Refusing to be Marginalized: Groupwork in Mental Health Services for Women Survivors of Childhood Sexual Abuse

Childhood sexual abuse is a major aetiological factor in the development of mental health difficulties experienced by women. Although this conclusion is supported by two decades of extensive research, it has had little impact on the provision of mainstream mental health services. It remains exceptional for there to be specialist therapy or counselling provision for women survivors of childhood sexual abuse within statutory mental health services. This represents a serious gap in service provision and, it is argued, results in extended and inappropriate treatment for women survivors using mental health services. In this article, the development of a multi-agency approach to the provision of groupwork for women survivors of childhood sexual abuse within mental health service is described. A women-centred model of groupwork is outlined. Evaluation and funding are discussed. It is argued that, as a time-limited and effective treatment option, groupwork for women survivors of childhood sexual abuse should form a central part of service provision within statutory adult mental health services.     

Developing Black Mental Health Provision: Challenging Inequalities in Partnership

This article describes and comments upon the process of developing the Sanctuary project in London, a project that will provide two community-based crisis support services for African and African-Caribbean women and men in mental crisis and distress. This initiative is informed by the extensive research documenting the ways in which mainstream, mental health services fail Black people, and by evidence suggesting that innovations in service provision for Black people are often vulnerable and limited in their impact. In an effort to avoid replicating these problems, considerable emphasis has been given to developing the project in partnership with the main stakeholders—in this instance statutory and Black voluntary sector agencies as well as Black users, carers and community members. Within this context, issues relating to inequalities can be proactively addressed, thereby reducing the risk that they undermine the effectiveness of service provision at a later stage. However, working in partnership can also hinder or delay service developments if discussions between stakeholders become protracted or conflicts unresolved. The author draws on experience gained from this project to identify the potential as well as the difficulties of using a partnership approach to developing effective Black mental health provision. The author's role in the development of these projects has been as representative of one of the partners, the King's Fund Centre for Development.     

Reconstructing Hymens or Constructing Sexual Inequality? Service Provision to Islamic Young Women Coping with the Demand to be a Virgin

In Islamic culture, there is an imperative demand that women should be virgins on their wedding night. Service providers in The Netherlands are increasingly confronted by Islamic young women who find themselves in serious difficulties because they are no longer virgins, and are about to enter a forced or arranged marriage. These young women report a diversity of problems such as loneliness, social isolation, depression, despair, suicidal feelings, identity problems and serious conflicts with parents. In this article we focus attention on the circumstances that can result in these types of difficulties, and also critically consider the kinds of help that young Islamic women are given. Attention is paid to the question of whether existing forms of service provision, especially surgical reconstruction of the hymen, take sexual and other inequalities into account.     

Mapping Men's Mental Health

The central theme of this paper is that men are at one and the same time both damaged and damage-doing. The process of being damaged through the agency of masculinity predisposes men to exploit, dominate and abuse—not only as boys, as partners and fathers, but as priests, teachers, therapists, lawyers, nurses, psychologists and psychiatrists. Mental health services need to see both aspects of this male equation: a focus on male abuse alone leads to punishment, containment and, very likely, the continuation of abuse; a focus on male damagedness alone preserves the ideology of male unaccountability. However, evidence reviewed here suggests that most traditional psychiatric services fail to acknowledge the impact of inequalities on men's mental health as comprehensively as they fail to acknowledge the impact of these inequalities on the mental health of women. This is a significant problem, and we suggest ways that a gendered analysis of masculinity can be used to help address this deficit. This analysis is used to develop a map of men's mental health that not only accommodates traditional categories of mental health difficulty, but other important consequences of the close association between masculinity and sexuality inequality, especially the use of violence and the capacity to do harm. This analytical framework also invites consideration of the invisibility of male distress, the disallowing and desensitizing of ‘vulnerability, and their submersion in a kind of psychology of entitlement. Finally, we consider the implications of this mapping exercise for mental health services and for working with men.     

Varieties of musical experience

In this paper, we argue that music cognition involves the use of acoustic and auditory codes to evoke a variety of conscious experiences. The variety of domains that are encompassed by music is so diverse that it is unclear whether a single domain of structure or experience is defining. Music is best understood as a form of communication in which formal codes (acoustic patterns and their auditory representations) are employed to elicit a variety of conscious experiences. After proposing our theoretical perspective we offer three prominent examples of conscious experiences elicited by the code of music: the recognition of structure itself, affect, and the experience of motion.     

A Swedish adaptation of the Emotional Contagion Scale: factor structure and psychometric properties

The Emotional Contagion Scale (ECS) is a self-report scale used to measure individual differences in susceptibility to converge towards the emotions expressed by others. The original American ECS (Doherty, 1997), translated into Swedish, was completed by 665 undergraduate students in two independent samples (N = 233 and N = 432, respectively). To investigate the factor structure of the ECS, confirmatory factor analyses of alternative models derived from previous research in emotion and emotional contagion were conducted. The results showed that the proposed one-dimensional structure of the ECS was not tenable. Instead a multi-facet model based on a differential emotions model and a hierarchal valence/differential emotions model was supported. Cross-validation on the second independent sample demonstrated and confirmed the multi-faceted property of the ECS and the equality of the factor structure across samples and genders. With regard to homogeneity and test-retest reliability, the Swedish version showed acceptable results and was in concordance with the original version.     

Applying a Theory of Change Approach to Interagency Planning in Child Mental Health

This paper describes the use of a theory of change approach to community-based cross-agency service planning for children with serious emotional disturbance and their families. Public agency planners in Contra Costa County, California used the theory of change approach to organize service planning for a population of youth who had been arrested and involved with juvenile probation. The theory of change process described in this paper links community outcomes with planned activities with the assumptions or principles that underlie the community planning efforts. When complete, a theory of change logic model can serve as a guide for implementation, ensuring that community plans for service delivery remain true to their intent. The theory of change development process includes twelve stages and is based on a step-by-step approach. Theory of change logic models establish a context for articulating a community's shared beliefs and prompt local stakeholders to establish logical connections between the population to be served, expected results, and strategies intended to achieve those results.     

不同阶层心理健康观念及需求状况的调查研究

运用开放式和封闭式问卷调查法 ,对不同阶层共 483人的心理健康观念及心理健康需求状况进行了调查研究。结果表明 :( 1 )不同阶层、不同年龄段的人关于心理健康标准的观念具有显著差异。 ( 2 )人们认为 ,心理健康的人应具有的最典型特征是“处世乐观、热情、诚恳”和“心平气和、与世无争、乐于助人”。 ( 3 )心理不健康的人或心理变态的人所表现的最典型特征是“性格孤僻、与人不合群”和“对生活失去信心、悲观”。 ( 4)虽然不少人认为心理健康与咨询工作者当前最急需开展的工作是“宣传心理健康知识、开展心理卫生服务” ,但只有极少的人能够正视自己的心理健康需求 ,提出自己需要心理健康服务或咨询。     

Behavioral momentum in computer-presented discriminations in individuals with severe mental retardation

Behavioral momentum was examined in 2 individuals with severe mental retardation via within-subject manipulations of obtained reinforcer rates. Subjects performed self-paced discrimination problems presented on a touch screen computer monitor. Two different problems, Tasks A and B, alternated in blocks of 15 trials on a multiple schedule. Reinforcers were snack foods. The reinforcement schedule for Task A was continuous (fixed-ratio 1) and the schedule for Task B was continuous in some conditions and variable ratio in other conditions. Behavioral momentum was assessed in test sessions by prefeeding, presenting response-independent food, and making available alternatives to the tasks. When the obtained reinforcer rate for Task A was at least twice that for Task B, resistance to change was greater for Task A. When both reinforcer rates and response rates were a pproximately equal for the two tasks, resistance to change was approximately equal. These results are consistent with behavioral momentum effects. They extend previous findings with humans by examining momentum in self-initiated discrete-trial discrimination tasks with ratio schedules, and by isolating relative reinforcer rates as a controlling variable via within-subject manipulations.