Resources and Support for Sexual Assault Survivors Receiving Services From the U.S. Air Force: What Survivors Say They Need for Recovery.

Sexual assault (SA) is a serious challenge faced by the U.S. military. Participants in this study included men and women who volunteered in response to a call for survivors of SA. Participants included active duty and reserve U.S. Air Force (USAF) members, spouses of service members, or civilian employees for the USAF (beneficiaries). The primary research question was, "if you could design the perfect response system to support survivors, what would be included in this system?" The research team conducted in-depth interviews with nine survivors. Next, 82 survivors completed a survey agreeing or disagreeing with strategies identified by interview participants to improve services for survivors and offered additional suggestions. Analysis revealed survivor recommendations to improve SA services.

Identifying and mitigating moral injury risks in military behavioral health providers.

The term "moral injury" was initially used to describe the multifaceted pain that service members feel after perpetrating, witnessing, or failing to prevent acts that conflict with their moral codes. More recently the term has been used to describe healthcare providers' pain stemming from their experiences serving on the frontlines of the healthcare system when: a medical error causes serious harm to patients, systems continuously impede their abilities to provide proper care, or providers assess that they have acted in ways that conflict with their professional ethics or oaths to "do no harm." This article explores moral injury risk at the intersection of military service and healthcare by examining challenges that military behavioral healthcare providers face. Leveraging moral injury definitions previously applied to service members (personal or witnessed transgressions) and in two healthcare contexts ("second victim" to adverse client outcomes and system-driven moral distress), as well as literature on ethical challenges in military behavioral health, this paper uncovers situations that may amplify military behavioral health providers' risks for moral injury. It concludes by offering policy and practice recommendations germane to military medicine aimed at alleviating pressures military behavioral healthcare providers face and mitigating moral injuries' potential ripple effects on provider wellness, retention and care quality.

How the COVID-19 Pandemic Can and Must Expand Social Worker e-Interventions for Mental Health, Family Wellness, and Beyond.

Both media and academic reports have highlighted COVID-19's negative impacts on mental health and safety in the United States, yet care and service gaps persist. Evidence suggests that a default to in-person service delivery did not meet clients' needs before the pandemic, and that unmet needs have ballooned since COVID-19 spread throughout the United States due to a combination of increased stress, social isolation, and fewer available services during lockdowns. This article reviews literature on online interventions' utility and effectiveness in preventing and treating problems likely exacerbated under pandemic conditions, including mental health conditions, anger, couple dynamics, parenting, and alcohol misuse. The article also describes barriers to evidence-based e-interventions' wider and more consistent use, highlights some vulnerable populations' unique service needs, outlines service gaps that online programs might effectively mitigate, and offers a path by which social workers can lead an interdisciplinary charge in researching, developing, and implementing e-interventions during the current pandemic and beyond.

Serving on multiple fronts: A grounded theory model of complex decision-making in military mental health care.

RATIONALE: Military mental health providers must navigate multiple competing professional boundaries when delivering care in complex cases. Currently no clear policy exists to balance clinical professional obligations to do no harm with potentially-contradictory military policies. Thusly, military providers may face Catch-22 situations where they must choose to seemingly neglect either their duty to the military or their duty to clinical professional standards. OBJECTIVE: Recognizing such situations as emblematic of role strain (Goode, 1960), this study employed a grounded theory approach to examine military mental health providers' decision-making in the face of competing professional demands. METHOD: An evolving, semi-structured interview guide steered discussions with 20 active duty and civilian mental health providers across 16 Air Force/Department of Defense facilities. Using a symbolic interactionism framework, three rounds of coding enabled increasing levels of abstraction, ultimately revealing a grounded theory model of complex decision-making. RESULTS: The final model includes four antecedents - training, resources, consultation, and clinic climate. Those antecedents influence development of three different role views: clinical professional, agent of the client, and agent of the military. Role views impact decision-making and provider behaviors that may either enhance or detract from quality care. Decision-making and provider behaviors link to consequences at the patient, provider, clinic, and community levels. CONCLUSIONS: The model offers insights into military mental health providers' growth versus burnout, and engagement in quality-enhancing versus -detracting behaviors. It also illuminates strategies military leaders might leverage to normalize and relieve provider role strain as a means to improve individual and community trust, wellness, and helpseeking.

Do online parenting programs create change?: A meta-analysis.

With online education and programs becoming increasingly common, it is necessary to examine their effectiveness. In this study, we conduct a meta-analysis of online parenting programs. In this meta-analysis, we included 28 studies yielding 127 effect sizes examining 15 outcome variables. We found that online parenting programs had the strongest effects on increasing positive parenting and parents' encouragement. We also found significant effects of reducing negative parent-child interactions, child problem behaviors, negative discipline strategies, parenting conflicts, parent stress, child anxiety, parent anger, and parent depression. Results also revealed programs' significant effects on increasing parent confidence, positive child behavior and parenting satisfaction. Comparisons of programs that included clinical support (meaning programs through which participants had access to content experts, therapists, or content specialists in conjunction with the online program) versus programs that only contained online components, revealed no significant differences in 6 program outcomes between programs with and without clinical support. Comparisons of programs provided to targeted populations versus general populations revealed no significant differences in four program outcomes between populations. Results suggest that online parenting programs can provide benefits for parents who may not be able to access in-person resources. (PsycInfo Database Record (c) 2020 APA, all rights reserved).