Mark B. White

Problems That Couples Bring to Therapy: A View across the Family Life Cycle.

This study examined reports of marital problems from couples at different stages of the life course. Data were collected from 160 couples during intake at a family therapy clinic. Couples were asked to indicate their presenting problem, as well as their level of severity in 14 problem areas, such as communication and financial issues. Results indicated that presenting problems were generally the same, regardless of whether the couple was newly married, in the child-bearing years, or married over a decade. Moreover, wives reported more problems in their relationships than did husbands, especially among wives married longer than 10 years.

Secondary traumatization in pediatric healthcare providers: compassion fatigue, burnout, and secondary traumatic stress.

The primary aim for this research was to explore the overlap and differences between the concepts related to secondary traumatization: posttraumatic stress disorder (PTSD), secondary traumatic stress (STS), compassion fatigue (CF), and burnout (BRN). A secondary aim for this research was to examine the impact of secondary traumatization and some of the personal and professional elements that affect how pediatric healthcare providers experience PTSD, STS, CF, and BRN. An online survey was sent via e-mail to numerous list serves for healthcare providers who had worked on PICU, NICU, or PEDS units within the last year. The analyses revealed that a significant overlap existed between the terms of STS, PTSD, BRN, CS, and CF for PICU, NICU, and PEDS providers. However, a hierarchical linear regression revealed a significant amount of unique contributions to the variance in CF based on each of the measured concepts. Despite previous literature that indicates that the terms STS and CF can be used interchangeably, the two most prominent measures utilized in the assessment of CF and STS are actually capturing at least some unique elements. Given these results, future researchers should examine and conceptualize the difference in etiology, prevalence, symptoms, and treatment efficacy for CF and STS as separate but related entities and then return their focus to understanding secondary traumatization in healthcare providers.

Group treatments for women sexually abused as children: a review of the literature and recommendations for future outcome research

OBJECTIVE Adults with a history of sexual abuse often suffer many long-term consequences. It is important that therapists be able to provide effective treatment to address the host of issues that are presented in therapy by adult survivors of childhood sexual abuse (CSA). In order to provide the best possible treatment, therapists should know which treatments are most effective. METHOD This paper provides a critique of the outcome research of 13 studies (six uncontrolled and seven controlled) on the treatment of adults who suffered childhood sexual abuse and discusses specific methodological strategies that can enhance the quality of such research in the future. RESULTS Although many of the studies contain methodological limitations, the results generally indicate that group treatment helps reduce symptomatology in the short-term and at follow-up. CONCLUSION Although outcome research has not been published on specific individual or conjoint treatment approaches for adult survivors of CSA, several outcome studies have found group treatment to be effective in the recovery of female CSA survivors.

The First-Year Veterinary Student and Mental Health: The Role of Common Stressors

The present study evaluated the impact of academic and non-academic stressors on depression levels in a longitudinal investigation of 78 first-year veterinary medical students enrolled at Kansas State University (KSU). Students completed the Center for Epidemiological Studies Depression Scale during their first and second semesters to evaluate the dependent variable, depression. Students provided information about specific stressors and relevant demographic variables that yielded independent variables. One-third of veterinary medical students surveyed in their first and second semesters reported depression levels above the clinical cut-off; 15% of the sample experienced an increase in depression of at least one standard deviation, despite the apparent stability of the proportion of students experiencing significant depressive symptoms. Students whose depression scores increased by one standard deviation or who maintained scores above the clinical cut-off score were identified as struggling. Struggling students reported more first-semester homesickness and academic concerns, along with difficulty fitting in with peers and poorer perceived physical health during the second semester. This study helped to identify those students most prone to develop or maintain concerning depression scores. The discussion section addresses specific suggestions for intervening with struggling students.

Maternal fatigue and its relationship to the caregiving environment.

For women with an autoimmune illness, fatigue can be a debilitating symptom that impacts many aspects of their life. There is scant research on maternal fatigue and its impact on the caregiving environment for either well women or women with chronic illnesses. The objective of this study was to examine the role maternal fatigue played in the caregiving environment, specifically in the mothers experience of the daily hassles of parenting, the discipline style she employed, and how she monitored her childs whereabouts. Two-hundred sixty-two mothers participated in this study: 103 mothers with multiple sclerosis (MS), 68 mothers with rheumatoid arthritis (RA), and a comparison group of 91 well mothers. Mothers completed questionnaires assessing their self-reported levels of fatigue, depression, quality and quantity of sleep, parenting daily hassles, discipline styles, and monitoring. After sleep, depression, and number of children were controlled for, fatigue explained additional variance in predicting monitoring for all three groups of mothers. Fatigue was also a significant predictor of parenting daily hassles for both well mothers and mothers with RA, but not for mothers with MS. For mothers with MS, it was the covariates (i.e., the number of children in the family and sleep quality and quantity) that were predictive of parenting daily hassles. Several explanations for mothers with MS not being as influenced by fatigue are discussed.

Invisible and Visible Symptoms of Multiple Sclerosis : Which Are More Predictive of Health Distress?

&NA; The purpose of this study was to examine whether it is the invisible or the visible symptoms or signs of multiple sclerosis (MS) that are associated with greater health distress. Visible symptoms include the use of assistive devices, problems with balance, and speech difficulties, while invisible symptoms include fatigue, pain, depression, and anxiety. In a sample of 145 adults with MS, participants reported on these symptoms and their current level of self‐reported health distress. Hierarchical regression analyses were used to determine whether invisible or visible symptoms were more predictive of health distress. When visible symptoms were added as the first step in the regression, 18% of the variance in health distress was explained. When invisible symptoms were added as the first step, 53% of the variance was accounted for. The invisible symptoms of pain and depression were the most significant predictors of distress. For a subset of the sample that had had MS for more than 11 years, pain and depression continued to be important predictors, but assistive‐device use and fatigue were also important. Nurses should be aware that invisible symptoms may be more troubling to patients than visible symptoms and should ensure that adequate screening and treatment are provided for those with MS.

Technological Implications for Clinical Supervision and Practice

Abstract This paper will review and describe the use of ‘virtual’ (i.e., persons interacting in different geographic locations) technologies in clinical supervision. First, a rationale for using such technologies as a tool for doing clinical supervision will be presented. Second, a review and description of available technological resources will be offered. These include: e-mail, computer-mediated communication (CMC), videoconferencing (VC), Internet or World Wide Web, and WebTV. Third, some of the settings that have utilized such technological resources in conducting clinical supervision (i.e., psychiatry, medicine, education) and therapy will be reviewed. Ethical issues in using these technologies and implications for supervision will be explored.

Chronically ill mothers experiencing pain: relational coping strategies used while parenting young children

Objective: There has been little research on women who are parenting while they experience pain and none of this research has focused on mothers with young children. The purpose of this study was to consider relational coping strategies generated by mothers that they used when parenting young children and experiencing pain. Methods: Two-hundred sixty-two mothers participated in this survey research; 171 who have either multiple sclerosis (MS) or rheumatoid arthritis (RA), and a comparison group of 91well mothers. Mothers completed questionnaires inquiring about (a) their coping strategies, (b) levels of pain, fatigue and physical functioning, and (c) if they were currently experiencing an exacerbation of their chronic illness. Results: Well mothers reported using more self-care when parenting while experiencing pain. Mothers with RA were more likely to set boundaries around their behaviour. Women with MS who were experiencing an exacerbation changed their coping strategies to include more child activities and encourage more mature child behaviour when compared to women with RA who were experiencing an exacerbation. Discussion: From the perspective of relational coping theory, mothers consider their own pain while simultaneously attending to their responsibilities as a parent. Previous research has suggested that women may withdraw or reduce their parenting activities when they are in pain and this study supported the previous research, especially for women with RA.

Understanding Social Support and the Couple's Relationship Among Women with Depressive Symptoms in Pregnancy

This qualitative study explored the experiences of seven couples where the female partner experienced depressive symptoms during pregnancy. Female and male partners were interviewed together and data was collected and analyzed according to Colaizzis () phenomenological research design. The interviews yielded the following themes: (a) Challenges and stressors associated with depressive symptoms during pregnancy, (b) Pregnancys effect on mood states, (c) Relationship dynamics that influence moods, (d) Pregnancy and the influence of mood on relationship dynamics, and (e) Reliance on external sources of support. The findings extend current research and provide insight into possibilities of how to enhance assessment and intervention for women who are depressed during pregnancy by including a relational component. Findings, clinical implications, and future research are discussed.

Clinical Decision-Making Strategies of Marriage and Family Therapists in the Treatment of Adult Childhood Sexual Abuse Survivors

The incidence of childhood sexual abuse (CSA) in the general population, as well as the greater prevalence of CSA survivors among those who enter therapy, mean that therapists are likely to treat sexual abuse survivors in their clinical work. A modified Delphi study was used to collect data to determine how American Association of Marriage and Family Therapy (AAMFT) Approved Supervisors make treatment decisions following client disclosures of CSA. Three rounds of data were collected. The results suggested that there are several issues to address in therapy regardless of treatment modality and disclosure type. Suggestions for treatment were provided depending on the disclosure scenario.