The Home-Based Occupational Therapy Intervention in the Alzheimer's Disease Multiple Intervention Trial (ADMIT)

There is no way to prevent functional declines related to Alzheimer's Disease (AD). The use of occupational therapy (OT) has been shown to be successful in managing some aspects of AD. We added home-based OT to evidence-based best practice for AD with the aim of delaying functional decline in people with AD. OT was delivered in the home to a caregiver dyad including the person with AD and her/his caregiver. This article describes the OT intervention for the AD Multiple Intervention Trial, a parallel randomized controlled trial. We include baseline data on the 180 caregiver dyads.     

Characteristics of Adult Caretakers of Children and Youth Served by an Urban Child Welfare Agency

The child welfare system of the early 1990s was marked by the proliferation of home-based services. Research on the effectiveness of various home-based interventions indicates results have been equivocal. The need to make explicit the specific characteristics of the adults and children targeted for home-based services, particularly families from diverse cultural backgrounds, has been identified as a critically needed contribution to the literature. In this study, the characteristics and service utilization experiences of adults and families served in an urban, home-based, child welfare program was examined. The results are discussed in relation to findings on the characteristics and experiences of adults and families served in other settings. Implications for future research and service delivery are discussed.     

Collaborative Home-Based Therapy (CHBT): A Culturally Responsive Model for Treating Children and Adolescents Involved in Child Protective Service Systems

Mental Health professionals are challenged with utilizing innovative treatment models to meet the needs of diverse communities. Enhancements in interventions have led to a reconceptualization of the role of mental health professionals, specifically, family therapists. This paper presents a collaborative, home-based model for working with children and adolescents involved in foster care. We begin by examining literature on home-based therapy. This review provides a framework to understand the need for a culturally responsive approach. A collaborative, home-based approach is presented along with unique issues and guidelines for practice. A clinical case is presented to illustrate implications for treatment.     

Impacts of Home-Based Telework on Quality of Life for Employees and Their Partners. Quantitative and Qualitative Results From a European Survey

The study investigates the effects of home-based telework on quality of life (QoL). Four dimensions of QoL were analysed; overall satisfaction with life, sense of belonging, sense of becoming and sense of being. Through cross-national survey data (from 217 job holders and 112 partners) and by means of structural equation modeling, a positive association was found between home-based telework to a worker's sense of belonging (beta = 0.30, p < 0.001). On the other hand, a negative path was detected from the job holder's home-based telework to his or her partner's overall satisfaction with life (beta = –0.27, p < 0.05). After controlling for subdimensions of life quality, home-based work did not affect the job holder's overall life satisfaction. Moreover, the more concentration the job holder reported, the lower the sense of belonging was reported by his or her partner (beta = –0.28, p < 0.05). No simple explanation for the negative effects were found, but our interviews with the group of workers and their families leave us the impression that the problem of overworking and withdrawal was most relevant to the cases, in combination with negative spill-over effects and unclear boundary settings in the home.     

Home-based early intervention: Emerging purposes,intervention approaches,and evaluation strategies

Infant and toddler home visiting programs constitute an important subgroup within the rapidly growing field of early intervention. Scores of such programs have been implemented by health, educational, and mental health agencies during the past decade. Recent reviews have reported on home-based early intervention for specific populations, such as biologically impaired infants or infants from economically disadvantaged families. Other reviews have focused on the effects of home-based early intervention in particular outcome domains, such as I.Q., or infant health. In this review the author draws together the information emerging from partial reviews and specific program reports in order to describe the full range of purposes and strategies encompassed by home-based early intervention and to draw inferences about its potential to enhance infant health and development and broader family functioning.     

Therapists' perspectives on home-based family therapy

Abstract

As a result of the passage of Public Law 96-272, home-based family services have proliferated throughout the United States, with family therapy playing a vital role. Voices of therapists providing these services have been absent from literature. Ten therapists participated in this study; each had experience providing home-based and clinic-based family therapy. A qualitative strategy was used to explore therapists' perspectives on factors regarding home-based family preservation services. Four themes emerged from semistructured interviews: the home environment, safety, context preference, and efficiency and effectiveness. Three recommendations are drawn from results and discussed.     

Reliability and validity of the Revised Children's Manifest Anxiety Scale (RCMAS) across samples of Mexican,Mexican American,and European American children: a preliminary investigation1 Table of means,standard deviations,and correlations of the RCMAS indicators are available from the first author upon request.

Abstract

The relationship between work and home-based stressors in predicting burnout symptoms was examined amongst 120 drug and alcohol service employees. Staff who reported high levels of burnout on the Maslach Burnout Inventory across all three scales of Emotional Exhaustion, Depersonalization and Personal Accomplishment were compared with a sample of low burnout employees. High burnout was associated with younger age, larger agency size, high levels of total work stressors, work overload, and daily hassles and a lower level of peer cohesion. Regression analyses revealed that male gender, younger age, work overload, role ambiguity and daily hassles were significant predictors of Emotional Exhaustion. Younger age was also a significant predictor of Depersonalization. Marked differences were found in the way in which males and females responded to work and non-work stressors and the interaction between these variables. For women, a significant interaction was found between total work stressors and home-based stressors in the prediction of Emotional Exhaustion and a trend in this direction was evident for Depersonalization. Low levels of home problems appeared to protect women from the adverse impact of work stressors. The burnout levels of women were relatively unaffected by work stressors, unless home stressors were also high. The level of daily hassles had a direct effect upon symptoms of Emotional Exhaustion, but did not interact with work stressors in predicting Emotional Exhaustion for women. Burnout levels of male employees on Emotional Exhaustion and Depersonalization scales were strongly linked to the level of work stressors and were not predicted by total home stressors nor the interaction between these variables. Symptoms of Emotional Exhaustion in males were predicted by severity of daily hassles, but this variable did not interact with work stressors in predicting Emotional Exhaustion.     

A Survey of the Attitudes and Practice Experiences of Home-Based Practitioners

This article reports on the findings from a study that assessed the attitudes and practice experiences of home-based therapists. Existing research in the field of couple and family therapy encompasses largely qualitative information detailing the experiences of this therapist population. We explored several hypotheses generated from the qualitative literature on home-based therapy. Study results corroborated much of the qualitative data on home-based therapists’ experiences and reveal the profile of today’s home-based therapists along with their attitudes and therapeutic practices. A surprising result was that various aspects of home-based therapy models seem incongruent with therapist attitudes about the delivery of home-based services.     

Job level, demands, and resources as antecedents of work–family conflict

Although substantial research has examined the conflict that employees experience between their work and family roles, the literature has not investigated the prevalence and antecedents of work–family conflict for individuals who work at different levels of an organization. This study examines differences in work–family conflict (work interference with family and family interference with work) for lower-level and higher-level employees, the factors that might explain these differences, and the differential effect of resources on conflict across job levels. Results indicate that higher-level workers experience greater conflict in both directions than lower-level workers, and that work- and home-based resources are differentially related to the conflict experienced by employees who hold lower-level and higher-level jobs.     

Office-based vs home-based behavioral treatment for obsessive-compulsive disorder: a preliminary study

The current study investigated whether exposure with response prevention (ERP) for obsessive compulsive disorder (OCD) is more effective when administered in a participant's home or other natural environments where symptoms tend to occur, than in a therapist's office. Twenty-eight outpatients with a principal diagnosis of OCD were randomly assigned to receive ERP in their therapist's office vs. wherever their symptoms usually occur (e.g., at home, at work, in public places, in the car, etc.). Participants received 14, 90-min sessions of ERP with an individual therapist. Participants were assessed at pretreatment, post-treatment, and at 3- and 6-month follow-up. Assessments included both self-report as well as clinician-rated indicators of OCD symptom severity, depression, and functional impairment. Results suggested that participants improved significantly, regardless of where treatment occurred. There were no differences in efficacy between the home-based and office-based treatment for OCD. Implications of these findings are discussed.     

Evaluating Training Needs for Home-Based Family Therapy: A Focus Group Approach

Therapists and supervisors engaged in the delivery of home-based services participated in two rounds of focus groups. Participants discussed the challenges they face doing home-based therapy, and how an accredited family therapy program could modify its curriculum to better prepare trainees to meet these demands. Eight topic areas considered necessary for home-based practice were identified and the implications for training reviewed. The focus group methodology is described in detail and is recommended as a useful tool to assess training needs and as a way of promoting improved collaboration among training sites.     

家长投入对子女成就目标的影响:教养风格的调节作用

本研究通过调查2038名中小学生,考察不同方面的家长投入(学业社会化、基于家庭的投入、基于学校的投入)与子女成就目标的关系,以及教养风格(自主支持/控制)在其中的调节作用。结果表明,学业社会化正向预测三种成就目标,基于家庭的投入正向预测成绩回避目标,基于学校的投入正向预测掌握目标;自主支持的教养风格增强了家长投入与掌握目标的关系,控制的教养风格增强了家长投入与成绩目标的关系;结果存在一定的年龄差异。     

Electronic Visibility Management of Lesbian,Gay, and Bisexual Identities and Relationships in Young Adulthood

Visibility management is a process the lesbian, gay, and bisexual-identifying (LGB) people use to manage the extent to which they will identify (“out”) themselves in various contexts such as school, work, family, and home-based settings. The purpose of this study then was to explore LGB persons' experiences of electronic visibility in online environments such as social networking sites and the manner in which LGB persons most commonly monitor their electronic visibility as individuals and in couple relationships. Analysis of the survey responses of 61 young adult participants indicated that this sample felt more positive about their identities overall compared with a national sample and that they frequently reported their sexual orientation online, most often on Facebook. In addition, participants reported online disclosure did not have an effect on their relationship satisfaction. Discussion and implications for research and clinical practice are presented.     

Contextualizing and Clarifying Criticisms of Memory Work in Psychotherapy

This article aims to reduce the polarization that has characterized discussion of memory work in psychotherapy. First, the article attempts to help critics of memory work understand the cultural and historical context in which their arguments have been received by practitioners and victim advocates: There are good reasons why attacks on memory work have been viewed with suspicion. Second, the article tries to convince practitioners and victim advocates that there nonetheless are legitimate grounds for concern about some forms of memory work. The goal here is to persuade practitioners whose work includes a focus on childhood trauma to be cautious in their use of memory recovery techniques, without undermining support for survivors of childhood sexual abuse.     

Dewey's enduring vitality

Conclusion There are many loose ends in this study and I shall make no effort to tie them together in some neat summary. I trust that my basic sympathies with Dewey have been clear throughout. What I have discovered in the course of writing this is that reflecting upon Dewey's work in the light of contemporary problems and schools of philosophy not only casts light on these problems and schools but enhances one's appreciation for the distinctiveness, coherence and value of his work.     

Eldercare demands, strain, and work engagement: The moderating role of perceived organizational support

Demographic changes give rise to an increasing number of middle-aged employees providing home-based care to an elderly family member. However, the potentially important role of employees' perceptions of organizational support for eldercare has so far not been investigated. The goal of this study was to examine a stressor–strain–outcome model (Koeske & Koeske, 1993) of eldercare strain as a mediator of the relationship between eldercare demands and caregivers' work engagement. Perceived organizational eldercare support was expected to attenuate the positive relationship between eldercare demands and eldercare strain and to buffer the negative relationship between eldercare strain and work engagement. Results of mediation and moderated mediation analyses with data collected from 147 employees providing eldercare supported the hypotheses. The findings suggest that perceived organizational eldercare support is especially beneficial for employees' work engagement when eldercare demands and strain are high.     

Home-Based vs. Clinic-Based Parent–Child Interaction Therapy: Comparative Effectiveness in the Context of Dissemination and Implementation

Disruptive child behavior disorders remain a major public health issue despite the proliferation of several strong Evidence-Based Practices (EBPs) for these children and their families. This may stem from barriers to treatment facing many families in need, particularly families with low resources. Home-based treatment may be best suited for this population; however, EBPs are not always available or tested as home-based interventions. The current study compares an intensive home-based adaptation of Parent Child Interaction Therapy (PCIT) to the standard clinic-based model in the context of a statewide implementation. As part of the statewide implementation, therapists entered archival data into an online system. Data was gathered for 314 families receiving PCIT, with 181 children in clinic-based PCIT and 133 in intensive home-based PCIT. Consistent with other trials of PCIT, results of the current study indicate that both versions of the therapy were effective in reducing child-behavior problems and increasing parenting skills; however, there were marked differences in attrition. Intensive home-based participants were twice as likely to complete treatment (64.66%) compared to clinic-based participants (33.15%) despite facing more adversity. These results underscore the importance of scientifically-sound adaptations of EBPs, as well as the role of comparative effectiveness studies as a critical tool in the integrative model of intervention science.     

Brief Report: Safe at Home Base: Working Parents' Reasons for Choice of Home-Based Child Care

The current generation of working parents faces new challenges to the traditional family model. Despite this, they select forms of home-based child care more than any other type of care. Prior data also reveal that parents who use home-based care, center-based care, and family day care all cite quality as the primary reason for their choice. Given the similarity of reason and the difference in care actually used, working parents who use home-based care were interviewed on additional reasons for their choice. These parents lacked confidence in center-based care and preferred their children to receive one-to-one attention. Age of child, cost of care, and availability of centers did not affect choice. These adults seem to be selecting home-based care in an attempt to provide care as close as possible to parental care. They are making a statement on the importance of the home environment even as their participation in the workplace increases.     

Home-based reinforcement: Behavioral covariation between academic performance and inappropriate behavior

This article describes the effects of a home-based reinforcement program on the academic performance and inappropriate behaviors of 3 fourth-grade boys. Home contingencies were placed on only academic performance. The home-based system resulted in marked increases in academic performance and large decreases in disruptive behavior for all three subjects. Throughout baseline and treatment conditions, there was a strong negative correlation between academic performance and disruptive behavior. The intervention was evaluated using both visual inspection (multiple baseline across subjects) and interrupted time-series analysis.     

Home-Based Preventive Parenting Intervention for at-Risk Infants and Their Families: An Open Trial

The purpose of this study was to examine the feasibility, acceptability, and initial outcome of a home-based adaptation of Parent-Child Interaction Therapy for at-risk infants with externalizing behavior problems. Seven 12- to 15-month-old infants and their families were recruited at a large pediatric primary care clinic to participate in a home-based parenting intervention to prevent subsequent externalizing behavior problems. Home-based assessments were conducted at baseline, postintervention, and a 4- to 6-month follow-up. Six of the 7 (86%) families completed the intervention, and all completers reported high satisfaction with the intervention. All of the mothers demonstrated significant improvements and statistically reliable changes in their interactions with their infant, and most reported clinically significant and statistically reliable changes in infant behavior problems. The current study provides preliminary support for the use of this brief, home-based parenting intervention in addressing behavior problems as early as possible to improve access to an intervention for at-risk infants and their families. Successes and challenges with the development and implementation of this intervention are discussed along with directions for future research and clinical practice.