Desiree M. Seponski

The Impact of PREPARE on Engaged Couples: Variations by Delivery Format

To further advance our understanding of the efficacy of inventory-based premarital education programs, this study examined whether the effects of the PREPARE program varied by delivery format. Following participation in the program, engaged couples exhibited positive gains in knowledge, felt more confident in their relationship, engaged in more positive conflict management behaviors, and felt more satisfied with their relationship. No differences were found between participants who completed a series of conjoint sessions versus a 1-day group workshop. These findings highlight the robustness of premarital education and suggest group workshops can have similar effectiveness as the more prevalent conjoint sessions.

A Practitioner’s Guide to End-of-Life Intimacy

Sexuality and intimacy, including contact, tenderness, and love, are important at every life stage. Intimate expression is especially vital at the end of life, when relationships with loved ones are time limited. Unfortunately, care providers often ignore the potential need for sexual expression, especially at the end of life. In this article, we consider current research on sexuality and end-of-life care and situate these two fields in an ecological framework. We explore how end-of-life sexuality and intimacy can be supported by practitioners in multiple nested contexts and provide suggestions for theoretically-driven interventions. We also provide reflexive considerations for practitioners.

Cross-cultural supervision in international settings: experiences of foreign supervisors and native supervisees in Cambodia

With the global expansion of family therapy, it is vital to engage in culturally responsive methods of training and supervision. This is especially critical when international training involves Western-based therapy models and supervision from non-native supervisors. This study explores how native Cambodian therapists experience clinical supervision conducted by non-native supervisors. In this responsive evaluation, data were triangulated across multiple stakeholders (N = 95) and collection methods, including focus groups, interviews, and live supervision observations. Emergent themes highlight the need for intentionally culturally responsive supervision and included challenges with non-native supervisors, unresponsive methods of learning and power imbalances. Therapists emphasized that they were less likely to attend supervision and felt discouraged when it was not culturally responsive. Data-driven suggestions for increasing cultural responsiveness in supervision are provided. Practitioner points Supervisors can challenge personal cultural assumptions and deepen contextual understanding by seeking local cultural knowledge Supervision contracts created with input from stakeholders can attend to likely cultural differences The supervisory relationship can be supported through open discussion and negotiation of cultural differences In cultures with high regard for those in authority, supervisors can use a strengths-based approach to feedback and demonstration

Conflict and Care Israeli Healthcare Providers and Syrian Patients and Caregivers in Israel

Israel has provided immediate healthcare to Syrian children, civilians and fighters since early 2013 despite being in an official state of war with Syria since 1973. We present qualitative findings from a larger mixed-methods phenomenological study to understand how the geopolitical and social history of Israel and Syria influences healthcare providers and Syrian patient caregivers in northern Israel. Theories of humanization and cognitive dissonance guided this study and frame the beliefs and experiences of healthcare providers who treated wounded Syrians in Israeli hospitals. Findings indicate healthcare providers and Syrian caregivers adjusted their beliefs to allow for positive healthcare experiences. Qualitative analysis revealed two major themes: supportive and hindering systemic elements contributing to the healthcare provider-patient-caregiver relationship. Internal psychological developments, contextual factors, and relational processes influenced humanization of the other within the relationship. This study illuminates unique ethical and humanitarian demands relevant for healthcare workers and those with whom they interact.

Four decades following the Khmer rouge: sociodemographic factors impacting depression, anxiety and PTSD in Cambodia

Abstract Background: Reliable population-based epidemiological data of Cambodian mental health is lacking. Aims: This study identifies the prevalence of and factors associated with anxiety, depression and PTSD in Cambodian adults. Methods: A nationally representative sample of Cambodian adults (N = 2690) was interviewed utilizing the Harvard Trauma Questionnaire (assessment of PTSD symptoms) and the Hopkins Symptom Checklist-25 (assessment of symptoms of anxiety and depression). Results: Respondents expressed high rates of anxiety (27.4%), depression (16.7%) and PTSD (7.6%). Correlations between symptoms and sociodemographic markers varied in significance. Women had significantly higher rates of mental health symptoms than men. Women who were in debt, widowed or divorced and had low levels of education were the most likely to report symptoms. Conclusions: These findings can inform Cambodian mental health policies and development strategies, especially targeting the most vulnerable groups.

Thank You for Including Us! - Introducing a Community-Based Collaborative Approach to Translating Clinic Materials

When working with clients in another language, having culturally relevant and properly translated clinic materials is vital to effective clinical practice. Not having them presents a barrier for bilingual therapists and their clients. This paper reviews common translation methods and introduces a multi-level, community-based approach for translating clinic materials for non-English speaking clients. Informed by decolonizing practices, this five-tier method includes members from the target community as cultural brokers to verify the accuracy and nuances of language for their cultural group, as well as a constant comparative method to ensure methodological rigor in the process of inclusion. We present community members feedback and recommendations, as well as discuss advantages and challenges of using this collaborative culturally responsive translation method.

Family, Health, and Poverty Factors Impacting Suicide Attempts in Cambodian Women

Background: Our recent report demonstrates that 5.5% of Cambodian women have previously attempted suicide. Despite these high rates and critical need for intervention, research on suicide attempts in Cambodia is lacking, and life-saving information on suicide prevention is therefore unknown. Aims: This study explores factors impacting Cambodian women suicide attempts. Method: A total of 1,801 women participated in the large national survey during which 100 of these women (5.5%) reported at least one suicide attempt. Of the 100 participants 76 provided qualitative reasons for the suicide attempts. Only the 76 who provided the reasons for suicide attempt were included for analysis in this study. Results: Four major themes emerged: (1) family conflict, (2) emotional distress, (3) poverty, and (4) illness. Family conflict, emotional distress, poverty, and illness were all interrelated with each other; for example, women without money were unable to pay for treatment of otherwise treatable illnesses. Limitations: Owing to the nature of the data collection, member checking could not be conducted. Conclusion: Cumulative and intertwined personal, interpersonal, and contextual-level factors impacting suicide attempts included emotional distress, illness, family conflict, and poverty. Findings highlight points of intervention at individual, familial, and contextual levels to prevent suicide.

Mental Health Indicators of Suicide in Cambodian Women

Global suicide rates are steadily increasing, and suicide completions in Asia outnumber those in Western countries. Young females are especially at risk, with higher rates of completion and lack of suicide support because of familial and cultural stigma and constraints. Lack of infrastructure to systematically record suicide deaths and attempts makes studying suicide in low- and middle-income countries challenging. Given the critical public health need for suicide intervention and prevention, research on suicide is crucial. The present study adds to the lack of information regarding suicide in Cambodia by exploring reports of attempted suicide by women from a nationally representative sample of Cambodian women (N = 1813). In a series of logistic regression models, findings indicate that a culturally salient measure of Cambodian syndromes, symptoms of depression, and posttraumatic stress disorder contributed to increased odds of attempting to commit suicide. Implications for policymakers and interventionists within Cambodia and Asian contexts are discussed.

Humanitarian healthcare: treating Syrian patients in Israeli hospitals

Purpose The purpose of this paper is to present the findings on interpersonal relational processes of Israeli healthcare providers (HCPs) and Syrian patients and caregivers using data collected in two Israeli hospitals. Design/methodology/approach Using a parallel mixed-methods design, data were integrated from observations, interviews, and surveys. In total, 20 HCPs and three Syrian patient caregivers provided interview data. Quantitative data were collected from 204 HCPs using surveys. The qualitative component included the phenomenological coding. The quantitative analysis included factor analysis procedures. Throughout parallel analysis, data were mixed dialogically to form warranted assertions. Findings Results from mixed analyses support a three-factor model representing the HCPs’ experiences treating Syrian patients. Factors were predicted by religious and occupational differences and included professional baseline, humanitarian insecurity, and medical humanitarianism. Research limitations/implications Limitations of this study included issues of power, language differences, and a small Syrian caregiver sample. Practical implications As the fearful, injured, and sick continue to flee violence and cross geopolitical borders, the healthcare community will be called upon to treat migrants and refugees according to ethical healthcare principles. Originality/value The value of this research is in its critical examination of the HCPs’ interactions with patients, a relationship that propels humanitarian healthcare in the face of a global migrant crisis.

A Feminist-Informed Integration of Emotionally Focused and Solution-Focused Therapies

ABSTRACT This article outlines the integration of emotionally focused and solution-focused therapies through a feminist family therapy lens. Integrating therapy models using a feminist-informed lens strengthens traditional family therapy models by addressing gender, ethnic, racial, and social inequities in the family and therapeutic relationships. The epistemology, theoretical framework, and brief overview of each model are provided and a proposed integration is described in-depth, with a table presenting the merging of the models in regards to the stages and steps of emotionally focused therapy so one can move from abstractly discussing feminist issues to integrating them in theoretically consistent, intentional manner.