Family caregivers of the mentally ill and adaptive coping

The issue investigated in this thesis concerned the adaptive coping strategies that caregivers of the mentally ill adopt at different stages of encounter with their family member’s illness. Specifically, family caregivers’ responses to the illness were investigated within the parameters of the Spaniol and Zipple (1994) 4-stage model of the evolution of caregivers’ responses to mental illness. The accuracy of the model’s representation of the experience of caregivers across all kinship relationships to the care-recipient was evaluated. Spaniol and Zipple proposed four stages which they termed (1) Discovery/Denial, (2) Recognition/Acceptance, (3) Coping and (4) Personal/Political Advocacy. The first stage is characterised by persistent denial of mental illness and seeking answers from multiple sources. The second stage involves caregivers’ expectations of professionals providing answers when the illness is recognised. At this stage caregivers experience guilt, embarrassment and blame. The cyclical nature of the illness impedes acceptance and caregivers experience a deep sense of loss and crisis of meaning as they gradually accept the reality of the situation. In the third stage coping replaces grieving and the issues encountered include loss of faith in professionals, disruption to family life and recurrent crises. Belief in family expertise grows and the focus of coping changes. The fourth stage proposes that caregivers become more assertive, self-blame decreases and the focus is upon changing the system. New meanings and values are integrated. This study found that the model did not accurately describe the experience of all caregivers. Caregiver did not deny mental illness and adaptive coping occurred throughout all stages. Coping evolved as the issues encountered changed and was independent of resolution of grief. The issues encountered were more extensive than the model proposed and differed according to kinship relationship to the care recipient. The ways in which adaptive coping evolved were identified, as were the issues and their accompanying responses. Caregivers coped by adaptively responding to the requirements of care provision, maintaining a sense of self worth and generating positive effect.

Caring for individuals with an eating disorder

A longitudinal study indicated that carers experienced long-term moderate levels of psychological distress and burden. High levels of negative expressed emotion, use of maladaptive coping strategies and unmet needs predicted burden longitudinally. Further, eating disorder sufferers underestimate the burden experienced by carers. The results support the use of carer-based intervention.

Development of a measure of health literacy for caregivers of people with cancer

Caregivers play a key role in supporting people with cancer. Little is known about challenges that caregivers might have when finding and understanding health information, making health-related decisions, and navigating the healthcare system. Using an innovative mixed-methods approach, the study developed and evaluated a tool to measure cancer caregiver health literacy.

Quality of life instruments for caregivers of patients with cancer : A review of their psychometric properties

The quality of life of caregivers of patients with cancer is an important construct given the substantial impact of caring on the physical, psychological, social, and financial well-being of caregivers. Moreover, caring for patients with cancer also affects family functioning and places burdens on caregivers. The reliability and validity of instruments used to assess the quality of life of caregivers of patients with cancer were reviewed to aid in the selection of the most appropriate measures For research and practice. MEDLINE (1980-2000) and c/NAHL (1982-2000) searches located relevant quality of life instruments using the keywords "cancer and quality of Iife" and "caregiver or spouse or partner." The search identified the following instruments: the Caregiver Quality of life Index-Cancer Scale, the 'Caregiver Quality of Life Index, the Quality of Life Tool, and the Quality of life Index-Cancer Version. Quality of life instruments developed specifically to measure the quality of life of caregivers of patients with cancer had the best psychometric properties. The Caregiver Quality of Life Index-Cancer Scale, in particular, met or exceeded minimum psychometric criteria for reliability and validity. The development of reliable and valid caregiver quality of life measures is an important factor in developing interventions to enhance quality of life of caregivers of patients with cancer.

The treatment of multicultural issues in contemporary forensic psychology textbooks

This article examines whether practice issues relating to clients from different cultural or ethnic groups are adequately addressed in a wide selection of contemporary forensic psychology textbooks. Specifically, we examine the extent to which cross-cultural issues are engaged within these texts, and how well the information provided informs forensic practice. While most of the reviewed texts acknowledged the need to consider cultural issues, there was relatively little discussion of specific issues, and practical guidelines were rarely offered. It is argued that without more widespread acknowledgment of the direct implications of cultural issues for forensic practice, it is unlikely that a fair and reliable system for the investigation and treatment of complaints made by and against people from different cultural groups will be obtained.

The emergence of an online learning community in first year tertiary studies in psychology

The introduction of an online supported, resource based learning environment into a large, multi-modal first year psychology unit led to the spontaneous development of a small, but active, learning community. While off campus students were more active online contributors, many other students "observed" these interactions, not actively contributing but finding the discussion postings valuable to their learning. Overall, use and perceived value of the online communication facilities were related to how confident students were that they had an appropriate study strategy, with off campus and older students reporting greater confidence in their study approach. The results highlight that the nature and function of learning communities for large, multi-modal foundation units are quite different to those typically articulated in the literature and are worth further investigation.

Specialisation within specialisation? Thoughts on the content of contemporary forensic psychology programs

This paper provides details of, and the rationale for, a Doctorate of Forensic Psychology recently developed at Deakin University, Melbourne, Australia. The course prioritises training in psycho-legal issues with children and young people. In discussing this program, the presenters identify two issue  that guided the development of the program. The first concerns the need to delineate forensic content from that in clinical programs, while still maintaining appropriate focus on the skills needed to work effectively in forensic settings. The second addresses the need for courses to acknowledge the marked diversity among forensic clientele and to develop competencies that lead to effective work practices with these sub-groups. In constructing the Deakin forensic program, it was noted that forensic psychologists required an increasing degree of expertise in the procedural and substantive aspects of the legal system. The authors propose that as forensic psychology gains momentum as a discrete area of expertise, there is an increasing need for practitioners to have a sound understanding of the legal institutions and practices they work under, as well as being able to apply specialist knowledge to particular sub-groups. This paper discusses these issues, and outlines how the authors sought to address them in their course curriculum.

The education needs of caregivers of stroke survivors in acute and community settings

Stroke is a major cause of chronic illness in Australia, where it is estimated that between 200,000 and 250,000 people live with disabilities due to stroke. Given stroke's effect on survivors and the accompanying burden on caregivers, attention should be given to addressing the needs of caregivers of stroke survivors because they are central to supporting survivors living in the community. Research has shown that the information needs of caregivers are not being met across healthcare settings. Thus, some attention must be given to the development of educational materials that address caregiver needs. In this study we interviewed caregivers to determine their perspectives on support and educational needs at two different stages in the recovery of the stroke survivor: the acute hospital and the community. Despite a high level of uncertainty among caregivers in the acute and community settings, limited information was provided to assist them in their new role. A multifaceted approach would involve the development and implementation of specifically designed educational materials for caregivers, the use of a tool such as a patient-held record to assist in and improve the continuity and communication of care, and the provision of ongoing support from a stroke nurse practitioner who would follow stroke survivors from the acute setting to the community. This approach should be evaluated so that the important issue of addressing caregiver needs is given its due attention.

The impact of caring on caregivers' mental health : a review of the literature

This paper provides a brief overview of the literature on the impact of caring on the mental health of informal caregivers in the areas of aged care, disability and mental health. Factors discussed that may impact on caregivers' mental health include the relationship between the caregiver and care recipient, the nature of the care recipient's disability and the stage of the caregiving process. Several moderators of the impact of caring on mental health are described, including socio-economic factors, social support and coping strategies. This information provides a context within which to examine the type of interventions appropriate to assist caregivers in various situations.

Caregivers as managers of subjective wellbeing: a homeostatic perspective

Background: This paper proposes that the adequacy of service delivery and caregiving to people who are disabled should be assessed using two criteria. One is the objective circumstance of living, which should be at a standard acceptable to the community at large. The other is a level of subjective wellbeing (SWB) within the normal range. Method: This latter criterion is a novel conception based on an understanding that SWB is homeostatically managed to lie normally within a narrow range of values. Results: People who have a disability are more likely than usual to have a fragile homeostatic system because of the additional life challenges imposed by their disability. Conclusions: The role of a caregiver is to provide resources and protection against strong threats to homeostasis, thereby ensuring that the person in their care has a normal-range level of SWB.

Positive psychology and the demise of defamation

Defamation is one of the more complex and fluid areas of the law and varies considerably across the Australian jurisdictions. There are moves to unify defamation law. The threshold issue that is raised in any such process is whether there is in fact a justification for continuation of defamation law. Recent advances in happiness studies and positive psychology suggest that the chief interest protected by defamation law, reputation, is over-rated and is not in fact conducive to human well-being. What others think of us is not relevant to our well-being. Anecdotally it seems that people spend much time and energy in a bid to impress others in the hope that they will grow in the estimation of others and the world at large. Hence, the results of the studies into human well-being so far as reputation is concerned may appear counter-intuitive. Nevertheless, the studies are far more convincing than lay assumptions. People are often wrong about what is in their interests. This is recognised in the concept of regret. Individuals yearn for some things, but sometimes when they acquire them they discover that the journey was wasted. Reputation is one such thing. Defamation law perpetuates the myth that reputation is intrinsically important. Defamation should be abolished. In its place, a new cause of action should be introduced whereby damages are awardable for misleading and deceptive communications which cause damage to the individual who is the subject of the communication. This cause of action should be modelled on the misleading and deceptive conduct provisions of the Trade Practices Act 1974 (Cth).

Issues arising from an online resource-based learning approach in first year psychology

This paper reports on an evaluation of an innovative, online resource-based learning (RBL) approach used in first year psychology at Deakin University. The evaluation revealed a number of critical issues that must be considered to ensure effective implementation of an RBL approach. Emphasis is giveen to educational considerations covering the use and value of a diversity of print and electronic learning resources, online discussions and face-to-face teaching arrangements. The importance of strong integration of all elements of the learning environment, and provision of clear guidelines to learning are highlighted.