The disproportionate increase in suicide rates among female Veterans, particularly those not currently using Veterans Healthcare Administration (VHA) care, has underscored the need to understand how to reach these Veterans. The Vulnerability, Stress, and Adaptation model was used to explore how being female in a militarized masculine environment contributes to their health and well-being. This study explored how female military experience influenced the health-seeking behaviors during and after active service. A phenomenological heuristic qualitative study with 11 female Veterans (M length of service = 10 years; Service Range = 3 to 27 years) was conducted using a semi-structured interview guide. The thematic analysis found two main themes and corresponding subthemes that prevented participants from accessing health services: misogyny and poor healthcare. Clinical and research implications are discussed.

Asian Americans (AAs) are the fastest growing ethnic group in the United States, with an 88% increase from 2000 to 2019. Alongside this population growth, the rate of suicide among AAs has also risen, particularly within the East AAs community, the focus of this study. The study involved 195 second-generation AA participants. Path analysis was conducted to examine the associations among bicultural identity integration, conflict stemming from parental expectations, depression, and experiences of discrimination with the constructs of belongingness and burdensomeness-central elements of the interpersonal theory of suicide (ITS). Findings indicate that greater integration into both the East AAs and U.S. American cultural contexts enhance feelings of belongingness, which subsequently reduces suicidal ideation. In contrast, elevated conflict due to parental expectations and greater depression symptoms were linked to increased feelings of burdensomeness, thereby increasing risk for suicidal ideation, planning, and attempts. Although discrimination showed significant correlations with thwarted belongingness and suicidality, belongingness did not mediate the relationship between discrimination and suicidal outcomes. Clinical and research implications of these findings are discussed.

The purpose of this mixed-method study was to better understand how social isolation and support would be associated with depression among older adults in rural areas in the U.S. during the COVID-19 pandemic. A total of 103 participants completed a Qualtrics survey. As hypothesized, the hierarchical regression findings indicated that depressive symptoms were positively associated with social isolation and were negatively associated with only social support from significant others. Five interviews were analyzed by themes including social isolation, technology use and social connectivity/support, and depression. The findings of this study provide insights and useful information for practitioners to develop effective services.

La thérapie de désensibilisation et de retraitement par les mouvements oculaires (EMDR) est considérée comme un traitement fondé sur des données probantes pour le traitement du trouble stress post-traumatique (TSPT) chez l’adulte, mais il y a des différences dans la façon dont les diverses directives internationales de traitement jugent la solidité de cette base de preuves. En outre, dans des domaines autres que le TSPT de l’adulte, les principales lignes directrices diffèrent encore davantage quant à la solidité de ces preuves et quant au moment où on utilisera l’EMDR. En 2019 a été lancée la Commission de chercheurs sur l’avenir de la thérapie EMDR ( Council of Scholars : The Future of EMDR Therapy Project ). Plusieurs groupes de travail ont été créés dans cette commission, l’un d’entre eux étant centré sur la recherche. Le présent article a été produit par ce groupe de travail. Le groupe a tout d’abord conclu qu’il y avait cinq domaines pour lesquels il existait une certaine base factuelle indiquant que l’EMDR était efficace, mais que davantage de données étaient nécessaires pour augmenter la probabilité qu’elle soit prise en compte dans les futures directives internationales de traitement. Ces domaines couvraient le TSPT chez les enfants et les adolescents, les interventions EMDR précoces, les TSPT liés aux conflits armés, la dépression unipolaire et la douleur chronique. Les recherches portant sur le rapport coût-efficacité de la thérapie EMDR ont été en outre identifiées comme l’une des priorités à aborder. Nous avons employé un système de hiérarchisation pour classer et évaluer les preuves dans les différents domaines abordés. Après avoir évalué les 120 études de résultats relatives à ces domaines, nous concluons ici que pour deux d’entre eux (le TSPT chez l’enfant et l’adolescent, et les recherches portant sur les interventions EMDR précoces), la force des preuves est évaluée au niveau le plus élevé, tandis que les autres domaines obtiennent le deuxième niveau le plus élevé. Nous formulons également quelques recommandations générales pour améliorer la qualité des futures recherches sur l’efficacité de la thérapie EMDR.

The study examined how Black heterosexual couples cope with the impact of racial discrimination on their relationship. The Vulnerability Stress Adaptation (VSA) model was utilized to examine the role of self-compassion in mitigating negative interaction in the relationship and how racial discrimination might disrupt this protective process. Further, the influence of open communication on the relationship between negative interaction and overall relationship satisfaction was explored. Participants included 210 Black married heterosexual couples. A common-fate moderated mediation model was used to analyze the data. The results indicated that first, higher levels of self-compassion in both spouses were associated with lower negative interaction within the couple's relationship. Second, among wives, the relationship between self-compassion and negative interaction changed in response to higher levels of racial discrimination. Third, couples' negative interaction suppressed the positive effects of self-compassion on overall relationship satisfaction. Fourth, for wives, the level of open communication played a role in the relationship between negative interaction and relationship satisfaction. Fifth, specifically for wives, the extent to which self-compassion was related to relationship satisfaction through negative interaction depended on the level of discrimination perceived by wives and the degree of open communication in their relationships. The findings have implications for clinical work and further research.

Muslims in the USA experience unfair treatment and direct exposure to discriminatory acts because of their religion. Trauma stemming from discrimination can strengthen couples' relationships as they find solace in each other, or strain relationships if couples struggle to cope with the stress. This study examined the relationship between experiencing anti-Muslim hate and couples' interactional quality. Further, the role of open communication between partners in moderating the impact of anti-Muslim hate on couple interactions was examined. The study included a sample of 129 Muslim couples. The results indicated gender disparity whereby anti-Muslim hate was linked to negative interactions in relationships for Muslim women, but this was not true for their male partners. In addition, open communication had contracting gender effects on the relationship between anti-Muslim hate and couple interactions. Increased self-disclosure buffered the adverse effects of anti-Muslim hate by reducing the likelihood of negative interactions. Among women, increased self-disclosure exacerbated the detrimental effects of anti-Muslim hate on the couples' relationship such that couples engaged in more negative interactions. Clinical implications are discussed.

While eye movement desensitization and reprocessing (EMDR) is considered an evidence-based treatment for posttraumatic stress disorder (PTSD) in adults, there are differences as to how various international treatment guidelines judge the strength of this evidence base. Furthermore, in areas other than adult PTSD, major guidelines differ even more as to the strength of the evidence base and when to use EMDR. In 2019, the Council of Scholars: The Future of EMDR Therapy Project was initiated. Several working groups were established, with one assigned to the focus area of research. This article is a product of that working group. Firstly the group concluded that there were five areas where there was some base that EMDR was effective, but more data were needed to increase the likelihood that it would be considered in future international treatment guidelines. These areas were PTSD in children and adolescents, early EMDR interventions, combat PTSD, unipolar depression, and chronic pain. In addition, research into cost-effectiveness of EMDR therapy was identified as one of the priorities. A hierarchical system was used for classifying and rating evidence in the focus areas. After assessing the 120 outcome studies pertaining to the focus areas, we conclude that for two of the areas (i.e., PTSD in children and adolescents and EMDR early interventions research) the strength of the evidence is rated at the highest level, whereas the other areas obtain the second highest level. Some general recommendations for improving the quality of future research on the effectiveness of EMDR therapy are formulated.

Eye Movement Desensitization and Reprocessing (EMDR) has demonstrated efficacy in treating major depressive disorder. EMDR increases cerebral perfusion in the anterior cingulate cortex (ACC) and dorsolateral prefrontal cortex (dlPFC). Activity in the ACC and dlPFC can be measured by theta cordance (TC) but has not been examined in EMDR. Ten participants (3 men, 7 women, M age = 42.31 +/- 15.03) received ten 75 +/- 15 minute EMDR sessions over 6.5 +/- .5 weeks. Results indicated that PHQ-9 depression scores reduced from T1 (M = 13.9 +/- 3.31) to T11 (M = 6.30 +/- 3.23) with EMDR (SMD = 2.30), and that fTC but not pfTC was significantly related to this change. Depression declined as fTC declined. EMDR may engage the dlPFC or ACC that modulates depression and aid in reducing fTC and thus depression levels.

In this chapter, we describe intervention efforts aimed at promoting maintenance behaviors in romantic relationships and the factors that influence these initiatives. We highlight current cultural forces surrounding clinical and educational practices, the definitions and theories that inform interventions to sustain and enhance partners’ maintenance behaviors, and important considerations for increasing the effectiveness of these interventions. The interventions featured in our review focus on enhancing positive aspects of relationships or mitigating threat to relationship maintenance processes within the cultural context of contemporary relationships. Suggestions for advancing the field include further research on the relevance of specific maintenance strategies and theories of change across the life course, the influence of cultural context and resilience on maintenance processes, unintended consequences of relationship maintenance interventions, and the evaluation process for interventions promoting maintenance behaviors.

Muslims are frequent targets of negative stereotypes and discrimination, especially after the 9/11 attacks and the rhetoric of the 2016 U.S. presidential election campaign. This study examined how 129 American Muslim couples cope with perceived religion-based discrimination. Results indicate that perceiving that one's religion is accepted by the community is negatively related to discrimination, and overt markers of Islam for men (clothing/grooming styles) is positively related to discrimination. Further, discrimination is linked with negative interactions between couples, which in turn is linked to lower relationship satisfaction. In other words, discrimination has an indirect effect on satisfaction through negative couple interactions. This indirect effect can be buffered by couples' joint coping skills only when these skills are sufficiently developed.

"Thank You Message from the Editor-in-Chief." Journal of Feminist Family Therapy, 32(3-4), pp. 155–156

Street/public harassment framed as stranger intrusion more accurately recognizes and accounts for the potential harm perpetrated on survivors of harassment. Considering the #MeToo Movement, this paper highlights the ubiquitous nature of street/public harassment and the overlooked emotional and physical harm daily perpetrated in public spaces onto marginalized groups. This paper describes possible healing and meaning making that gendering and renaming street/public harassment can offer to survivors of such harassment, what helps perpetuate such acts, recourse for survivors, and the role of practitioners and family scholars in combatting the origins and effects of street/public harassment. Implications of understanding the harm of stranger intrusion include working towards social change to non-normalize stranger intrusion, facilitating healing, and working with perpetrators to increase accountability.

Background: The intense nature of the camp experience and the unique role of camp counselors can be a rewarding experience for camp counselors and campers alike. However, to experience compassion satisfaction necessitates evaluation of a number of factors that may enhance or decrease compassion satisfaction. Purpose: To better understand the camp counselor experience of compassion satisfaction, this study examined the factors of self-compassion, self-care activities, stress, values progress, values obstruction, and burnout on compassion satisfaction. Methodology/Approach: Data from 27 female camp counselors (Mage = 20.33 years, 92.59% White/Caucasian, 85.18% undergraduate students) were collected 4 times over a 10-week period. A series of Bayesian linear regressions was conducted to examine the effect of these variables on compassion satisfaction. Findings/Conclusions: Compassion satisfaction was best explained by a combination of burnout (M = −0.67, 95% credible interval [CRI] = –[0.88, −0.48]), self-care activities (M = 0.38, 95% CRI = [0.10, 0.65]), and stress (M = 0.14, 95% CRI = [0.01, 0.26]). Implications: Factors such as burnout, self-care activities, and stress contribute both negatively and positively on camp counselor compassion satisfaction. Suggestions for how to address each are addressed in addition to the importance of training interventions to enhance camp counselor compassion satisfaction.

Introduction: The purpose of the study was to gain understanding of the health issues and needs of rural adolescents by listening to their voices and eliciting their personal perspectives. Rural counties in the USA are defined as having 6-19.9 persons per square mile. Method: Focus group interviews were conducted with 65 adolescents aged between 13 and 19 years old, from four rural counties in the USA. These counties are medically underserved with one primary care physician per 3500 population. Grounded theory analysis was utilized to identify overarching themes. Results: Thematic content analysis revealed two themes of health issues - making healthy choices and lack of pro-social, health-promoting role models - and four themes of health needs - privacy, reliable information, accessible health care, and prioritizing health. The findings that speak to the complexity of adolescent health go beyond the inability to access health care and may provide important information that can help mitigate some of the obstacles to adolescents accessing health care in rural settings. A main contributor to adolescents' health choices is the lack of positive role models. Adolescents look for role models in their parents, siblings, peers and adults in their communities. The absence of positive role models means adolescents lack guidance at an age when they are highly impressionable. Contrary to general perceptions that adolescents do not want to affiliate with their parents, adolescents in this study desired connection with their parents and adults in general. Adolescents in the study called for 'frank' discussions with adults about stress management, consequences of substance abuse, realities of adolescent pregnancy and sexual health. It is through open dialogue and frank conversations with adults that adolescents believe they would best obtain the type of credible, realistic health information they need. Common features of rural settings such as familiarity and close-knit communities, though integral in developing a sense belonging, can be an impediment to privacy. Lack of exposure and resources to educate residents of rural communities may enhance biases against the mentally and physically ill. Biases can lead to the stigma associated with seeking health care that in turn leads to distancing and fear promotion, making it difficult, and at times impossible, for adolescents to seek the health care they need. Conclusions: Barriers to developmentally necessary health care and health information that all adolescents need are compounded by the unique rural socio-environment and the involvement of multiple systems - family, school, peers, and healthcare providers-rooted within communities that may hinder adolescents from becoming thriving, contributing citizens. It is crucial that adults in rural communities seek to hear, strengthen, and empower young people through education, sharing of personal experiences and struggles, focusing adolescents' time and energies on positive, pro-health activities, and providing positive role models. Attaining and maintaining good health is a lifelong process. Learning how to be healthy takes time and effort. Communities that lack recreational resources for adolescents to have positive 'down time to unwind', engage with others in the community and re-energize do a disservice to adolescents who want to be active and thriving. The lack of healthy forms of recreation and community engagement can lead to boredom, and engagement in activities that may not be the safest or healthiest.

This study examined how open communication between spouses may buffer against discrimination experienced by Black-White couples. Results from 178 couples analyzed using a combination of common-fate and actor-partner interdependence models, indicated that for Black partners, marital satisfaction was not contingent on the level of openness when experiences of couple discrimination were low. When experiences of couple discrimination were high, levels of marital satisfaction were maintained among partners who reported high openness and reduced among partners who reported low openness. Moderation effects were not found for White partners. The results suggest that because Black partners are more aware of and sensitized to discrimination, White partners' abilities to attune to their partners' needs for support could help enhance their relationships.

In Turkey, conflicts with parents-in-law can be shaped by opposing viewpoints that can emerge from the coexistence of modern secular and Islamic traditions. The integral role of parents-in-law in Turkish families makes it important to understand the nature of conflict between couples and their in-laws, and how these conflicts are managed. Guided by structural family theory, this preliminary study aims to explore the nature and management of conflict between parents-in-law and couples. This interpretive phenomenological study analyzed semi-structured interviews conducted with four Turkish couples. Conflicts with parents-in-law appeared to be gendered in nature and stemmed from unmet expectations and family roles. Gender also influenced how conflict was resolved. Daughters-in-law tended to avoid conflict by remaining silent, and sons-in-law were more forthcoming about their dissatisfactions or took the blame to avoid conflict. In-laws of opposite sex appeared to have more contemptuous relationships compared to in-laws of the same sex. Implications for clinical work and research are discussed.

The experience of exercise among women survivors of sexual violence is a multifaceted phenomenon. In effort to inform treatment interventions, we used a phenomenological approach to describe the lived experience of exercise among women survivors of sexual violence. Data analysis from a focus group discussion and individual interviews with eight women survivors receiving services at a rape crisis center (RCC) revealed four themes: exercising (and not exercising) fosters safety, exercising is risky, past trauma restricts exercise choices, and exercising is beneficial. Findings indicate that survivors’ experience of exercise is related to their connections with self and their social environment. Survivors’ choices related to exercise were impacted by their stage of recovery. A variety of social-contextual factors appeared to support or impede motivation to exercise and it was not disinterest in exercise or low confidence in the ability to exercise, but restricted exercise options perceived as safe that influenced exercise motivation.

This study examined the impact of technology on couples in committed relationships through the lens of the couple and technology framework. Specifically, we used data from 6,756 European couples to examine associations between online boundary crossing, online intrusion, relationship satisfaction, and partner responsiveness. The results suggest that participants’ reports of online boundary crossing were linked with lower relationship satisfaction and partner responsiveness. Also, lower relationship satisfaction and partner responsiveness were associated with increased online boundary crossing. The results suggest that men, but not women, who reported greater acceptability for online boundary crossing were more likely to have partners who reported lower relationship satisfaction in their relationships. Implications for clinicians, relationship educators, and researchers are discussed.