A randomized controlled trial of a coping group intervention for adults with HIV who are AIDS bereaved: longitudinal effects on grief.

The authors sought to study the longitudinal effects of a cognitive-behavioral group intervention for coping with AIDS bereavement among a diverse sample of adults who were HIV positive. Participants (N = 267) were randomly assigned to receive the 12-week intervention or individual therapy upon request. Measures were administered at baseline, postintervention, and 4-, 8-, and 12-month follow-ups. Longitudinal data were analyzed with linear mixed models to examine change in grief by condition across the study period and the effect of the intervention on grief through its interaction with psychiatric distress. The authors used the Grief Reaction Index to assess grief and the Symptom Checklist-90-Revised to assess global psychiatric distress. Participants in both conditions reported decreases in grief severity. However, among those with higher levels of psychiatric distress, participants in the group intervention had significantly lower grief severity scores compared with participants in the individual therapy condition. The long-term effectiveness of this AIDS-bereavement intervention for psychiatrically distressed people with HIV/AIDS supports the need for tailored interventions among those at risk for complicated grief responses.     

An evidence-based group coping intervention for women living with HIV and history of childhood sexual abuse

Women living with HIV/AIDS and a history of childhood sexual abuse often exhibit sexual trauma symptoms and elevated rates of HIV-risk behaviors. In this paper, we describe a coping skills group intervention that reduced traumatic stress and sexual-risk behavior in a recent randomized clinical trial. We focused on clinical issues that emerged among female participants receiving the intervention. Clinical observations showed that recognizing connections between trauma, psychological distress, and high risk behaviors was a new and powerful experience for many participants. Participants successfully applied psychoeducational material, expressing an increased sense of power and control over their relationships and behaviors as they developed more adaptive cognitive and behavioral skills. Women expressed high levels of satisfaction with the intervention. Recommendations for clinical practice are provided.     

Constructions of social selves living with HIV/AIDS: A Jungian phenomenological study

This study explored sense of social well-being influences on self-identity and the stigma and discrimination among people living with HIV/AIDS (PLWHA). Informants were 15 PLWHA from a rural background in a South African community (female = 87%, age range = 26 to 64 years; and males = 13%, age range = 55 to 64 years). They completed semi-structured interviews on their lived experiences relating to a sense of social inclusion and belongingness. We thematically analysed the data, and interpreted the findings applying Jungian archetypes of the Self, Shadow, and Persona. Findings suggest PLWHA’s sense of a dominant Shadow to be a barrier to self-acceptance whereas a Persona (mask) was guided by a need to be socially acceptable. A positive sense of social well-being among PLWHA is important to their health and well-being.     

Emotional distress in nonmetropolitan persons living with HIV disease enrolled in a telephone-delivered, coping improvement group intervention.

The study delineated depressive symptoms and modeled emotional distress in persons living with HIV disease in nonmetropolitan areas of 13 U.S. states. Participants (N=329) were enrolled in a randomized clinical trial of a telephone-delivered, coping improvement group intervention, and 60% reported moderate or severe levels of depressive symptomatology on the Beck Depression Inventory. Structural equation modeling indicated that participants who experienced more severe HIV symptomatology, received less social support, and engaged in more avoidant coping also experienced more emotional distress (a latent construct comprising depressive symptoms and emotional well-being). Greater HIV-related stigma and rejection by family led to more emotional distress, with social support and avoidant coping mediating almost entirely the effects of the former 2 variables. The model accounted for 72% of the variance in emotional distress in nonmetropolitan persons living with HIV disease.     

Positive living: A pilot study of group positive psychotherapy for people with schizophrenia

Positive psychology interventions target positive emotions in order to increase happiness, engagement in life, and well being while also ameliorating the impact of symptoms on a person's life. We examined an adapted version of group positive psychotherapy for people with schizophrenia (Positive Living (PL)) in a pilot study. Sixteen participants were recruited to participate in two separate PL groups and were assessed at baseline, post-intervention and at 3-month follow-up. We examined feasibility of this intervention in addition to a preliminary exploration of well-being outcomes including psychological well-being, hope, savoring, and self-esteem as well as clinically related outcomes including symptoms, psychological recovery, and social functioning. Findings indicate that the PL group was feasible and associated with possible improvements in psychological well-being, hope, savoring, psychological recovery, self-esteem, and psychiatric symptoms.     

A short-term group treatment model for gay male survivors of childhood sexual abuse living with HIV/AIDS

HIV-positive gay male survivors of childhood sexual abuse (CSA) face three layers of trauma: childhood abuse, homophobic oppression, and HIV/AIDS. Additionally, CSA has been shown to increase HIV risk behavior among gay men, and the trauma of HIV infection often parallels the experience of CSA. Effective coping strategies are particularly important for people living with HIV/AIDS in order to adapt to physical, psychological, and social implications of infection. However, coping strategies once adaptive in the context of CSA may become maladaptive in adulthood. Interventions are needed that enhance coping and address CSA for survivors living with HIV/AIDS to protect their own health and to prevent new transmissions. This article presents a group model found to be efficacious for treating gay male survivors of CSA living with HIV/AIDS.     

Health information on the Internet and people living with HIV/AIDS: information evaluation and coping styles.

Individuals who seek information on the Internet to cope with chronic illness may be vulnerable to misinformation and unfounded claims. This study examined the association between health-related coping and the evaluation of health information. Men (n = 347) and women (n = 72) who were living with HIV/AIDS and reported currently using the Internet completed measures assessing their Internet use. Health Web sites downloaded from the Internet were also rated for quality of information. HIV-positive adults commonly used the Internet to find health information (66%) and to learn about clinical trials (25%); they also talked to their physicians about information found online (24%). In a multivariate analysis, assigning higher credibility to unfounded Internet information was predicted by lower incomes, less education, and avoidant coping styles. People who cope by avoiding health information may be vulnerable to misinformation and unfounded claims that are commonly encountered on the Internet.     

Developing a model for online support group use, empowering processes and psychosocial outcomes for individuals living with HIV/AIDS

This study examined the mechanism through which online support group (OSG) participation may promote patient empowerment among 340 individuals living with HIV/AIDS. Results from structural equation modelling revealed that greater use of OSGs was associated with more frequent occurrence of the empowering processes as measured by receiving useful information, receiving social support, finding positive meaning and helping others. Receiving useful information and finding positive meaning were related to higher levels of adaptive coping and lower levels of maladaptive coping, while receiving social support and helping others were related to higher levels of self-care self-efficacy, which in turn was related to higher levels of adaptive coping, and lower levels of maladaptive coping. Finally, higher levels of maladaptive coping were related to poorer quality of life, while higher levels of adaptive coping were related to better quality of life. Results suggest that OSG participation may offer some benefits for those living with HIV/AIDS.     

Developing a model for online support group use,empowering processes and psychosocial outcomes for individuals living with HIV/AIDS

This study examined the mechanism through which online support group (OSG) participation may promote patient empowerment among 340 individuals living with HIV/AIDS. Results from structural equation modelling revealed that greater use of OSGs was associated with more frequent occurrence of the empowering processes as measured by receiving useful information, receiving social support, finding positive meaning and helping others. Receiving useful information and finding positive meaning were related to higher levels of adaptive coping and lower levels of maladaptive coping, while receiving social support and helping others were related to higher levels of self-care self-efficacy, which in turn was related to higher levels of adaptive coping, and lower levels of maladaptive coping. Finally, higher levels of maladaptive coping were related to poorer quality of life, while higher levels of adaptive coping were related to better quality of life. Results suggest that OSG participation may offer some benefits for those living with HIV/AIDS.     

Strengths and distress in adults who are aging with HIV: a pilot study

In this qualitative pilot study, distress and strengths associated with aging with Human Immunodeficiency Virus (HIV) were identified for 12 participants. Potential sources of distress were fear of death, financial worries, fear of disclosure, stigma, and long-term coping. Strengths were hardiness, renewed spirituality, social support, community service, and openness to aging. Ways of mitigating these barriers and accentuating these strengths can be explored by mental health professionals if extended with a representative larger sample.     

Development of a model for spiritual assessment and intervention

A multidisciplinary model for making spiritual assessments and interventions is described. The practitioner bases these assessments and interventions upon knowledge gained from philosophy, theology, physiology, psychology, and sociology. Specific assessments are made in the areas of spiritual development and seven practical dimensions of spiritual care. The patient's life experiences, events, and questions shape the nature of spiritual care as the practitioner works toward assisting the patient to maintain or expand the level of spiritual functioning.She is a recipient of a National Institute of Mental Health Academic Award. This award provided funding during the time this article was written.     

Ladies in waiting: a group intervention for families coping with deployed soldiers

It is widely recognized that military service during wartime can take a toll on a soldier's psychological health. Recent work has revealed effects on the families left behind as well, as reflected, for example, in an increase in child abuse and neglect in these families. My interest in studying the transgenerational transmission of trauma led me to offer the National Guard a pro bono group therapy for women whose husbands had been deployed overseas. A slightly unorthodox approach paved the way not only to group treatment but, ultimately, individual treatment for these women and their children. My hope is that this work can serve as a model for other therapists who share my interest in treating the intergenerational transmission of trauma by implementing group and mother-child psychotherapy.     

Counselling implications of anxiety and depression in AIDS and HIV infection: A pilot study

Anxiety and depression are two major psychological reactions to HIV infection. The recognition and treatment of these are of fundamental importance as they may alleviate the suffering for those with a potentially terminal illness, may increase coping and may improve the quality of their life. Furthermore, many of the physical symptoms associated with anxiety mirror AIDS symptoms. For prompt care it is important that those with HIV/AIDS, and those caring for them, recognize the role of anxiety to minimize unnecessary symptoms and recognize those which could respond to medical intervention. In this study a group of front line AIDS/HIV workers were given an in-depth training course on anxiety and depression. Evaluation of the course revealed a high number of patients suffering from anxiety (80.1%) and depression (31%). The evaluation revealed gains in counselling proficiency, knowledge and symptom recognition. Some of the entrenched myths, particularly surrounding suicide, were not resolved. These findings are discussed in the light of the difficulties of training non-mental health workers in the use of counselling skills.     

A rational-emotive group intervention for preventing and coping with stress among safety officers

A stress management and prevention workshop for nonclinical industrial workers using rational-emotive principles with 18 months followup is reported. Twenty-two senior safety officers participated in an intervention program of five weekly meetings aimed at improving cognitive skills and assertiveness mainly by decreasing irrational thought processes. We hypothesized an increase in assertiveness, and a decrease in irrational beliefs, and emotional and cognitive stress symptoms (manifested in somatic complaints and cognitive weariness). Assertiveness improved and somatic complaints and irrationality decreased in the short term. Eighteen months later, cognitive weariness was also reduced. The other improvements were still evident, but not to the same extent as short-term effects. Although the workshop improved rationality, further practice would be needed in the behavioral aspect of stress prevention to achieve long-term improvements in assertiveness.Talma Kushnir, Ph.D., is a social and medical psychologist at the Occupational Health and Rehabilitation Institute, Raanana, Israel, and teaches psychology and health promotion at the Tel-Aviv University Medical School.Ruth Malkinson, Ph.D., fellow and RET trainer and supervisor of the Institute for RET, and teaches at the School of Social Work and Medical School at Tel-Aviv University, Israel. Both authors contributed equally to this studyThis study was supported by the Committee for Preventive Action and Research in Occupational Health, The Ministry of Labor and Social Affairs, Jerusalem, Israel.The authors thank Estie Weisberg for her administrative assistance in organizing the workshops.     

Social competence group intervention (SOCO) for children with autism spectrum disorder: A pilot study

This study aimed to describe concept of social competence as a theoretical background for social skills group intervention for children with autism spectrum disorder (ASD). A model of social competence comprised of three components: social skills, social performance, and social adjustment. We also examined the feasibility and preliminary efficacy of the manualized Social Competence group intervention for children with autism spectrum disorder (SOCO) using a variety of outcome measures. The nine-month intervention included children groups, parental support groups and co-operation with teachers. A pilot study involved 23 children aged 7 to 12 years (n = 16 intervention, n = 7 control) and intervention outcomes were measured with questionnaires for parents and teachers, neuropsychological tests, and observations. The parents of the intervention group reported improvements in social skills and social adjustment, whereas the teachers reported increases in social performance. Findings also indicated that affect recognition skills, social overtures, and reactions to peers were improved in the intervention group. Although the evidence of the pilot study should be considered as preliminary, it gives some indication of the feasibility of the SOCO group intervention and supports the usability of the theoretical background and approach for multiple outcome measures.     

Effects of an early intervention group program for anxious and depressed adolescents: a pilot study

The Resourceful Adolescent Program is an early intervention program designed to enhance psychological resilience in adolescents with emotional problems. Eight adolescents with high anxious and/or depressive symptoms were treated with this 11-session group program. Treatment effects were examined by means of self-report questionnaires of anxiety, depression, and self-efficacy. Pre- and postintervention data showed reductions in anxiety and depression scores and a concomitant increase in adolescents' self-efficacy.     

Child and parental outcomes of a group parenting intervention for Latino families: A pilot study of the CANNE program

Criando a Nuestros Ni?os hacia el éxito (CANNE) is the Spanish adaptation of Parenting Our Children to Excellence (PACE). A pilot study conducted with 124 parents of preschoolers (mostly recent Mexican immigrants) provides preliminary evidence for the community acceptability and efficacy of CANNE. Eighty-eight of the 124 parents who enrolled in the program attended one or more of the 8 sessions (17% attended 1 session, 11% attended 2-4 sessions, and 72% attended 5 or more sessions), participated actively in sessions, and expressed high degrees of program satisfaction. Over time, parents improved on measures of harsh-inconsistent discipline, and children improved on social competence and social-communication skills. When high-versus-low attenders were compared, high attenders (parents who attended 4 sessions or more) reported greater increases than low attenders in their appropriate-positive parenting practices and clear expectations, and in their children's social competence and communication skills, and they reported greater decreases in their harsh-inconsistent discipline and in their children's aggressiveness and hyperactivity. Some of these changes were evident by the end of the program, whereas others became apparent (or stronger) over a 3-month follow-up period. These encouraging results point to the need for an efficacy study that assesses how well CANNE can help larger numbers of Latino parents in the important task of bringing up their young children in the United States.     

Health-related Internet use, coping, social support, and health indicators in people living with HIV/AIDS: preliminary results from a community survey.

Widespread Internet use has revolutionized health information and patient education for persons with chronic illnesses. The authors surveyed 147 HIV-positive persons to examine factors associated with Internet use and associations between Internet use and health. Information, motivation, and behavioral skills associated with using the Internet were related to Internet use. The authors found that health-related Internet use was associated with HIV disease knowledge, active coping, information seeking coping, and social support among persons who were using the Internet. These preliminary findings suggest an association between using the Internet for health-related information and health benefits among people living with HIV/AIDS, supporting the development of interventions to close the digital divide in HIV/AIDS care.