An Intervention to Help Community-Based Organizations Implement an Evidence-Based HIV Prevention Intervention: The Mpowerment Project Technology Exchange System

Considerable resources have been spent developing and rigorously testing HIV prevention intervention models, but such models do not impact the AIDS pandemic unless they are implemented effectively by community-based organizations (CBOs) and health departments. The Mpowerment Project (MP) is being implemented by CBOs around the US. It is a multilevel, evidence-based HIV prevention program for young gay/bisexual men that targets individual, interpersonal, social, and structural issues by using empowerment and community mobilization methods. This paper discusses the development of an intervention to help CBOs implement the MP called the Mpowerment Project Technology Exchange System (MPTES); CBOs’ uptake, utilization and perceptions of the MPTES components; and issues that arose during technical assistance. The seven-component MPTES was provided to 49 CBOs implementing the MP that were followed longitudinally for up to two years. Except for the widely used program manual, other program materials were used early in implementing the MP and then their use declined. In contrast, once technical assistance was proactively provided, its usage remained constant over time, as did requests for technical assistance. CBOs expressed substantial positive feedback about the MPTES, but felt that it needs more focus on diversity issues, describing real world implementation approaches, and providing guidance on how to adapt the MP to diverse populations.     

Approaching Homelessness: An Integral Re-Frame

This article explores a metaview of the many faces of homelessness. It analyzes an evolutionary meaning of home and suggests that ever-complexifying life conditions influence how societies enforce conformity to the status quo of homefulness. It goes on to describe how homelessness might be reframed as a complex adaptive form of survival for diversity generators who cannot or will not conform to the status quo. The article proposes an integral framework on which intervention strategies could be structured to provide evolutionary, appropriate, and flexible approaches to homelessness.     

Assessing the Effectiveness of a Trauma-Oriented Approach to Treating Prostituted Women in a Prison and a Community Exiting Program

Women who have been prostitutes are social work clients in many clinical, correctional, and community settings. Unique programming that addresses the high levels of trauma symptoms reported by prostituted women has yet to be explored. The purpose of this study is to explore the effectiveness of a group trauma and abuse intervention for prostituted women from two settings, prison and a community exiting program. A quasi-experimental research design was used. Twenty-nine women participated in a 12-week psychoeducational trauma and abuse intervention program called Esuba. All participants reported decreases in trauma symptoms, but the prison group showed a greater number of significant changes in trauma symptomology than the community group. Implications for practice and future research implications are discussed.     

Unique Ethical Concerns in Clinical Trials Comparing Psychosocial and Psychopharmalogical Interventions

In recent years, there has been a particular emphasis placed on conducting randomized controlled trials (RCTs) that compare the relative efficacy of psychosocial and pharmacological interventions. This article addresses relevant ethical considerations in the conduct of these treatment trials, with a focus on RCTs with children. Ethical concerns, including therapeutic misconception, treatment preference, therapeutic equipoise, structure of treatments, and balancing risks versus benefits, are introduced through a clinical scenario and discussed as they relate to psychotherapy versus medication RCTs. In each case, suggestions are made for researchers seeking to minimize the impact of these ethical concerns on research participants.     

Psychological interventions for carers of people with dementia: A systematic review of quantitative and qualitative evidence

Rationale: Carers of people with dementia experience significant levels of stress in their everyday role. The National Dementia Strategy in England identifies the key role that carers play in supporting people with dementia living at home, often to the detriment of their social, emotional and physical health. Aims: To add to the substantive knowledge‐base by combining search criteria used by Pinquart and Sörensen (2006) and Gallagher‐Thompson and Coon (2007) to update the literature on psychological interventions for carers of people with dementia published between 2005 and 2011. Method: Following the study inclusion criteria, comprehensive searches were conducted using the electronic databases Medline, PsycINFO, ERIC, and PubMed. Twenty studies were identified, graded and synthesised into the reported systematic review with both quantitative and qualitative studies included to maximise practice application. Results: Consistent with previous findings, three categories of psychological intervention were identified: (i) psychoeducational‐skill building (n=8); (ii) psychotherapy‐counselling (n=1); (iii) multicomponent (n=6). Our review also identified a fourth intervention category, (iv) technology‐based (n=5). The majority of studies in the updated review examine the constructs of depression, burden, social support and well‐being. The development of focused interventions for carers, whether individually tailored interventions or group interventions around a common issue, was significant for developing practice. Future studies across all categories should continue to embed supervision arrangements within their psychological intervention protocols.     

Couple Therapy Interventions for Problems with Extramarital Affairs

SUMMARY

A number of couples request therapy because of relational problems resulting from an extramarital affair. In treating such couples, five phases of cognitive and emotional aspects of problematic affairs have been identified: (1) the start, (2) suspicion and negation, (3) explosion and impulsive reactions, (4) making choices and deadlock, (5) working through. Clients may enter therapy at very different points in these phases. Some come in full crisis, others in the deadlock phase, not being able to decide what to do. A different therapeutic intervention is proposed for each phase.     

Computer Technology Review

No abstract available for this article.     

Who Benefits from Couple Relationship Education? Findings from the Largest German CRE Study

In evaluation studies on couple relationship enhancement (CRE) programs, researchers are encouraged to also investigate which couples benefit from program participation. The authors qualified 104 university students to offer an evidence-based CRE program. Up to a 15-month follow-up, the participating couples (N = 234) reported a significant decrease in unsolved relationship conflicts. A 2-day-long intensive training led to better results compared with a weekly format regarding dropouts. Couples with lower pretest satisfaction ratings reported significant improvements over time, whereas couples with initial higher ratings reported no change or a deterioration. Further predictors were identified. The findings should be taken into account in future research.     

Therapists’ perspectives about working with meaning in life in psychotherapy: A survey

Of 212 practicing therapists who completed a survey about working with meaning in life (MIL) in psychotherapy, 129 (61%) had recently worked with MIL with at least one client and reported on their work with a client in this survey. Those therapists who had worked with a client on MIL as compared with those who had not were older, more experienced, more humanistic/existential/experiential in orientation; reported more MIL training; and felt more competent working with MIL. Clients reported on primarily had internalizing, interpersonal, and career issues. Only 12% of clients explicitly labeled MIL as an issue coming into therapy. The three most frequently used interventions involved offering support; helping clients examine thoughts, feelings, and behaviors to discover hopes and goals; and facilitating exploration of MIL cognitions and experiences. Therapists reported many positive consequences from working with MIL. Therapists reported minimal training in MIL and moderate competence in working with MIL. Implications for practice, training, and research are presented.