A life of ease and immorality: Health professionals' constructions of mothering on welfare

Mothering on welfare is often discussed as perpetuating disadvantage and discouraging individuals from meaningful social activity defined as paid employment. This is understood in the context of increasing commitment to a neo‐liberalist agenda, where people are viewed as autonomous individuals in a market economy, and unequal rewards within this economy are due to individual failings. The discourse analysis presented here examines how health professionals in New Zealand construct what it means to be a mother on welfare within the context of interviews on the health care needs of adolescent mothers. Mothering on welfare is predominantly described as transgressing social norms, where a life of ease is an indicator of immoral conduct and personal value is determined through education and employment. The welfare mother is also viewed as transgressing the norms of appropriate family structures and the sexual practices sanctioned within these structures. The legitimate work of mothering is absent in these accounts while the life of ease and plenty on welfare is made visible. These discourses draw attention to the ways in which welfare mothers are disqualified from neo‐liberal definitions of citizenship, and demonstrate how motherhood on welfare is regarded as undermining rather than contributing to society. Copyright © 2008 John Wiley & Sons, Ltd.     

What Low-Income,Depressed Mothers Need From Mental Health Care: Overcoming Treatment Barriers From Their Perspective

Maternal depression is a major public health concern, as children of depressed mothers have a substantially increased risk for psychiatric problems into adulthood. Low-income mothers have high rates of depression, yet few receive mental health care. Barriers have been identified, but solutions have been based on what mental health professionals believe is helpful rather than mothers’ own perspectives, or require participation in an existing treatment. The purpose of our study was to learn what low-income, depressed mothers believe they need from mental health care to overcome barriers to mental health care. Twelve mothers with at least one child between the ages of 2 and 17 participated in individual interviews. Using qualitative grounded theory methodology, data were organized into six theoretical constructs. These included: (1) attitudes, expectations, and emotions impact the intention to enter treatment, (2) identifying as self-sufficient inhibits the intention to enter treatment, (3) providing knowledge, skills and environmental resources facilitate treatment entry, (4) habits and life circumstances that make treatment seem unimportant inhibit treatment entry, (5) balancing acceptance, change, and the therapeutic relationship facilitates treatment retention, and (6) sharing similarities with people involved in treatment often, but does not always facilitate treatment retention. A 3-step theory was developed regarding variables that influence mothers’ (a) intentions to enter treatment, (b) treatment entry, and (c) treatment retention. Offering what low-income, depressed mothers believe they need could better engage and retain them in mental health treatment.     

Parenting Self‐Construals of Mothers With a Serious Mental Illness: Efficacy,Burden, and Personal Growth1

We explored parenting self‐construals among mothers with serious mental illness (n= 379). Mothers reported feeling moderately positively about themselves as parents, more efficacious than inefficacious, more positive than negative, more valued than disvalued; but also at least somewhat restricted and burdened by motherhood. Factor analyses revealed 3 parenting self‐construal factors: efficacious, burdened, and parenting as a personal growth experience. In hierarchical regression analyses, parenting self‐construal factors significantly added to prediction of parenting behaviors and attitudes (nurturance, explanatory parenting style, and parenting stress), once demographic, mental health history, and current social context variables (support, stress, and current mental health) were taken into account. Maternal parenting self‐efficacy increased (while self‐construal of parenting as a burden decreased) positive parenting style.     

For Shame: Feminism,Breastfeeding Advocacy,and Maternal Guilt

In this paper, we provide a new framework for understanding infant‐feeding‐related maternal guilt and shame, placing these in the context of feminist theoretical and psychological accounts of the emotions of self‐assessment. Whereas breastfeeding advocacy has been critiqued for its perceived role in inducing maternal guilt, we argue that the emotion women often feel surrounding infant feeding may be better conceptualized as shame in its tendency to involve a negative self‐assessment—a failure to achieve an idealized notion of good motherhood. Further, we suggest, both formula‐feeding and breastfeeding mothers experience shame: the former report feeling that they fail to live up to ideals of womanhood and motherhood, and the latter transgress cultural expectations regarding feminine modesty. The problem, then, is the degree to which mothers are vulnerable to shame generally, regardless of infant feeding practices. As an emotion that is less adaptive and potentially more damaging than guilt, shame ought to be the focus of resistance for both feminists and breastfeeding advocates, who need to work in conjunction with women to oppose this shame by assisting them in constructing their own ideals of good motherhood that incorporate a sense of self‐concern.     

The risk of low risk: First time motherhood,prematurity and dyadic well-being

Premature birth has a well-documented impact on infants, mothers and their dyadic interactions. First time motherhood in the context of low risk premature birth—relatively unexplored in the literature—is a specific experience that sits at the nexus of premature infancy, motherhood and the processes that underpin dyadic connection. This qualitative study analyzed semistructured interviews with first time mothers of low risk premature babies. Findings were generated in response to research questions concerning mothers’ meaning-making, bonding and identity. Findings demonstrated that maternal meaning-making emerged from a dyadic framework. When mothers or their infants were considered outside of a dyadic context, surplus suffering inadvertently occurred. Findings have important implications for infant mental health practice in medical settings, for postnatal support in the aftermath of premature birth, and for understanding the meaning of risk.     

Mental health and North American Indian/Native communities: Cultural transactions,education, and regulation

Critical issues in the delivery of mental health services to North American Indians/Natives residing in rural areas are discussed by describing Indian populations/communities; briefly summarizing available literature concerning the nature of mental health problems within Indian communities; examining Indian belief systems relevant to participation in mental health service delivery processes; exploring community expectations for structuring participatory interactions which may inhibit utilization of mental health services; and describing transactions between Indian consumers and non-Indian professionals which have become typical over time. The rural context was examined as it interacts with individual and community characteristics to affect Indian mental health. Relations between geography and culture, important in understanding the mental health problems of Indian people, are discussed in regard to expanding community healing resources through empowerment, and viewing "education as transformation" as a key concept in enhancing community healing processes.     

The Association Between Implicit Racial Bias and Mindfulness in Mental Health Practitioners

The mental health research literature on implicit bias is limited (Boysen, 2009), and little is known about how factors that are associated with self‐perceived multicultural counseling awareness, such as mindfulness, relate to implicit racial bias in practicing mental health professionals. Using a correlational research design, we examined the association between mental health practitioners' implicit bias, self‐perceived multicultural counseling competence, facets of dispositional mindfulness, and mindfulness practices. A total of 137 mental health professionals completed an online questionnaire. Results revealed a negative relationship between the observing component of dispositional mindfulness and the implicit racial preference associating White and “good” words. In addition, results indicated that the frequency of engaging in mindfulness practices negatively predicted implicit racial preference associating White and good. Implications for counselor training, practice, and future research are discussed.     

Motherhood: a potential source of bias in employment decisions

Results of 2 experimental studies in which job incumbents were said to be applying for promotions to traditionally male positions demonstrated bias against mothers in competence expectations and in screening recommendations. This bias occurred regardless of whether the research participants were students (Study 1) or working people (Study 2). Although anticipated job commitment, achievement striving, and dependability were rated as generally lower for parents than for nonparents, anticipated competence was uniquely low for mothers. Mediational analyses indicated that, as predicted, negativity in competence expectations, not anticipated job commitment or achievement striving, promoted the motherhood bias in screening recommendations; expected deficits in agentic behaviors, not in dependability, were found to fuel these competence expectations. These findings suggest that motherhood can indeed hinder the career advancement of women and that it is the heightened association with gender stereotypes that occurs when women are mothers that is the source of motherhood's potentially adverse consequences.     

A behavior genetic investigation of adolescent motherhood and offspring mental health problems

The present study examines the relations between adolescent motherhood and children's behavior, substance use, and internalizing problems in a sample of 1,368 children of 712 female twins from Australia. Adolescent motherhood remained significantly associated with all mental health problems, even when using a quasiexperimental design capable of controlling for genetic and environmental confounds. However, the relation between adolescent motherhood and offspring behavior problems and substance use was partially confounded by family background variables that influence both generations. The results are consistent with a causal relation between adolescent motherhood and offspring mental health problems, and they highlight the usefulness of behavior genetic designs when examining putative environmental risks for the development of psychopathology. The generalizability of these results to the United States, which has a higher adolescent birth rate, is discussed.     

Development of parenting self‐efficacy in mothers of infants with high negative emotionality

Maternal parenting self‐efficacy (PSE) is a potential target for infant mental health interventions because it is associated with a number of positive outcomes for children and mothers. Understanding the development of maternal PSE under conditions of increased parenting stress, such as parenting an infant who is easily distressed and difficult to soothe, will contribute to providing more effective interventions. This study examines the development of maternal PSE in mothers of infants with high negative emotionality (NE). The Neonatal Behavioral Assessment Scale (NBAS; T. Brazelton, 1973 ) was administered twice to 111 infants to select a sample of irritable (n = 24) and nonirritable (n = 29) infants for a prospective study comparing the development of PSE in mothers of infants differing in neonatal NE. Consistent with our hypotheses and previous research, at 8 weeks' postpartum, mothers of irritable infants have significantly lower domain‐specific PSE than do mothers of nonirritable infants. Contrary to our predictions, mothers of irritable infants exhibit a significant increase in domain‐specific and domain‐general PSE from 8 to 16 weeks' postpartum. The implications of these results for infant mental health screening, infant mental health interventions, and research on self‐efficacy theory are discussed.     

Predictors and correlates of coping well with early motherhood in the Australian Longitudinal Study on Women's Health

Women who become mothers at an early age are characterised by socio-economic disadvantage and unhealthy lifestyles; however, some cope extremely well. This paper describes Australian women who become mothers at an early age, in order to identify factors that predict coping. The younger cohort of the Australian Longitudinal Study of Women's Health was used to identify 1064 young women who became mothers between Survey 1 and Survey 2. These women were categorised on the basis of the Mental Health Index of the SF-36 as having High, Normal or Low mental health. Survey 1 data were used to examine predictors, and Survey 2 data to examine correlates, of mental health. Surprisingly, few socio-demographic or health-related variables predict level of coping with early motherhood. Women who would have High mental health as mothers were likely to be in paid work, had few symptoms, and had low levels of stress. They were least likely to have a history of miscarriage and most likely to use contraception. There were no significant effects for other socio-demographic factors, or health-related behaviours. In the longer term, however, all young mothers may suffer an increasing level of disadvantage and distress relative to their peers.     

Invisible Mothers: A Content Analysis of Motherhood Ideologies and Myths in Magazines

The purpose of this study is to identify prevalent motherhood ideologies and myths in contemporary women's magazines. The results indicate that contemporary magazines promote a traditional motherhood ideology, yet perpetuate motherhood myths that undermine mothers who stay home. Traditional motherhood, which excludes Women of Color and employed mothers, is promoted. Mothers are almost exclusively presented in the domestic, rather than the public or integrated domestic–public, contexts. Myths that employed mothers are busy, tired, and guilty, and that employed mothers neglect and are unattached to their children, are not upheld. However, negative myths that at-home mothers are confused, overwhelmed, and interested only in superficial topics are upheld in the magazines analyzed. The implications of these results on the perpetuation of patriarchy are discussed.     

Postpartum Depression in Mothers and Fathers: The Role of Parenting Efficacy Expectations During the Transition to Parenthood

Research demonstrates that belief in one’s effectiveness as a parent (parenting efficacy) is linked to numerous positive outcomes for new parents. Conversely, the perceived inability to meet expectations is associated with negative mental health consequences for mothers and fathers. In the present paper we examine the impact of parenting efficacy expectations on the mental health statuses of new parents. Using three waves of data spanning from the prenatal period to the 4-months postpartum period from a sample of 150 first-time mothers and fathers in the Midwestern United States, we find that parenting efficacy is negatively associated with postpartum depression (PPD) for both mothers and fathers throughout the transition period. We also find that mothers and fathers whose parenting efficacy experiences were more negative than expected reported higher levels of PPD at 1-month postpartum. This effect dissipates for mothers, but not fathers, by 4-months postpartum, suggesting differences in the experiences of mothers and fathers during this transition. We conclude that research on the transition to parenthood should continue to include fathers in an effort to better understand the mental health consequences of becoming a parent for the first time, as well as enhance interventions designed to assist couples experiencing this important transition.     

Balancing Act: Career and Family During College-Educated Women’s 30s

We assessed career, marriage, and motherhood expectations of 118 White Women and 82 Women of Color in 1993, when they were seniors at five northeastern U.S. colleges. Sixteen years later, in 2009, 77.5 % responded to our survey and answered questions about their career, marriage, motherhood, attitudes, and life satisfaction outcomes. As seniors, they wanted it all, career, marriage, and motherhood. In 2009, nearly two thirds were employed full time, 91 % had married, nearly three quarters were mothers, and about 57 % were combining full-time employment and motherhood. Comparisons are made among three role-status outcome groups: Have It All (mothers, employed full time); Traditional (mothers, employed part time or not at all), and Employed Only (childfree, employed full time). Educational level of the women did not predict role status. Spouses’ educational level relative to the women’s predicted role status, with Have It All women more likely to be married to less educated spouses than Traditional or Employed Only women. The role-status groups did not differ in their attitudes toward women in general, but Have It All mothers had lower levels of employment-related concerns about separation from their children than Traditional mothers. Most of the women still wanted to have it all. Many Traditional women looked forward to returning to employment, and many of the Employed Only women wanted to have children. Being a mother was associated with higher life satisfaction than being childfree. Results are discussed in terms of multiple-role theory and the positive influence of having family roles in the mix.     

Teenage Childbearing,Reproductive Justice,and Infant Mental Health

Reproductive justice advocates emphasize the rights of women to choose to have children, to decide the conditions under which they give birth, and to parent their children with support, safety, and dignity. This article examines what a reproductive justice perspective contributes to infant mental health work with teenage mothers and their families. It explores the historical framing of teenage pregnancy in which young mothers are the cause of a variety of social problems and in which the primary policy and practice approach is pregnancy prevention. The article offers alternative framings of teenage childbearing, based on reproductive justice principles, which focus on social conditions surrounding teenage parenthood and the meaning of motherhood in the lives of young women. These alternative frames shift the practice agenda to eradicating unjust social conditions and providing supports for young women in their roles as parents. The article then describes ways in which two infant mental health programs have incorporated reproductive justice principles into their work with young families: Chicago's community doula model and Florida's Young Parents Project for court-involved teenage parents. Finally, the article extracts a set of principles deriving from a reproductive justice perspective that are relevant to infant mental health work with young families.     

Predictors and outcomes of early motherhood in the Australian Longitudinal Study on Women's Health

Early motherhood is identified as a social problem, and having children at an early age is assumed to lead to psychological distress, welfare dependence and socioeconomic disadvantage. Analysis of responses from 9,689 young participants in the Australian Longitudinal Study on Women's Health was used to examine predictors and outcomes of early motherhood in Australia. Survey 1 (1996, aged 18 - 23) and Survey 2 (2000, aged 22 - 27), were used to categorize women as Childless, Existing Mothers (before Survey 1) and New Mothers (became mothers before Survey 2). Multivariate logistic regressions provided comparisons on sociodemographics, gynaecological variables, psychological wellbeing and health behaviours. Survey 1 data show that Existing Mothers experience socioeconomic disadvantages and unhealthy lifestyles. However, those who will go on to become mothers earlier than their peers already experience similar disadvantages. Further, the Survey 2 data show that, when these pre-existing disadvantages are controlled for, the additional deficits experienced by early mothers are relatively minor. Social disadvantage predisposes women to become mothers early, and to adopt unhealthy behaviours. However, young Australian women cope well with the challenges of early motherhood. In the longer term, unhealthy lifestyles and low education may lead to ill health and disadvantage, but early motherhood is not the initiator of this trajectory.     

Performance of Mental Health Counselors in Integrated Primary and Behavioral Health Care

Integrated primary and behavioral health care (IPBH) is becoming a preferred mode of service delivery in the United States. Integrated care includes the participation of medical and mental health professionals, such as mental health counselors. The clinical outcomes of these professionals need to be studied to determine their effectiveness in such settings. We examined the performance of 10 mental health counselors on the clinical outcome of 1,747 clients treated in an IPBH center. Analyses using growth curve modeling and pre‐post test design revealed that mental health counselors were effective overall, but they differed in client dropout rates and efficiency in reducing clients' initial symptoms. We used the analyses to rank order counselors based on their effectiveness. Counselors who were the most effective varied in their efficiency but demonstrated the lowest client dropout rates. Implications for future research and counseling practice were discussed.     

Community-based Peer Groups: an Intervention Programme for Teenage Mothers

This paper assesses the use of community-based peer groups as an intervention strategy to provide teenage mothers with an opportunity to share common experiences, receive social support and identify links between personal and social problems. The method utilized in a recent community project on teenage pregnancy is outlined. Over a period of 8 weeks a group of 10 teenage mothers met weekly to share their experiences of pregnancy and motherhood. The facilitators used various games and audio-visual aids to build rapport and to enhance willingness to discuss sensitive topics. The final session comprised a 1-day training workshop to enable the participants to act as co-facilitators for similar groups in the future. The evaluation indicated that the participants felt empowered by the opportunity to discuss common experiences and to have their perceptions affirmed by their peers. The potential value of this programme within the broader mental health context of South Africa is briefly discussed, and also the possibility of adding a consciousness-raising element to such groups.     

Amicus Curiae Brief for the United States Supreme Court on Mental Health Issues Associated With “Physician‐Assisted Suicide”

After providing background material related to the Supreme Court cases on “physician‐assisted suicide” (Washington v. Glucksberg, 1997, and Vacco v. Quill, 1997), this article presents the amicus curiae brief that was submitted to the United States Supreme Court by 2 national mental health organizations, a state psychological association, and an ad hoc coalition of mental health professionals. The document focuses on the role mental health professionals can play in discussions about hastened death. In particular, it is asserted that mental health professionals can assess capacity the decision‐making process, and the role of coercion in such decisions. The effect of the brief on the Supreme Court and within the organizations involved is also discussed.     

Mental health professionals and child custody disputes: Are there alternatives to the adversarial process?

An increasing problem that can have serious consequences for children, adults and social institutions is child custody after divorce. The risks associated with the various courses of action in child custody cases are discussed. Alternatives to the adversarial process are presented. The position of the legal system is explained and the importance of the involvement of mental health professionals is emphasized. Also discussed are the possible roles mental health professionals can assume on behalf of the child in working with the family and the legal system.