Posttraumatic Growth in Women With a Long-Standing Experience of Involuntary Childlessness in the Czech Republic

This qualitative research study aimed to examine aspects of posttraumatic growth (PTG) in women with a long-standing experience of involuntary childlessness. In-depth semi-structured interviews, lasting an average of 53 min, were conducted in the Czech Republic. Twenty-four women, averaging 38.8 years old with an average of 6.2 years of infertility experience, participated. They were asked how involuntary childlessness affected/changed their partnerships, sexual life, job, future plans, attitude to children/values/faith, and leisure time. Participants shared both positive and negative aspects of the infertility experience. Data were analyzed using thematic analysis. Five main themes of PTG were identified: strengthening of partnership, greater humility, deeper self-appreciation, reassessment of relationships, and changes in the philosophy of life. These findings could be useful to mental health providers to facilitate the PTG process in patients.

Psychosocial concerns in a context of prolonged political oppression: Gaza mental health providers’ perceptions

In this qualitative exploratory study, we investigated the perspectives of mental health providers in Gaza, Palestine, regarding the primary concerns of their clients who are exposed to low-intensity warfare and structural violence. We conducted qualitative interviews with 30 psychologists, social workers, psychiatric nurses, and psychiatrists providing services to communities in Gaza. Participants were asked to discuss their clients’ most commonly occurring mental health problems, diagnoses, and psychosocial conditions. Thematic analysis identified one superordinate theme (Impact of the Blockade on Mental Health and Quality of Life) and four second-order themes (Concerns about Social Problems, General Concerns about Quality of Life, Concerns about the Mental Health of the Community, and Concerns Related to Children's Mental Health). Participants indicated that the social and political dimensions of mental health and the economic, educational, and health-related consequences of the ongoing blockade of Gaza were the main determinants of psychological burden among their clients. Findings demonstrated the importance of adopting an approach to mental health that includes understanding psychological indicators in a broader framework informed by human rights and social justice. Implications for research and clinical work are discussed, including the role of investments in social capital that may provide individuals with access to resources such as social support, which may in turn promote overall mental health.

Using evaluative frameworks to examine the implementation outcomes of a cognitive behavioral therapy program for autistic students with anxiety within public school settings

Cognitive behavioral therapy for youth with autism spectrum disorder and anxiety is effective, but disparities exist in accessing these programs. Training school providers to deliver cognitive behavioral therapy may help to address these disparities. However, little is known about how cognitive behavioral therapy programs are implemented by interdisciplinary school providers and the broader impact of these programs. This study aimed to address this gap and was part of a larger trial that examined the effectiveness of Facing Your Fears–School-Based across 25 public schools. Study aims were to understand the impact of Facing Your Fears–School-Based and factors that impacted implementation. Thirty providers participated in exit interviews guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Primary themes included (1) the fit of Facing Your Fears–School-Based for diverse students; (2) the effects of Facing Your Fears–School-Based on students’ school participation; and (3) planned Facing Your Fears–School-Based maintenance. Participants also highlighted the program’s accessibility for non-mental health providers and reported adapting Facing Your Fears–School-Based in response to student needs. Results suggest that Facing Your Fears–School-Based may have a broader impact on students and highlight the importance of task sharing to overcome mental health staff shortages within public schools. Programs that can be implemented flexibly are also critical given variability in school structures and student needs. Lay abstract Cognitive behavioral therapy helps to treat anxiety symptoms in autistic youth, but it is difficult for families to access cognitive behavioral therapy in the community. Training school providers to deliver cognitive behavioral therapy may help autistic youth and their families to access these programs. Unfortunately, we do not know how cognitive behavioral therapy programs can be delivered by school providers and how these programs help the autistic students who access them. This study addressed this gap and was part of a larger study that looked at the effectiveness of Facing Your Fears–School-Based in 25 public schools. The study goals were to understand whether Facing Your Fears–School-Based helped students and the factors that made it easy or difficult to deliver Facing Your Fears–School-Based in schools. Thirty providers participated in interviews guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Participants shared information that fell into several major categories that included (1) delivering Facing Your Fears–School-Based to many different students; (2) the positive impact of Facing Your Fears–School-Based on students’ school participation; and (3) plans to continue using Facing Your Fears–School-Based. School providers also shared that Facing Your Fears–School-Based was easy to use for non-mental health providers and reported adapting Facing Your Fears–School-Based to meet student needs. The results of this study suggest that Facing Your Fears–School-Based may help autistic students and highlight the importance of using mental health programs in schools that are flexible, able to be adapted, and that are able to be used by many different types of school providers.

In Pursuit of Development: Post-Migration Stressors among Kenyan Female Migrants in Austria

The emphasis on migration for development obscures its diverse challenges. The migration development nexus is paradoxical, problematic, and controversial. Remittances have long gained wide interest. Migrants’ subjective experiences are important in understanding overall migration outcomes. International African female migration has increased and it is underexplored. This paper investigates the psychosocial stressors of migration based on the lived experiences of Kenyan female migrants in Austria. A sample of 6 female migrants was selected. Narrative data were recorded and analysed using interpretative phenomenological analysis. The findings showed that migration resulted in troubled relationships within the core and extended families. The economic dependency of family members in Kenya caused conflicts in interracial marriages. Acculturation led to alienation, family separation and isolation. Achieving economic goals proved challenging due to unpredictable effects in Austria. Failed expectations driven by stereotypes about Europe resulted in disillusionment and high expenses. Routine racism and Black female body objectification affected the mental health of the participants. This article contributes to knowledge on international African migration and gender-specific issues concerning African female migrants. The results will inform policymakers, academia, future migrants and mental health providers. Further research on the effects of migration on African migrants is recommended.

Validation of the Arabic Version of the Refugee Health Screener-13 Among Perinatal Syrian Refugees in Lebanon

Background: Refugee mothers are at a significantly increased risk of suffering from perinatal depression. However, available tools to screen for it often use a western paradigm of mental health, may not be culturally appropriate, and may not account for the background stress experienced by refugees. The objective of this study is to test and validate RHS-13, which was developed by consultation with refugees from different backgrounds, among a group of Syrian refugee mothers living in Beka’s valley in Lebanon. Methodology: The tool was tested on a sample of 103 women. Internal consistency of the items for each subscale was assessed using Cronbach’s alpha. An interitem correlation was performed to examine the most correlated items on the scale. Pearson correlation coefficient was calculated between each subscale and its diagnostic proxy. To find the best fit cut-point between sensitivity and specificity, ROC curves were used. Results: RHS-13 is a reliable and valid tool to detect depression and anxiety among perinatal Syrian mothers (Internal consistency 0.803) (correlation with PHQ: 0.63), (correlation with GAD-7: 0.73). The best fit cut-points were 12, 15, and 25 indicating the severity of symptoms from mild to severe, respectively. Conclusion: RHS-13 is a valid tool among perinatal refugees in Lebanon and can be used by primary care physicians, mental health providers, social workers working with refugees from the Middle East to screen mothers for depression and anxiety.

Psychosocial Experiences That Support Positive Self-Concept in Children with Cleft Lip and Palate Adopted From China

Objective Existing psychosocial research offers little information on the unique challenges and strengths of children adopted from China with cleft lip and/or palate (CL/P). The present study aimed to understand biopsychosocial factors that support positive self-concept in this population. Design Qualitative, semistructured interviews were conducted with children and their parents. Interpretive phenomenological analysis of transcribed interviews was utilized for data analysis. Setting Participants were recruited in an outpatient, pediatric multidisciplinary cleft clinic during a standard team visit. Patients, Participants Participants were ages 8 to 12 years with a diagnosis of isolated cleft lip-palate who were internationally adopted from China before the age of 2 years and English-speaking. Participants also included English-speaking parents. Results Themes reflecting data from the child and parent subsamples include: (1) child's characteristics, (2) family strengths, (3) adoption identity, (4) cultural identity, (5) coping with a cleft, and (6) social factors. Additional 2 to 3 subthemes were identified for the parent and child subsamples within each broader theme. Conclusions Findings from this sample suggested factors supporting positive self-concept included pride and self-efficacy in activities, family support, instilment of family values, strategies for coping with a cleft, family belonging, cultural exposure, and normalization of differences. Medical providers can support patients and families by providing education on surgeries, CL/P sequelae and outcomes, and pediatric medical stress. Mental health providers can screen for social and emotional challenges and provide psychoeducation on racial/ethnic socialization, identity development, and coping.

Evaluation of an Advanced Topics Workshop in Geropsychology: The Value of Depth in Training

The Geriatric Scholars Program- Psychology Track (GSP-P) was implemented to address the dire shortage of mental health providers with geriatrics expertise within the VA, a large integrated healthcare system. One hundred and five psychologists participated in the GSP-P introductory geropsychology competencies course. Though they exhibited significant improvements in confidence, knowledge, and skills across geropsychology domains, increased depth (in addition to breadth) of training is needed. In 2019, GSP-P implemented an advanced workshop for graduates of the introductory course. Twenty-one psychologists participated in the workshop, which included 3.5 days of expert-led seminars followed by completion of an individualized learning plan over six months. Results from our evaluation indicated significant improvements in four of five geropsychology domains on the Pikes Peak Geropsychology Knowledge and Skill Assessment Tool. Our findings demonstrate continued enhancement of geropsychology competencies through advanced coursework is feasible and improves depth of training, particularly when combined with individualized learning plans.

Pilot study of a new telehealth program for depressed older adults: The Positive Experience Project (P.E.P.)

Social isolation, logistical challenges, and limited access to mental health providers who accept Medicare contribute to older adults having a higher risk for untreated depression. Primary care providers (PCPs) are strained due to time demands and lack of training in behavioral activation and similar therapies. This study was designed to reduce depression in older adult primary care patients without burdening their PCPs. We evaluated whether outpatients age 65+ with mild to moderate self-reported depressive symptoms (measured by PHQ-8) benefited from a brief evidence-informed program, the Positive Experience Project(PEP). This is derived from the tenets and practices of both behavioral activation and the “tiny habits” program. The former emphasizes the value of increasing engagement in everyday positive activities to lift mood; the latter provides a method to enhance success by encouraging patients to link these activities with existing habitual behaviors, and to celebrate completion. A script was written for each of four 30-minute sessions conducted in small groups using a telehealth platform. An analysis of patients of the first author yielded 50 eligible patients. 8 were invited to participate and 7 did. The group’s mean PHQ-8 score pre-intervention was 10.1; post-intervention (4 weeks later), the average was 6.1 (P=.039). The use of “scripts” that guide the PCP through the visit enhances adoption. And PCPs can bill for these 30-minute sessions, making it feasible to help patients receive treatment for their depression. These promising results are currently being replicated by additional PCPs and their data will be included in the poster presentation.

Seven-State Study of Assisted Living and Healthcare Providers’ Responses to COVID-19

COVID-19 has inordinately affected assisted living (AL), such that the proportion of fatalities to cases has been 21% in AL versus 2.5% for the general population. Understanding how AL administrators and medical and mental health providers have responded to COVID-19 can inform health care going forward. Using a seven-state stratified random sample of 250 communities, administrators were interviewed and providers completed questionnaires regarding COVID-19 practices. Preliminary data indicate that 79%, 44%, and 62% of administrators reported serving meals in rooms to segregate residents, using telemedicine, and providing extra pay for staff, respectively. Perceived use/effectiveness of practices differed based on dementia case-mix (e.g., face coverings, social distancing). Providers reported less access to patients (82%), more telehealth (63%), and less ability to provide care (43%). However, they uniformly reported high confidence in AL staff ability to prevent (94%) and respond to outbreaks (96%). Discussion will summarize points important for future care.