Psychotherapeutic practitioners’ views of the efficacy of mindfulness for the treatment of obsessive compulsive disorder: A qualitative key informant analysis

Objectives: A substantial proportion of individuals affected by obsessive compulsive disorder (OCD) are not experiencing adequate therapeutic outcomes from current standard psychotherapeutic treatments. Mindfulness has had a positive therapeutic impact on many symptoms associated with OCD. This study investigated the views of experienced psychotherapeutic practitioners concerning the potential efficacy of mindfulness as a therapeutic intervention for individuals with OCD.

Method: Six psychotherapeutic professionals experienced in using mindfulness with individuals affected by OCD were interviewed. Data were subjected to thematic analysis.

Results: Participants reported that engaging in mindfulness enabled people with OCD to experience an altered relationship with their symptoms and self. This new attitude, in conjunction with cognitive behavioural therapy, was perceived as helping individuals manage their OCD in an effective and healthy way. However, participants were unsure whether an exclusively mindfulness-based treatment would be effective.

Conclusion: This study indicates the potential for mindfulness practice to constitute a valuable therapeutic resource in helping people manage their OCD experience. Implications for future research and practice are considered.     

What is the key to culturally competent care: Reducing bias or cultural tailoring?

Objective: To gain a better understanding as to whether disparities in patient–provider relationships arise from ethnic minority patients being treated differently than European American patients while they would prefer to be treated the same, or whether disparities arise when ethnic minority patients are treated the same as European American patients while they would prefer to be treated differently.

Method: African-American, Latina/Latino and European American community members were recruited to participate in one of 27 focus group discussions. Topics included what made a good or bad relationship with a doctor and what led one to trust a doctor. A thematic analysis was conducted using NVivo 10.

Results: Patients of all groups described experiences that reflected the concepts of patient-centred care, such as wanting a clinician who is attentive to patients’ needs. African-American patients reported experiences they viewed as discriminatory. Some African-American patients felt it was appropriate to racially/ethnically contextualise their care, and most Latina/Latino patients preferred language/culturally concordant clinicians.

Conclusion: Health care disparities might be reduced through a patient-centred approach to cultural competency training, general knowledge of the cultural context of clinicians’ patient population, and attention to the effects of racial bias and discrimination among both clinicians and non-clinical staff.     

Fear of evaluation unpacked: day-to-day correlates of fear of negative and positive evaluation

Background and objectives: Social interactions inevitably go along with repeated evaluations. Some individuals are particularly sensitive to social evaluations: Psychometric studies suggest stable and distinct individual differences on fear of negative evaluations (FNE) and fear of positive evaluation (FPE). However, little is known about day-to-day correlates of FNE and FPE, particularly their respective contribution to positive/negative affect level and affect reactivity to different stressor types.

Design: Two studies naturalistically assessed the level of negative/positive affect and its reactivity to different stressor types (from distant or close social network, work and daily hassles, assessed daily) as a function of FNE/FPE.

Method: Ecological Momentary Assessment employed five daily prompts during 12/10 days in convenience samples of 50/59 participants.

Results: FNE predicted lower positive affect level only in Study 2. Consistent across studies negative affect reactivity to stressors emanating from the distant social network was increased in individuals high in FNE or FPE.

Conclusions: Results document the relevance of both types of evaluation fears (FNE/FPE) for day-to-day affect and stress reactivity. They further specify whose evaluations are well tolerated (close network) or feared (distant network), thereby refining current psycho-evolutionary accounts of FNE/FPE.     

Successes and failures in resisting cigarettes affect partner support for smoking cessation

Objective: Potential support providers may rely on observable behaviours (e.g. resisting a cigarette vs. smoking) to determine how much and what kind of support to provide. We evaluated the effect of smokers’ salient behaviour on partners’ likelihood of providing positive and negative support.

Design: Partners of smokers (N = 131) were randomly assigned to recall a time when their partner either successfully resisted a cigarette, failed to resist a cigarette or a control condition (no recall). All participants reported the likelihood of providing positive and negative support to their partner. Perceived commitment to quitting smoking was measured as a potential mediator.

Main Outcome Measures: The main outcome was intention to provide support for a quit attempt.

Results: Participants who recalled their partners’ past failures reported more intentions to engage in negative support and smaller ratios of positive to negative intended support than did participants in the success or control condition. These effects were partially mediated by perception of commitment to quitting.

Conclusion: Lapses in a quit attempt may change the nature of the support quitters receive. Interventions to improve communication between partners about the smoker’s commitment to quitting and experienced challenges may result in better support.     

Realism,Reliabilism, and the ‘Strong Programme’ in the Sociology of Scientific Knowledge

In this essay, I respond to Tim Lewens’s proposal that realists and Strong Programme theorists can find common ground in reliabilism. I agree with Lewens, but point to difficulties in his argument. Chief among these is his assumption that reliabilism is incompatible with the Strong Programme’s principle of symmetry. I argue that the two are, in fact, compatible, and that Lewens misses this fact because he wrongly supposes that reliabilism entails naturalism. The Strong Programme can fully accommodate a reliabilism which has been freed from its inessential ties to naturalism. Unlike naturalistic epistemologists, the Strong Programme’s sociologistic reliabilist insists that all scientific facts are the product of both natural and social causal phenomena. Anticipating objections, I draw on Wittgenstein’s rule‐following considerations to explain how the sociologistic reliabilist can account for standard intuitions about the objective elements of knowledge. I also explain how the Strong Programme theorist can distinguish between a belief’s seeming reliable and its being reliable.

?Ich setzte

?den Fuß in die Luft,

?und sie trug.

?(Hilde Domin)     

Effects of optimism on recovery and mental health after a tornado outbreak

Objective: Dispositional optimism, a stable expectation that good things will happen, has been shown to improve health outcomes in a wide range of contexts, but very little research has explored the impact of optimism on post-disaster health and well-being.

Design: Data for this study come from the Centers for Disease Control and Prevention’s Public health systems and mental health community recovery (PHSMHCR) Survey. Participants included 3216 individuals living in counties affected by the April 2011 tornado outbreak in Mississippi and Alabama.

Main outcome measures: This study assesses the effect of dispositional optimism on post-disaster recovery and mental health.

Results: Dispositional optimism was found to have a positive effect on personal recovery and mental health after the disaster. Furthermore, it moderated the relationship between level of home damage and personal recovery as well as the relationship between home damage and post-traumatic stress disorder (PTSD), with stronger effects for those with increased levels of home damage.

Conclusions: The utility of screening for optimism is discussed, along with the potential for interventions to increase optimism as a means of mitigating adverse mental health effects and improving the recovery of individuals affected by disasters and other traumatic events.     

Changes over time in head and neck cancer patients’ and caregivers’ illness perceptions and relationships with quality of life

Objective: This study investigated changes in illness perceptions from diagnosis to six months later in patients with head and neck cancer (HNC) and their caregivers. The study also examined whether discrepancy in patient and caregiver perceptions at diagnosis predicted patient health-related quality of life (HRQL) at six months.

Design: Forty-two patient–caregiver dyads completed the Brief Illness Perception Questionnaire (Brief IPQ) at diagnosis and again six months later. Patients also completed a HRQL questionnaire at both time points. Analyses were performed using the Actor–Partner Interdependence Model.

Main Outcome Measure: Total patient HRQL assessed by the Functional Assessment of Cancer Therapy (FACT-H&N).

Results: Perceptions of emotional impact and illness concern reduced over time in patients and caregivers. Perceptions of treatment control and identity increased in caregivers only. After controlling for the effects of baseline HRQL, and the individual contribution of patient and caregiver illness perceptions, greater discrepancy in perceptions of timeline, personal control, and illness identity among dyads at diagnosis predicted lower patient HRQL at six-month follow-up.

Conclusion: Patients’ and their caregivers’ perceptions of HNC are dynamic over time. Greater discrepancy between patients’ and caregivers’ illness perceptions at diagnosis predict poorer subsequent patient HRQL.     

Interpersonally traumatised patients’ view of significant and corrective experiences in the psychotherapeutic relationship

Background: Clinical experience points to the importance of significant experiences in the therapy relationship for patients who have been interpersonally traumatised but the empirical research is limited.

Aim: The aim was to gain increased knowledge about how significant and potentially corrective experiences within the therapeutic relationship were described by patients in trauma-focused therapy and how the participants thought such experiences might have affected the therapeutic work.

Method: Five patients who were, or recently had been, in trauma-focused therapy were interviewed about their experiences of the therapy relationship. Thematic analysis was used to analyse the interviews.

Results: Four themes were identified: ‘Human contact’, ‘Validation’, ‘To face the painful’ and ‘Development of trust’. Positive experiences in the therapeutic relationship were sometimes seen as crucial for the therapeutic work and for patients’ improvement.

Conclusions: Previous findings about the significance of corrective experiences in psychotherapy were confirmed, particularly experiences of the therapist’s accepting stance, personal and human contact and encouragement. The therapist’s ability to evoke trust in the patient and her capacity to help patients to face painful material may be particularly important for traumatised patients.     

Dyadic coping mediates the relationship between parents’ grief and dyadic adjustment following the loss of a child

Background and Objectives: This study aimed to examine forms of dyadic coping (DC) as mediators of the association between parents’ grief response and dyadic adjustment and to determine whether these indirect effects were moderated by the child’s type of death, timing of death, and age.

Design: The study design was cross-sectional.

Method: The sample consisted of 197 bereaved parents. Participants completed the Prolonged Grief Disorder Scale, Revised Dyadic Adjustment Scale, and Dyadic Coping Inventory.

Results: Significant indirect effects of parents’ grief response on dyadic adjustment were found through stress communication by oneself and by the partner, positive and negative DC by the partner, and joint DC. The timing of death moderated the association between grief response and dyadic adjustment and between joint DC and dyadic adjustment. Grief response was negatively associated with dyadic adjustment only when the death occurred after birth. Grief response was negatively associated with joint DC, which, in turn, was positively associated with dyadic adjustment, when the death occurred both before and after birth. However, the association was stronger in the latter.

Conclusions: Specific forms of DC might be mechanisms through which grief response is associated with dyadic adjustment and should be promoted in clinical practice.     

The impact of experiential avoidance on the relations between illness representations,pain catastrophising and pain interference in chronic pain

Objective: The aim of this study was to examine the effects of experiential avoidance (EA) on the indirect relationship of chronic pain patients’ illness representations to pain interference, through pain catastrophising

Design and main outcome measure: The sample consisted of 162 patients diagnosed with an arthritis-related or a musculoskeletal disorder. The effects of EA on the pathway between illness representations, pain catastrophising and pain interference were examined with PROCESS, a computational tool for SPSS

Results: After controlling for patient and illness-related variables and pain severity, the ‘illness representations–pain catastrophising–pain interference’ pathway was interrupted at the higher levels of EA. The reason was that, at the high levels of EA, either the relation of illness representations to pain catastrophising or the relation of pain catastrophising to pain interference was not statistically significant.

Conclusion: The findings indicate that EA is not a generalised negative response to highly aversive conditions, at least as far as the factors examined in this study are concerned. EA may rather reflect a coping reaction, the impact of which depends on its specific interactions with the other aspects of the self-regulation mechanism. At least in chronic pain, EA should become the focus of potential intervention only when its interaction with the illness-related self-regulation mechanism results in negative outcomes.     

Book reviews

The Psychological Attitude of Early Buddhist Philosophy. Lama Anagarika Govinda, 1991, Delhi, Motilal Banarsidass, Rs 125

The Law of Karma: a philosophical study. Bruce R. Reichenbach, 1990, Honolulu, University of Hawaii Press, pp. xiv + 238, $38.00

Religious Philosophy of Tagore and Radhakrishnan. Harendra Prasad Sinha, 1993, Delhi, Motilal Banarsidass Publishers 188 pp., Rs. 150

Scripture, Canon and Commentary: a comparison of Confucian and Western exegesis. John B. Henderson, 1991, Princeton, NJ, Princeton University Press, xii + 247 pp. $32.50

Chan Insights and Oversights: an epistemological critique of the Chan tradition. Bernard Fauré, 1993, Princeton, NJ, Princeton University Press, ix + 322 pp. £45

Reason and Tradition in Indian Thought: an essay on the nature of Indian philosophical thinking. Jitendra Nath Mohanty, 1992, Oxford, Clarendon Press, 306 pp. £37.50

Avicenna. L. E. Goodman London, Routledge, 1992, xii + 240 pp. £12.99

Becoming Bamboo: Western and Eastern explorations of the meaning of life. Robert E. Carter, 1992, Montreal, McGill‐Queen's University Press, xvi + 224 pp. £22.95     

Book reviews

The Rise of Christianity: A Sociologist Reconsiders History. Rodney Stark, 1996 Princeton, NJ: Princeton University Press xiv + 247 pp., US$24.95, £16.95 ISBN 0–691–02749–8

Church Watch: Christianity in the Countryside. Leslie J. Francis, 1996 London: SPCK 248 pp., £9.99 ISBN 0–281–04951–3

Strategic Church Leadership. Robin Gill & Derek Burke, 1996 London: SPCK vii + 96 pp., £9.99 ISBN 0–281–04901–7

’Nice When They Are Young’: Contemporary Christianity in Families and Schools. Mairi Levitt, 1996 Aldershot: Avebury viii +171 pp., £32.50 ISBN 1–85972–388–8

Die Sekten‐Kinder. Kurt‐Helmuth Eimuth, 1996 Freiburg: Herder Verlag 239 pp., DM 19.80 (pb) ISBN 3–451–04397–1

The Good Heart: His Holiness the Dalai Lama Explores the Heart of Christianity—and of Humanity. H.H. The Dalai Lama, 1997. London: Rider xiv + 207pp., £9.99 (pb) ISBN 0–7126–7275–3

Scientists as Theologians: A Comparison of the Writings of Ian Barbour, Arthur Peacocke & John Polkinghome. John Polkinghorne, 1996 London: SPCK 95 pp., £9.99 ISBN 0–281–04945–9

Psychiatry and Religion: Context, Consensus and Controversies. Dinesh Bhugra, ed., 1996 London, New York: Routledge 236 pp., £50.00, US$65.00 ISBN 0–415–08955–7 (hb)

Ethical Issues in Six Religious Traditions. Peggy Morgan & Clive Lawton, eds, 1996 Edinburgh: Edinburgh University Press 278 pp., £14.95 (pb) ISBN 0–7486–0709–9

Religious Institutions and Women's Leadership: New Roles Inside the Mainstream. Catherine Wessinger, ed., 1996 Columbia: University of South Carolina Press x +434 pp., US$24.95 ISBN 1–57003–073–1

Traveller in Space: In Search of Female Identity in Tibetan Buddhism. June Campbell, 1996 London: Athlone Press 225 pp., £17.95 ISBN 0–485–11494–1

Forbidden Revolutions: Pentecostalism in Latin America, Catholicism in Eastern Europe. David Martin, 1996 London: SPCK 96 pp., £7.99 ISBN 0–281–04999–8

The Ukrainian Greek Catholic Church and the Soviet State (1939–1950) Bohdan R. Bociurkiw, 1996 Edmonton, Toronto: Canadian Institute of Ukrainian Studies Press 310 pp., Ca$39.95(hb) ISBN 1–895571–12‐X

Qur'an, Liberation & Pluralism: An Islamic Perspective of Interreligious Solidarity against Oppression. Farid Esack, 1997 Oxford: Oneworld Publications xii + 288 pp., 3 Appendices + Glossary + Bibliography; £14.99, US$22.95 ISBN 1–85168–121–3

A Sociological Analysis of the Theology of Quakers: The Silent Revolution Studies in Religion and Society Volume 34 Pink Dandelion, 1996 Lampeter: Edwin Mellen Press xxxiv +417 pp., £59.95 ISBN 0–7734–8807–3

Counting the Days to Armageddon: The Jehovah's Witnesses and The Second Presence of Christ Robert Crompton, 1996 Cambridge: James Clarke & Co. 160 pp., £22.50 ISBN 0–2276–7939

Magical Religion and Modern Witchcraft. James R. Lewis, ed., 1996 Albany, NY: State of New York University Press vi + 423 pp., US$19.95 (pb) ISBN 0–7914–2890–7

The Divine Versus The Asurian: An Interpretation of Indo‐European Cult and Myth. Michael York, 1995 Bethesda, MD: International Scholars Publications 635 pp., US$94.95 ISBN 1–57309–029–8     

Couple adjustment to a stressful life event: a dyadic investigation of the roles of positive reframing and perceived benefits

Background and Objectives: This study examines positive reframing (a form of meaning making), perceived benefits (a form of meanings made) and adjustment in couples who experienced a stressful life event in the past year. This study tested whether couple members’ scores were nonindependent and whether one’s own perceived benefits was predicted by their own positive reframing (actor effect) as well as their partner’s positive reframing (partner effect). Further, this study tested actor and partner effects for the link between perceived benefits and adjustment and whether positive reframing (the initial variable) works through perceived benefits (the mediator) to affect adjustment (the outcome) at the dyadic level.

Design: A standard dyadic design was used.

Methods: Eighty couples completed measures of positive reframing, perceived benefits, and adjustment (depression, anxiety, positive affect, life satisfaction, and relationship satisfaction).

Results: Partners’ scores on study variables were related, and although only actor effects were found for the path between positive reframing and perceived benefits, both actor and partner effects were found for the path between perceived benefits and adjustment. Mediation was found for actor–actor and actor-partner indirect effects.

Conclusions: Results indicate that a greater focus on interpersonal factors is needed to further meaning-making theory and inform practice.     

Broken mirror: The intertwining of therapist and client stories of childhood sexual abuse (CSA)

In recent years, there has been a great deal of attention given to the potential increased risk of vicarious traumatisation (VT) for clinicians with a history of childhood sexual abuse.

I am curious about whether the silencing, which has been ubiquitous within society, is also prevalent within the therapeutic profession. I wonder if therapists with a history of abuse feel they have to bracket their experience, and if this limits the potential for positive transformation.

In this paper, I draw upon my narrative study of therapists with a history of abuse. The methodology followed was narrative inquiry with two therapists in addition to an autoethnography. I used ‘narrative analysis’ to analyse the data. The findings of the study covered themes of transgenerational trauma, ‘the wounded healer’, caregivers’ responsibility in communal cultures and dissociation.

In this paper, I will consider the part dissociation plays when there is a shared history of trauma, and the ways in which dissociative enactments within the consulting room themselves may be part of the mutual healing. For this paper, only extracts from interviews with one of my participants will be included.     

Physical and mental health trajectories of cancer patients and caregivers across the year post-diagnosis: a dyadic investigation

Objective: Evidence suggests interdependence between cancer patients’ and their caregivers’ physical and mental health. However, the extent to which caregivers’ health relates to their patients’ recovery, or patients’ health affects their caregivers’ outcomes, is largely unknown. This dyadic investigation reports the relations between cancer patients’ and their caregivers’ physical and mental health trajectories during the year following diagnosis.

Design: Ninety-two colorectal cancer patient–caregiver dyads completed questionnaires at 2, 6 and 12 months post-diagnosis.

Outcome measures: Self-reported physical and mental health using the Medical Outcomes Study Short Form Health Survey-12.

Results: Patients reported improved physical health over the year following their diagnosis, whereas caregivers reported declining physical health. Patients with lower mental health at diagnosis had stagnated physical health recovery. Caregivers’ physical health declined most noticeably among those reporting low mental health at diagnosis and whose patients reported low physical health at diagnosis.

Conclusion: Findings suggest targeting health interventions to cancer patients and caregivers reporting poor mental health at diagnosis may mitigate their long-term physical morbidity. Limited evidence of dyadic interdependence between patients’ and caregivers’ physical and mental health trajectories suggests future studies are warranted to identify psychosocial and medical characteristics moderating the relations between patients’ and caregivers’ health.     

Parent Grief 1–13 Months After Death in Neonatal and Pediatric Intensive Care Units

Objective. Describe changes in mothers’ and fathers’ grief from 1 to 13 months after infant or child neonatal or pediatric intensive care unit death and identify factors related to their grief.

Methods. Mothers (n = 130) and fathers (n = 52) of 140 children (newborn–18 years) completed the Hogan Grief Reaction Checklist at 1, 3, 6, and 13 months postdeath.

Results. Grief decreased from 3 to 13 months for mothers and from 3 to 6 months for fathers. Grief was more intense for mothers of deceased adolescents and mothers whose children were declared brain dead.

Conclusion. Mothers’ and fathers’ grief intensity may not coincide, resulting in different needs during the 13 months after infant or child death.     

Impulse control disorders in Parkinson’s disease: Predominant role of psychological determinants

Objectives: Impulse Control Disorders (ICDs) in Parkinson’s disease (PD) have previously almost exclusively been considered to result from anti-parkinsonian medication. However, this biomedical perspective has failed to achieve a full understanding of the phenomenon and it is argued that a failure to consider psychological factors is a critical omission.

Design: The present study examined the predictive relationship between ICDs in PD and a range of psychological measures, whilst controlling for a number of biomedical determinants.

Main outcome measures: One hundred participants with idiopathic PD completed questionnaires that assessed demographic and clinical characteristics, psychological measures and the presence of ICDs (QUIP-RS).

Results: Increased use of a ‘negative’ coping strategy, stronger illness identity, more emotional illness representations and stress were found to be significant predictors of ICDs, and different psychological predictors were associated with different ICDs. Medication was not found to predict ICDs in the presence of psychological factors, either when total treatment levels were considered or when agonist dose was considered alone.

Conclusions: This study provides the first quantitative evidence of a predominant predictive relationship between psychological factors and ICDs in PD. The results suggest that psychological interventions may have useful therapeutic role to play for ICDs in PD.     

Book notes

Ruchy Pogranicza Religii i Nauki. Jako Zjawisko Socjopsychologiczne [Movements on the Border of Science and Religion as Socio‐Psychological Phenomenon]

Tadeusz Doktor, ed, 1996 Warsav: Wydawnictwa University Warsav 274 pp. ISBN 83–230–9829–8

Religion: North American Style, 3rd edn. Thomas E. Dowdy & Patrick H. McNamara, eds, 1996 New Brunswick, NJ: Rutgers University Press 221 pp., US$48.00 (hb), US$16.95 (pb) ISBN 0–8135–2343–5 (hb), ISBN 0–8135–2344–3 (pb)

Islam in a World of Diverse Faiths. Dan Cohn‐Sherbok, ed, 1997 Houndsmill, Basingstoke: Macmillan Press 218 pp., £45.00 (hb), £15.99 (pb) ISBN 0–333–52612–0 (hb), ISBN 0–333–69067–2 (pb)

Spirituality and Culture: The Case of Celtic Christianity. Oliver Davies, 1996 Oxford: Religious Experience Research Centre, Westminster College 10 pp., £2.00 ISBN 0–906165–13‐X

Christianity and New Age Thought. Frank Whaling, 1996 Oxford: Religious Experience Research Centre, Westminster College 11 pp., £2.00 ISBN 0–906165–08–3

Religious Experience: A Sociological Perspective. Bryan Wilson Oxford: Religious Experience Research Centre, Westminster College 15 pp., £2.00 ISBN 0–906165–09–1

Searching for the Truth around the Next Twist: Why Do We Like The X‐Files Mark Fox. Oxford: Religious Experience Research Centre, Westminster College 9 pp., £2.00 ISBN 0–906165–11–3

Sexual Morality in the World's Religions. Geoffrey Parrinder, 1996 Oxford: Oneworld Publications 276 pp., £8.95 (pb) ISBN 1–85168–108–6

The Sacred Thread: Hinduism in its Continuity and Diversity, 2nd edn John I. Brockington, 1996 Edinburgh: Edinburgh University Press 222 pp., £10.95 (pb) ISBN 0–7486–0830–3

Behind the Crystal Ball: Magic and Science from Antiquity to the New Age. Anthony Aveni, 1996 London: Newleaf 406 pp., £20.00 ISBN 0–7522–0549–8

Historical Dictionary of Methodism. Charles Yrigoyen, Jr. & Susan E. Warrick, 1996 Lanham: Scarecrow Press 299 pp., £44.65 ISBN 0–8108–3140–6

Historical Dictionary of the Orthodox Church. Michael Prokurat, Alexander Golitzin & Michael D. Peterson, 1996 Lanham, Maryland, London: Scarecrow Press 440 pp., £80.40 ISBN 0–8108–3081–7

God's Straggler: Religion in the Writings of Nikos Kazantzakis. Darren J. N. Middleton & Peter Bien, eds, 1996 Macon, Georgia: Mercer University Press 236 pp., US$32.95 ISBN 0–86554–499–9

Apocalypticism in the Dead Sea Scrolls. John J. Collins, 1997 London: Routledge 187 pp., £37.50 (hb), £11.99 (pb) ISBN 0–415–14636–4 (hb), ISBN 0–415–14637–2 (pb)

The Word Made Strange: Theology, Language, Culture. John Milbank, 1996 Oxford; Cambridge, MA: Blackwell 298 pp., £45.00, US$59.95 (hb), £14.99, US$23.95 (pb) ISBN 0631–20335–4 (hb), ISBN 0631–20336–2 (pb)

The Simple Guide to the Roman Catholic Church. Edmund Hartley, 1997 Folkestone, Kent: Global Books 144 pp., £5.99 ISBN 1–86034–023–7

The Simple Guide to Judaism. David Starr‐Glass, 1997 Folkestone, Kent: Global Books 120 pp., £5.99 ISBN 1–86034–008–3

The Simple Guide to Hinduism. Venika Mehra Klngsland, 1997 Folkestone, Kent: Global Books 117 pp., £5.99 ISBN 1–86034–018–0

Mission on the Margins. Mary Beasley, 1997 Cambridge: The Lutterworth Press 110 pp., £7.99 ISBN 0–7188–2966–2     

Cancer survivors’ and partners’ key concerns and quality of life

Objective: Understanding the concerns of cancer survivors is essential for effective interventions. This study was designed to identify the primary concerns of dyads coping with cancer, how concerns differed by role and sex, and whether concerns expressed during counselling were associated with survivors’ psychosocial well-being and adjustment.

Design: Forty-three dyads with breast and prostate cancer (N = 86 participants) were enrolled in an interpersonal telephone counselling intervention. Audio recordings of 228 counselling sessions were transcribed and content analysed qualitatively to identify major themes and key concerns. A total of three 30-min sessions were coded for each study participant. Quantitative data and statistical analyses were used to predict changes in survivors’ quality of life.

Main Outcome Measures: Participants completed psychosocial well-being measures (depression, positive/negative affect, and relationship satisfaction), pre- and post-counselling.

Results: Survivors’ concerns focused on cancer- and treatment-related issues, whereas partners’ concerns centred on the well-being of their spouse/partner with cancer, and what they were doing to help their loved one cope with his/her illness. Key concerns for all consisted of relationship maintenance and communication issues. Further, discussion of these concerns was predictive of significant improvements in adjustment post-counselling for women with breast cancer.

Conclusion: Discussion of interpersonal concerns may play a more important role in the well-being of women, than men, coping with cancer.