The transition to fatherhood - evaluation of an online intervention for New fathers.

This mixed-methods study explores an innovative online group intervention for new fathers. The specific aims were to investigate attendance rates, fathers' participation experiences, and the effects on their psychological well-being and marital quality. The research design included a randomized controlled trial with 122 participants split into intervention (n = 62) and comparison groups (n = 60). The study measured post-partum depression symptoms (PPD) using the Edinburgh Post-Natal Depression Scale (EPDS) and spousal relationship quality using the Israeli Marital Quality Scale (IMQS). Qualitative data were collected through session transcripts and feedback questionnaires that were completed two years post- intervention. Results reveal an 86.47% average attendance rate in the intervention groups and positive outcomes at both individual and spousal levels. Participants reported feeling a sense of normalcy, decreased loneliness, increased awareness of fatherhood transition, and becoming active co-parents. Marital quality also showed better results for the intervention group. Further research is recommended to explore online group interventions among additional groups of post-partum fathers.

Editorial: Health and Well-Being Related to New Family Forms: Perspectives of Adults, Couples, Children, and Professionals.

The aim of this Special Issue is to advance our understanding of the factors that shape the experience, well-being, and mental health of individuals on their path to creating new family forms, including adults and children, and to inform the development of policies and practices designed to promote the thriving of these families. This Special Issue contains a collection of 13 papers that shed light on a range of micro- and macro-level factors contributing to the experience and outcomes of members of new family forms from various countries, such as the UK, Israel, Italy, China, Portugal, the Netherlands, the US, and Russia. The papers extend the current knowledge on the subject from a variety of perspectives, including medical, psychological, social, and digital communications. Their findings can aid professionals supporting members of new family forms to recognize the similarities and challenges they share with their counterparts in traditional heterosexual two-parent families, as well as their unique needs and strengths. They may also encourage policymakers to promote laws and policies designed to address the cultural, legal, and institutional constraints facing these families. Based on the overall picture that emerges from this Special Issue, we suggest valuable avenues for future research.

The Social Experiences of Single Gay Fathers in Israel: An Intersectional Perspective.

Through an intersectional lens, this study explores the experience of being a single gay father by choice in Israeli society, which continues to view the traditional heterosexual two-parent family as the ideal. Analysis of 15 in-depth, semi-structured interviews with single gay Israeli fathers suggests that their experiences are characterized by constant tension between their self-perceived social acceptance and sense of belonging on the one hand and their encounters with discrimination and bias on the other. The findings shed light on the ways in which the fathers' complex experiences are shaped by the intersection between their identity as parents and their two marginalized identities: single male parents and gay fathers. These identities were found to be highly contextual and affected by macro-level factors. As the fathers cope with their environment, they develop a sense of belonging alongside a deep sense of otherness, suggesting that the sense of belonging and the sense of otherness are not binary opposites, but rather two social categories that are continually constructed through the intersection between different identities and their interaction with macro-level factors, making single gay parenthood a multidimensional experience.

Lone parenthood in the COVID-19 context: Israeli single gay fathers' perspective.

This article focuses on Israeli single gay fathers, using the Stress Process Model (SPM) as a framework to investigate their fathering experiences during the COVID-19 pandemic. Thematic analysis of 15 in-depth semi-structured interviews with Israeli single gay fathers during the third national lockdown revealed that their parenting experiences during the pandemic were shaped by both COVID-related stress exposure and interpersonal resources, which the fathers viewed as interactive. These fathers described three main pandemic-specific stressors: financial insecurity and workplace transformation, feelings of loneliness and isolation and health-related fears. Our findings highlight the cumulative effects of these stressors on the fathers' well-being. The fathers also described the ways in which their interpersonal resources (i.e., social networks and strengthened relationship with their children during the pandemic) facilitated their coping with the pandemic-related stressors. The study highlights the need for social workers to recognize the emerging family forms and to broaden their approach to parents during a time of ongoing community crisis, by addressing the differential effects on parents in diverse family structures.

"Is There Room for Both Loves?": The Experience of Couplehood Among Women Living With a Widower With Young Children.

Very few studies to date have explored the couplehood relationship in blended families with young children created after widowhood. This study sought to add to our knowledge of this issue by examining the couplehood experience of women who started a family with a widower with young children, with no children of their own. Semi-structured interviews were conducted with 30 Israeli women aged 32-78 years. The findings indicate that many participants feel that the deceased wife continues to be present in their partner's life and that she is an integral part of their couplehood relationship. The participants described two subsystems existing alongside the couple subsystem with their partner, namely, the partner's spousal subsystem with his first wife; and a triadic subsystem consisting of the woman, her partner, and his deceased wife. The perceived presence of the first wife raised poignant questions concerning the place of the two women in the partner's life. Participants' narratives revealed the dissonance between understanding and acknowledging their partner's continuing bond with and affection for his deceased wife on the one hand, and recognition of his love for them on the other hand. The findings shed light on the complexity inherent in a couple relationship with a widower and may assist professionals who provide support to blended families in understanding the unique challenges faced by these women. This would enable them to tailor their counseling and the therapeutic process to the particular needs of these women.

"I Kind of Want to Want": Women Who Are Undecided About Becoming Mothers.

This study focuses on women who define themselves as being undecided about becoming mothers. It addresses the question of how these women navigate their lives between two main conflicting cultural directives and perceptions: pronatalism and familism entwined in perception of linear time on one hand; and individualism and its counterpart, the notion of flexible liquid society, on the other. The research is based on group meetings designated for these women, which were facilitated by the first author. Ten women participated in the study-of whom, most were heterosexual, half were single, and half were partnered. Data were collected using (1) questionnaires completed during individual interviews that preceded the group encounter; (2) transcripts of the discussions held during the ten group sessions; and (3) questions regarding the status of the women's doubts about motherhood asked 4 years after participating in the group. Our findings expand the existing typology of women's reproductive decision-making, and demonstrate how categories that are commonly perceived as binary intersect when one challenges the rigid classifications of "active decisions" and "passive decisions"; "motherhood" and "non-motherhood," and "want to be a mother" and "do not want to be a mother." The findings also suggest that after becoming mothers, women can change their maternal status from "non-mother" to "mother," yet still continue to view themselves as indecisive regarding motherhood. Based on our findings, we will argue that while indecisiveness about motherhood derives from individualized neoliberal rhetoric, it simultaneously undermines that same rhetoric and contradicts the injunction to "know, to decide, to strive." It opposes the expectation in post-feminist discourse, that women will make choices about their bodies and exert them, while also opposing the pronatalist rhetoric, and the temporal linear discourse positing that women should "move forward" toward motherhood along with the ticking of the "biological clock." Whereas some women sought to resolve their indecisiveness, other women found that the indecisiveness leaves all options open in a manner that expands their boundaries of autonomy in a society that seeks to limit it.

What We Know and What Remains to Be Explored about LGBTQ Parent Families in Israel: A Sociocultural Perspective.

This paper reviews research on gay and lesbian parent families in Israel through cultural lenses while recognizing the diversity of these families. The major aims of the review are: (1) to provide an overview of the situation of LGBTQ parent families in Israel, as well as of the sociocultural background of the Israeli context and its effects on sexual minorities and LGBTQ parent families; and (2) to identify the limitations and lacunas in the existing research and shed light on what remains to be explored. We searched numerous databases for relevant studies, adopting a narrative approach to summarize the main findings while taking into account the literature on the socio-cultural context in Israel and its impact on sexual minorities and LGBTQ parent families. The search yielded empirical results only for gay and lesbian parent families, with studies emphasizing the challenges they face and the factors related to their well-being and that of LGB individuals aspiring to become parents. In addition, it revealed that research on children's psychosocial adjustment as a function of parental sexual orientation is quite scarce in Israel. Moreover, it indicated the absence of investigations of bisexual, transgender, or queer parents. We conclude that the sociocultural context of Israel, including its pronatalist and familistic orientation, may play an important role in shaping the experiences of LGBTQ parent families, and should be taken into consideration when studying LGBTQ parents.

Gender Differences in Psychosocial Outcomes of Hair Loss Resulting from Childhood Irradiation for Tinea Capitis.

Recent studies have linked hair loss due to childhood irradiation for tinea capitis, a fungal infection of the scalp, to adverse psychosocial and health outcomes in women. However, no study to date has examined gender differences in the outcomes of this type of hair loss. The current study aimed to investigate gender differences in health and psychosocial outcomes of hair loss resulting from childhood irradiation for tinea capitis, and to identify the risk factors associated with depression in both men and women. Medical records held at the archives of the Israel National Center for Compensation of Scalp Ringworm Victims were retrospectively reviewed for 217 women and 105 men who received maximum disability compensation due to severe hair loss resulting from irradiation for tinea capitis. We found that women were at increased risk of developing psychosocial symptoms, including depression. Gender emerged as a significant predictor of depression, distinct from other predictors, such as marital status, age at radiation, exposure to verbal and physical bullying, low self-esteem, social anxiety, and physical health problems. Thus, the psychosocial needs of patients, particularly female patients, who were irradiated for tinea capitis during childhood need to be taken into account by the healthcare professionals treating them.

The Use of Online CB-ART Interventions in the Context of COVID-19: Enhancing Salutogenic Coping.

Community crises require the provision of short-term reflective intervention methods to help service users identify stressors, and access and intensify their adaptive coping. Here, we demonstrate the use of a single-session online cognitive behavioral- and art-based (CB-ART) intervention within the context of the COVID-19 pandemic. In this method, the individual draws three images: his/her COVID-19-related stress, his/her perceived resources, and an integration of stress and resources. This method provided a reflective space in which individuals could identify their experienced stressors, acknowledge their coping resources, and integrate these two elements within the context of the current pandemic. In this article, we use illustrative examples from a study implemented during the first national lockdown in Israel and present a tool that can be easily implemented by mental-health professionals in ongoing community crises. The aims of this intervention were to co-create knowledge with service users, access their self-defined needs and strengths, and enhance their coping by enabling them to view stress and coping as part of the salutogenic continuum.

Correction to: Hair loss due to scalp ringworm irradiation in childhood: health and psychosocial risks for women.

An amendment to this paper has been published and can be accessed via the original article.

Does Severity of Hair Loss Matter? Factors Associated with Mental Health Outcomes in Women Irradiated for Tinea Capitis in Childhood.

Hair loss resulting from childhood irradiation for tinea capitis has been linked to mental health effects in women. However, the association of hair loss severity with mental health in this population is unknown. To address this gap, this study examined the association between hair loss severity and mental health outcomes in women irradiated for tinea capitis in childhood as well as the factors that contribute to these outcomes. Medical records, held at the archives of the Israel National Center for Compensation of Scalp Ringworm Victims, were retrospectively reviewed for 2509 women who received compensation for full or partial alopecia resulting from irradiation for tinea capitis. Mental health outcomes were determined by the number of mental health conditions reported. The results show that among women with more hair loss, risk was increased for a range of mental health problems, especially social anxiety (RR 2.44, 95% CI 2.09-2.87). Hair loss severity emerged as a significant predictor of mental health, adding to the effects of other predictors such as family, social and physical health problems (ß = 0.13, 95% CI 0.27, 0.56). The effects of hair loss severity on mental health outcomes were mediated by women's negative social experiences (indirect = 0.72, 95% bias-corrected confidence interval, 0.53-1.08). Healthcare professionals supporting women with hair loss after irradiation for childhood tinea capitis should be alert to a history of severe levels of hair loss.

Medical social workers as mediators between patients, physicians, and the court: the case of former ringworm patients.

Facilitating benefit and resource acquisition to assist clients is a major responsibility of medical social workers, requiring them to have a thorough knowledge of community resources, legislation, and regulations. The aim of the current study was to examine knowledge of the Law for Compensation of Scalp Ringworm Victims and ringworm-related irradiation damage among 101 social workers employed in diverse healthcare settings in Israel. We found that 65.3% of the social workers were aware of the law, but only 40.6% were aware of the health effects of scalp ringworm irradiation. Media coverage and clients who underwent scalp ringworm irradiation were social workers' major sources of knowledge. Working with former ringworm patients had the strongest association with knowledge of the law and of ringworm-related irradiation damage. Results highlight the important contribution of exposure to clients' experiences and knowledge to expand social workers' knowledge of health issues.

Hair loss due to scalp ringworm irradiation in childhood: health and psychosocial risks for women.

BACKGROUND: Until 1960, hundreds of thousands of children worldwide had been treated for scalp ringworm by epilation via irradiation. The discovery of late health effects in adulthood prompted investigation of the medical aspects of irradiation in childhood and led to the establishment of strict protocols for the use of X-ray irradiation. These studies ignored alopecia, which affects some individuals who underwent irradiation for scalp ringworm as children. This study examined the impact of alopecia due to irradiation for scalp ringworm on the health and psychosocial status of affected women. METHODS: We analysed a random sample of 130 medical files of women recognised by Israel's state committees as suffering from permanent hair loss as a result of scalp ringworm irradiation in childhood. The coded medical data included demographic variables, self-reported mental health conditions, self-reported physical health conditions, self-reported social conditions, and spousal relationship. RESULTS: Compared with the general population of women in Israel, research participants reported significantly higher rates of depression, anti-depressant and/or anti-anxiety drug use, psychotherapy or psychiatric hospitalisation, attempted suicide, migraines, cancer, and divorce. Many described humiliating social experiences due to their appearance, both in childhood and adulthood, that led them to curtail their social interactions. The participants also reported that alopecia negatively affected their spousal relationships. CONCLUSIONS: Life with hair loss from scalp ringworm irradiation in childhood has a negative impact on women's health status and psychosocial state. Health policy-makers must broaden their approach to women who underwent scalp ringworm irradiation by addressing the effects of their hair loss in addition to the effects of the radiation treatment per se. This may be achieved by guiding physicians who provide medical services to these women to take into account the psychosocial and health risks related to hair loss in their diagnosis and treatment as well as by creating a cadre of specially trained mental health professionals who can address their unique psychosocial needs. They must also consider including the specialized mental health services tailored for these women's unique needs in the Healthcare Basket.

CB-Art Interventions Implemented with Mental Health Professionals Working in a Shared War Reality: Transforming Negative Images and Enhancing Coping Resources.

Research on mental health professionals (MHPs) exposed to a shared war reality indicates that they are subject to emotional distress, symptoms of posttraumatic stress disorder, and vicarious trauma. This article focuses on a CB-ART (cognitive behavioral and art-based) intervention implemented during the 2014 Gaza conflict with 51 MHPs who shared war-related experiences with their clients. The intervention included drawing pictures related to three topics: (1) war-related stressors, (2) coping resources, and (3) integration of the stressful image and the resources drawing. The major aims of the study were (1) to examine whether significant changes occurred in MHP distress levels after the intervention; (2) to explore the narratives of the three drawing and their compositional characteristics; and (3) to determine which of selected formats of the integrated drawing and compositional transformations of the stressful image are associated with greater distress reduction. Results indicate that MHP distress levels significantly decreased after the intervention. This stress-reducing effect was also reflected in differences between the compositional elements of the 'stress drawing' and the 'integrated drawing,' which includes elements of resources. Reduced distress accompanied compositional transformations of the stressful image. MHPs can further use the easily implemented intervention described here as a coping tool in other stressful situations.

Correction to: Hierarchy of hair loss stigma: media portrayals of cancer, alopecia areata, and ringworm in Israeli Newspapers.

The original publication of this article [1] contained an incorrect title.

Hierarchy of hair loss stigma: media portrayals of cancer, alopecia areata, and cancer in Israeli newspapers.

BACKGROUND: Over 300,000 people in Israel cope with temporary or permanent hair loss (alopecia) that results from diseases and medical treatments. For women, hair loss can be a highly traumatic event that may lead to adverse psychosocial consequences and health outcomes. Nevertheless, this phenomenon has been mostly ignored by health professionals as it is primarily considered an aesthetic-rather than as a health-related issue. Only recently the Healthcare Basket Committee approved financial assistance for the purchase of wigs by patients coping with hair loss. Given the important role that the media plays in shaping health policies related to diagnoses, treatment and support services, the current study sought to enrich our understanding of how the media portrays disease-related hair-loss. METHODS: Using framing and agenda-setting theories, this study examined the media portrayals of hair loss associated with three diseases-cancer, alopecia areata, and ringworm, depicted in Israeli newspapers in 1994-2016. The sample consisted of 470 articles about the three diseases: 306 on cancer, 36 on AA, and 128 on ringworm. RESULTS: Textual and visual analysis revealed the ways media marginalize this physical flaw. Cancer was framed in medical terms, and patients were portrayed as older Israeli-born people whose hair loss was absent from their experience. Ringworm was framed as a fear-inducing disease; patients were portrayed as faceless, unidentified immigrants that coped with visible hair loss. Articles on AA provided the greatest focus on the patient's experience of hair loss, but patients were portrayed as young foreign people. CONCLUSIONS: Our results revealed a hierarchy of stigmas against hair loss, in which the media coverage marginalized this experience. The omission of hair loss by the media may explain, at least in part, why health professionals often ignore the psychosocial needs of these patients. Health insurance funding of wigs is a helpful but nevertheless insufficient solution to coping with feminine hair loss. Our findings may encourage media leaders to conduct planned media interventions to increase awareness of clinicians and health policymakers about the unique challenges faced by women coping with hair loss and promote health policy-making aimed at the well-being of these women.

Addressing the needs of new mothers in a multi-cultural setting: an evaluation of home visiting support for new mothers - Mom to Mom (Negev).

This study evaluated the Mom to Mom (M2M) program operating in the Negev region of Israel, an area with a high proportion of immigrants. M2M helps women cope with the first year of parenting through home visits of volunteer mothers. Specific objectives were to evaluate (1) Participants' motivations for joining M2M; (2) Gains from participation; and (3) The effect of participation on post-partum depression (PPD). Three stages included (1) Analysis of demographics of all 440 mothers in M2M; (2) A telephone survey of 51 mothers to assess gains from participation; and (3) 137 mothers filled out the Edinburgh Post-Natal Depression Scale (EPDS) and were followed for one year. Most mothers in M2M were first time mothers, with a high rate of perinatal complications (54.4%) and positive EPDS scores (38.7%). Two major reasons for participation were being an immigrant and having low income. The greatest gains from home visits were increased self-confidence, improved parenting skills and communication with the partner. Seventy-nine percent of mothers with PPD symptoms were functioning at work and at home after a year from joining the program. Our findings suggest that M2M has the capacity to address challenges in the post-natal period among women from diverse cultures.

Shared War reality effects on the professional quality of life of mental health professionals.

BACKGROUND: To date, studies on the outcomes of a shared war reality among mental health professionals (MHPs) in southern Israel have focused only on those residing and working in Otef Gaza. The aim of this study is to determine the impact of different exposure levels to shared trauma on the professional quality of life of MHPs in southern Israel. This study compares the level of secondary traumatic stress, burnout, and compassion satisfaction of social workers from Otef Gaza to social workers living and working in the Beer-Sheva area who experience occasional missile attacks. METHODS: The Professional Quality of Life Scale was used to examine the level of secondary traumatic stress, burnout, and compassion satisfaction of 125 social workers living and working in the Negev: 72 from Beer-Sheva and 53 from the regional councils of Otef Gaza. RESULTS: No statistically significant differences were found in the three professional quality of life variables between the Otef-Gaza and Beer-Sheva groups. CONCLUSIONS: The lack of secondary traumatic stress and burnout differences between the study groups, despite the chronic exposure to terror attacks among the Otef Gaza social workers, may be explained by the strong sense of belonging and support evidenced by many Otef Gaza residents as well as by the comprehensive trauma training MHPs receive for work in the region. The results of this study are important for health policy geared to trauma prevention efforts, moderating the effects of work under shared war reality, and promoting the professional quality of life of MHPs in conflict areas.

The contribution of parental smoking history and socio-demographic factors to the smoking behavior of Israeli women.

This study examined the interplay between sociodemographic factors and parental smoking history in shaping the smoking behavior of Israeli women (N = 302). The study was conducted in the Negev region, which is characterized by a high proportion of immigrants and high percentage of low socioeconomic and educational groups. The specific objectives of this study were to examine: (1) The prevalence and characteristics of women smokers, ex-smokers and never-smokers; and (2) the contribution of education and parent smoking history to women's current smoking. Low levels of education, being Israeli born or veteran immigrants of European-American origin significantly increased the risk of smoking, whereas an orthodox lifestyle and new immigrant status significantly reduced the likelihood of smoking. Occasional smokers reported significantly higher primary care utilization than never smokers. A significant relationship between smoking and pain, gynecological symptoms and depression was found. Results indicate that childhood exposure to maternal smoking was a significant risk factor for smoking, whereas paternal past smoking negatively affects smoking in women. Also, results show that parental educational level affects women's smoking behavior indirectly by influencing their own educational attainment, which in turn is negatively associated with the likelihood of smoking. Mothers with higher education were more likely to smoke, an effect that was reversed for their daughters. Our results demonstrate how demographic, parental and lifestyle factors affect women's smoking in a multi-ethnic society and highlight the need to examine both generational and intergenerational effects.

The contribution of negative reproductive experiences and chronic medical conditions to depression and pain among Israeli women.

This study of 302 Israeli women sought to investigate the associations among stressful reproductive experiences (e.g. fertility problems, abortions, and traumatic births), chronic medical conditions, pain, and depression. The specific aims of the study were to examine (1) the effect of stressful reproductive experiences, chronic medical conditions, and pain on depressive symptoms and (2) the effect of stressful reproductive experiences, chronic medical conditions, and depressive symptoms on pain. Our findings corroborate with previous studies demonstrating that depression and pain are two interrelated, but different phenomena, which have both common and distinct risk factors. The findings are discussed in the light of stress and adaptation theories that point to the long-term effects of stressful life events on emotional and physiological aspects such as depression and pain.