Childhood abuse and depressive vulnerability in clients with gender dysphoria

Background: Childhood abuse in the early lives of gender variant people has been under‐reported, although higher psychiatric morbidity, particularly depression and suicidality, than in the general population is more widely recognised. There are increasing numbers of people seeking advice and treatment for gender dysphoria (GD) some of whose experiences of depression and childhood abuse may be additional treatment considerations. Aim: To illuminate the issues relating to childhood abuse, depression and GD via case examples underpinned by a summary review of the relevant literature, for their combined relevance to therapeutic practice and service provision. Methods: A review of relevant online literature was conducted and two case examples were developed subsequently to capture the core review themes from a practice perspective. Results: Nine studies met the inclusion criteria. Gender variant children and adolescents may experience abuse by peers and teachers, as well as parents and caregivers. Emotional abuse and neglect may have more adverse consequences than more active forms of abuse. Conclusions: This is an under‐researched area, and inconsistencies of design, definition, measurement and controls were evident in the literature. While no clear association between depressive vulnerability and childhood abuse could be found, prevalence of such abuse was high. A case is made for clients with GD to have the opportunity to explore the influence and meaning of their adverse childhood experiences on their social and psychological development, and for additional training and education for practitioners.     

An overview of transpersonal psychology

Abstract

An overview of transpersonal psychology is provided with specific focus on a number of its central themes (nonduality, intrinsic health, self‐transcendence, and inclusivity) and practices (meditation, ritual, and inquiry). The relationship of transpersonal psychology to both mainstream psychology and spiritual wisdom traditions is discussed. The field's implications for diversity issues, research, and service applications are also considered.     

Inside the experience of anorexia nervosa: A narrative thematic analysis

Aim: This study considers the question of whether inpatient admission for anorexia nervosa was a therapeutic experience for two women with chronic anorexia nervosa. The question of whether inpatient admission for anorexia nervosa can be therapeutic is not answerable through existing research evidence. Method: The women were interviewed about their experience of having anorexia, its impact on their lives and the treatment they received. The interviews involved learning about the women's experiences by listening to their stories rather than asking them direct questions about what has been therapeutic about their treatment. Analysis: Their narratives were used to develop understanding grounded in experience and were analysed using a narrative thematic analysis. Ideas, themes and connections were noted but not coded as found in some forms of thematic analysis. Discussion: Consideration is given to the therapeutic qualities of the treatments the women received and the place of therapeutic inpatient admission. The central theme of this research was ‘relationships’ which indicates the use of therapeutic approaches that emphasise the importance of the therapeutic relationship in the treatment of chronic anorexia nervosa. It is suggested that psychodynamic and attachment theories should be used to inform overall treatment models. Some important issues for service provision and areas for further research are identified.     

“Out on the edge of my comfort”: Trainee counsellor/psychotherapists' experiences of spirituality in therapy—A qualitative exploration

The integration of spirituality into counselling and psychotherapy poses complex challenges. Personal spirituality, professional competency and ethical considerations may impact on trainees' experiences of integrating spirituality into therapy. This study adopted an inductive, qualitative approach to explore trainee counsellor/psychotherapists' experiences and perceptions of integrating spirituality into therapy. Six trainee counsellors and psychotherapists were recruited using purposive sampling from a professional counsellor and psychotherapist training institution in the UK. In‐depth, semi‐structured interviews were conducted, audio‐recorded and transcribed verbatim. Thematic analysis of the interviews revealed two overarching themes: spirituality provides support but needs a warning; and spirituality is relevant but undervalued. These themes encompass a wide range of trainee concerns associated with integrating spirituality into therapy. Participants reported that they felt unprepared to work therapeutically with clients' spiritual beliefs. However, the value of spirituality in providing support to both the trainee and their clients was highlighted by several participants. Some participants described integrating clients' spirituality as having a positive impact on the therapeutic relationship, but often felt threatening to the trainee. This research has implications that are important for counselling and psychotherapy training and developing enhanced consideration of client spirituality and the interpersonal environment in which therapy is delivered.     

Framing heterosexism in lesbian families: a preliminary examination of resilient coping1

The goals of this study are to examine the kinds of difficulties children face vis‐à‐vis heterosexism, how families help their children cope with these difficulties, and how coping leads to children's resilience. The experiences of six daughters of lesbian parents, ranging in age from 7 to 16, were empirically investigated through semi‐structured interviews with parents and children. Analysis included open and focused coding. Results suggest heterosexism is evident, but does not seem to negatively impact children's development. Themes include: how parents prepare their children to deal with heterosexism and how parents and children cope with incidents. Results elucidate the findings of previous studies, call for more qualitative research, and suggest future research directions. Copyright © 2004 John Wiley & Sons, Ltd.     

Stress and coping among early childhood intervention professionals receiving reflective supervision: A qualitative analysis

Reflective supervision/consultation (RS/C) is an important component of infant mental health training and practice. Given high levels of job stress reported by a variety of early childhood professionals, the present study offers a qualitative examination of early childhood intervention professionals’ perceptions of stress and coping before and after receiving regular RS/C. Thirty-one professionals received 9 months of RS/C and completed semistructured interview questionnaires at the pre-/postassessments. Questionnaires focused on job-related experiences, including what participants found stressful and how they coped with job-related stress. Inductive analysis techniques were used to identify themes that arose from the data. Relationships between themes were discovered through axial coding. Three key themes of individual, relational, and organizational stress were identified across the pre-/postassessments. Similar themes were evident in reports of coping. Following 9 months of RS/C, analysis revealed greater detail and reflection among the majority of participants. These results contribute to the literature through identification of multiple levels of stress and coping as well as areas of continuity and change among participants receiving RS/C. Future research should consider how professionals’ reports of stress and coping relate to reported self-efficacy and observed competence with young children and families.     

Breaking bread: spirituality,food and early childhood education

The spiritual aspect of early childhood education is supported by the early childhood curriculum in Aotearoa New Zealand, Te Whāriki. Research in three different early childhood settings presents new perspectives on the everyday experiences of children in terms of spirituality. Each setting formed a case study that included the voices of children, parents and teachers. Focusing on the practices that surround food and eating, this narrative account takes the sharing of food as a starting point for analysing the spiritual experiences of young children and the metaphor of ‘breaking bread’ is used. It is proposed that the concept of everyday spirituality informs the practice of teachers in each context and working with young children involves considering issues of equity, culture and well‐being.     

Children's biobehavioral reactivity to challenge predicts DNA methylation in adolescence and emerging adulthood

A growing body of research has documented associations between adverse childhood environments and DNA methylation, highlighting epigenetic processes as potential mechanisms through which early external contexts influence health across the life course. The present study tested a complementary hypothesis: indicators of children's early internal, biological, and behavioral responses to stressful challenges may also be linked to stable patterns of DNA methylation later in life. Children's autonomic nervous system reactivity, temperament, and mental health symptoms were prospectively assessed from infancy through early childhood, and principal components analysis (PCA) was applied to derive composites of biological and behavioral reactivity. Buccal epithelial cells were collected from participants at 15 and 18 years of age. Findings revealed an association between early life biobehavioral inhibition/disinhibition and DNA methylation across many genes. Notably, reactive, inhibited children were found to have decreased DNA methylation of the DLX5 and IGF2 genes at both time points, as compared to non‐reactive, disinhibited children. Results of the present study are provisional but suggest that the gene's profile of DNA methylation may constitute a biomarker of normative or potentially pathological differences in reactivity. Overall, findings provide a foundation for future research to explore relations among epigenetic processes and differences in both individual‐level biobehavioral risk and qualities of the early, external childhood environment.     

Working with suicidal clients: The person‐centred counsellor's experience and understanding of risk assessment

Background: Client risk assessment within the person‐centred paradigm is traditionally seen as squarely opposed to its ethos. Aim: To determine how the person‐centred counsellor experiences and understands the issue of risk assessment within the confines of their work ethos. Method: Semi‐structured interviews with seven person‐centred counsellors using thematic analysis were conducted. Findings: Three main themes emerged following thematic analysis: The impact of the risk assessment process on self; The counsellor's experience of self, and The therapeutic process in relation to risk assessment. Discussion: The findings suggest that person‐centred counsellors conduct risk assessments taking a holistic approach involving not only individual risk predictors and characteristics of the client but also individual factors related to self.     

Supporting families of transgender children/youth: Parents speak on their experiences,identity, and views

ABSTRACT

Background: Transgender children/youth demonstrate the best possibility for resilience and positive mental health when they are part of an affirming and supportive family. To optimize families in supporting transgender children/youth, parents/caregivers need to be supported. Transgender children/youth and their families regularly navigate a myriad of challenges through society.

Aims: Within the extant literature on transgender children and youth, relatively little attention is focused on the experiences of parents/caregivers and how their close family relationships are affected. The present qualitative study addresses this gap in knowledge through its exploration of the experiences, identities, and views of parents/caregivers of transgender children/youth.

Method: The study is longitudinal and this article represents the first wave. Fourteen parents of 12 transgender children/youth, aged 6–17, participated in in-depth semistructured interviews. Participants were recruited via social media and at an on-site conference for transgender youth and their families. All children/youth had socially transitioned. Those who were eligible for puberty suppression and/or hormone therapy were receiving those. The interviews were inductively coded for themes by two coders using the constant comparative method.

Results: Participants' reports on their experiences yielded three themes: (1) transgender issues as the family's focus; (2) proactivity, child-focused: preemptive actions to prevent adverse consequences; and (3) self-care. These themes included subthemes on effective coping strategies to mitigate struggles. Three themes related to participants' identity and views emerged: (1) identity reformation, (2) self-evaluation, and (3) views of future. These themes included subthemes that reflected how participants viewed themselves, their child, and the future.

Discussion: A transgender identity in one family member affects all household members. Parents/guardians may experience guilt and self-doubt over decisions. Factors that may improve outcomes with extended family and schools include families' preemptive dissemination of information on transgender identities and explicating expectations of respect and nonintrusion. Ingrained traditions may force life-altering decisions.     

Multiple family therapy for Chinese families of children with attention deficit hyperactivity disorder (ADHD): treatment efficacy from the children’s perspective and their subjective experiences

This paper reports the results of our study that assessed the treatment efficacy of multiple family therapy (MFT) from the perspective of participating Chinese children with attention deficit hyperactivity disorder (ADHD) and identified their subjective experiences. Forty‐three children with ADHD in the experimental group (EG) completed a forty‐two‐hour MFT, whilst forty‐five children with ADHD in the control group (CG) had attended two writing classes scheduled three months apart that were similar to those of the MFT. Data from the outcome study were gathered using standardized questionnaires and data from the qualitative study were drawn from thirteen children with ADHD who had completed the MFT and attended the focus group interviews (n = 5) or individual interviews (n = 8) conducted in the post‐treatment phase. The results of the Paired sample t‐test and MANOVA indicated no significant changes on the scores for the four measures adopted (perception of competence, hopefulness, parent‐child relationship and perceived social support) in the pre‐ and post‐treatment for the EG and the CG. Five themes emerged from the narratives of children with ADHD, which revealed the children’s subjective experiences with the MFT: (a) full of fun; (b) building friendships through common experiences; (c) a happy family time; (d) safe space; and (e) positive parental responses and communications.     

‘Coming out’ in therapy? Perceived risks and benefits of self‐disclosure of sexual orientation by gay and lesbian therapists to straight clients

Primary objective: The study's primary objective was to investigate the experiences of gay and lesbian therapists, when considering self‐disclosure of their sexual orientation to straight (i.e. heterosexual) clients. This qualitative study set out to ascertain the key factors gay therapists take into account when considering this decision and to explore the effects this self‐disclosure may have on themselves, their clients and their therapeutic relationships. Research design: The research design was based on the use of semi‐structured interviews, undertaken with a non‐random, purposive sample of counsellors and psychotherapists (n=8) in current practice. The rationale for this method was to aid exploration of therapists' experiences of the process of self‐disclosure. Methods and procedures: Inclusion criteria were for therapists who self‐identified as being gay or lesbian, and who were experienced in clinical work with straight clients. Transcribed data was analysed using inductive thematic analysis. Main outcomes and results: Some therapists reported being confident with self‐disclosure relating to their own sexual orientation. However, a common theme related to the reportedly high levels of anxiety and vulnerability, which therapists identified. Key themes emerged around: respondents' fears of client judgement; a need for therapist self‐protection; self‐awareness of the potential impact of their own fears and prejudices on the therapeutic relationship; and the potential relevance of internalised homophobia, as an overall constraining factor. Conclusions: Self‐disclosure of their sexual orientation to straight clients is constructed, in this initial survey, as being potentially problematic and risky for some gay therapists.     

Posttraumatic Stress Symptoms and Stressful Life Events Predict the Long-term Adjustment of Survivors of Childhood Cancer and Their Mothers

Objectives: To examine prospectively the impact of posttraumatic stress symptoms (PTSS) in response to childhood cancer and treatment on general adjustment while accounting for the role of other stressful life events and appraisal of life threat and treatment intensity. Methods: As part of a larger study assessing PTSS, 56 childhood cancer survivors, aged 8 to 18, and 65 mothers completed self-report measures of PTSS and appraisal of the intensity and life threat associated with cancer treatment at time 1 and self-report measures of stressful life events and general adjustment at time 2 (approximately 18 months after time 1). Results: For child survivors and their mothers, posttraumatic stress at time 1 significantly predicted general adjustment at time 2, over and above the significant contribution of lifetime stressful events. The life events variable did not function as a mediator in the association of PTSS and general adjustment. Conclusions: Trauma responses to childhood cancer and its treatment have implications for the long-term adaptation of children and their families. Early signs and symptoms of posttraumatic stress and stressful life experiences require early assessment and intervention.     

Reappraising Past and Future Transitional Events: The Effects of Mental Focus on Present Perceptions of Personal Impact and Self‐Relevance

This research examined how instructions to focus on the concrete details (experience focus) versus broader life significance (coherence focus) influence present perceptions of transitional impact and self‐relevance for past and future transitional events. Participants (Study 1, N = 119; Study 2, N = 251) selected a past or future transition and wrote about it using either an experiential or coherence focus. Participants then rated the event on transitional impact, self‐relevance, and other phenomenological characteristics. Individuals instructed to use a coherence focus on a past transition reported higher levels of material and psychological impact and rated the event as more self‐relevant, compared to those instructed to use an experiential focus. The manipulation did not influence ratings for future events. Controlling for temporal distance and emotional valence did not alter the findings. Future transitions were regarded as more personally important than past transitions. Appraisals of the impact and self‐relevance of transformative past events (but not future events) are affected by the mental focus adopted at retrieval. The findings are considered in light of essential differences between remembering and forecasting and support the notion that a coherence focus promotes adaptive self‐reflection by affording people the cognitive means with which to reconcile transitional experiences.     

The Phenomenology of erwin Straus: An overview and appraisal of its relevance for human studies

Abstract

The purpose of this paper is to discuss the veridicality of nonconventional cognitions as they pertain to transpersonal psychological inquiry. It is argued that the validation and efficacy of transpersonal constructs are dependent upon the manner by which they are theoretically and empirically supported, namely, accurately conceptualized and operationalized, and not metaphysicalized. Salient impediments germane to the study of transpersonal phenomena are also reviewed with the concomitant assumption that their ontological and epistemological status should be consistent with objective, nomothetic, empiricism. In response to this scientific appropriation, one measurement instrument is discussed, the Self‐Expansiveness Level Form (SELF; Friedman, 1981; 1983), which is both reliable and valid in measuring transpersonal‐like phenomenon. Taking into consideration these notions, this paper closes with a discussion on the implications of this measurement scale to the field of transpersonal psychology as well as to conventional psychological research and clinical applications.     

Changes in childhood caregiving impressions among middle-aged and older adults

Childhood experiences and impressions are important for individuals' health and well-being—they often set the stage for how people approach relationships across the lifespan and how they make sense of their relational worlds. However, impressions of these experiences are likely not static and can change over time, even years after these experiences happened. The current study examined how impressions of parental relationships in childhood changed over time, and predictors of these changes, among middle-aged and older adults followed over a 4-year period (N = 2692; M_age = 66.67, SD = 9.15; 64.1% women). Childhood impressions of parental care were mostly stable over time, with 53.5%–65.0% of participants reporting consistent impressions. Becoming divorced/separated as an adult was associated with more negative impressions about relationships with fathers in the past. Having a mother pass away was associated with more positive impressions of mothers' caregiving when participants were children. Higher depressive symptoms at follow-up were associated with darker perceptions of the past—more negative impressions of mothers and fathers as caregivers. The current study is one of the most comprehensive studies of late-life changes in childhood impressions to date, suggesting future directions for studying the organization of relational experiences and recollection over time.     

Mothers' subjective employment experiences and the behaviour of their nursery school children

Most research on the effects of maternal employment on children has followed the ‘maternal deprivation’ hypothesis, which focuses on differences in the behaviour of children of employed and non-employed mothers. Yet this framework may have impeded an examination of a more relevant question, namely the impact of mothers' employment-related experiences. Accordingly, this study assesses the influence of mothers' job satisfaction, job involvement and role conflict on the behaviour of their nursery school sons and daughters (n=46 and 45 respectively). The effects of maternal employment on their nursery school children were found to be mediated by (a) the nature and quality of the employment experience (i.e. positive or negative), (b) the type of child behaviour assessed, and (c) the sex of the child. Mothers' job satisfaction was positively associated with daughters' self-control and negatively with conduct problems; their role conflict was negatively related to sons' and daughters' self-control, and positively associated with sons' conduct problems and daughters' immaturity. These results support the hypothesis that the quality of the maternal employment experience influences nursery school children's behaviour.     

The Global Context and People at Work: Special Issue Introduction

Although considerable research has been conducted on a variety of cross‐cultural management topics, we still know very little about how organizations can effectively manage people involved in global work or how cross‐cultural differences impact individuals and groups at work. To address this gap, we edited a special issue of Personnel Psychology that presents scholarly research contributing to understanding how global experiences and contexts impact people at work. We identified 3 research themes: cross‐cultural comparisons, the different types of global workers, and theoretical perspectives that underlie the accepted articles’ contributions to this special issue. We conclude with specific theoretical and methodological recommendations for research on human resource management and organizational behavior topics incorporating the global context.     

Considering the role of early discrimination experiences and the parent–child relationship in the development of disruptive behaviors in adolescence

Discrimination has been shown to be related to diminished psychological adjustment and greater risk for substance use when personally experienced by adolescents and when their caregivers experience discrimination. Our research considers the impact of primary caregiver experiences of racial- and socioeconomic-based discrimination in early (age 3–5 years) and late childhood (age 9½) on adolescent disruptive behaviors (age 14) with a large sample of diverse caregiver–child dyads (N = 634). In addition, we examine the potential protective effects of parent–child relationship quality in early and late childhood in buffering the effects of caregiver discrimination on adolescent disruptive behaviors. We also explore possible gender differences in children's vulnerability to engage in disruptive behaviors in the context of caregiver experiences of discrimination. The findings from this study indicate that at trend level, early childhood experiences of primary caregiver discrimination (ages 3–5) predicted adolescent disruptive behaviors, accounting for the effects of more recent (age 9½) caregiver discrimination. In addition, parent–child relationship quality at age 9½ years was found to buffer the effects of late childhood (age 9½) primary caregiver discrimination on adolescent disruptive behaviors for both male and female youth. The findings highlight the need for prevention and intervention techniques that foster healthy and positive primary caregiver–child relationships.