Expanding Mental Health Services to Older High-Utilizing HMO Patients: A Pilot Study

Background: Expanded mental health benefits were offered to older HMO patients who were high medical utilizers. Outcomes of interest were use of services, subjective well-being, and psychopathology. Methods: Sixty-nine (25 male, 44 female) patients age 55 or above seeking frequent outpatient medical care completed the SF-36 health survey and the revised Symptom Check List (SCL-90-R). Patients were assigned to usual care, health education, or expanded mental health benefit conditions. Results: Patients showed high initial levels of psychopathology and distress. Over the 6 months of the study, patients in the expanded benefits group made a mean of 11.5 visits to mental health professionals versus a mean of 3.4 visits by usual care patients. Patients in the expanded benefits group showed significant improvement in SF-36 General Health and Mental Health well-being scores. Patients in the health education group showed no improvement. Patients in the usual care group showed improvements in Vitality scores. Psychopathology summary scores showed improvement for both usual care and enhanced benefit groups. Conclusions: Mental health treatment may improve well-being and reduce psychopathology in older high-utilizing patients. Creativity will be needed in expanding access to mental health services for this population.     

Children's perceptions and experiences of care giving: A focus group study

The stress of care giving for spouses and adult children has been extensively documented in the empirical literature. More recently attention has been paid to children's involvement in family care giving. Qualitative studies in the social welfare field have highlighted the social restrictions caring places upon children. There remains a need, however, to understand what children are thinking and feeling in an effort to cope with their care-giving demands. This study used a focus group methodology and individual interviews to explore the experiences of 17 young carers aged between 10 and 16. Thematic analysis was employed to identify themes relating to the nature of stressors, their appraisal of them, and the coping strategies they use to manage the task of caring.     

Career barriers and reading ability as correlates of career aspirations and expectations of parents and their children

Data were obtained from 176 Year 7 children (mean age = 12.2 years) on career status aspirations and expectations, career barriers, academic engagement, academic control beliefs, general ability and literacy; and from parents, mainly mothers, on aspirations, expectations and career barriers. Discrepancy scores between aspirations and expectations were calculated for both children and parents. Children differed from parents on career status aspirations and expectations; boys did not differ from girls, and parents did not differentiate between boys and girls. Parents’ and children’s aspirations were both associated with reading ability, although the association was weak for the children. Children’s expectations were associated with perceptions of career barriers, and a trend towards reading abilities, while parents’ expectations were associated with general ability and reading.     

Caring for Someone with Depression: Attitudes and Clinical Practices of Australian Mental Health Workers

Many people who support a person with depression report struggling with the carer role and being dissatisfied with the inclusivity and lack of support provided by clinicians. However, little is known about what influences the support provided to Australian carers of people with depression. To investigate this, 119 Australian mental health workers completed a self‐report questionnaire to gather information on their attitudes towards, barriers experienced and current clinical practices when working with carers of people with depression. Participants' attitudes towards family members and carers were generally positive. Reported inclusive clinical practices varied. Participants identified a number of barriers to inclusive practice that were predominantly organisational in nature. Participants who perceived more barriers reported providing more clinical interventions. Attitudes and barriers were associated with the inclusive clinical practice of participants who worked with mental health consumers, but not participants who worked with family members and carers. Even among this sample of self‐selecting clinicians, there was room for significant improvement in rates of carer inclusive practice. Further research should explore not only what inhibits but also what enables the participation of family members and carers in the care and treatment process for people with depression.     

Stronger Than You Think: Older Women and Physical Activity

Many negative stereotypes of older women are related to changes in the body that render it incompetent (e.g., weak, frail, debilitated). Such stereotypes disempower women in the eyes of others and in their own eyes if they come to embody the stereotype. One way to resist the stereotype and remain empowered is to engage in regular physical activity, which increases stamina, energy, muscle strength, joint flexibility, and balance. Here we review the physical and mental health benefits of physical activity for older women and discuss the barriers that keep many older women from regular exercise. We discuss ways that feminist therapists can encourage their older clients to become more physically active, provide information about role models who can inspire clients, and suggest resources suitable for recommendation.     

Selling with technology: understanding the resistance to mobile sales assistant use in retailing

The rise of online competitors and increasingly well-informed customers have spurred stationary retailers to take measures to increase the quality of face-to-face selling as a key differentiator. Mobile sales assistants (MSAs) represent an intensively discussed technological approach to address these challenges in the salesperson–customer dyad. However, in many cases, salespeople do not or only sporadically use MSAs. Prior research provides inadequate answers as to why this is the case, as extant technology acceptance and resistance theories have limited applicability to MSAs. To address these research gaps, the authors conduct a qualitative, theory-building approach and identify 21 factors associated with resistance. In a subsequent quantitative survey study, they validate these factors and refine their conceptual structure. The results show that several largely unknown factors are associated with salespeople’s resistance to MSA use: The three higher-order constructs, ‘incongruence’, ‘relationship deterioration’, and ‘operational imperfection’, are newly introduced to the literature on technology resistance. The findings extend prior technology acceptance and resistance theories and provide comprehensive insights for retail managers.     

Barriers to forgiveness

Society generally encourages individuals to forgive their transgressors because forgiveness can yield many psychological, physiological, and social benefits (Exline & Baumeister, 2000 ). Nevertheless, victims face barriers to forgiving others, and other people face obstacles that prevent them from encouraging victims to forgive. We aim to provide insight into the various barriers that deter forgiveness by examining the role of the various parties involved—victims, transgressors, and uninvolved third parties—in creating barriers to forgiveness. We contend that beliefs held by these various parties significantly reduce the likelihood that victims will forgive their transgressors. By identifying how these beliefs impede forgiveness, we can begin to understand more fully why convincing victims to forgive is often a challenge. In our discussion, we also suggest ways by which victims, transgressors, and third parties can overcome these barriers to forgiveness.