Significant Others Research Articles

From Model to Practice: A Qualitative Study on Factors Influencing the Implementation of the Active Recovery Triad (ART) Model in Long-Term Mental Health Care.

Background: The Active Recovery Triad (ART) model provides a framework for recovery-oriented care in the long-term mental health setting. The aim of this study is to gain insight into factors influencing the implementation process of the ART model. Methods: Focus groups were conducted with fourteen multidisciplinary teams that were in the process of implementing the ART model. Data were thematically analyzed. Results: Three phases of implementation were identified. In the first phase, getting started, support from both the top of the organization and the care workers, sufficient information to care workers, service users, and significant others, and creating momentum were considered crucial factors. In the second phase, during implementation, a stable team with a good team spirit, leadership and ambassadors, prioritizing goals, sufficient tools and training, and overcoming structural limitations in large organizations were seen as important factors. In the third phase, striving for sustainability, dealing with setbacks, maintaining attention to the ART model, and exchange with other teams and organizations were mentioned as core factors. Conclusions: The findings may support teams in making the shift from traditional care approaches towards recovery-oriented care in long-term mental health care.

Predictors of Moderate-High Posttraumatic Growth in Parents of Children With Cancer: A Cross-sectional Study.

Parents of children with cancer may experience posttraumatic growth (PTG). In clinical practice, this parental enhancement is more likely to be seen with a moderate-high PTG. The aim of this study was to determine the moderate-high PTG prevalence of parents of children diagnosed with cancer at least 6 months and to investigate its relationship with hope, social support, and patient-parent characteristics. This cross-sectional study was conducted with the parents of children with cancer admitted to the pediatric hematology-oncology unit using the Parent-Child Characteristic Questionnaire, Posttraumatic Growth Inventory, Multidimensional Scale of Perceived Social Support and Dispositional Hope Scale. Univariate and multivariate logistic regression analyses were performed to investigate the variables associated with moderate-high PTG. One hundred one parents were enrolled in this study, and the prevalence of the moderate-high PTG was 79.2%. There was a statistically significant difference between moderate-high PTG and children's age (P = .037). Multivariate logistic regression analysis showed that social support from significant others (odds ratio = 1.138, 95% confidence interval = 1.030-1.257, P = .011) was a predictor of moderate-high PTG. Moderate-high PTG is common among parents of children diagnosed with cancer. Perceived social support from healthcare professionals and other patient parents is a predictive factor. Interventions that encourage the support of health professionals and interaction with the parents of other patients, such as peer counseling, group-based interventions, and expanding the social support network, seem to be clinically promising in helping parents to improve from the cancer experience.

Is Resilience the Bridge Connecting Social and Family Factors to Mental Well-Being and Life Satisfaction?

AbstractFamily and social support can enhance our perception of our ability to cope with stressful life events, as well as our psychological flexibility and mental well-being. The main goal of this unique study was to explore how a complex interplay of family, social, and personal factors contribute to mental well-being and life satisfaction. We hypothesized that differentiation of self (DoS) and social support (from family, friends, and significant others) would be positively associated with mental well-being and life satisfaction through the mediation of resilience. The sample included 460 participants (mean age 45.2; 236 males), who filled out questionnaires examining DoS, social support, resilience, mental well-being, and life satisfaction. In light of gender disparities evident in both existing literature and the current study, we analyzed the model separately for women and men. The findings revealed a mediation model, indicating that resilience mediated the relationship between two dimensions of DoS (emotional reactivity and I-position) and mental well-being for males, while DoS and social support contributed to women’s mental well-being without the mediation of resilience. Two factors emerged as contributors to improved mental well-being and life satisfaction: DoS and social support. Specifically, DoS was deemed important for both men and women, while social support emerged as a crucial dimension mainly for women.

Danish citizens' perspectives on the preventive medication recommended after screen-detected cardiovascular disease: A qualitative study.

The rationale for screening for cardiovascular disease (CVD) is debated as a prevention strategy. However, research shows that when preventive medication is initiated after screening for CVD, mortality rates decrease, especially among men. When implementing screening programmes, facilitating citizens' informed decisions and empowering their autonomy in the decision-making process are crucial. We therefore aimed to explore citizens' perspectives on and decisions regarding initiating cardiovascular preventive medication for screen-detected CVD. We employed an exploratory qualitative design using semi-structured interviews to investigate participants' perspectives on and decisions regarding initiating cardiovascular preventive medication for screen-detected CVD. Twelve interviews were conducted and analysed using thematic analysis following Braun and Clarke's six-step approach. We found one overall theme, Being on a continuum between wellness and illness, with two underlying sub-themes. Sub-theme (1) Navigating mixed feelings and pathways reflects participants' perspectives on CVD preventive medication, which were positioned on a continuum with shifting perspectives. The state between wellness and illness was experienced as liminal and characterised by uncertainty and concerns about CVD risk. (2) Navigating medication decisions: a negotiated process. Pivotal medical decisions hinged on trust in authorities or own judgement, influenced by attitudes towards the need for medication, perception of meaningfulness, asymptomatic condition, age, family responsibility and predisposition. Participants' medical decisions were supported and impacted by significant others. We uncovered a continuum of shifting perspectives ranging from feeling improved health to experiencing fear of CVD. For certain citizens, it is like navigating between these contrasting feelings. The perceived necessity and meaningfulness, in particular, shape medical decisions. Providing support for informed decisions is crucial and includes significant others. Shared decision-making with healthcare professionals as facilitators is needed. Future research is warranted to investigate how to embrace the various perspectives on initiating CVD preventive medication in clinical practice.

The significant others’ responses to trauma scale (SORTS): applying factor analysis and item response theory to a measure of PTSD symptom accommodation

ABSTRACT Background: Symptom accommodation by family members (FMs) of individuals with posttraumatic stress disorder (PTSD) includes FMs’ participation in patients’ avoidance/safety behaviours and constraining self-expression to minimise conflict, potentially maintaining patients’ symptoms. The Significant Others’ Responses to Trauma Scale (SORTS) is the only existing measure of accommodation in PTSD but has not been rigorously psychometrically tested. Objective: We aimed to conduct further psychometric analyses to determine the factor structure and overall performance of the SORTS. Method: We conducted exploratory and confirmatory factor analyses using a sample of N = 715 FMs (85.7% female, 62.1% White, 86.7% romantic partners of individuals with elevated PTSD symptoms). Results: After dropping cross-loading items, results indicated good fit for a higher-order model of accommodation with two factors: an anger-related accommodation factor encompassed items related largely to minimising conflict, and an anxiety-related accommodation factor encompassed items related primarily to changes to the FM’s activities. Accommodation was positively related to PTSD severity and negatively related to relationship satisfaction, although the factors showed somewhat distinct associations. Item Response Theory analyses indicated that the scale provided good information and robust coverage of different accommodation levels. Conclusions: SORTS data should be analysed as both a single score as well as two factors to explore the factors’ potential differential performance across treatment and relationship outcomes.

Study on The Implementation Intention of Health Protection Behavior of College Students in Epidemic Situation of Infectious Diseases

From the perspective of social cognitive theory, this paper refines and integrates the theory of protective motivation, the theory of planned behavior and the individual and social environment factors in risk research, a comprehensive analytical framework was built to predict the implementation intention of public health behaviors. Through the investigation of the college students during the epidemic of Covid-19, we found that the willingness of the public to carry out health behaviors was influenced by two kinds of factors: external social environment and individual internal conditions. As far as the external environment is concerned, perceived normative influence of “Significant others” and informational influence from mass media can positively promote the implementation intention of health protection behavior. At the same time, media attention can also indirectly affect the public's willingness to carry out health behaviors through the mediating effects of self-efficacy and coping efficacy, respectively. As far as internal factors are concerned, self-efficacy is the most powerful direct factor to predict individuals' health behaviors. The existence of cognitive deficit and optimism bias results in the failure of the predictive power of the element of threat assessment on the willingness to carry out health behaviors, however, perceived severity can have a negative effect on health behavior intention through the mediation of the “Avoidance” concept. The study also found that the emotional response not only positively affected the intention to carry out healthy behaviors independently of the cognitive assessment process, but also played a positive moderating role between media attention and the intention to carry out healthy behaviors, however, improper risk concept may have a blocking effect on the implementation intention of health behavior.

Characterizing the mental health concerns of significant others of those with Borderline Personality Disorder (BPD) and how BPD impacts them

Introduction: Borderline personality disorder (BPD) is a serious psychiatric condition characterized by emotional, interpersonal, and behavioral dysregulation. Significant others (SOs: family member, romantic partner, friend) of those with BPD also endorse elevated mental health concerns. The general severity of BPD symptoms, and/or severity of specific BPD dysregulation components (i.e., emotional, interpersonal, or behavioral) may uniquely influence distinct SO mental health concerns. However, which specific mental health concerns are experienced by SOs of those with BPD, and whether and how BPD influences them, remains unknown. This study therefore aimed to: (1) characterize the mental health concerns (i.e., depression, anxiety, trauma exposure and posttraumatic stress disorder, objective and subjective burden, behavioral dysregulation) of SOs of those with BPD; and (2) clarify whether and how overall BPD symptom severity, and specific BPD dysregulation components, are associated with these SO mental health concerns. Methods: SOs of those with BPD (N = 46) completed measures of mental health concerns, and informant-reports of their loved one with BPD's symptom severity at baseline, 1-, and 2-month follow-ups. Results: SOs exhibited low psychopathology across all mental health concerns, except anxiety severity, which was moderate. Higher overall BPD symptom severity, emotion dysregulation, and behavioral dysregulation, but not interpersonal dysregulation, in the person with BPD predicted worse SO mental health concerns. Discussion: Behavioral and emotional BPD symptom domains may be particularly deleterious to SO mental health, and BPD treatment providers may wish to consider referrals for SO mental healthcare in such instances.

Grief Due to Loss of Significant Others: The Role of Social Support, Spiritual Intelligence and Wellbeing-Life Satisfaction

Grief Due to Loss of Significant Others: The Role of Social Support, Spiritual Intelligence and Wellbeing-Life Satisfaction

Resilience Through Social Support: An Intersectional Analysis of Sexual Minority Women’s Social Resources for Wellbeing

ABSTRACT Sexual minority women (SMW) are at higher risk for a range of health conditions (e.g. depression, anxiety, and alcohol use disorder) than heterosexual women. However, poor health outcomes do not occur for all SMW. Resilience provides a lens for understanding why some SMW maintain good mental and behavioral health despite the presence of multiple risk factors. Few studies have examined the resilience-promoting factor of social support in relation to depression, anxiety, and alcohol use disorder in SMW. There is a need for further research clarifying sources of social support (e.g. family, significant others, friends, LGBTQ+ community) associated with resilient outcomes for SMW. This study used data from a telephone-based survey of 520 SMW to examine the relationships between resilience and social support. We used multiple regression and tested for interactions with ethnoracial identity and sexual identity. Greater levels of overall social support were associated with greater resilience, as was social support from the LGBTQ+ community in particular. There were few differences in these relationships by ethnoracial identity, sexual identity, or their intersections. Interventions that increase social support across any of four support sources appear to have the potential to increase resilience and decrease mental and behavioral health risks for SMW.

Becoming a Mother as a Teenager: Self-Acceptance of Adolescent Girls Who Choose to Get Married

Age is one of the essential aspects of everyone's life, including physiological considerations of health and psychological states. At each stage of development, in line with age, a person will face tasks and challenges in life. It is the same as when someone is married, where age also determines the readiness and acceptance of new roles. This study describes the self-acceptance of adolescent girls who do early marriage and motherhood at a young age. The research sources comprised six people, of which two were primary subjects and four were significant others. The criteria for participants used in this study are adolescent girls who married under the age of 19 and have children from the marriage. The method used in this research is qualitative with a phenomenological approach. This research shows that primary informant 1 has good self-acceptance because she can interpret the situation and be responsible for her decisions. Interpret the problem, take responsibility for the decisions, and adjust to her roles as wife and mother. Meanwhile, self-acceptance in primary informant 2 is not good enough because she has yet to view the situation positively and adapt to her role as a wife and mother.

Qualitative Exploration of Speech Pathologists' Experiences and Priorities for Aphasia Service Design: Initial Stage of an Experience-Based Co-Design Project to Improve Aphasia Services.

Stroke survivors with aphasia (impaired language/communication) have poor outcomes and gaps in the clinical implementation of best practice contribute to this. Little is known, however, about speech pathologist perspectives on the touchpoints (key moments shaping experiences) in the clinical care pathway that have the greatest impact on service delivery nor how this varies by geographical location. We explored the experiences of speech pathologists who provide aphasia services to establish priorities for improvement and design. This is the initial experience gathering and priority identification stage of an experience-based co-design (EBCD) project. Speech pathologists were recruited from 21 geographically diverse Hospital and Health Services in Queensland, Australia. Speech pathologists working in acute, rehabilitation and community services shared positive and negative experiences of delivering aphasia care in interviews and focus groups. Experiential data were analysed using qualitative thematic analysis to determine touchpoints. Priorities for service design were identified using an adapted nominal group technique. Speech pathologists (n = 62) participated in 16 focus groups and nine interviews and shared 132 experiences of delivering aphasia care. Providing care in teams with poor awareness of the impacts of aphasia was identified as a key challenge, as poor patient-provider communication was perceived to increase risk of adverse outcomes for patients. Speech pathologists identified areas for improvement related to their own professional needs (e.g., greater access to clinical supervision); collaborative health care (e.g., better coordination and interdisciplinary care to increase therapy time); and the service context and environment (e.g., psychological services able to support diverse communication needs). Speech pathologist delivery of aphasia services could be improved through increased access to clinical supervision, opportunities for peer debriefing and interdisciplinary care. Priorities for service design varied by geographical location and included: education to support care transitions (remote areas), improved referral pathways and service linkage (regional areas) and dedicated aphasia staffing (metropolitan areas). A consumer advisory committee comprising people with aphasia (n = 3, authors K.M., K.D. and B.A.), their significant others (n = 2, authors J.D. and P.M.), and a Cultural Capability Officer (author G.B.) guided this research. The team: (1) reviewed participant information; (2) co-designed surveys and workshop resources; (3) copresented research outcomes and contributed to publications. Research questions and study design (e.g., analysis methods and assessment measures) were developed by the research team (authors L.A., V.J.P., D.A.C. and S.J.W.).

Exploring lived experiences in oral cavity cancer: An Asia-Pacific perspective on psychosocial challenges and opportunities for enhanced patient-centric care.

12097 Background: Locally advanced oral cavity squamous cell carcinoma (LA OC SCC) is profoundly emotionally taxing, characterized by a dual burden of undergoing treatment and adapting to post-treatment changes. The research explores lived experiences including psychosocial aspects, to identify approaches to establish a resilient supportive system for patients to improve coping and reduce anxiety and distress. Methods: A total of115in-depth interviews were conducted across Australia, Hong Kong, South Korea, Taiwan and Vietnam. Informants were LA OC SCC patients who underwent surgery and adjuvant chemoradiotherapy, their caregivers, multidisciplinary team (surgeons and clinical, radiation and medical oncologists) and supportive care HCPs (nursing, case managers/care coordinators, psychologists, speech therapists, dietitians, and dentists). Interview guide design and thematic analysis were guided by the Psycho-Onco Emotional Anxiety (POEM) framework and the Capability, Opportunity, Motivation, Behaviour (COM-B) model. Results: The POEM framework illuminated patients’ lived cancer experiences, emotions and psychological thoughts and processes influenced by beliefs of the world, others and self which impact coping responses that maintain or drive anxiety. Key themes emerged: physical and functional impairments result in negative psychosocial impact; constraints hinder person-centered care communications with HCPs and interpersonal dynamics with significant others; and personal and interpersonal experiences result in negative coping, exacerbated by inadequate health services and social support. Multimodal therapeutic interventions for LA OC SCC lead to physical and functional impairments implicating psychosocial and psychosexual quality of life. LA OC SCC stigma, societal norms and highly socially constrained patients grapple with distress from inadequate psychosocial support. Furthermore, HCPs may have preconceptions of LA OC SCC patients hindering patient-centered approaches to care and management. In certain regions, insufficient hospital support systems exacerbate the toll of strained interpersonal relationships and caregiver burden on physical, psychological and emotional well-being. Consequently, treatment adherence, self-care and survivorship experiences of patients and caregivers are affected. Conclusions: Utilizing the POEM framework, the study delved into nuanced patient and caregiver-narrated experiences in 5 Asia-Pacific countries/territories with distinctive supportive care systems. Findings underscore the imperative of improving patient-centric care through enhanced psychosocial support for patients and caregivers, identifying specific areas where health services can be better equipped to support holistic patient health delivery, especially psychosocial health.

Integrative multimodality spatial biomarker analysis for tailoring checkpoint inhibitor therapies in non-small cell lung cancer.

e14664 Background: Checkpoint inhibitor therapy has become a cornerstone in the treatment of non-small cell lung cancer (NSCLC). However, the response to checkpoint inhibitors varies widely among patients, with some experiencing significant benefits and others facing adverse reactions without therapeutic gain. The ability to accurately predict which patients will benefit from checkpoint inhibitor therapies is essential for enhancing treatment efficacy and minimizing side effects. In this context, the identification and analysis of predictive biomarkers, including the expression of immune checkpoint proteins such as PD-L1 and TIGIT, and the comprehensive profiling of cytokines in the tumor microenvironment, are of paramount importance. Methods: A multimodal strategy was employed to identify predictive biomarkers for checkpoint inhibitor therapy in non-small cell lung cancer (NSCLC). This approach integrated metabolic, transcriptomic, and proteomic data to achieve a thorough insight into the biomarkers likely to influence patient responses. The diverse data sets were fused through advanced machine learning techniques, creating a holistic dataset. Analysis of this integrated dataset facilitated the discovery of multimodal biomarker signatures, offering the potential to predict which NSCLC patients would positively respond to checkpoint inhibitor treatments. Results: Initial observations revealed considerable variability in the expression of PD-L1 and TIGIT alongside other immune checkpoint molecules, across different regions of the tumor microenvironment in non-small cell lung cancer (NSCLC). Multimodal biomarker signatures, encompassing distinct expressions of immune checkpoint inhibitors, cytokine levels, and the presence of immune cells, showed a strong correlation with patient outcomes following treatment with immune checkpoint inhibitors. Conclusions: Our research highlights the significant promise of using a multimodal stratification method to unravel the complexities of non-small cell lung cancer (NSCLC) and to predict patient responses to immune checkpoint inhibitors. Through the integration of metabolomic, transcriptomic, and proteomic data, we discovered distinctive biomarker signatures that were highly predictive of responses to these immunotherapies.

Do measures of social support and social distress share general factors associated with suicidal ideation and attempts?

Aspects of social relationships have variably been associated with suicidal ideation (SI) and suicide attempts (SAs). This study assessed whether social support and social distress measures have general factors versus measure-specific factors that are associated with suicide risk. Adults (N = 455, 60.0% female), admitted to psychiatric inpatient units following a recent suicide attempt or active SI, completed assessments of social support (emotional support, instrumental support, friendship, perceived support from significant others, friends, family) and social distress (loneliness, perceived rejection, perceived burdensomeness, thwarted belongingness). Bifactor modeling examined general and specific factors of social support and distress in relation to SI (week prior to hospitalization, via the Beck Scale for SI) and SAs (past 30 days, via the Columbia Suicide Severity Rating Scale). SI was significantly associated with the general social support (B = -1.51), the general social distress (B = 1.67), and the specific perceived burdensomeness (B = 1.57) factors. SAs were significantly associated with the specific Perceived Rejection (OR = 1.05) and Thwarted Belongingness (OR = 0.91) factors. General social support and social distress were associated with SI but not recent SAs. Specific social distress factors were also related to SI and SAs controlling for general social distress, suggesting areas for future interventions.

Interaction-focused music therapy with cancer-affected children and their significant others: a randomized controlled feasibility study with subsequent intervention (INMUT)

BackgroundPaediatric oncology/haematology patients and their families are confronted with a life-threatening situation for which music therapy can be a cross-linguistic field of action. The creative act of making music together offers the possibility to strengthen competences and make conflicts tangible. Besides its complementing of evidence-based biomedical care, there is little research on the feasibility and efficacy of interactive music therapy including the diagnosed child and their significant others.MethodsWe conducted an assessor blind, prospective, multicentric feasibility randomized controlled trial (RCT) with subsequent intervention. Including overall 52 child-significant other dyads, INMUT investigates interaction-focused music therapy with cancer-affected children and their significant others (INMUT-KB; n = 21) compared to music therapy only with the child (MUT-K; n = 21) and a wait-list group (WLG; n = 10). The measurement points include the screening for a cancer diagnosis, psychometric baseline (pre-T1), initial assessment (T1/T2), music therapy sessions (T3–T9), final assessment (T10), final psychometric evaluation (post-T10), and 3-month follow-up (cat-T11). Feasibility and acceptability of the (1) research methodology, (2) intervention and (3) estimation of effect sizes will be assessed using qualitative and quantitative data. The proposed primary outcome includes the parent–child interaction (APCI), and the proposed secondary outcomes refer to subjective goal achievement (GAS), quality of life (KINDL), system-related functional level (EXIS), psychosocial stress (BAS), psychosomatic complaints (SCL-9k), and resources (WIRF). We plan to investigate the efficacy of INMUT-KB and MUT-K post-intervention (post-T10) within the RCT design and at 3-month follow-up (cat-T11).DiscussionThis study will provide insights into the feasibility of INMUT and the final sample needed for a confirmatory RCT. We will reflect on successfully implemented study procedures and, if necessary, provide recommendations for changes considering the design, procedures, measures, and statistical analyses. The discussion will conclude with an evaluation whether a confirmatory RCT is worth the investment of future resources, including the calculated number of child-significant other dyads needed based on the efficacy trends derived from this feasibility study.Trial registrationClinicalTrials.gov: NCT05534282; date of registration: June 23, 2022.

“It’s not a normal relationship, and it won’t be”: The impact of aphasia on spouses

ABSTRACT Background Aphasia has far-reaching effects on both the affected individuals and their surroundings. In 2001, the World Health Organization (WHO) introduced the International Classification of Functioning (ICF) model, which includes the concept of “third-party disability”, highlighting the challenges faced by healthy partners when their significant others have a medical condition. Despite family members expressing a willingness to engage in rehabilitation, healthcare professionals often overlook their negative emotions. Aim & Methods This study explores the impact of aphasia on spouses of people with aphasia (PWA). Using mixed methods, it involved 30 spouses who completed the Family Aphasia Measure of Life Impact questionnaire (FAMLI. Grawburg et al. 2019), assessing the healthy partner’s functioning concerning the PWA. Additionally, 12 spouses from the same group participated in in-depth interviews about their lives before the stroke, their experiences during it, and life alongside aphasia. Results The FAMLI questionnaire revealed notably low scores in four of five categories: health and daily life, helping others, communication and emotion and outside influences and interactions. However, the attitudes and personal life category yielded a positive score. The communication and emotion category had the most pronounced negative impact, a finding supported and enhanced by the interviews. Challenges included an overwhelming sense of burden and profound loss within marital relationships. Conclusion Spouses of PWA face an emotionally taxing journey, with communication impairment reshaping marital dynamics. Speech-language pathologists should play a role in restoring effective communication. Addressing spouses’ unique needs should be a research and clinical priority.

Use of Ubuntu Spiritual Psychotherapy in Counselling adolescents with Conduct Disorder in Nkayi Secondary Schools, Zimbabwe

The aim of this study was to embrace Ubuntu Spiritual Psychotherapy as a technique for counselling adolescent with conduct disorder in Nkayi Rural District secondary schools. Ubuntu Spiritual Psychotherapy is an approach that combines elements of Ubuntu philosophy, spiritual principles, and psychotherapy to address the psychological and spiritual well-being of individuals. When it comes to counselling adolescents with conduct disorder in secondary schools, it has been observed by the researcher that Ubuntu Spiritual Psychotherapy miss the mark in utilising the valuable approach by failing to take a holistic view of individuals, considering their psychological, emotional, social, and spiritual dimensions. Understanding the cultural background of the adolescents and respecting their beliefs and values is a problem with rural secondary school teachers. The study is guided by Bronfenbrenner’s Ecological Systems theory. The nature of this research was essentially qualitative and phenomenological research design guided data gathering from 20 participants through focus group discussion and individual interviews with students, school counsellors and parents. The study concluded that although most of the teachers in schools appreciate Ubuntu spiritual psychotherapy as a holistic approach to counselling adolescent students with conduct disorder, some barriers such as inadequate knowledge and skill, lack of collaboration and training, negative attitudes and unavailability of standardised protocols condenses its effectiveness. The study further concluded that educators in secondary schools should embark on integrating Ubuntu spiritual psychotherapy into counselling practices in secondary schools to support adolescents with conduct disorders through appropriate teacher training and professional development on Ubuntu spiritual psychotherapy, collaboration between parents, teachers, school counsellors and mental health professionals and establishing a supportive and nurturing classroom environment. This study therefore recommended that teachers and school counsellors need to embrace Ubuntu Spiritual Psychotherapy as a technique for counselling adolescents with conduct disorder in secondary schools, through a collaborative effort from learners, parents, teachers, school counsellors and significant others.

School Refusal Behaviour and Social Skills in Children with Attention-Deficit/hyperactivity Disorder

ABSTRACT Children with Attention-Deficit/Hyperactivity Disorder (ADHD) have higher school absenteeism and poorer social skills compared with typically developing children. The objectives of this study were to investigate (1) which forms of school refusal behaviour (SRB) are more common and (2) the relationship between SRB and social skills in children with ADHD. Parents (N = 96) of children with ADHD (M age = 12.4, range 10–15, 61.5% boys) completed the School Refusal Assessment Scale – Revised and the Social Skills Improvement System. Findings were analysed using analysis of variance, correlational analyses, and multiple regression analyses. The most common forms of SRB were avoidance of aversive situations at school and seeking attention from significant others. Significant correlations between different forms of SRB and engagement, autistic traits, cooperation skills, and self-control were found. Less engagement significantly predicted more SRB due to avoidance of aversive situations, avoidance of social situations, and seeking attention from significant others in multiple regression analyses. Targeting social engagement in social skills training for children with ADHD may decrease SRB.

Common practices of Speech and language pathologists about partner oriented training to treat aphasia

Objective: To find the common practices among speech language pathologists regarding partner-oriented training for aphasic patients. Method: The exploratory, qualitative study was conducted at Riphah International University, Lahore, Pakistan, from March 1 to May 31, 2021, and comprised speech language pathologists working with aphasiac patients for at least 5 years in Lahore, Karachi and Islamabad. Data was collected using a structured interview guide that were conducted online. The recorded interviews were transcribed, and the data was subjected to thematic analysis. Result: Of the 10 subjects, 6(60%) were females and 4(40%) were males. Overall, 6(60%) subjects had professional experience of >10 years. Thematic analysis showed that most of the speech language pathologists used traditional approaches for aphasia treatment, and counselling of patient’s caregiver was done. However, there was no formal tool in Urdu language to provide basic communication strategies for the patient’s caregivers or their communication partners. The participants recommended efforts to develop such a tool. Conclusion: There was found a dire need of communication partner training (CPT) programme for aphasia patients and their significant others with appropriate linguistic and cultural norms to facilitate them with the aim of improving their quality of life. Key Words: Aphasia, Quality of life, Speech therapies, Acquired communication disorder, Partner communication.

Men's Suicide in Bangladesh: Impressions From the Socio-Ecological System Theory.

Suicide is a multilayered social behaviour containing overlapping components from individual to social spheres. This article discusses the findings of the context of male suicide in Bangladesh based on Bronfenbrenner's socio-ecological theory. The socio-ecological perspective allows to determine the risk factors of suicide at multiple levels. Fifteen male suicide cases were purposively selected from several rural areas of the Jhenaidah district which is known for high rates of suicide. Qualitative in-depth interviews (three for each case) with persons who are significant others to the deceased delineate the interactive context of suicide. While the analysis deductively hinges on four major themes (e.g., individual/micro, interpersonal/meso, community/exo, and societal/macro factors) in consonance with socio-ecological theory, ten sub-themes were inductively identified from the intriguing meanings of the interviews. Considering the integrative nature of suicide, the study underscores the necessity to introduce a multi-sectoral approach to effectively prevent suicide in Bangladesh.