A Model for Adapting Evidence-Based Interventions to Be LGBQ-Affirmative: Putting Minority Stress Principles and Case Conceptualization Into Clinical Research and Practice

The mental health field now possesses clinical trials attesting to the efficacy of affirmative practice with sexual minority individuals. With the goal of efficiently moving the results of these clinical trials into real-world clinical practice, this paper offers a model for adapting existing evidence-based practices originally developed for the general population to be lesbian, gay, bisexual, and queer (LGBQ)-affirmative. The adaptation model presented here guides clinicians to incorporate six LGBQ-affirmative transtheoretical principles of change into practice. These principles facilitate raising awareness of the impact of minority stress on sexual minority clients’ mental health and on client self-evaluation while drawing upon sexual minority resilience and intersectional experiences to build empowering coping skills and validating relationships. The adaptation model also provides a transtheoretical approach to case conceptualization that directs clinicians to consider the role of early and ongoing minority stress on sexual minority clients’ cognitive, affective, motivational, behavioral, and self-evaluative experiences that maintain current distress. This case conceptualization approach highlights common associations among these experiences, suggesting clear routes of interventions for many sexual minority client presentations. Case examples from recent clinical trials of LGBQ-affirmative cognitive-behavioral therapy illustrate how these principles and this case conceptualization can be effectively utilized in practice. While the principles and case conceptualization are meant to be transtheoretical and therefore applicable across therapeutic techniques, to date they have been tested only in clinical trials for cognitive-behavioral treatments. Therefore, this paper concludes with a call for future research to determine the effectiveness of implementing this adaptation model across diverse therapeutic modalities and client presentations.     

Effect of perceived public stigma on internalized homophobia,anticipated stigma,shame, and guilt: Outness as a moderator

Although previous studies found that distal minority stress contributes to proximal minority stress and shame/guilt among the lesbian, gay, and bisexual (LGB) population, it is unclear whether the extent to which LGB individuals' open display and discussion their sexual orientation moderates these relationships. A total of 1,452 Chinese LGB adults provided demographic information and completed measures of outness, perceived public stigma, internalized homophobia, anticipated stigma, shame, and guilt. Structural equation modelling was conducted to test the hypothesized moderation analyses. Perceived public stigma had positive associations with internalized homophobia, anticipated stigma, shame, and guilt. Outness played a moderating role in the associations of perceived public stigma with internalized homophobia, anticipated stigma, shame, and guilt. Specifically, when LGB individuals had higher levels of outness, the effects of perceived public stigma on internalized homophobia, anticipated stigma, shame, and guilt were lower. Moreover, such moderating effect did not differ by sexual orientation. The degree to which sexual minority individuals' sexual orientation is known by and openly discussed with others may lower the extent to which LGB individuals internalize sexual stigma, expect rejection after coming out, and develop shame and guilt as a result of perceived social prejudice and discrimination.     

The use of the occupational stress indicator (OSI) in factory workers in China

The purpose of the study was to investigate occupational stress among Chinese factory workers (N=342), from three cities of South East China, using the shortened version of the Occupational Stress Indicator (OSI)-2. The results showed that the reliabilities and predictive validity of the OSI-2 subscales and other subscales used for the study were reasonably high. Quite a high percentage of workers perceived high work pressure. The main sources of stress were intrinsic to the job; and the coping strategies that were most frequently used to tackle stress were “control” methods. In addition, “satisfaction on environmental condition” seemed to be a common predictor for job satisfaction, and mental and physical well-being. The logical relationships between job satisfaction, mental well-being and physical well-being in Chinese workers have provided support to the findings obtained in Western countries.     

Occupational conditions and workers' sense of community: Variations by gender and race

The literature is reviewed to define a sense of community in the workplace and to identify factors that may foster it. A model is developed and estimated with survey data from a culturally diverse sample of men and women performing lower-level jobs at a medium-sized manufacturing firm. Results of regression analyses are reported that correct for sample selection bias resulting from the lower response rates of minority workers. Findings suggest that well-designed jobs and supportive workplace relationships and policies are important in explaining workers' sense of community, defined as workers' perceptions of mutual commitment between employee and employer. Informal sources of support play a larger role in explaining men's sense of community, while formal sources of support are more important in explaining women's sense of community. Findings further suggest that African American workers, especially women, have a difficult time experiencing a sense of community at work. The authors thank the employees of Fel-Pro for their participation in this study and Melissa Roderick, Michael Sosin, and anonymous reviewers for their thoughtful comments. This research was funded by the Fel-Pro/Mecklenberger Foundation and the Lois and Samuel Silberman Fund.     

Differences in occupational stress in three European countries

In this study, the reliabilities of the Dutch translation of the Occupational Stress Inventory, which is based on the theory of Cooper (Cooper & Marshall, 1976), was investigated. The sample comprised 436 nurses. A comparison is made of the individual and job satisfaction stress levels of Dutch and British nurses (N = 546), and of British managers (N =123) and German managers (N =133). The differences in the reliabilities of the Dutch version, compared to the British and German, are small. The differences between the stress and satisfaction scores are found to be greater between occupational groups than between nations.     

乡村教师付出–回报失衡对离职意向的影响:有调节的中介模型

为探讨乡村教师付出–回报失衡和职业幸福感对离职意向的影响,选取四川省乡村教师358名,用付出–回报失衡量表、职业幸福感量表和离职意向问卷进行调查。结果表明:(1)控制月收入、年龄和教龄影响后,乡村教师付出–回报比显著提升离职意向;(2)乡村教师职业幸福感在付出–回报比对离职意向的影响中起部分中介作用;(3)乡村教师过度投入调节付出–回报比对职业幸福感的影响。与低过度投入组相比,高过度投入组的付出–回报比对职业幸福感有更强的负向作用。研究结果揭示了乡村教师付出–回报失衡对离职意向影响及作用机制。     

Older Adults’ Psychosocial Responses to a Fear of Falling: A Scoping Review to Inform Occupational Therapy Practice

Abstract

Falls in older adults are a major health concern, yet the “fear of falling”, a common psychosocial response that can occur post-fall, has seldom been investigated. A scoping review was conducted to identify and map interventions that occupational therapists can use to manage the fear of falling psychosocial response (FoFPR) among older adults. Thirteen electronic databases were searched and 22 studies were retrieved. Cognitive behavioral therapy, guided imagery, and Tai Chi were interventions found to help older adults deal with their FoFPRs. Occupational therapists assisting older adults in this area can play a significant role.     

Stigma towards psychosis: Cross‐cultural differences in prejudice,stereotypes, and discrimination in White British and South Asians

Public stigma towards people with mental health problems has been demonstrated in Western societies. Little is known about non‐Western cultures and whether cultures differ in their perceptions of people with mental health problems. Aim of this study was to examine cultural differences in prejudice, stereotypes, and discrimination towards people with psychosis. Participants were from White British and South Asian backgrounds (N = 128, aged 16–20 years) recruited from two schools and colleges in the United Kingdom. They completed a cross‐sectional survey on affective, cognitive, and behavioural dimensions of stigma. Results revealed significant cultural differences on all three stigma dimensions. South Asians attributed higher anger (prejudice) and dangerousness (stereotypes) to people with psychosis than White British. They also reported lower willingness to help, greater avoidance, and higher endorsement of segregation (discrimination). The effects of ethnic group on helping intentions, avoidance, and segregation endorsement were mediated by anger and by dangerousness. Understanding cultural differences in stigma towards psychosis will be important for designing stigma interventions as well as treatments for people with different cultural backgrounds.     

Imagined contact and mental illness stigma in an Asian context: Bolstering the effect and examining the impact of factual information

Imagined contact can be effective at reducing social stigma. However, the effect may depend on the strength of the stigma held. We tested the robustness of imagined contact in an Asian setting where stigmatization of mental illness is stronger than in Western countries. In Experiment 1 (n = 167) with five conditions, only an enhanced version of positive imagined contact was able to decrease stigma towards people with schizophrenia through decreasing intergroup anxiety. Given the potential discrepancy between imaginations and reality about experiences with stigmatized groups, in Experiment 2 (n = 121), we tested the hypothesis that after presenting participants with factual information about a mental illness group, imagined contact might backfire, resulting in more negative perceptions. However, enhanced imagined contact alongside factual message about schizophrenia did not increase stigma. The backfiring hypothesis was therefore not supported. Nevertheless, providing realistic information did negate the positive effects of enhanced imagined contact on stigma reduction. In both experiments, we also showed that intergroup anxiety mediated the effect of enhanced imagined contact on various measures of stigma.     

Is Workplace Harassment Hazardous to Your Health?

We examined cross-sectional and lagged effects of sexual harassment (SH) and generalized workplace harassment (GWH) on incidence of self-reported illness, injury, or assault in a sample of over 1,500 university employees. SH and GWH, but not other job stressors, were related to increased odds of illness, injury, or assault. This was true when SH, GWH, and illness, injury, or assault were measured at the same time point, as well as when SH and GWH were measured in year prior to illness, injury, or assault.The data presented here are part of an ongoing longitudinal study of workplace harassment conducted at the Department of Psychiatry of the University of Illinois at Chicago. This research was supported by the National Institute on Alcohol Abuse and Alcoholism (grants AA09989 and AA13332). Portions of this paper were presented at the annual meeting of the Society for Industrial and Organizational Psychology, April 2004, Chicago, Illinois. The data were collected by the Survey Research Laboratory at the University of Illinois at Chicago.