Ethnic and Cultural Diversity:

Within the past decade, feminist therapists have successfully taken a leadership role in challenging the traditional and inherent prejudice and discrimination concerning women in psychotherapeutic counseling theory and practice. As progress is made in research, theory, and practice affecting the mental health of women in therapy, more complex issues emerge. This paper will focus on the issues of ethnic and cultural diversity, as it applies to women of color seeking therapy.     

Citizen Advocacy Observed: Tool or Tokenism?

Citizen advocacy, where a volunteer works in partnership with a vulnerable person, compliments self- and legal advocacy. In the context of mental health services, citizen advocacy is a tool for enabling and empowering people who use these services, and is founded on the recognition that mental health service users are frequently socially oppressed and disadvantaged. This article describes the development of a Citizen Advocacy service for people with mental health difficulties, and also the problems they brought to this service. The problems encountered in sustaining the service are noted and lessons are drawn for the future.     

The mental health of unaccompanied refugee minors on arrival in the host country

Despite increasing numbers of unaccompanied refugee minors (UM) in Europe and heightened concerns for this group, research on their mental health has seldom included the factor “time since arrival.” As a result, our knowledge of the mental health statuses of UM at specific points in time and over periods in their resettlement trajectories in European host countries is limited. This study therefore examined the mental health of UM shortly after their arrival in Norway (n = 204) and Belgium (n = 103) through the use of self‐report questionnaires (HSCL‐37A, SLE, RATS, HTQ). High prevalence scores of anxiety, depression and posttraumatic stress disorder (PTSD) symptoms were found. In addition, particular associations were found with the number of traumatic events the UM reported. The results indicate that all UM have high support needs on arrival in the host country. Longitudinal studies following up patterns of continuity and change in their mental health during their trajectories in the host country are necessary.     

Aetiology of Coexisting Mental Health and Alcohol and Other Drug Disorders: Perspectives of Refugee Youth and Service Providers

In the general population, people with comorbid mental health (MH) and alcohol and other drug (AOD) disorders (comorbidity) have great difficulty accessing appropriate services, and poor outcomes. Little is known about comorbidity in resettled refugees in Australia. This study was designed to identify risk factors and patterns of comorbidity development in young people from refugee backgrounds living in a disadvantaged urban region of Adelaide, South Australia. This qualitative study utilised in‐depth semi‐structured interviews (n = 30) with resettled refugee youth and workers from MH, AOD, and refugee support services. Thematic analyses were conducted to investigate the aetiology of MH and AOD disorders in young refugees. Interviews with both groups revealed how the interrelated nature of risk factors may place young people from refugee backgrounds at heightened risk of experiencing MH and AOD problems. The situations and conditions described by both groups are discussed under six main themes: pre‐migration experiences of torture and trauma; familial factors of intergenerational conflict; post‐migration adjustment difficulties in terms of language, culture, education, and employment; exposure to and availability of substances; maladaptive coping strategies and self‐medication; and access to information and services. Implications for psychologists and MH professionals are identified, emphasising the need for clinicians to understand the complexities surrounding the aetiology of comorbidity in these youth. The initial assessment needs to be comprehensive, including pre‐ and post‐settlement experiences and cultural and family dimensions of their current situation. Treatment may often need to simultaneously address multiple contributing factors and involve culturally sensitive psycho‐education.     

The Relationship Between Caregiver Capacity and Intensive Community Treatment for Children with a Mental Health Crisis

We studied 9,220 children referred to a comprehensive mental health crisis stabilization program to examine the impact of caregiver capacity on crisis worker decisions to refer children for intensive community-based treatment as opposed to inpatient psychiatric hospitalization. Due to the different role of caregivers in the child welfare system, analyses were stratified by state custody status. Among both groups, there was a significant inverse association between child mental health need and referral to intensive community-based treatment. For children not in state custody with low mental health need, there was no difference in the likelihood of referral to intensive community-based treatment across levels of caregiver capacity. However, for children not in state custody with medium and high mental health needs, those whose caregivers were deficient or severely deficient were significantly more likely to be referred for intensive community-based treatment than were those who had capable caregivers. Multivariate analyses demonstrated similar results after controlling for potential confounding variables and confirmed that caregiver capacity contributes significantly to the logistic model’s classification accuracy. Results suggest further investigation of the impact of caregiver capacity on mental health crisis worker referral decisions is needed.     

Predictors of depressive symptoms among resettled unaccompanied refugee minors

This study investigated the level and predictors of depressive symptoms among unaccompanied refugee minors after resettlement in Norway. Participants (N = 414) were resettled in 26 municipalities from all regions of the country. The average length of resettlement time was 3.4 years. They originated from 33 different countries, mainly Afghanistan (n = 116), Somalia (n = 74), Sri Lanka (n = 41) and Iraq (n = 43). Participants completed a self-report questionnaire administered in groups. Findings show that unaccompanied minors are a high-risk group for mental health problems also after resettlement in a new country. A multilevel model predicting depressive symptoms from individual and contextual demographic factors indicated that, controlling for post-traumatic stress, females had more symptoms than males and Somalis had fewer symptoms than participants from other countries. Variation in symptom levels as a function of gender and ethnic background indicates that some groups may have inherent protective or vulnerability factors that need to be further studied to understand differences in psychosocial adaptation among unaccompanied minors. Further, findings imply that researchers, policy makers and mental health care workers need to expand their attention beyond the first phases of arrival of unaccompanied asylum seeking and refugee minors to the continuing experience of mental health problems after resettlement.     

Behavioral Health and Firefighters: An Intervention and Interviews with Canadian Firefighters

The present study described participatory action research regarding behavioral health of firefighters. At the request of the participant fire department, the Veterans’ Affairs Wellness kit was used to provide wellness information to members. During the intervention, qualitative data from the researcher perspective was collected and subsequently coded to reveal themes about lessons learned during provision of the materials. Following the intervention at the department level, individual interviews were completed with a subsample of members and their spouses. The combined outcomes from these two research phases suggest that wellness interventions for firefighters should be informal, firefighter-specific, focused on programs endorsed by firefighter-related organizations, and supported by management and frontline supervisors. From our data, we suggest that the Veterans’ Affairs Wellness kit should be studied further as a potentially meaningful fire service intervention. Further, we propose that this and other interventions should take into account job aspects identified as important by both members and their spouses.     

Occupational Therapy and Victim Advocacy

ABSTRACT

This article provides an orientation to increase the profession's awareness of occupational therapy's role in victim advocacy, an emerging area of community-based practice. Analysis and comparison of OT's core assumptions and values with general principles of victim advocacy and empowerment demonstrate striking similarities: Each acknowledges holism and a profound connection between the individual and society, as well as their ability to interact and influence each other. In addition, the cultures of OT and victim advocacy both value the dignity and worth of persons, self-determination, freedom and autonomy, latent capacity, human uniqueness and subjectivity, and active and mutual cooperation in restoration or recovery. The compatibility of OT and victim advocacy is further demonstrated in the context of one therapist's work with survivors of domestic and sexual violence.     

归因方式对心理健康的影响及干预研究之概观

该文就归因方式对心理健康影响的特点、规律及其心理机制以及通过归因干预改善和提高个体与群体健康水平的研究进行了简要的叙述,并对已有研究存在的问题进行了初步的讨论。作者认为,归因干预可能是改善和提高个体与群体的健康水平的一条重要途径;未来的研究应着眼于揭示个体对不同性质、不同类型的生活事件在特定归因和维度归因上对心理健康影响的特点、规律及其心理机制,并就归因干预的理论和实践等问题进行了深入的探讨。     

心理预防概念的更新及其对实践的指导意义

继Caplan的“公共卫生预防模型”之后,Gordon提出另一个综合性预防模型;美国国家科学院医学研究所绘制了“心理健康干预光谱”; 美国国家研究所和国家科学院医学院则进一步将“心理健康促进”正式纳入心理预防概念。“心理健康促进”是针对消极被动的传统预防而提出的积极主动的预防。心理预防概念的发展与更新,特别是将“心理健康促进”纳入心理预防体系,要求树立预防的全局观念,提高预防的针对性,将消极心理预防与积极心理健康促进结合起来。     

轻度智障学生心理健康教育干预的形式与方法

轻度智障学生具有学习焦虑、孤独感、好责备自己、缺乏主动性和积极性等心理健康方面的问题。产生这些问题的原因有个体因素、父母教养因素和学校教育因素等。针对这些问题,教育者使用多种辅导形式和方法进行干预,使轻度智障学生的心理健康水平得以提高与改善。本文最后提出了在进行教育干预时需注意的一些问题,为学校开展该方面工作提供参考。     

心理健康素养：概念、评估、干预与作用

心理健康素养是促进心理健康的重要途径。狭义概念指帮助人们认识、处理和预防心理疾病的相关知识和信念;广义概念指综合运用心理健康知识、技能和态度,保持和促进心理健康的能力。心理健康素养常in采用情景案例问卷、单维或多维评估量表等进行评估,可以通过社会运动、学校教育、自助式应用程序、心理健康急救培训等方式进行有效干e预s提高,其中心理健康知识、心理疾病识别、情绪调节、减少病耻感、积极的求助态度等成分都有促进n心c理健康的作用。未来研究可以在建构评估指标体系、探索作用机制、扩展涵盖群体与内容、加强实证干预研究等方面深入开展。