Surviving in Crisis Mode: The Effect of Material Hardship and Social Support on Emotional Wellbeing Among People in Poverty During COVID-19.

The COVID-19 pandemic triggered a sudden economic crisis that led to increases in hardship and poverty. Motivated by the concern that people living in long-term poverty have few reserves to draw upon in times of crisis and may experience severe consequences, this study focuses on the association between material hardship and emotional wellbeing among people in poverty. The data were collected in two waves of telephone surveys during the pandemic (n = 88). Participants for the study were recruited through social service departments in six cities in Northern Israel. The findings show that COVID-19 increased material hardship, and that material hardship has detrimental effects on the four measures of emotional wellbeing selected (stress, anxiety, depression, and physical symptoms). Informal social support has positive effects on emotional wellbeing but it does not counter the negative effects of material hardship. Policy implications are discussed.

Experiencing Couple Relationships in the Line of Fire.

The study aims to explore the way civilians living in the line of fire experience the impact of exposure to warfare on their couple relationships. Semistructured interviews were conducted with 14 couples living on the Israeli side of the border with the Gaza Strip. Four themes emerged: Overall perception of the security situation's impact on the dyadic relationships, dyadic intimacy, role division and decision-making, and Couple's emotional coping: partnership versus separateness. The findings were organized along a continuum between impacted and not-impacted relationships. Couple's position on this continuum was not fixed and could change as a result of to the security situation or marital therapy. The findings were framed in concepts from Dialectic Theory and from the Family Adaptation Models. Implications for couple therapy in these situations were specified.

Not the Promised Land: African Asylum Seekers and Refugees in Israel.

The phenomenon of African asylum seekers in Israel is relatively new. The purpose of the study was twofold: (a) to investigate how the asylum seekers construct their life stories and (b) to discover which aspects of the constructed life stories can be taken into consideration by various mental health professionals when providing help to asylum seekers. In this study, we interviewed 16 asylum seekers residing in Israel using the narrative method. Based on holistic analysis, we collected three groups of stories: "Then see what course life takes in the future," "I'm not yet free," and "Open prison." In the discussion of the findings, we focus on the similarities and differences among the groups of stories, with reference to the role of the sociopolitical context and to the private and social self as part of the participants' well-being. We make implementation suggestions for mental health interventions.

Risk factors for DSM-5 posttraumatic stress symptoms (PTSS) among Israeli civilians during the 2014 Israel-Hamas war.

In light of current modifications in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria for posttraumatic stress disorder (PTSD), this study aimed to revalidate well-known PTSD risk factors related to terrorism and war in Israel, namely, proximity to the Gaza Strip, dissociative symptoms, acute stress disorder (ASD) symptoms, and social support. One hundred and sixty Israeli civilians were assessed during the 2014 Israel-Hamas war at 2 time points: 1 week after the beginning of the operation (t1) and 1 month after initial evaluation (t2), using the DSM-5 PTSD Symptom Levels Scale (PSLS; Gil, Weinberg, Or-Chen, & Harel, 2015). A paired t test analysis showed significant reduction in the respondents' posttraumatic stress symptoms (PTSS) 1 month after the initial assessment point. A structural equation model (SEM) showed that higher ASD symptoms at t1 and higher dissociative symptoms at t2 increased the risk for PTSS at t2. Conversely, higher peritraumatic dissociation at t1 decreased the risk for PTSS at t2. Proximity to the Gaza Strip, and social support, failed to demonstrate significant association with PTSS at t2. DSM-5 PTSS 1 month after prolonged traumatic exposure are strongly associated with high ASD symptoms at 1 week as a risk factor; high levels of peritraumatic dissociation at 1 week as a protective factor; and high levels of dissociative symptoms at 1 month as a risk factor. Theoretically and clinically the findings of the study further suggest that ongoing massive terrorism and war cannot be viewed or treated as identical to other traumas.

Healing the social self: how parents whose children were killed in terror attacks construct the experience of help.

This study focuses on expressed needs and structures of assistance received by Israeli parents whose children were killed in terror attacks. The loss takes place within a multi-systemic network that can be a healing force and/or a distorting factor in the grief process. The qualitative research paradigm employed privileges the knowledge of the parents themselves. In-depth interviews were conducted with 16 parents. (1) The primary criterion that determines the parents' attribution of helpfulness is perceived inclusiveness. (2) The subsystem of "family of the bereaved" is salient in the healing process. (3) There is a clear preference for the services provided by NGO's as opposed to governmental agencies. (4) The bereaved parents engage the symbolic level of the macro-system-the heritage of the Jewish people. The article concludes with the practical implications of the findings for the development and delivery of psychosocial services to parents bereaved in terror attacks.

The impact of ongoing national terror on the community of hospital nurses in Israel.

The main goal of this study was to explore the connections between the exposure of nurses in Israel to national terror and the levels of distress experienced due to ongoing terror attacks. The data were collected from 214 nurses from various parts of Israel who work in three types of heath services (mainly hospital departments) and provide help to victims of terror. The nurses reported very high levels of burnout, high levels of stress and medium-to high levels of intrusive memories. Levels of exposure were associated with burnout, intrusive memories and level of stress. More professional attention should be given to hospital nurses who provide care for trauma patients.

Control of the self: partner-violent men's experience of therapy.

This study explores the experience of men who participated in programs for partner-violent men by understanding their perceptions of the treatment process, the treatment outcomes, and the meaning they attached to it. The sample included 25 men who completed these programs in agencies that specialized in treating domestic violence in Israel. A qualitative methodology was used to collect and analyze the data. The findings revealed that most of the men experienced therapy as positive and meaningful and underwent personal changes, especially the acquisition of self-control. Deeper analysis of the data, however, shows that the men still used a power scheme in understanding and creating relationships with others, especially with their woman partner. The findings are discussed in light of the complex and contradictory impact of the treatment process as it appears in the participants' experiences and in the meaning they attached to it.

Helping direct and indirect victims of national terror: experiences of Israeli social workers.

In this study we explored the subjective experience and the meaning attached to it by Israeli social workers who provide help to direct and indirect victims of national terror attacks. A qualitative methodology, based on grounded theory tradition, was used to conduct and analyze interviews with 29 social workers from three types of agencies (municipal social services, general hospitals, and the National Insurance Institute) from various parts of the country. Based on the data, three main themes were constructed: (a) professional and personal functioning during intervention, (b) the immediate and long-term impact of intervening with terror attacks, and (c) the meaning attached to the social worker's role in intervening with victims. Overall, the findings show that the social workers experienced symptoms similar to those of secondary traumatic stress disorder (STSD) for a few days only, but in the long-term, they perceived their experience of helping victims of terror attacks as leading to personal and professional growth.

"Motherhood starts in prison": the experience of motherhood among women in prison.

This study aims to explore the way in which women prisoners in Israel experience motherhood in prison and construct their motherhood after being released. In-depth interviews were conducted with 9 women, and the data were analyzed according to the phenomenological approach. The qualitative methodology generated 5 main themes: (a) motherhood in prison as a motive for survival; (b) the sense of failure experienced by mothers in prison; (c) coping versus avoidance in the mother-child relationship during imprisonment; (d) motherhood in prison as a motive for change; and (e) the transition from questioning the right to be a mother to redeeming motherhood. The 5 themes were organized into a model that depicts the process of becoming a mother in prison and the move toward mending the experience of motherhood. The findings indicate that side by side with the traumatic experiences of prison are other aspects that allow for growth and rehabilitation. The discussion focuses on 2 main issues that evolved from the findings: the reasons for the change in motherhood that occurs during imprisonment and the aspects of prison that enable this change.

Parents' experience and meaning construction of the loss of a child in a national terror attack.

This paper describes a qualitative study aimed at exploring the meanings that are given by parents to the loss of their children in terror attacks in Israel and examining how specific aspects of these meanings help or hinder them in coping with the loss. This paper focuses the collective context of loss, a theme that emerged from in-depth interviews with 16 bereaved parents who lost their children in different terror attacks. The collective context of loss includes three subthemes: (a) the loss in the context of Jewish and Israeli history; (b) assigning responsibility for the loss; and (c) using the collective meaning in the process of coping. Overall, the findings highlight the role of the sociocultural context in the bereavement process. The discussion raises possible explanations for the significance of this role, focusing on the reciprocal processes between the bereaved parents and society, which are functional and effective for both.

Teenagers response to threat of war and terror: gender and the role of social systems.

This study focuses on the role of gender and the way social systems (family and friends' support, stress attributed to parents, friends and others in the community) are perceived in contributing to the reaction to stressors of war and threat of terror among teenagers living in Israel along the Lebanese border. The study was implemented shortly after Israel's withdrawal from Lebanon with a sample of 353 teenagers. The study is based on the teenagers' self-report. The results reveals the following: (a) gender relates significantly to level of stress but not to general life satisfaction; (b) stress attributed to the parents and to the peers has a greater contribution to the level of stress than the supportive family atmosphere and peer support; (c) stress attributed to the parents and peers was found to be a mediator between gender and level of stress; (d) supportive family atmosphere was found to be a mediator between gender and one measurement of stress, while peer support was not found to have any mediating role. Special attention is given to the finding that stress attributed to parents and friends has greater significance than the support provided by them.

Are women at higher risk than men? Gender differences among teenagers and adults in their response to threat of war and terror.

The present study examined whether women are at higher risk of developing stress reactions in situations of war and terror. The study looked at gender differences within two samples-teenagers (n = 353) and adults (n = 890)-regarding the impact of stress that developed in response to a situation of threat of war and terror as a result of Israel's withdrawal from Lebanon. The study tested: (1) gender differences regarding cognitive appraisal of the stressor, coping styles, psychological symptoms, and life satisfaction; (2) whether cognitive appraisal and coping styles mediated gender differences in psychological symptoms and life satisfaction; and (3) whether the two age groups differed regarding the contribution of gender to the studied variables. The results revealed that among the teenagers, gender differences were found only in cognitive appraisal and psychological symptoms, while among adults, gender differences were found in all the studied variables. The results support the mediating hypothesis with regard to psychological symptoms, but not with regard to life satisfaction. The results also show a different contribution of gender in each of the age groups regarding psychological symptoms, but not regarding life satisfaction, which leaves some doubt regarding the assumptions that women tend to be more affected by stress than men.

The myth of creating an integrative story: the therapeutic experience of Holocaust survivors.

In this article, the authors explore how Holocaust survivors experience therapy. The qualitative method by which the authors illuminate the therapeutic experience is in-depth interviews with 11 survivors. They base their analysis on the phenomenological tradition and use psychodynamic perspective as a heuristic device, generating five main themes: (a) knowing and not knowing the story of the trauma, (b) therapy as a reproduction of the trauma and its aftermath, (c) the fight to keep the therapist as a split object, (d) the perception of therapy as interminable, and (e) creating alternative narratives. Overall, the findings contradict the traditional perception, in which the goal of therapy is defined as one of integrating the traumatic narrative with the entire life story. Successful therapy, as was found in the present study, is often experienced when the traumatic narrative is put into a capsule separated from other parts of the life story.

Exposure to threat of war and terror, political attitudes, stress, and life satisfaction among teenagers in Israel.

The study examines the pattern of relations between level of threat, political attitude (willingness for political compromise), and well-being (level of stress and life satisfaction) among Israeli teenagers in reaction to Israel's withdrawal from Lebanon. Participants were 419 teenagers from two residential areas: the Northern area (close to the Israeli-Lebanese border) and the Central area (distant from the border). The results show: (a) significant differences between the two groups on: political attitude (Center scored higher), on level of stress (North scored higher), and on life satisfaction (North scored lower); (b) a significant negative correlation between exposure to threat and political attitude; (c) significant negative correlations between political attitude and measures of stress, and a significant positive correlation with life satisfaction; (d) political attitude mediates between level of threat and well-being. Political and educational implications, and mental health policy are discussed.

Personal experience in professional narratives: the role of helpers' families in their work with terror victims.

This article describes research on the narratives of social workers who help terror victims, focusing on the relationship between the helpers' families and their work. Qualitative analysis of three training groups of social workers who are responsible for helping in the event of terror attacks in different parts of Israel, and of three debriefing groups for social workers after terror attacks, reveals that the helpers' families play a role in the narratives constructed by the helpers. Two main themes were identified. The first centers on the interaction between work and the family, and shows that in the situation of a terror attack, the conflict between the two disappears and the family often serves as a support system for the helpers. The second theme refers to the family dimension alone, and focuses on the dichotomy between vitality and loss. The way that family life events affect helpers'professional intervention is described. The findings are discussed in light of Conservation of Resources Theory, the fight-flight response to threat, and the concept of the family as a source of safety and risk taking.

Using social constructionist thinking in training social workers living and working under threat of political violence.

This article describes and analyzes an intervention program with social workers living and working in a situation of uncertainty created by political violence such as war and terrorism. The author used a social constructionist perspective as a theoretical framework, emphasizing the effect of the social and political context in constructing the experience and a recognition of the personal and professional knowledge acquired in the daily experience. The author used qualitative methods to evaluate the process and outcome. The narrative-holistic analysis focused on reconstructing meaning and adapting it to the new situation, the main thrust of the program. From the thematic analysis four main themes emerged: (1) loss as a result of political violence; (2) meaning of strength and weakness in situations of political violence; (3) preparation for terrorist attacks; and (4) definition of a safe place. The outcome evaluation describes the meaning of this kind of training program to the participants. The specific context of the training program is discussed as well as possibilities of using it in different contexts.