• Adaptive coping strategies of othermothers: An examination of social support, spirituality, stress and depression

      Smith, Pamela L.; Harrington, Donna (2003)
      Over the past decade, the public child welfare system has increasingly relied upon female African American caregivers to provide out-of-home placements for relative children removed from their homes because of child maltreatment. African American women who care for relative children are also known as "Othermothers" (Troester, 1984) and a growing body of research reveals that this population is at risk for psychological distress, particularly depression. Depressed Othermothers can pose a serious public health concern for women and children in state care. African American women often use social support and spirituality to foster emotional resilience. Drawing upon concepts of the Transactional Stress-Coping Model and the Africentric Paradigm, this study examined the role social support and spirituality played in mediating or moderating the relationship between caregiver stress and depressive symptomatology. Data from an on-going Title IV-E federal demonstration project on families in Maryland's foster care system were analyzed. The sample included 116 African American Othermothers. A Social Embeddedness/Sense of Community scale and Density of Support scale measured social support; the Short Form of the Brief RCOPE, Daily Spiritual Experiences Scale and Organizational Religiousness Items measured spirituality; a Cumulative Stress Index measured caregiver stressors; the CES-D measured depressive symptomatology. Twenty-seven percent of the Othermothers had a positive screening for depression. Increased caregiver stress was associated with increased levels of depressive symptomatology (r = .373, p < .0005). Spirituality in the form of negative spiritual coping strategies and church attendance partially mediated the relationship between caregiver stress and depressive symptomatology. Lower levels of church attendance and neighborhood involvement were associated with elevated levels of depressive symptomatology (p < .10). This research suggests that spirituality and neighborhood factors play important roles in the psychological adjustment of African American Other-mothers. Maternal and child health, social work education, as well as child welfare implications are reviewed for African American caregivers and families in foster care.
    • Forgiveness and psychotherapy

      Stipe, Ann Marie; DiBlasio, Frederick A. (1995)
      Forgiveness as a concept has been examined in the field of religion, philosophy, law, medicine, and the social sciences. In contrast, the literature on forgiveness and its role in psychotherapy is in its developmental infancy. Evidence thus far suggests that forgiveness has a definite impact on clients' individual and relational well being, yet the literature displays gaps in social work research, qualitative research, quantitative research, and generally research investigating the process of forgiveness in any sense. The purpose of this qualitative "grounded theory" field study was to explore psychotherapists' perceptions of forgiveness as it relates to psychotherapy. Fourteen psychotherapists from various out-patient counseling agencies participated. Semi-structured interviews were conducted with each participant in three rounds of data collection. Common themes from each round were identified. The constant comparative method was used to develop the final working hypotheses which eventually became "grounded theory". Spiritual orientation was unanimously identified by psychotherapists as having an impact on their perceptions of forgiveness. Psychotherapists from four spiritual perspectives participated: Unitarian, Jewish, self spirituality with a Christian foundation and traditional Christian orientation. Results indicate there are differences and similarities among psychotherapists of various spiritual orientations. There were similar perspectives regarding definition and agreement that forgiveness is an important process in psychotherapy that results in many benefits for the clients. Examining differences among spiritual orientations resulted in the discovery of a spiritual bias to which all psychotherapists agreed. Psychotherapists from traditional Christian orientation were more likely to use the word "forgiveness" in psychotherapy than those from other perspectives. Psychotherapists identified the connection of forgiveness to Judeo-Christian values as their reason for avoiding the word even though they were facilitating the forgiveness process with clients. This also was offered as the explanation for the paucity in the professional literature. Implications of these findings include recommendations for practice and research. The importance of the forgiveness process in psychotherapy was confirmed. Various components of the forgiveness process are outlined and the practitioner is alerted to possible spiritual bias. Additional research is needed to confirm these findings and to further explore the role of forgiveness in social work practice.
    • Intervention preferences of social workers with Jewish-Christian intermarried families

      Saltman, Joan Ettinger; Goldmeier, John (1994)
      The purpose of this study was to investigate the possible factors associated with social workers' opinions and practice behaviors about an aspect of the relationship between social work practice and religion. Specifically, this study explored whether, and if so how, professional MSW-level social workers employed at Jewish Family service agencies address the phenomenon of Jewish-Christian intermarriage when formulating an intervention plan. A variety of survey and analogue research questions were asked. Additional demographic information was obtained about these social workers. Data were obtained through a questionnaire mailed to 420 MSW-level social workers employed half-time or more at the 137 Jewish Family Service agencies in the United States and Canada during the spring of 1990. Findings were based on a sample of 175 respondents from 45% of the agencies. Statistical procedures used included frequencies, means, Pearson product-moment correlations, t-tests, and paired t-tests. Conclusions indicated that in the survey questions, approximately 75% of these social workers reported it was important to include the intermarriage issue in an intervention plan. In the analogue questions, over 90% of the respondents reported they would question the clients about the intermarriage issue. Subsequently, 75% would raise the issue themselves rather than wait for the clients to bring up the concern. It was also found that these social workers professed a theoretical orientation to practice. However, they tended not to adhere strictly to their orientation when they selected theoretically-based interventions in the analogues. Limitations of this study, recommendations for future research, implications for social work practice and education are presented. This study is of interest not only to Jewish family service agencies but to social work practitioners and educators in general. With an increasing recognition of the importance of pluralism in our society and an awareness of the importance of ethnicity and religion, it is hoped that the findings of this study will contribute to the knowledge base of social work, to the education of social work students, and to the ongoing education of social work practitioners.
    • The relationships between prenatal stress, social support, spiritual well-being, and maternal-fetal attachment for pregnant women

      Gau, Meei-Ling; Soeken, Karen (1996)
      The purposes of this study are to test four measurement models and a hypothesized structural model which related to maternal-fetal attachment (MFA). The conceptual model of this study is primarily derived from stress and coping theory (Lazarus & Folkman, 1984) and crisis theory (Burgess & Baldwin, 1981) which includes three major conceptual domains: stress (prenatal stress), moderators of stress (social support and spiritual well-being), and manifestation of stress (MFA). A sample of 349 pregnant women in their third trimester was recruited from obstetrical outpatient and inpatient centers, including high-risk and low-risk pregnant units, and childbirth education classes. The questionnaires consisted of the Visual Analog Scale (VAS) and the Taylor Manifest Anxiety Scale (TMAS) designed to measure prenatal stress, the Personal Resource Questionnaire (PRQ), the Spiritual Well-Being Scale (SWBS), the Prenatal Attachment Inventory (PAI), and selected demographic, obstetrical, and health related questions. Confirmatory factor analysis of the four research instruments yielded results that supported the initial structural definition of PAI, TMAS, and prenatal stress. The constructs of the SWBS, and the PRQ were not supported by the data. The violation of multivariate normality assumption and multicollinearity were the factors that seemed to impact model fit. After using item parceling and deleting items with similar wording, both models fit well. The results of testing the hypothesized structural model yielded results that the interaction terms were deleted from the model because of non-normality and multicollinearity problems. Attachment showed positive correlation with prenatal stress (beta = .36, t = 4.15, p < .05) and social support (gamma = .27, t = 3.36, p < .05). Prenatal stress was negatively related to spiritual well-being (SWB) (gamma = -.45, t = -3.40, p < .05). In addition, pregnancy health status had an interaction effect on the structural model indicating the model fit differently for those with high-risk pregnancy as compared to those with low-risk pregnancy. The research indicated the importance of social support in MFA. The PAI is a valid instrument for measuring prenatal attachment. Although the spiritual components did not show direct effect to prenatal attachment, it has an indirect effect to prenatal attachment through prenatal stress as well as social support. The interaction effect of pregnant health status on the structural model suggested that high-risk pregnant women may have different demands in social support, SWB, prenatal stress, and/or MFA as compared to low-risk pregnant women.
    • Struggling with paradoxes: The spiritual experience of women with cancer

      Halstead, Marilyn Tuls; Belcher, Anne E. (1998)
      Spirituality is an important aspect of holistic health for women with cancer. Though extensive research focuses on spirituality, three major areas lack delineation. First, the developmental nature of spirituality requires exploration. Second, minimal systematic research directed at understanding spirituality from the perspective of women with cancer is reported. Finally, research exploring spirituality within specific time frames of the cancer trajectory is nonexistent. The purpose of this grounded theory study was to examine the spiritual experience of women diagnosed with cancer within 5 years of initial treatment. Data from two interviews with 10 Caucasian women, ranging from 40-70 years of age, were analyzed using the constant comparison technique. As the women began to suspect a cancer diagnosis, they questioned how this would affect their lives. The diagnosis posed a threat to the meaning they ascribed to their lives. This problem was resolved through the basic social psychological process of Struggling with Paradoxes, a 3-phase process consisting of deciphering the meaning (Phase I), realizing human limitations (Phase II), and learning to live with uncertainty (Phase III). In Phase I, deciphering the meaning, five paradoxes were uncovered that focused on confronting the possibility of their own death, staggering distress, and vulnerability. The women struggled to maintain coherence in old and new ways by connecting in giving and receiving processes. In Phase II, realizing human limitations, the demands of treatment initiated the women's struggle with three paradoxes. Confronting death, connecting for support, and asking the difficult questions were important dimensions that helped the women move toward letting go of ultimate control over their lives. As they entered Phase III, learning to live with uncertainty, the women attained greater well-being but realized that permanent survival could not be assured. In this phase, as the women struggled with two paradoxes, the dimensions of redefining meaning, identifying spiritual growth, reintegration, and facing the possibility of recurrence emerged. Findings confirm the importance of spirituality for women with cancer. Development of curriculum to enhance nurses' knowledge of spirituality is needed. Based on women's perspectives, development and testing of interventions that support and enhance spiritual growth is crucial for research-based practice.