“More Life,Not Less”: Using Narrative Therapy With Older Adults With Bipolar Disorder

Counselors who work with older adults with bipolar disorder are in a unique position to help them navigate their challenges. Older adults with bipolar disorder have lived decades with mental illness and also face the regular aging process. Narrative therapy provides counselors with a framework to deal with these issues.     

Using the Tukey-Kramer omnibus test in the Hayter-Fisher procedure

Using Tukey-Kramer versus the ANOVA F-test as the omnibus test of the Hayter-Fisher procedure for comparing all pairs of normally distributed means, when sample sizes are unequal, is investigated. Simulation results suggest that using Tukey-Kramer leads to as much or more any-pairs power compared to using the F-test for certain patterns of mean differences, and equivalent per-pair and all-pairs power for all cases. Furthermore, using Tukey-Kramer results in a consonant test procedure, where there cannot be disagreement between the results of the omnibus test and the subsequent pairwise tests. The results suggest that when sample sizes are unequal, Tukey-Kramer may be preferred over the F-test as the omnibus test for the Hayter-Fisher procedure.     

Creating Personal Dispositions for a Professional Counseling Program

The Council for Accreditation of Counseling and Related Educational Programs requires counselor training programs to undergo systematic evaluation of trainees. This evaluation can be challenging at times. The authors posit the use of dispositions as a tool for ongoing assessment of student development by detailing the process used to establish dispositions in a counselor training program. Using an N= 1 intensive case study approach, they provide information about the relevance of dispositions in counselor training, the origin of dispositions for the program, and ongoing efforts to evaluate the dispositions in terms of their relevance to student growth. Implications for counselor training and curriculum development are discussed.     

The marriage checkup: increasing access to marital health care

Despite the ongoing prevalence of marital distress, very few couples seek therapy. Researchers and clinicians have increasingly been calling for innovative interventions that can reach a larger number of untreated couples. Based on a motivational marital health model, the Marriage Checkup (MC) was designed to attract couples who are unlikely to seek traditional tertiary therapy. The objective of the MC is to promote marital health for as broad a population of couples as possible, much like regular physical health checkups. This first paper from the largest MC study to date examines whether the MC engaged previously unreached couples who might benefit from intervention. Interview and survey data suggested that the MC attracted couples across the distress continuum and was perceived by couples as more accessible than traditional therapy. Notably, the MC attracted a substantial number of couples who had not previously participated in marital interventions. The motivational health checkup model appeared to encourage a broad range of couples who might not have otherwise sought relationship services to deliberately take care of their marital health. Clinical implications are discussed.     

A Preliminary Investigation of Body Dissatisfaction and Eating Disorder Symptomatology with Bisexual Individuals

Body dissatisfaction and eating disorder symptomatology were examined in bisexual individuals (n?=?139 women, n?=?37 men) and compared to lesbian/gay (n?=?51 women, n?=?96 men) and heterosexual individuals (n?=?82 women, n?=?34 men) in a U.S. online sample. Age, body mass index (BMI), income, and exercise frequency served as covariates. MANCOVA results showed a significant gender by sexual orientation interaction and significant main effects of gender and sexuality. Univariate tests were used to explore multivariate results. ANCOVA results for body dissatisfaction showed a significant gender by sexual orientation interaction. Post-hoc comparisons revealed higher levels of body dissatisfaction among all groups compared to heterosexual men. ANCOVA results for eating disorder symptomatology showed a significant main effect of sexual orientation. Post-hoc comparisons revealed higher levels of eating disorder symptoms among bisexual compared to heterosexual individuals. For bisexual men, gay community involvement, maladaptive social comparison, drive for muscularity, self-esteem, gender role orientation, and body dissatisfaction were explored as predictors of eating disorder symptomatology while controlling for age, BMI, exercise frequency, and income in a hierarchical regression analysis. The same factors, minus body dissatisfaction, were explored as predictors of body dissatisfaction in bisexual men. For bisexual women, similar factors, with the exception of drive for muscularity, were explored. Drive for muscularity predicted body dissatisfaction and exercise frequency predicted eating disorder symptomatology in bisexual men. BMI and self-esteem predicted body dissatisfaction in bisexual women; gay community involvement and body dissatisfaction predicted eating disorder symptomatology.     

Generalized Anxiety Disorder in Hispanics: Symptom Characteristics and Prediction of Severity

Literature suggests that an increasing number of Hispanic people suffer with GAD, and possible associated problems include high costs for treatment and elevated risk of severe impairment. The current study examined components of anxiety, as measured by currently available assessment instruments in both English and Spanish languages, among bilingual Hispanic individuals with GAD. Participants completed all instruments in both languages. Relations between these self-report measures and clinician-rated GAD severity were also studied. In factor analyses, the Spanish measures yielded two factors, the first of which included all instruments assessing physiological components of anxiety and one content specific measure of worry. The second factor included one worry scale and one trait anxiety scale. The English measures yielded a single factor solution. Regression analyses revealed that for the English measures, the BAI and PSWQ were statistically significant predictors of GAD severity. For the Spanish measures, the BAI was the only statistically significant predictor.