"Each week feels like a mountain": The impact of COVID-19 on mental health providers' wellbeing and clinical work.

The SARS-CoV-2 (COVID-19) pandemic has placed a tremendous strain on healthcare providers. Although there is a burgeoning body of literature on how COVID-19 has impacted frontline healthcare workers (i.e., providers treating COVID-19 patients), little attention has been dedicated to second-line workers (i.e., providers treating the mental health of people impacted by COVID-19). In this paper, we present findings from a thematic analysis of open text responses (n = 136) examining how COVID-19 shaped both the wellbeing of second-line workers, specifically mental health providers, as well as their clinical work in the early months of the COVID-19 pandemic in the United States. Results indicated that mental health providers were experiencing significant COVID-19-related burnout and poor physical and mental health outcomes. Participants described diminished negative effects on the quality of their clinical care from the burnout and trauma associated with COVID-19. Many also demonstrated resilience, identifying the duality of both negative (e.g., exhaustion) and positive (e.g., pride in helping others) meaning derived from their second-line work experiences. We conclude with recommendations for preventing and addressing burnout among mental health professionals in the era of COVID-19 and subsequent health emergencies.

The hole in my heart is closing: Indigenous relative reunification identity verification.

OBJECTIVE: The current study explored the experience of reunification as place identity verification for Indigenous individuals who were fostered/adopted as youth. BACKGROUND: Research on reunification tends to focus on disproportionality in child welfare and the factors associated with reunification. Few studies focus on experiences of reunification among Indigenous individuals including their perceptions and comprehensions about the reunification experience. METHOD: Data from 70 fostered/adopted Indigenous individuals that reunified during adulthood were analyzed from the Experiences of Adopted and Fostered Individuals Project. Inductive thematic analysis was used to examine open-ended survey data about experience of reunification. RESULTS: Three themes inductively emerged including: (1) relative reunification, (2) perceptions about reunification, and (3) comprehensions about reunification. During relative reunification, participants reunified with parent(s), extended caregiver(s), grandparent(s), sibling(s), cousin(s), niece(s)/nephew(s), and tribe. Participant's perceptions about reunification included happiness, relief, anger, mourning, and anxiety/excitement. Participant's comprehensions about reunification related to belonging, sense of place, history/heritage, healing, and resemblance. All five functions of place identity verification were met in reunification according to the Indigenous participant's voices. CONCLUSIONS: This study explored the experience of relative reunification of Indigenous individuals who were separated from their families of origin during childhood by foster care and adoption.

Marital quality and depression as mediators linking childhood maltreatment to adult physical health.

BACKGROUND: Childhood maltreatment is known to influence adult physical health among midlife adults. Evidence suggests that depressive symptoms mediate the association. However, research has discounted the role of marital quality in understanding health outcomes among adults maltreated in childhood. OBJECTIVE: To advance this line of inquiry, we examined the relationship between marital quality and depressive symptoms in a sequential mediation model linking childhood maltreatment to adult physical health over ten years. PARTICIPANTS AND SETTING: Our sample consisted of midlife adults (n = 550) from three waves of the Midlife Development in the United States (MIDUS) study. The majority (n = 91.4 %) were white. At MIDUS 2, the mean age was 54.84 (SD = 10.78) and the mean age at MIDUS 3 was 63.96 (SD = 10.81). METHODS: Structural equation modeling was used to examine the degree to which marital quality and depressive symptoms mediated the relationship between childhood maltreatment and adult physical outcomes. Bootstrapping procedures were used to estimate the indirect effects. RESULTS: The serial mediation effects from maltreatment to adult physical health through marital quality and depressive symptoms were significant. Likewise, the simple indirect effects from maltreatment to subjective evaluations and the number of chronic health conditions through depressive symptoms were also significant. CONCLUSIONS: Childhood maltreatment is linked to adult physical health problems through marital quality and depressive symptoms, suggesting that the quality of adult marriages may play a critical role in health outcomes. Improving the quality of marriages may reduce risk factors, such as depression, that potentate future physical health problems.

Criticism, Compassion, and Conspiracy Theories: A Thematic Analysis of What Twitter Users Are Saying About COVID-19 in Correctional Settings.

We examined Twitter data using thematic analysis to understand public perceptions of the impact of COVID-19 on incarcerated people and reactions to including incarcerated populations in the early phases of the vaccine rollout. Our findings from n = 513 Tweets yielded six themes: Twitter as usual, Advocacy, Deserve to suffer, Vaccine priority debate, Inadequate response, and Misinformation. Stigma-laden statements cut across themes, highlighting the role pathologizing beliefs play in forming opinions about incarcerated people in public health crises. Trust of government response and buy-in to public health communication are positively associated with adherence to guidelines. Although public health decisions are derived from logic and research, our findings indicate that public perception may be driven by personal morals and stigma associated with justice-involved individuals. We recommend that attention be turned toward effective policy messaging, and use of social media, to increase trust and decrease stigma that tends to dominate societal perception.

Against the Odds: A Structural Equation Analysis of Family Resilience Processes during Paternal Incarceration.

On any given day, approximately 2.1 million children in Europe have an incarcerated parent. Although research indicates that material hardship is associated with parental incarceration, and particularly paternal incarceration, little is known about family processes that may mitigate the harmful effects of such hardship on children with an incarcerated parent. Guided by a resilience framework, this study examined how family processes mediate the effects of material hardship on youth academic adjustment within the context of paternal incarceration. Using Danish data that assessed key family constructs, structural equation modeling was used to perform a mediational within-group analysis of primary caregivers (n = 727) to children with an incarcerated father. Results indicate that although social support and parenting skills did not yield mediating effects, caregiver mental health strongly mediated the effects of material hardship on youth academic adjustment during paternal incarceration. Findings suggest that economic conditions, as well as caregiver mental health symptoms, are important areas of intervention that may promote family-level resilience for youth of an imprisoned father. We conclude with research and practice recommendations to advance our understanding of resilience among families with an incarcerated parent.

The transition to teletherapy in marriage and family therapy training settings during COVID-19: What do the data tell us?

In the wake of the COVID-19 pandemic, little is known about how university training programs transitioned to teletherapy. This study describes the transition of two university marriage and family therapy (i.e., master's and doctoral) training clinics to teletherapy and presents preliminary analyses of the types of clients and cases that converted to teletherapy. A series of chi-square analyses, a t-test, a logistic regression model, and a multiple linear regression model were employed. Four key findings emerged: (1) most cases converted to teletherapy; (2) Hispanic ethnicity was the only demographic characteristic to significantly predict conversion to teletherapy; (3) individual cases were significantly more likely to convert to teletherapy than relational cases; and (4) the number of prior in-person sessions attended significantly predicted conversion to teletherapy. Teletherapy conversion implications are discussed across four systemic levels: client, student trainee, supervision, and larger systems.

From Private Practice to Academia: Integrating social and political advocacy into every MFT Identity.

While advocacy was essential to establishing the field of marriage and family therapy, at present a social and political advocacy skill set is lacking for the typical marriage and family therapist (MFT). This article reviews the importance of being active in social and political advocacy and highlights the attributes of MFTs' professional identity that uniquely position us for success in these areas. Other mental health fields' pedagogical approaches to training and education are explored, and recommendations are made for how MFTs can begin to increase their competency in advocacy. Ideas for incorporating advocacy into a professional identity are presented for MFTs at every level of professional experience. Finally, the concept self-of-the-advocate is introduced and discussed.