Susan L. McCammon

The psychological impact of disaster on rescue personnel

Seventy-nine rescue, fire, and medical personnel and police officers who treated victims of an apartment building explosion completed a questionnaire describing their emotional and coping responses to the disaster. Eighty percent had at least one symptom of posttraumatic stress disorder (PTSD). Eight of 21 PTSD symptoms were present in at least 10% of respondents. The most frequently reported symptom, intrusive thoughts about the disaster, occurred in 74% of those working with or searching for victims at the disaster site. On-the-scene rescue workers had significantly more (P less than .02) PTSD symptoms than did inhospital staff. Fifty-two percent of the respondents reported that family members and coworkers were supportive or very supportive in meeting their emotional needs following the disaster; 36% noted that support networks were not helpful. The coping behaviors most frequently used were to remind oneself that things could be worse (57%) and to try to keep a realistic perspective on the situation (53%). Eleven percent reported seeking emotional support from others or looking to others for direction. Emergency workers responding to a contained, small-scale disaster are likely to experience mild stress responses. Planning for the emotional aspects of these events is needed.

Enrichment, stress, and growth from parenting an individual with an autism spectrum disorder

Abstract Background Past researchers have focused primarily on the associated negative impact of caring for a child with special needs. In this study, caregivers report the enrichment and stress of caring for a child with an autism spectrum disorder. Method Eighty caregivers completed the Social Communication Questionnaire (SCQ), Effects of the Situation Questionnaire (ESQ), and Posttraumatic Growth Inventory (PTGI). Enrichment and stress scores were compared to symptom severity data and posttraumatic growth scores. Results Consistent with prior research, caregivers reported greater levels of stress than enrichment. On just over half of the stress/enrichment variables, parental ratings of stress and enrichment were negatively correlated. Scores of total stress and enrichment were not correlated to the severity of the individuals symptoms or caregivers’ growth scores. Conclusions These findings suggest that although stress is a major concern for caregivers, enrichment and growth may also occur in varying degrees.

Personality and Emotional Correlates of Self-Reported Antigay Behaviors

This study examined the relationship between the emotional response of homophobia and selected personality and self-report behavioral variables. Scales 4, 5, and 9 of the Minnesota Multiphasic Personality Inventory were related to the affective components of homophobia as measured by the Index of Attitudes Towards Homosexuals (IAH; formerly Index of Homophobia-Modified) and self-report of past aggressive behavior toward homosexuals as measured by a Self-Report of Behavior Scale (SBS), specifically developed for this study. Data from 80 male subjects were subjected to a canonical correlation analysis. The first cannonical correlation showed that high SBS and high IAH are correlated with adherence to traditional masculine values, not faking good, impulsivity, and social maladjustment. The second canonical correlation indicates that a combination of high scores on Scales 9 and 5 is associated with elevated SBS scores, but decreased IAH scores. These data suggest that among young men certain personality characteristics (Scales 9 and 5) compound homonegative affect and behavior.

Promoting Family Empowerment Through Multiple Roles

SUMMARY A guiding principle in the system of care philosophy for meeting the needs of children with serious emotional problems and their families is that the families “should be full participants in all aspects of the planning and delivery of services” (Stroul & Friedman, 1996, p. 9). Family members, both individually and as representatives of family organizations, are participating in systems of care in a number of vital roles. Friesen and Stephens (1998) delineated six of these roles, and summarized related practice and research. In this paper we expand and continue their discussion of multiple roles, adding a seventh with elaboration of the role of family members as educators and trainers, separating that from the role of service provider. The following roles are reviewed: family members as context; targets for change and recipients of service; partners in the treatment process; service providers; educators and trainers of professionals, students, and other family members; advocates and policymakers; and evaluators and researchers. Recognition of these expanded family roles may help service providers be better prepared to work collaboratively with families and family organizations, and to become aware of the accomplishments that may be achieved through such collaboration.

Wraparound—The Wave of the Future: Theoretical and Professional Practice Implications for Children and Families with Complex Needs

The wraparound process provides a contemporary perspective on providing mental health and related services to children and families with complex needs. Wraparound is a strengths-based, family driven orientation that focuses on the uniqueness of each child and family. In this article, the professionals role in the wraparound process is highlighted. Part 1 offers a historical perspective; political and economic implications atfederal, state, and community levels focusing on wraparound; and summarizes research outcome data associated with its use. Part 2 emphasizes clinical practice implicationsforfamily nurses or service providers in other disciplines who work with these children and families. A case study demonstrates how structural family therapy may be used as a theoretical framework in concert with the wraparound process.

Systems of care as asset-building communities: implementing strengths-based planning and positive youth development.

Using a strength-based approach is one of the hallmarks of the system of care (SOC) initiative, and is consistent with the foundations of community psychology. However, while strengths-based planning is recommended and child and family teams often list child and family strengths, the care plans often do not incorporate the strengths in strategies and interventions. The research base regarding strength implementation and effectiveness is summarized, and needed research is outlined. Steps are offered for promoting the use of strengths in SOCS. Implementing programs from the field of positive youth development is advocated as a way that the educational and criminal justice systems could be more actively engaged in implementing strength-based strategies in SOCs. Promoting SOCs to focus more attentively to asset-building (at the child, family, and community level) is compatible with a public health model that addresses mental health concerns in the context of a full range of supports and services so that all children might experience good mental health and realize their potential.

The Complexities of Implementing a Wraparound Approach to Service Provision: A View from the Field

SUMMARY The authors offer the perspective of several service providers on the benefits and barriers encountered in implementing the wraparound model within the context of a federally funded project to enhance a local system of care. The Pitt Edgecombe Nash-Public Academic Liaison project was instituted in three rural counties in Eastern North Carolina. A hallmark of this program was the role of families as treatment partners with the emphasis on collaboration among agencies, families and service providers. The actual process is organized by a service coordinator and led by an individual service team. While implementing the wraparound model, benefits and barriers were encountered at all levels of intervention. The authors suggest that quality-monitoring efforts should include the task of assessing implementation on an ongoing basis with an emphasis on analysis of the barriers and benefits encountered and subsequent midstream corrections to improve the wraparound model for each individual community.

School-Based Post-Flood Screening and Evaluation: Findings and Challenges in One Community

ABSTRACT This study examined a school-based screening and evaluation project to identify children with adjustment problems following a natural disaster. Six hundred twelve children ranging in age from 5 to 19 were screened in the aftermath of a hurricane and extensive flooding. Two hundred forty-eight children and 86 parents participated in the evaluation phase of the project, although few completed all measures. Severity of exposure alone was a limited predictor of child adjustment. However, screening for depression increased prediction of adjustment, and screening for traumatic stress symptoms helped predict parent-reported child PTSD. Barriers to conducting a school-based screening are discussed.

A Conceptual and Empirical Basis for Including Medical Family Therapy Services in Cancer Care Settings

Psychosocial interventions in oncology settings have largely been individually and group-based despite evidence that a family-based approach fills a treatment gap in the cancer care experience. Medical Family Therapists are trained to address the family as the unit of treatment and provide services that consider family dynamics, reorganization of couple and family roles, and broader systemic issues. This article describes the conceptual bases for Medical Family Therapy services provided in cancer care settings, and reviews research on their implementation and effectiveness. Following a review of the literature, recommendations for studying the effectiveness and efficacy of MedFT in cancer care treatment are detailed.

Sexual health concerns in patients with cardiovascular disease.

Sexual health concerns are common in patients with all types of cardiac disease, including patients with coronary artery disease, patients after a heart attack, those with implantable cardioverter-defibrillators, and patients with chronic heart failure.1–5 In fact, approximately 60% to 90% of patients with chronic heart failure acknowledge sexual dysfunction.2 Heart patients often experience changes in their ability to engage in and enjoy a broad range of sexual activities, which can result in less frequent and less satisfying sexual experiences. Sexual health is an important quality-of-life concern for patients and their partners, and healthcare providers can often help if they are aware of the problem. For men, the most frequently reported sexual problems include reduced sexual desire and difficulty achieving and maintaining an erection.2 Cardiovascular disease and its treatment may also affect a man’s ability to achieve orgasm. Women are more likely to experience decreased sexual desire, problems with orgasm, vaginal dryness, and pain during intercourse.1 See Table 1 for a list of common sexual problems in cardiac patients. View this table: Table 1. Common Sexual Problems Unfortunately, sexual problems are often not reported and go untreated, and they may negatively affect your physical recovery, emotional well- being, and intimate partner relationships. Moreover, studies suggest that a majority of patients and their partners have questions or concerns about their sexual health.6 Often, these concerns go unexpressed and remain untreated during routine cardiac care. Therefore, the purpose of this patient page is to describe common sexual difficulties, to identify strategies to improve your sexual health, to discuss …