Occupational Stress in University Staff

A survey was conducted of all staff members of an established Australian metropolitan university. The overall response rate for noncasual staff was 72% (77% for general staff and 65% for academic staff) resulting in a sample of N = 2,040. High levels of psychological stress were observed, despite the fact that trait anxiety and job satisfaction were normal. Psychological distress was highest and job satisfaction lowest among academic staff engaged in both teaching and research. In general, university staff reported high levels of autonomy and social support from colleagues. However those engaged in both teaching and research reported increased pressure arising from funding cuts to universities, resulting in heavier teaching loads and greater difficulty in securing research funds, as well as a decline in facilities and support for both teaching and research. The results are discussed in relation to the Demand–Control and Person–Environment Fit models of job stress.     

A Role for Occupational Therapy in Foster Care

The purpose of this publication is threefold. First, it is an attempt to document the need for occupational therapy services within the foster care population. Second, it describes methods that can be used by occupational therapists to provide appropriate interventions to people affected by foster care. And third, it highlights the need for and identifies specific assessments that can be used to evaluate individuals affected by foster care and to measure the effectiveness of occupational therapy services delivered to foster care agencies.     

The New Occupational Therapy Paradigm: Implications for Integration of the Psychosocial Core of Occupational Therapy in All Clinical Specialties

In this paper, it is argued that the new occupational therapy paradigm includes a core of psychosocial skills, consistent with the profession's historical roots in mental health. It is proposed that contrary to the declining presence of occupational therapy in mental health, psychosocial interventions should be explicitly integrated in all professional practice, such that occupational therapy will become the profession of choice in addressing psychosocial issues of all clients irrespective of clinical specialty. A case study is presented as an example to demonstrate how this explicit integration may be achieved in physical rehabilitation.     

Occupational Stressors, Stress Responses, and Alcohol Consumption Among Professional Firefighters: A Prospective, Longitudinal Analysis

This dual-site longitudinal prospective study monitored and measured change in self-reported occupational stressors, emotional trauma, symptoms of stress, and alcohol consumption in urban firefighters. Study participants were 188 firefighters employed by two urban fire departments. The results showed that of 19 occupational stressors examined, only 5 (26%) changed significantly over time, and of those 5, only two—job skill concerns and concerns regarding reduction in force and benefits—decreased, reflecting less bothersome subjective ratings. Of the 12 measures of posttraumatic and other symptoms of stress, 9 (75%) increased significantly over time and none decreased significantly, whereas alcohol consumption was stable over time. Job stressors, trauma caseness, and stress response symptoms at baseline were strongly and significantly associated with the same measures at the two-year follow-up. The implications of the findings for prevention and remediation of stress disorders in fire service personnel are considered. It can be concluded that the stressful nature of urban firefighting is significantly associated with negative health outcomes, including the potential overreliance on alcohol use.     

Psychosocial Occupational Therapy Interventions for Substance-Use Disorders: A Narrative Review

The review was conducted to explore psychosocial interventions for adults with substance-use disorders. A refined literature focus was placed on articles published by occupational therapists, or articles published by an allied health professional, that discussed occupational therapy performing the intervention. Ten articles met inclusion criteria, all focusing on aspects of life skills training. Study results support the professions’ ability to enhance functional independence and occupational performance for individuals recovering from substance use. Further, a more controlled investigation is warranted to further define occupational therapy’s scope within substance-use disorder treatment.     

Occupational Therapy Interventions for Children with Attention Deficit Hyperactivity Disorder: A Systematic Review

This systematic review examined evidence published 2005–2015 for occupational therapy interventions for children with Attention Deficit Hyperactivity Disorder (ADHD). We identified 590 abstracts with 17 full-text articles eligible for review. Fourteen articles were included in the final analysis with two level I studies, two level II studies, eight level III studies, and two level IV studies. Occupational therapy interventions focused on play, sensory, motor, and cognitive skills. While the interventions yielded good results, there were limitations in study design, interventions, and outcome measures. Future research should include larger sample size, randomization, control groups, and interventions that can be replicated.     

职业压力对西部山区中小学教师主观幸福感的影响：有调节的中介模型

为了探讨西部山区中小学教师职业压力与主观幸福感的影响,采用问卷调查法对2568名西部山区中小学教师进行调查,结果显示：（1）西部山区中小学教师主观幸福感在性别、是否担任班主任、月收入、教龄等人口学变量上存在显著性差异;（2）职业压力显著负向预测西部山区中小学教师主观幸福感;（3）职业倦怠中介了职业压力对西部山区中小学教师主观幸福感的影响;（4）职业认同调节了职业压力→职业倦怠→西部山区中小学教师主观幸福感这个中介过程的前半段。     

Occupational Therapy Interventions for Adults at the End of Life: A Systematic Review of Dignity Therapy

The objectives of this study were to determine the effects of dignity therapy, a psychological intervention for individuals with terminal illness, and to explore whether this is an appropriate occupational therapy intervention. A literature search produced 10 dignity therapy studies for review. Four reported positive effects (decreased anxiety, depression, suffering), one reported negative effects (decreased quality of life, increased depression), and five reported no effects. With its client-centered and occupation-based approach, dignity therapy aligns with the values of occupational therapy. Practitioners should explore dignity therapy as an intervention and direct future research toward examining its efficacy as part of a holistic treatment plan.     

Effectiveness of Occupational Therapy Interventions for Students with Mental Illness Transitioning to Higher Education: A Systematic Review

This systematic review examined the available evidence for occupational therapy interventions for students with any mental illness transitioning to post-secondary education. Seven articles were included. The evidence of occupational therapy interventions for this population supported the use of supported education programs consisting of goal setting, skill development, and cognitive training, as well as student-directed planning. Quantity of high levels of research was limited. Articles included were not exclusively related to transition into post-secondary education, but also focused on vocation and supported education. Additional research is needed to determine the best practice in transition services for individuals with any mental illness.     

Exposure Therapy for Posttraumatic Stress Disorder: A Meta-Analysis

This meta-analysis compares the findings of empirical studies that employ either a traditional form of cognitive–behavioral-based exposure therapy or virtual reality exposure therapy (VRET) for the treatment of posttraumatic stress disorder (PTSD) to determine which is more viable and effective. Statistical analyses were performed on 26 studies to determine pre- to posttreatment effect sizes and interactions. Results demonstrated a trend toward significance in favor of traditional exposure therapy showing lower posttreatment PTSD. Limitations included a restricted number of relevant studies; future research on VRET for PTSD should orient more to experimental designs, larger samples, and increased use of control groups.     

Psychosocial Characteristics of Student Veterans with Service-Related Disabilities: Implications for Further Research and Occupational Therapy Involvement

The purpose of this study was to assess how post-9/11 university student veterans differ from nonveteran university students on four mental health indicators. In comparison to a demographically matched sample of nonveteran students, it was found that veterans in this study had significantly higher levels of depression and post-traumatic stress symptomatology and non-significantly lower levels of engagement in meaningful activities and meaning in life. This non-experimental study indicates that mental health differences between student veterans and their nonveteran peers do exist, and argues for the inclusion of occupational therapy services for student veterans.     

Distress Tolerance and Rational-Emotive Behavior Therapy: A New Role for Behavioral Analogue Tasks

Rational-emotive behavior therapy (REBT) is a widely utilized treatment approach for many mental disorders, but it has been “relatively neglected in the professional scientific literature” (Ellis 2003b). This neglect has been attributed in part to a lack of solid REBT outcome studies, which in turn stems from the difficulty of measuring constructs of interest in REBT, such as irrational beliefs, via self-report measures. In light of these concerns, the current paper aims to identify the potential utility of behavioral analogue laboratory tasks for advancing the understanding of mechanisms in REBT, as well as treatment outcome using this therapeutic approach. Specifically, we focus on the utilization of behavioral measures of distress tolerance and their application to the key REBT construct of frustration intolerance. In identifying the parallels across distress tolerance and frustration intolerance, we consider how the incorporation of distress tolerance tasks into REBT research can be useful in evaluating the role of frustration intolerance in the initiation, maintenance, and treatment of disordered behavior across a broad range of clinical disorders.

Cognitive Processing Therapy Versus Supportive Counseling for Acute Stress Disorder Following Assault: A Randomized Pilot Trial

The study tested the efficacy and tolerability of cognitive processing therapy (CPT) for survivors of assault with acute stress disorder. Participants (N = 30) were randomly allocated to CPT or supportive counseling. Therapy comprised six individual weekly sessions of 90-min duration. Independent diagnostic assessment for PTSD was conducted at posttreatment. Participants completed self-report measures of posttraumatic stress, depression, and negative trauma-related beliefs at pre-, posttreatment, and 6-month follow-up. Results indicated that both interventions were successful in reducing symptoms at posttreatment with no statistical difference between the two; within and between-group effect sizes and the proportion of participants not meeting PTSD criteria was greater in CPT. Treatment gains were maintained for both groups at 6-month follow-up.     

Treatment Outcome for Low Socioeconomic Status African American Families in Parent-Child Interaction Therapy: A Pilot Study

The course and efficacy of parent-child interaction therapy (PCIT) were examined in 18 socioeconomically disadvantaged African American families of preschoolers with disruptive behavior disorders. Mothers reported significant improvements in child disruptive behavior but not in maternal depressive symptoms or parenting stress. Attrition was 56%, most often occurring after pre-treatment assessment but before treatment began. Results suggest that PCIT may lead to positive behavior changes for disadvantaged young African American children when families complete treatment. Recruitment, engagement, and retention remain significant problems requiring further study. Reduction of parenting stress also requires study in this population.     

Exposure Therapy Beliefs and Utilization for Treatment of PTSD: A Survey of Licensed Mental Health Providers

Exposure-based therapies for posttraumatic stress disorder (PTSD) and anxiety disorders remain underutilized, despite their effectiveness and widescale dissemination efforts. This study surveyed a broad range of licensed providers (N = 155) to examine rates at which prolonged exposure (PE) and other interventions are used to treat PTSD and to investigate provider characteristics linked to exposure beliefs and utilization. While 92.3% of clinicians reported understanding of or training in exposure, only 55.5% of providers reported use of PE to treat PTSD. Clinicians with current cognitive behavioral therapy (CBT) orientation, CBT training orientation, a doctoral degree, and training in PE endorsed greater likelihood of exposure utilization for PTSD (ps < .001, ds = 0.82–1.98) and less negative beliefs about exposure (ps < .01, ds = 0.55–2.00). Exposure beliefs also differed based on healthcare setting (p < .001). Among providers trained in exposure (n = 106), master’s degree and non-CBT current theoretical orientation were associated with high utilization yet also negative beliefs. Results suggest exposure training, accurate beliefs, and utilization still lag among some groups of providers. Additionally, negative beliefs and misunderstanding of the exposure rationale may persist even among providers who are trained and report high utilization.     

A journey through languages: A systematic literature review on the multilingual experience in counselling and psychotherapy with children and adolescents

The purpose of this research was to address the gap in the existing literature on the multilingual aspect of language in psychotherapy with children and adolescents. This research aimed at interpreting possible meanings for clients of being multilingual in the therapeutic process as well as reflect on the influence of clients’ multilingualism in the therapeutic relationship. The researcher used a systematic literature review (PRISMA guidelines, 2009) to select articles based on empirical qualitative/mixed studies with participants up to 25 years old or adults referring to childhood/adolescence. The researcher used thematic synthesis (Thomas & Harden, 2008) to extract, analyse and interpret data. The rigour of this study was enhanced by the use of auto-ethnography as a source of evidence (McLeod, 2015). The auto-etnography documents self-reflections on personal experience of being multilingual contributing to deeper contextualised knowledge. The findings confirm previous research on the existence of a link between multilingualism and “identity” (Costa, 2020, p. 5). This research suggests that the meaning a client gives to bilingualism can be co-constructed within an attuned therapeutic relationship. In this co-construction journey, there is a significant opportunity for children and young people in finding their way through languages, hence reaching emancipation and affirmation in the world. The main limitation of this research relates to the fact that there are not many studies with children/young people. This led the researcher to also include studies based on a mixed sample and with adults referring to childhood/adolescence, which might have influenced the interpretation of findings.     

Durability of Cognitive Behavioral Therapy Effects for Youth and Adolescents With Anxiety,Depression, or Traumatic Stress:A Meta-Analysis on Long-Term Follow-Ups

Cognitive behavioral therapies (CBT) for youth with anxiety, traumatic stress, and depression have demonstrated strong effects in individual studies and meta-analyses. Relatively more attention has been given to posttreatment effects, though, and assessment of follow-up effects has been limited at the meta-analytic level. The current meta-analysis aimed to (a) examine the effects of youth CBT at posttreatment, 1-month, 3-month, 6-month, 1-year, and long-term (2 + years) follow-up as well as (b) identify research-related variables (e.g., measure respondent type) that relate to effects. Using a random effects model across 110 child and adolescent CBT groups, within-group effect sizes were large at posttreatment (g = 1.24) and from 1-month through long-term follow-up (g = 1.23–1.82), and effect sizes did not significantly differ by treatment target (i.e., anxiety, traumatic stress, depression). However, availability of outcome data for effect sizes diminished across later follow-up assessments. Moreover, effect sizes were significantly associated with outcome respondent type across assessment timing, with outcome measures from caregiver and youth respondents associated with smaller effect sizes (B = -0.97, p < 0.001) relative to outcome measures that were evaluator-reported. Results provide initial support for the durability of treatment effects for youth CBTs and highlight the importance of some confounding variables. Implications for improving treatment research standards and prioritizing assessment of long-term follow-up assessment are discussed.     

Parent-Child Interaction Therapy for Puerto Rican Preschool Children with ADHD and Behavior Problems: A Pilot Efficacy Study

This study evaluates the initial efficacy of the Parent-Child Interaction Therapy (PCIT) for Puerto Rican preschool children aged 4–6 years with a diagnosis of attention-deficit/hyperactivity disorder (ADHD), combined or predominantly hyperactive type, and significant behavior problems. Thirty-two families were randomly assigned to PCIT ( n =20) or a 3.5-month waiting-list condition (WL; n =12). Participants from both groups completed pretreatment and posttreatment assessments. Outcome measures included child's ADHD symptoms and behavior problems, parent or family functioning, and parents' satisfaction with treatment. ANCOVAs with pretreatment measures entered as covariates were significant for all posttreatment outcomes, except mother's depression, and in the expected direction ( p <.01). Mothers reported a highly significant reduction in pretreatment hyperactivity and inattention and less aggressive and oppositional-defiant behaviors, conduct problems assessed as problematic, parenting stress associated with their child's behavior, and an increase in the use of adequate parenting practices. For the WL group, there were no clinically significant changes in any measure. Treatment gains obtained after treatment were maintained at a 3.5-month follow-up assessment. PCIT seems to be an efficacious intervention for Puerto Rican families who have young children with significant behavior problems.