93, p = .003, η2 = .278, and anxiety, F(2, 34) = 6.44, p = .004, η2 = .275. Mothers’ ratings of their children’s impairment significantly improved, F(2, 42) = 6.27, p = .005, η2 = .270, though children’s self-rated impairment and depressive symptomatology did not change. Results were confirmed using random regression analyses. Conclusion: SFT has promise for simultaneously addressing mothers’ and children’s needs in community mental health settings. However, structural barriers impacting feasibility were identified and discussed.

Case managers' perspectives on what they need to do their job.

OBJECTIVE The purpose of this brief report is to identify the perceived training needs of case managers working on community support teams in a community mental health center serving a semi-rural/suburban area. METHODS Semi-structured interviews were conducted with 18 case managers and 3 supervisors to inquire about areas of training need in case management. Interviews were coded and analyzed for common themes regarding training needs and methods of training improvement. RESULTS Identified training needs called for a hands-on, back-to-basics approach that included education on the symptoms of severe mental illness, co-morbid substance use problems, and methods of engaging consumers. A mentoring model was proposed as a potential vehicle for disseminating knowledge in these domains. CONCLUSIONS Case managers identify significant training needs that would address their basic understanding of severe mental illness. Programs targeting these needs may result in improved outcomes for case managers and the individuals with psychiatric disabilities they serve.

The Relationship Between Maternal and Child Symptom Change in Community Mental Health

The mental health of mothers and children are closely linked. This study examined the relationship between child and maternal symptom change during a period in which children participated in community mental health treatment. Symptom change was measured using the Child Behavior Checklist for children and the Beck Depression Inventory for Mothers. Results indicate that mothers whose children improve in community mental health treatment are significantly more likely to report a reduction in maternal depressive symptoms than mothers whose children do not improve. Implications of these findings for mental health service settings are discussed.

Factor Analysis of Data on the Barrett-Lennard Relationship Inventory from Married Couples

The Barrett-Lennard Relationship Inventory was administered to 264 husbands and 259 wives and the data were factor analyzed separately for males, females, and total sample. The inventorys five subscales (Level of Regard, Empathic Understanding, Congruence, Unconditionality of Regard, and Willingness To Be Known) did not emerge as factors. Instead, two general factors were identified, one related to positive affect and attitudes and the other to negative affect and indifference. Findings were briefly discussed in terms of the work of Bradburn and others.

Structural Design for a University–Agency Research Collaboration: Bridging an Historical Distance:

Social service agencies need the knowledge that can be gained through research, and universities are equipped to conduct research. It seems like a natural partnership. Yet, university research conducted in agencies often fails to satisfy the interests of either party. In seeking successful frameworks for meaningful applied research in community settings, universities and agencies must form an intentional relationship that integrates the capacities of the differently oriented partners. This article describes a partnership framework in which both community agency staff and university researchers discarded the usual disunified approach to addressing service questions and committed to an embedded, interactive, investigative model in which all participants merged their specific skills to gain mutually fulfilling outcomes.