The mental health benefits and costs of critical consciousness: A longitudinal investigation of the co-occurring positive and negative effects of critical consciousness among sexual minorities.

Critical consciousness is a powerful tool for individuals from marginalized groups to transcend their oppressive conditions through engagement in critical reflection, motivation, and action. Nonetheless, the mental health benefits and costs of critical consciousness have received limited research attention. The present study utilized a longitudinal research design to explore the positive and negative relationships between critical consciousness and mental health among sexual minority individuals in different developmental stages. A total of 636 sexual minority individuals were involved in the baseline study and were asked to complete a follow-up questionnaire after one year. The results demonstrated a co-occurrence of positive and negative effects of critical consciousness on mental health among sexual minority individuals across time. On the one hand, critical consciousness was associated with better mental health outcomes through the mediation of internalized oppression and community connectedness. Specifically, critical consciousness was associated with reduced internalized oppression, which in turn was linked to lower levels of emotional distress. Critical consciousness was also associated with heightened levels of community connectedness, which in turn was associated with improved well-being. On the other hand, the results revealed a positive direct effect of critical consciousness on emotional distress, after controlling for internalized oppression and community connectedness. Notably, developmental stage moderated the relationship between critical consciousness and well-being. A negative association between critical consciousness and well-being was observed among sexual minority youth, whereas no such association was found among sexual minority adults. While the study highlights that critical consciousness can be a pedagogical and therapeutic tool for the liberation and empowerment of sexual minority individuals, it is equally important to acknowledge the potential risks associated with critical consciousness. Striking a balance between critical consciousness and self-care is crucial for sustaining meaningful engagement in the pursuit of social change.

Gender identity differences in the experiences of family stressors and violence among transgender and non-binary individuals in China.

Emerging research has demonstrated that transgender and non-binary (TNB) individuals face an elevated risk of experiencing family rejection and violence. However, there remains a significant knowledge gap regarding how TNB individuals manage stressors and their gender identity within the family context, particularly in regions where TNB individuals are highly stigmatized and where legal protections against family violence are lacking. The present study represents one of the first pioneering efforts to provide large-scale quantitative data examining the experiences of family stressors, the management of gender identity and expression, and family violence among TNB individuals in China. A national sample of 1063 TNB individuals in China was involved in the study. They completed questionnaires about their experiences of family stressors and violence. The results indicated that 76.0% of TNB individuals reported having encountered at least one form of violence perpetrated by their family members. Transfeminine individuals were more likely to report experiencing emotional and physical abuse, whereas transmasculine individuals were more likely to be subjected to gender identity and/or expression change efforts. Family stressors, including family non-acceptance and the pressure to marry and reproduce, were positively associated with non-disclosure of gender identity, the suppression of gender expression, and family violence. The findings underscore the substantial burden of family violence borne by TNB individuals in China, which warrants immediate legal, institutional, and social responses. Trans-inclusive family violence prevention and intervention are urgently needed, with a focus on Chinese cultural factors and gender identity differences in violence screening and risk assessment.

The Pathways to Join, Engage in, and Quit Sexual Orientation Change Efforts (SOCE): A Qualitative Study of Sexual Minority Individuals who Self-Initiated SOCE in Hong Kong.

Despite the growing recognition of their harmful effects, sexual orientation change efforts (SOCE) continue to be practiced in various societies. This study examines the experiences of 11 sexual minority individuals in Hong Kong who have undergone SOCE. The findings reveal the pervasive influence of deeply ingrained homonegativity values within religious, family, educational, and soiocultural contexts during LGBTQ+ individuals' formative years. These prevailing stigmas compelled them to pursue SOCE through different methods. However, these methods have been proven ineffective and psychologically harmful, leading to increased distress and internalized homonegativity. The availability of knowledge and access to affirming LGBTQ+ values within religious, community, and sociocultural spheres played a crucial role in helping the respondents come to accept their sexual orientation and cease their attempts at SOCE. This study shed light on how the interplay of Chinese familial values and Christian doctrine in Hong Kong contributes to the promotion of homonegativity, consequently restricting the diverse expressions of sexuality. It is important to recognize that the notion of individuals actively "choosing" to undergo SOCE is misguided, as these decisions are often driven by social stigma and external pressures. Progress in this area requires confronting the systemic heteronormativity embedded within Hong Kong's cultural fabric.

Differential resilience effects of everyday political engagement against heterosexist victimization among sexual minority youth: The importance of identity-based action.

Everyday forms of political engagement, such as civic participation and collective action, have been recognized as a crucial factor for positive youth development, but less is known about their resilience effects on youth from marginalized populations, especially in less democratic societies. The present study investigated experiences of everyday political engagement among sexual minority youth in China and examined their compensatory and protective effects against heterosexist victimization. A sample of 793 Chinese sexual minority youth was included in the study. The results showed that collective action operated as a protective factor in buffering the effect of heterosexist victimization, such that its association with academic engagement was not significant among those with higher levels of collective action. In contrast, civic participation served the compensatory function and was associated with greater academic engagement, a stronger sense of school belonging, and fewer depression symptoms, but it did not protect against the negative effects of heterosexist victimization. The findings highlight the importance of identity-based action among sexual minority youth and provide insight into the differential resilience effects of everyday political engagement. The study has implications for fostering resilience among sexual minority youth with victimization experiences in school and counseling settings.

Sexual orientation disparities in developmental assets among youth: The mediating role of bullying victimization.

BACKGROUND: Navigating the developmental transition from adolescence to young adulthood while simultaneously integrating the emergence of a sexual minority identity can be overwhelming for lesbian, gay, bisexual, and questioning youth as the developmental tasks pose tremendous challenges to the cultivation of developmental assets, which are the building blocks necessary for fostering positive youth development and thriving. OBJECTIVES: The present study aimed to estimate the sexual orientation disparities in bullying victimization and developmental assets, investigate whether these sexual orientation differences varied by sex assigned at birth, and examine the mediating role of bullying victimization in the association between sexual orientation and developmental assets. METHODS: This study included a national sample of 3020 Chinese youth (51.5 % assigned male at birth; 48.5 % assigned female at birth) with a mean age of 15.71 years. They completed a self-report questionnaire on experiences of bullying victimization and developmental assets. RESULTS: Sexual minority and questioning youth showed significantly lower levels of developmental assets than heterosexual youth. The sexual orientation differences in developmental assets did not significantly differ by sex assigned at birth. In addition, sexual minority youth were at heightened risk of relational bullying than heterosexual youth. The results obtained from the structural equation modeling indicated that bullying victimization mediated the association of sexual orientation with developmental assets. Compared to heterosexual youth, sexual minority youth were more likely to be subjected to bullying, which was linked to lower levels of developmental assets. CONCLUSIONS: The study shows sexual orientation disparities in developmental assets among youth in China and reveals that the positive development of sexual minority youth may be hindered by their experiences of bullying victimization. The implications for positive psychological interventions and anti-bullying policies in Chinese educational settings are discussed.

Effects of identity disclosure on school victimization and long-term educational outcomes among lesbian, gay, bisexual, transgender, and intersex students in China.

This study examined identity disclosure among lesbian, gay, bisexual, transgender, and intersex (LGBTI) students in China and investigated the effects of coming out on school victimization as well as current academic performance and long-term educational outcomes. The study drew on a national sample of 9260 Chinese LGBTI students (age range = 12-42 years) and 9668 LGBTI individuals who were not in education (age range = 14-85 years). The results showed that LGBTI students were more likely to come out to their fellow students (61.4%) than to their teachers (42.4%). Approximately 40.2% of LGBTI students reported having encountered victimization in school, and they also were more likely to report school dropout and lower levels of educational attainment than those who did not experience school victimization. Transgender and gender nonconforming students and intersex students were particularly vulnerable to the experiences and adverse effects of school victimization. In addition, the findings indicated that although students who came out in school were more likely to experience school victimization, identity disclosure was related to better long-term educational outcomes. This study is one of the first to document the identity disclosure, victimization experiences, and school outcomes of LGBTI students in China. The results show that identity concealment may bring short-term benefits by protecting LGBTI students from school victimization but may be harmful to them in the longer run. To foster a supportive climate and a safe school environment, it is important to enact sexual and gender diversity education, inclusive school policies, and teacher training programs at different levels of schooling.

Contextual Influence of School-Level Gender Role Attitudes and Sexual Prejudice on Allyship, Bullying, and Internalized Homonegativity.

Previous studies have primarily used an individual differences approach to identify dispositional factors associated with bullying behavior, which often neglect the broader school context in which bullying occurs. The present study used a multilevel research design to examine the contextual influence of school normative climate on allyship, bullying, and internalized homonegativity. The study included 3020 students (M = 15.83 years, SD = 1.50) from ten secondary schools in China. The results showed that school-level gender role attitudes were positively associated with bullying perpetration among heterosexual students as well as bullying victimization and internalized homonegativity among LGBQA+ students. In addition, there was a negative association between school-level sexual prejudice and allyship among heterosexual students. The findings demonstrate the contextual influence of school normative climate and highlight the need for regular school climate assessments, so that appropriate instructions, policies, and practices can be implemented to address gender biases and homophobia and the resulting bullying behavior.

Experiences of minority stress and their impact on suicidality among asexual individuals.

INTRODUCTION: While the asexual community has become increasingly visible, the pathologization and denial of asexuality remain strong, which may be linked to a higher prevalence of suicidality in this population. The present study examined experiences of minority stress and their relationship with suicidality among asexual individuals. METHODS: This study included a global sample of 12,449 individuals on the asexual spectrum. They completed an online survey assessing minority stress (including verbal aggression, victimization, and health care discrimination), impairment in different aspects of life, and suicidality. RESULTS: The results showed that 64.8 % of asexual individuals had experienced minority stress based on sexual and/or romantic orientation. Approximately 32.2 % reported suicidal ideation, 10.6 % had suicide plans, and 2.7 % had attempted suicide in the past 12 months. Suicidality was more prevalent among asexual men and non-binary individuals than among asexual women. Asexual individuals who were younger, identified as transgender, and lived in lower-income countries were more likely to report suicidality. Among the different dimensions of minority stress, victimization was most significantly associated with suicidal ideation, plans, and attempts. The positive association between minority stress and suicidality was mediated by impairment in health. LIMITATIONS: The cross-sectional nature of the data might prevent causal inferences from being drawn. Validated measures of asexual-specific minority stress were not available. CONCLUSION: The findings have implications for asexuality-affirming mental health practices supporting asexual individuals in coping with minority stress experiences. Public education efforts are needed to raise awareness of asexuality as a valid sexual orientation and to dispel misconceptions about asexuality.

Monosexism as an Additional Dimension of Minority Stress Affecting Mental Health among Bisexual and Pansexual Individuals in Hong Kong: The Role of Gender and Sexual Identity Integration.

Monosexism has been increasingly recognized as a minority stressor uniquely experienced by plurisexual individuals. The present study investigated the effects of monosexist discrimination on mental health and examined the moderating role of gender and sexual identity integration (i.e., negation, authenticity, and disclosure). In a sample of 314 bisexual and pansexual individuals in Hong Kong (73.9% women and 26.1% men), the results showed that monosexist discrimination was associated with higher levels of depression and anxiety symptoms, above and beyond heterosexist discrimination. The association between monosexist discrimination and depression symptoms was stronger among bisexual and pansexual men than women, despite there being no gender differences in vulnerability to monosexist discrimination. Moreover, sexual identity negation, authenticity, and disclosure moderated the associations of monosexist discrimination with depression and anxiety symptoms, such that the associations were not significant among those with more positive integration of sexual identity (i.e., lower levels of sexual identity negation as well as higher levels of sexual identity authenticity and disclosure). This study provides insight into the deleterious impact of monosexism and the protective role of sexual identity integration. Implications for plurisexual-affirming psychological intervention, public policy, and community practice are discussed.

Sex Conservatism, Internalized Homonegativity, PrEP Stigma, and Intention to Use PrEP: A Study of Chinese-Speaking Gay and Bisexual Male Youth in Hong Kong.

Pre-exposure prophylaxis (PrEP) stigma has been found to be a major barrier to PrEP acceptability and uptake. Research has found that different ethnic/cultural groups display varying levels of PrEP stigma. This article studies sex conservatism and internalized homonegativity as two sexuality- and culture-related aspects that influence PrEP stigma and intention to use PrEP. An online survey of 279 young gay and bisexual men in Hong Kong found that internalized homonegativity was positively associated with PrEP stigma. Respondents who were more conservative about sex showed lower intention to use PrEP, whereas those who had higher income and more positive attitudes about PrEP were more likely to express intention to use PrEP. This study provides novel empirical evidence for understanding PrEP stigma and uptake from a sexuality and cultural perspective. The influence of sexuality- and culture-related factors on PrEP stigma and uptake warrants greater attention, especially in the Asia-Pacific region.

Heterogeneity in the Desire to Undergo Various Gender-Affirming Medical Interventions Among Transgender People in Hong Kong: Findings from a Community-Driven Survey and Implications for the Legal Gender Recognition Debate.

Previous estimates suggest that there are at least nine million transgender people in Asia-Pacific; however, in most countries, legal gender recognition has not been made possible or there are otherwise stringent eligibility criteria. The obligation of having undergone gender-affirming medical interventions as a basis for such recognition is being hotly debated. However, there has been little empirical evidence on the desire to undergo various gender-affirming medical interventions among transgender people. This study fills the research gap by studying Hong Kong, where a transgender person must produce medical evidence for "complete" sex reassignment surgery in order to change the sex entry on their identity card. A community-driven survey of 234 transgender people found that only 13.0% of the participants who were assigned male at birth could fit such a requirement. Strikingly, because none of the participants assigned female at birth had undergone construction of a penis or some form of a penis, all of them would be excluded from legal gender recognition. Financial reasons and reservations about surgical risks and/or techniques were the most commonly cited reasons for not undertaking the medical interventions. The findings suggest that an overwhelming majority of transgender people in Hong Kong are excluded from legal gender recognition, which fundamentally affects their civil, political, economic, social, and cultural rights. More generally, this study shows heterogeneity among transgender people in the desire for different gender-affirming medical interventions, and thus argues that the legal gender recognition debate needs to consider their concerns and self-determination.

The Influence of Concerns About a Child's Sexual Orientation on Mental Health Among Parents of Lesbian, Gay, and Bisexual Children in Hong Kong.

Sexual minority stress affects not only lesbian, gay, and bisexual (LGB) individuals, but also their families. Due to the pervasiveness of stigma and discrimination, parents of LGB children often express concerns about the public perception of their child's sexual orientation and its possible impact on children, parents, and families. The concerns are particularly pertinent to parents in Chinese families, where there is a strong bond between parents and children. The present study seeks to understand the different dimensions of concerns among Chinese parents of LGB children and examine how these concerns affect their mental health. A total of 146 parents of LGB children in Hong Kong were recruited to participate in a survey regarding attitudes and concerns about their child's sexual orientation. The results revealed three areas of concern, which reflect parental worries about how a child's LGB identity may negatively impact the child, parent, and family. Parents who viewed homosexuality and bisexuality as innate and accepted their child's sexual orientation were likely to show fewer concerns. The results of structural equation modeling indicated that parental acceptance was negatively related to depression and anxiety symptoms through lower levels of child-oriented and family-oriented concerns. As accepting a child's sexual orientation is the key to reducing parental concerns and mental health problems, family-focused psychoeducation is needed to provide parents with accurate information about sexual orientation and foster supportive attitudes toward their LGB child. Clinicians and human service providers should also address child-oriented and family-oriented concerns among parents of LGB adolescents who are more inclined to be concerned about their child's sexual orientation.

Experiences of COVID-19 among Chinese-speaking lesbian, gay and bisexual people in Hong Kong: an inductive thematic analysis of survey response data.

As social inequalities during the COVID-19 pandemic have been recognised, emerging research showed that lesbian, gay and bisexual (LGB) people may be additionally affected during the pandemic. This paper adds to the understanding of the experiences of LGB people during the pandemic with a focus on Hong Kong, where issues of space significantly influence LGB people's lives in this city with high population density. As part of a larger community study of LGB lives in Hong Kong, COVID-19-related impact on 434 Chinese-speaking LGB people was explored. Data collection was conducted from 20 May to 30 June 2020. Inductive thematic analysis of the open-text response survey data found that the LGB participants described both negative and positive impacts brought by COVID-19. Such impacts could be dimensionalised into those related to personal space and privacy, romantic and sexual space, and community space. It was also found that the experiences of COVID-19 among LGB people in Hong Kong were intersectional, along the lines of living arrangement and relationship status. Such findings make unique contributions to the emerging literature. First, there needs to be a more nuanced understanding of sexual minority individuals' experiences during COVID-19 across cultural contexts. Second, COVID-19 was described as having brought positive impact in addition to its widely known negative impact.

Differentiation of self, proximal minority stress, and life satisfaction among sexual minorities: Intrapersonal and interpersonal pathways to life satisfaction.

Differentiation of self (DoS) is the self-regulatory capacity to balance intimacy and autonomy in relationships. Accumulating evidence suggests that DoS is fundamental to achieving a satisfying and fulfilling life. The ability may be even more relevant to lesbian, gay, and bisexual (LGB) individuals who are often in a continual struggle between disclosing their sexual identity and gaining social acceptance. However, less is known about whether and how DoS influences their experiences of proximal minority stress and life satisfaction. The present study proposed a dual-process model to explain the association between DoS and life satisfaction among sexual minorities. A total of 219 sexual minority individuals participated in the study and completed a self-report questionnaire on DoS, proximal minority stress, self-esteem, loneliness, and satisfaction in life. The results revealed the intrapersonal and interpersonal processes underlying DoS and life satisfaction, such that the association between DoS and life satisfaction was mediated by self-esteem and loneliness, respectively. Moreover, the results identified a minority stress-specific pathway through which DoS was linked to life satisfaction through reduced levels of proximal minority stress and loneliness. The findings provide empirical evidence for the role of DoS as a crucial factor in shaping how sexual minority individuals negotiate their boundaries and relationships with other people, which may affect their life satisfaction. Implications on social-emotional learning and LGB-affirmative psychological interventions for fostering DoS among sexual minority individuals were discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Effects of sexual orientation concealment on well-being among sexual minorities: How and when does concealment hurt?

As a common experience for sexual minority individuals, sexual orientation concealment has complex implications. Self-determination theory (SDT) and previous studies suggest a mediation path where hiding sexual orientation is associated with well-being through eroding lesbian, gay, bisexual-specific authenticity and inducing loneliness. However, this relationship has rarely been examined using longitudinal data. This study also built on minority stress theory to determine whether the psychological process of concealment operates differently as a function of perceived acceptance in different contexts. A community sample of 636 sexual minority individuals in Hong Kong (48.3% men, 50.5% women, and 1.3% transgender and nonbinary individuals; mean age = 25.36 years) was recruited through lesbian, gay, bisexual, and transgender (LGBT) social media, nongovernmental organizations, and social venues to complete a baseline and 1-year follow-up survey. The results showed that loneliness mediated the relationship between concealment and well-being. Moreover, the mediation path from concealment to well-being via loneliness was moderated by the perceived LGBT-friendliness of the family. The negative association between concealment and well-being was only significant when the family was perceived as supportive of sexual and gender minorities. The study findings elucidated the complex mechanisms involved in the adverse outcomes of sexual orientation concealment and highlighted the importance of loneliness and family context when working with sexual minority clients on their concerns over sexual orientation concealment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Dyadic associations between COVID-19-related stress and mental well-being among parents and children in Hong Kong: An actor-partner interdependence model approach.

The spread of COVID-19 and its subsequent social distancing policies have profoundly impacted the lives of parents and children. Prolonged exposure to parenting-related responsibilities and heightened levels of family conflict under stay-at-home orders coupled with reduced access to support systems and resources have rendered parents and children more prone to stress and mental health difficulties. Drawing on a transactional model of parent-child interactions, the present study applied an actor-partner interdependence model approach to examine the transactional relationship between COVID-19-related stress and mental well-being among parents and children. Data from 109 Chinese parent-child dyads in Hong Kong were included in the study. Parents and their 8- to 10-year-old children completed a questionnaire on COVID-19-related stress, parent-child relationships, and mental well-being. The results showed that 53.2% and 30.3% of the parents and children, respectively, showed poor mental well-being, indicating possible emotional problems. Both actor and partner effects of parent COVID-19-related stress were found. Parent COVID-19-related stress was indirectly related to lower levels of parent and child mental well-being, through the mediation of parent-child conflict. To facilitate psychological adjustment following the COVID-19 outbreak, effective family-based mental health and parenting interventions are needed to promote family cohesion and alleviate stress-induced psychological symptoms. Even in the time of social distancing, telepsychotherapy and other online non-psychotherapeutic interventions can serve as a valid alternative for parents and children who experience excessive distress. Implications for psychological services, family-friendly policies, and social protection measures are also discussed.

Effects of Online Heterosexist Experiences on Physical and Mental Health in Sexual Minorities: An Examination of the Cognitive and Affective Mechanisms.

Cyber violence has emerged as a new source of minority stress over the past decade. Due to the anonymous and unrestrictive nature of the internet, cyber violence is even more blatant and pervasive than in person violence for sexual minority individuals. The present study aimed to examine whether and how online and offline experiences of heterosexism are related to physical and mental health. A total of 941 sexual minority individuals participated in a community-based online survey study. The findings indicated that online heterosexist experiences explained variance in physical and mental health, beyond the contribution of offline heterosexist experiences. Among sexual minority young adults, the effect of online heterosexist experiences on mental health was stronger than that of offline heterosexist experiences, whereas the association between online heterosexist experiences and health problems was not observed in the adult sample. The results of mediation analysis showed that heterosexist experiences were related to heightened expectations of rejection, which, in turn, were related to poor physical and mental health. The association of heterosexist experiences and mental health was also mediated by negative affect. Given the detrimental effect of online heterosexist experiences, effective interventions are needed to combat cyber violence motivated by sexual orientation and enhance the coping and confrontation strategies in response to harmful online content.

Elevated Levels of COVID-19-Related Stress and Mental Health Problems Among Parents of Children with Developmental Disorders During the Pandemic.

COVID-19 not only threatens people's physical health, but also creates disruption in work and social relationships. Parents may even experience additional strain resulting from childcare responsibilities. A total of 129 parents participated in this study. Parents of children with developmental disorders showed higher levels of parenting stress, depressive symptoms, and anxiety symptoms than did parents of children with typical development. Parenting stress and health worries were positively related to mental health symptoms. The association between having a child with developmental disorders and mental health symptoms was mediated by parenting stress. This study provides a timely investigation into the stress and mental health of parents during the COVID-19 pandemic. Implications on web-based parenting skills interventions, online psychological support services, and family-friendly policy initiatives are discussed.

Resistance as a form of resilience in sexual and gender minorities: Differential moderating roles of collective action on the discrimination-depression relationship among sexual minority men and women.

BACKGROUND: As a fundamental means for transforming and advancing the conditions of lesbian, gay, bisexual, and transgender (LGBT) individuals, collective action has gained increasing attention in research, policy, and practice over the past decade. While collective action is influential in driving public awareness and policy changes, less is known about its psychological effects on individuals undertaking collective action. METHODS: The present study developed a scale to measure collective action for LGBT rights and examined the underlying dimensions of collective action in a sample of 1050 LGBT individuals in Hong Kong. The moderating roles of collective action on the relationship between perceived discrimination and depressive symptoms were also examined. RESULTS: The LGBT Collective Action Scale measured two dimensions of collective action, i.e., private and public collective action. Private collective action moderated the association between perceived discrimination and depressive symptoms among sexual minority men and women; however, the moderating effect of public collective action was only found in sexual minority women. CONCLUSIONS: These differential moderating effects could be attributed to gender role socialization and gender-specific coping mechanisms in response to minority stress. Although public collective action is more powerful in triggering structural changes than private collective action, individuals in less democratic societies may not necessarily have access to public collective action due to the absence of opportunity structures. Private collective action, which is able to be initiated and undertaken individually, can be directed to transform heterosexist biases in interpersonal context. For LGBT individuals in less democratic societies, private collective action may be a more manageable way to maintain mental health in the face of stigmatization.

Nine-Month Longitudinal Impact of Peer Support Workers' Recovery Attributes on Service Users' Recovery in Hong Kong.

OBJECTIVE: In this study, the authors investigated the longitudinal effect of the recovery attributes of peer support workers (PSWs) on users of mental health services in Hong Kong over a 9-month period. METHODS: Recovery attributes were measured among PSWs (N=26) employed by four local nongovernmental organizations before their commencement of service. The recovery-related outcomes of regular service users (N=181) were measured every 3 months for 9 months. Multilevel mixed-effects linear regression analyses with restricted maximum likelihood were used to analyze the possible association of PSWs' qualities on service users' recovery outcomes. The Holm-Bonferroni method was used to adjust for p values to account for multiple comparisons. RESULTS: Results showed that levels of hope and self-esteem among PSWs were statistically significantly associated with improvements in hope and empowerment among service users over time. CONCLUSIONS: PSWs' recovery attributes may benefit service users' personal recovery. Future exploration on the specific pathways of recovery attributes of PSWs on service users' recovery is suggested.