Womanist Therapy with African American Women with Disabilities

Abstract

African American women are at increased risk for disabilities. There is very little information available, however, regarding psychological interventions with African American women with disabilities. The purpose of this article is to discuss psychological intervention in working with African American women with acquired disabilities from a womanist perspective. Themes and interventions will be discussed. Recommendations for working with African American women with disabilities in a therapeutic context will be offered.     

Example

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The Genogram

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Condom Use and Contraception Non-Use Amongst 16-19 Year Olds: A Within Subjects Comparison

Abstract

The present study used a within subject design to examine which situation specific factors discriminated between the use of condoms and non-use of contraception in the context of preventing unwanted pregnancy. Adapting the methodology of Gold et al (1991, 1992), 215 16 to 19 year olds completed a questionnaire concerning the most recent time they had experienced sexual intercourse without using contraception (the “without contraception” encounter) and me most recent time they had experienced sexual intercourse using a condom (the “with a condom” encounter). The results showed that although past behaviour did not differentiate between the two encounters, situational factors relating to preparation for action, affect and interpersonal interaction were important. However, when analysed for men and women separately most of the differences were only found for women. In particular, the results suggest that women report non-contraception use as associated with feeling more guilty, having a partner who is less motivated to use contraception than they are, with neither themselves nor their partner raising the desire to use contraception, not expecting to have sex and not discussing contraception and not having contraception available. In contrast, for men, only the availability of contraception appeared to differentiate between the two encounters. The results are discussed in terms of the usefulness of the methodology and the associated shift in emphasis from users and non-users of contraception to use and non-use. The implications of the results in terms of health education interventions are also considered.     

An evaluation of the accuracy of self-reports for predicting menstrual onset

Abstract

The self-reported predicted and actual day of menstrual onset were compared for 107 female volunteers. The differences between predicted and actual day of menstrual onset were compared by categorizing women into the ovulatory, premenstrual, and menstrual phases separately based on their predicted and actual days of menstrual onset. A main effect for phase suggested that menstrual women were less accurate in predicting menstrual onset. Thus, the degree of inaccuracy differed by phase and varied as a function of whether predicted or actual menstrual onset date was used to assign women to phases. These data provide a more precise indication of the degree of unreliability of self-reports and suggest a phase-accuracy connection which may be influenced by a number of factors, particularly recall of last menstrual onset.     

Physical activity levels in young adult Hispanics and Whites: Social cognitive theory determinants

The psychosocial determinants of health-impairing physical inactivity among Hispanic populations have not been well explored nor have systematic comparisons been made with White populations using Social Cognitive Theory (SCT) measures. Three exercise-relevant efficacy measures (task, scheduling, and response efficacy), three exercise-relevant expectancy measures (physical health, psychological health, and self-evaluative), and self reports of activity levels were obtained from 20-year-old male and female Hispanics (n?=?94) and Whites (n?=?94). Activity levels for the two groups were analyzed in separate regression analyses that included the six SCT measures and gender as predictors. The set of seven predictors accounted for 51% of the variance in self-reported activity levels in each analysis. For young adult Hispanics, task efficacy, response efficacy, mental-health expectancies, and self-evaluative expectancies predicted activity level. For young adult Whites, scheduling efficacy and self-evaluative expectancies predicted activity level. Gender was not a significant predictor of activity level for either group. A multivariate analysis of variance indicated that the only SCT predictor on which Hispanics and Whites significantly differed was mental-health expectancies. The results of this study indicate that the psychosocial determinants of exercise are qualitatively different for the two groups and that the determinants of physical activity levels for young adult Hispanics may not be as effective as those of young adult Whites in sustaining lifelong exercise habits. Thus the present study offers a promising strategy for detecting inactivity-related physical- and mental-health risks at an age when lifelong habits of physical activity are still being formed.     

Young women’s construction of their post-cancer fertility

Younger women diagnosed with cancer often face compromised fertility as a result of their treatment. However, previous research has adopted a biomedical model of fertility and utilised hypothetico-deductive research methods which have not allowed for full exploration of women’s subjectivity. This study explored younger women’s construction of their fertility post-cancer, and their discussions of fertility with healthcare professionals, from a social constructionist epistemology. Semi-structured one-to-one interviews were conducted with eight women aged 18–26, across a variety of cancer types. Foucaultian Discourse Analysis identified three subject positions associated with fertility concerns: ‘Inadequate woman: Accepting the motherhood mandate’; ‘Adequate woman: Resisting the motherhood mandate’; and ‘Survival of the fittest: Woman as genetically defective’. Implications of these subject positions included feelings of inadequacy, fear and devastation; feeling undesirable to romantic partners; and concern about passing on cancer-positive genes. In describing healthcare professional interactions, women adopted positions of ‘Satisfied patient’; ‘Passive recipient patient’; or ‘Resisting the passive patient position’. Accounts of inadequate information provision were associated with anger and frustration, whereas feeling adequately informed was associated with satisfaction at making decisions about fertility preservation. These results suggest that fertility is of importance to young women cancer survivors, and that compromised fertility can negatively impact subjectivity.     

Psychological consequences of positive results in cervical cancer screening

Abstract

This study was carried out to assess the psychological impact of abnormal cervical smear results. Existing literature contain only uncontrolled studies or controlled studies with non-standardised measures. Subjects were recruited from women attending two general practices for routine cervical smears over a six month period. A comparison was made between women with positive results who were referred for colposcopy, with mild abnormalities who were asked to return for a repeat smear in six months, or negative smear results. Psychometric assessment by postal questionnaire was carried out one week after receiving the result. The measures used were the 28-item General Health Questionnaire (GHQ-28), Spielberger State Anxiety (STAI), and a measure designed specifically for use in the study, the Cervical Screening Questionnaire (CSQ). Results indicated that women with positive smear test results who were referred for colposcopy had significantly higher scores on GHQ (p<.01) STAI-S (p<.05) and CSQ (p<.001) than women with mild abnormalities or negative results. Significant differences between the groups with mild abnormalities and negative results were found on the CSQ (p<.05). These findings suggest that positive results on cervical screening are associated with a significant psychological impact including a range of specific concerns about gynaecological health and cancer, increased anxiety and impaired well-being. Even mildly abnormal results, which involve a recommendation for early repeat screening, cause raised concern about cancer for the recipients. The procedures for providing smear results should be organised to minimise the level of distress.     

Why Young Men in South Africa Plan to Become Teenage Fathers: Implications for the Development of Masculinities within Contexts of Poverty

Drawing on in-depth interviews with young fathers (n=37) aged 14 to 20 in impoverished communities in South Africa, this study focuses on the young men who intentionally planned to have children while still teenagers. It interrogates their reasons for doing so, as well as their responses to their impending fatherhood and reactions after the birth of their child. Reasons such as wish-fulfillment, leaving a legacy, wanting to keep a partner, and wanting to be seen as ‘fashionable’ amongst their peers are discussed. An analysis is provided of the relationship between young fatherhood, poverty and masculinities. Key to the discussion are the interrelated notions of ownership and responsibility, and the ways in which impoverished young men find young fatherhood to be a powerful mediator in contexts where alternative pathways to exhibiting dominant masculinities are scarce.     

Sport,Girls, Trouble and Humour: Black and Indian Boys Negotiating Gender,Race and Class in a Formerly White Single Sex School in South Africa

This article reports on an interview study conducted by Deevia Bhana and Rob Pattman of Grade 11 (16–17 year old) boys attending different kinds of public schools in the Durban, South Africa. It investigated their accounts personal lives and identities as young men and women in and outside their schools. We conducted semi-structured interviews with the participants to determine how they experienced school and how they presented themselves in the interviews, their interests, aspirations, relations with other boys and girls in and out of school, and the kinds of identifications they made. The data for this are from two interviews conducted with black and Indian boys at Elmsdale, a formerly white boys' high school near Durban with an excellent academic and sporting reputation. We analyzed the data using narrative and discourse analysis. Concerns about being marginalised in school were expressed by both the black and the Indian boys. Issues of gender, race, class, sexuality and power were prominent in the interviews, notably when the boys were discussing sport, trouble, being funny and girls.