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PubMed1984

Some effective therapeutic factors in group cognitive-behavioral therapy with problem drinkers.

The mechanisms of cognitive-behavioral treatment with 18 problem drinkers (14 men) during 12 2-hr sessions with two therapists were investigated. The patients were studied pretreatment, and 3-7 days, 3 months and 6 months after treatment. The sample was divided into two groups of nine patients: For Group A, the therapists cued and reinforced all positive self-statements, statements of attitudes or feelings, and future-oriented "verb" statements; challenged negative self-statements; used self-disclosure; and helped the patients achieve a compromise between their real and ideal selves through role playing, modeling and rehearsal. For Group B, treatment was the same except that therapists used only anonymous case histories and not self-disclosure; kept personal opinions to a minimum; and did not reinforce positive self-statements or challenge negative ones. According to videotape ratings, Group A improved across the sessions significantly more than Group B in these areas: positive and negative self-statements, future-oriented "verb" statements, and statements of attitudes or feelings. There were nonsignificant differences in: reinforcements by therapists and alcohol-related sentences. Across the 6 months of follow-up, Group A improved significantly more than Group B in: a behavioral rating made by a psychologist after a structured interview; alcohol consumption (according to self-reports and corroboration); and measures of Social Avoidance and Distress, Fear of Negative Evaluation, Neuroticism and Extroversion. There was a nonsignificant difference in a measure of Psychoticism. Results show that manipulation of cognitive factors improved the maintenance of behavioral gains, and that selective reinforcement and relevant self-disclosures and opinions by therapists increased treatment success.

Alcoholism↗
PubMed1997

Minding the close relationship.

In this theoretical analysis, we argue that a process referred to as minding is essential for a couple to feel mutually close and satisfied in a close relationship over a long period Minding represents a package of mutual self-disclosure, other forms of goal-oriented behavior aimed at facilitating the relationship, and attributions about self's and other's motivations, intentions, and Mort in the relationship. Self-disclosure and attribution activities in minding are aimed at getting to know the other, trying to understand the other's motivations and deeper disposition as they pertain to the relationship, and showing respect and acceptance for knowledge gained about other. We link the concept of minding to other major ideas and literatures about how couples achieve closeness: self-disclosure and social penetration, intimacy, empathy and empathic accuracy, and love and self-expansion. We argue that the minding process articulated here has not previously been delineated and that it is a useful composite notion about essential steps in bonding among humans. We also argue that the minding concept stretches our understanding of the interface of attribution and close relationships. We present research possibilities and implications and consider possible alternative positions and counter arguments about the merits of the minding idea for close relationship satisfaction.

Journal Article↗
PubMedDate not supplied

Family responses to disclosure of self-as-lesbian.

Disclosure or nondisclosure of self-as-lesbian to family is a difficult task. Eleven lesbians aged 25-47 years old described their experiences of disclosure or nondisclosure to family. The primary source of data collection was focus groups. Family disclosure was preceded by recognition of self-as-lesbian. Five story patterns of lesbians and their families related to disclosure or nondisclosure were derived from text analysis. The participants also described missing sociocultural landmarks and symbols for lesbian lives. Implications are included for lesbians who are contemplating disclosure and their health care providers.

Adaptation, Psychological↗
PubMed1983

Hypertension, disclosure of personal concerns, and blood pressure response.

Studied the degree of self-disclosure in borderline and hypertensive individuals (N = 50) using a checklist of personal concerns. Shoppers who sought blood pressure measurements in a health display had blood pressure measured before and after the completion of the checklist. Results showed that individuals with elevated blood pressure did not disclose as many personal concerns as normotensives and were less likely to report feeling stressed after the cognitive task even when blood pressure increases had occurred. These findings indicate the need both for further understanding of the nature of self-disclosure and also concurrent investigations of hypertensive characteristics and blood pressure responsivity.

Adaptation, Psychological↗
PubMed2002

The out-group must not be so bad after all: the effects of disclosure, typicality, and salience on intergroup bias.

Two contact studies integrated the personalization (M. B. Brewer & N. Miller, 1984) and category-based models (M. Hewstone & R. J. Brown. 1986), proposing that greater reduction of intergroup bias can be achieved by the interactive effects of disclosure and typicality (Study 1) or disclosure and salience (Study 2). In Study 1 the impact of self-disclosure and typicality combined interactively to augment intergroup acceptance. Study 2 extended these findings by examining the combined effects of disclosure and category salience. It also explored the mediational roles of group-relevant and person-relevant information on the effects of typicality and disclosure, respectively. Results showed that during cooperative dyadic out-group contact, self-disclosure, typicality, and salience were key factors for reducing bias toward new members of that out-group category.

Analysis of Variance↗
PubMed2003

Disclosure of HIV infection in south India: patterns, reasons and reactions.

The aim of this study was to examine aspects related to self-disclosure of their seropositive status among 68 persons (35 men and 33 women) infected with HIV. Data was collected through in-depth interviews to assess ways in which HIV-related disclosure took place and factors that influenced disclosure. The data was subjected to both qualitative and quantitative analysis. Voluntary disclosure was noted in 44 subjects (65%), while in other 24 (35%) subjects disclosure occurred without consent. Of those who disclosed, 78% of the subjects reported self-disclosure to family members, 7% to friends and 15% exclusively to health professionals. Expectations of emotional and material support from the family members were one of the commonly cited reasons for voluntary disclosure. Only half of the subjects disclosed complete and truthful information while in the rest, disclosure was partial or disguised as a less stigmatizing illness. Stigma, fear of discrimination, disgrace to family and self and futility were reported as the main reasons for non-disclosure. The majority of the subjects (73%) reported anticipation of negative societal reaction as the main concern following disclosure. In India, where HIV-related counselling services are still not freely available, there continue to be non-uniform practices related to confidentiality and disclosure. The findings of this study are important in identifying cultural factors related to disclosure in HIV infection and highlight the need to examine the varying patterns and concerns related to disclosure among HIV-infected individuals.

Adolescent↗
PubMed2005

Depressive symptomatology, youth Internet use, and online interactions: A national survey.

PURPOSE: To investigate the online communications and self-disclosure practices of youth reporting depressive symptomatology. METHOD: The Youth Internet Safety Survey was a nationally representative telephone survey of 1501 Internet-using youth between the ages of 10 and 17 years, and one caregiver in their household. Fifty-three percent of youth participants were male and 73% were white race. The purpose of the survey was to obtain prevalence rates for unwanted sexual solicitation, harassment, and unwanted exposure to sexual material among young people online. Questions about current depressive symptomatology were also queried; this variable was defined based upon the DSM-IV definition of a major depressive episode: major depressive-like symptomatology (5+ symptoms of depression and functional impairment in at least one area); minor depressive-like symptomatology (3+ symptoms of depression); mild or no depressive symptomatology (<3 symptoms of depression). Data were cross-sectional and collected between the fall of 1999 and spring 2000. Multinomial logistic regression was used to estimate the conditional odds of reporting DSM-IV-like major or minor depressive symptomatology vs. mild/no symptomatology given the indication of self-disclosure practices and interactions with others online. Males and females were assessed separately. RESULTS: Talking with strangers online, using the Internet most frequently for e-mailing others, and intensity of Internet use differentiated youth reporting depressive symptoms from asymptomatic peers. Report of depressive symptomatology was not related to most measures of general Internet use nor gender differences. Personal disclosure was significantly more likely to be reported by both young men and young women who reported major depressive symptomatology vs. mild or no symptomatology. Differences were observed for how adolescents choose to self-disclose; females posted pictures of themselves, whereas males were more likely to provide personally identifiable information. Finally, most gender-related variation reflected differences in the magnitude of Internet associations with depressive symptoms rather than the types of Internet use, access, or online communications. CONCLUSIONS: Youth-reported depressive symptomatology is associated with differences in online interactions and self-disclosure practices.

Adolescent↗
PubMed2005

Developing a model of adolescent friendship formation on the internet.

Previous research has been largely silent about what precisely influences online friendship formation and has ignored motives for online communication as potential explanations. Drawing on a sample of 493 adolescents, this study tested a path model of adolescent friendship formation including as predictors introversion/extraversion, online self-disclosure, motive for social compensation, and frequency of online communication. Our path analysis showed that extraverted adolescents self-disclosed and communicated online more frequently, which, in turn, facilitated the formation of online friendships. Introverted adolescents, by contrast, were more strongly motivated to communicate online to compensate for lacking social skills. This increased their chances of making friends online. Among introverted adolescents, a stronger motive for social compensation also led to more frequent online communication and online self-disclosure, resulting in more online friendships. The model suggests that the antecedents of online friendship formation are more complex than previously assumed and that motives for online communication should be studied more closely.

Adolescent↗
PubMed2004

Nurse experiences as cancer survivors: part II--professional.

PURPOSE/OBJECTIVES: To uncover dimensions of nurses' professional experiences of cancer survivorship. DESIGN: Interpretive, phenomenologic. SETTING: Metropolitan area in the northeastern United States. SAMPLE: 25 RNs diagnosed with cancer. Average age was 50 years, and 20 participants were less than five years from initial diagnosis. METHODS: Interviews. Data were analyzed using the methodology of Newman (1994, 1999) and VanManen (1990). MAIN RESEARCH VARIABLES: Nurses' professional experiences of cancer survivorship. FINDINGS: Professional experiences of cancer survivorship fell into five themes: (a) role ambiguity, (b) a deepening level of compassion for patients and others, (c) self-disclosure as a therapeutic intervention, (d) becoming an advocate for change, and (e) volunteerism. CONCLUSIONS: Cancer survivorship was a factor in reshaping participants' clinical practice. Experiencing the role of the patient affirmed the necessity of compassionate care for these participants. Nurses experienced a deepening level of compassion for patients and used self-disclosure as a therapeutic intervention. During and shortly after treatment, role ambiguity (being both patient and nurse) could cause difficulties. Nurses took action to change their clinical environment through their influence on colleagues and the healthcare system and by working through other organizations to improve patient care. IMPLICATIONS FOR NURSING: Nurse cancer survivors can benefit from the support of colleagues and healthcare providers and an appreciation of the challenge of being both a professional and a patient. The invitation for dialogue as they return to work may help with the challenges of role ambiguity as nurse cancer survivors. Based on this study, nurses value the opportunity to enhance care environments with their two-world knowledge through compassionate care, disclosure, advocacy, and volunteering, and coworkers need to appreciate each nurse's unique response to this potentially life-changing process. Nurses in all settings can learn from their cancer survivor colleagues who have been the recipients of care to reflect on their own clinical practice in the areas of advocacy, sensitivity to patient concerns, and care experiences.

Adult↗
PubMed2006

I don't know who I am: severely mental ill Latina WSW navigating differentness.

We examine interviews from a qualitative study designed to examine HIV perceptions, risk, and risk management among Puerto Rican women who have sex with women (WSW) and who also have been diagnosed with major depression, bipolar disorder, or schizophrenia. These women's stories challenge both the lesbian and the Latino communities to reexamine how and why they claim individuals as their own and they similarly challenge professional communities, including HIV educators, health researchers, and medical care providers, to develop effective HIV prevention programs and counseling approaches that facilitate patient/client self-disclosure and consider cultural and contextual barriers to both self-disclosure and the provision of services.

Adaptation, Psychological↗
PubMed2001

Life-threatening illness in the analyst.

The literature on practicing throughout a life-threatening illness is reviewed and important differences about attitudes toward self-disclosure are understood by noting a division between two perspectives on transference: "one-body" and "two-body" views. The analyst's use of self-disclosure is informed by the prominence given the interpretation of transference as against that given the patient's needs in the collaborative relatedness supporting the therapeutic alliance. Themes and illustrative clinical vignettes are presented from the author's own experience practicing during such an illness. Three phases of working during illness are delineated, each somewhat different regarding the analyst's state, and hence patients' needs and reactions. Recommendations are made regarding conditions that make it possible to work effectively during a life-threatening illness. The analyst needs help from his or her own analyst to make the clinically and sometimes ethically appropriate decisions about practice; while this is important in instances in which the analyst recovers, it is essential should the analyst become terminal and face more certain death.

Adolescent↗
PubMedDate not supplied

When it's good to talk.

Overall, the experience was a positive one for both the facilitators and, according to their evaluation forms, the group members. The group were visibly upset at the end of the final session and there were many vigorous handshakes upon departure. On reflection, there were several specific aspects that could be adjusted to improve the format of future groups. First, there were some queries over the necessity of the last two sessions as it was felt the group peaked at session eight in terms of self-disclosure of new information, reflecting on this and moving forward. In the last two weeks the material introduced tended to be replications of input from previous meetings and there was a sense of the sessions being drawn out to fill the time. In hindsight, this may have been due to the winding-down process that is a common in group work. The timing within each session could also be managed more closely to ensure that sufficient space was allowed at the end for reflection on the themes addressed. This proved more difficult than it appeared while running the group as the men tended to use the summary time to introduce further self-disclosures that could not go unacknowledged and so in turn reinitiated discussions. Despite having spent time with each potential group member when inviting them to participate, explaining what we hoped to achieve, a further improvement would be to make the anticipated direction more explicit. It was felt that attendees came to the first session without having formed a clear understanding of what was expected of them. This caused unnecessarily high levels of anxiety for facilitators and group members alike. Overall, however, these points represent quite small adjustments and it is hoped that this article will raise awareness of the issues with readers wishing to facilitate such groups so that they can benefit from our experiences and enhance their group work as a consequence.

Aged↗
PubMed2006

When psychotherapists disclose personal information about themselves to clients.

Psychotherapists sometimes disclose personal information to their clients during therapeutic sessions. We report here our analysis of how these 'therapist self-disclosures' are done. In a sample of 15 sessions involving four therapists, we find that all therapists use them sparingly and some not at all. When they do, they 'match' something in the client's preceding turn. Vehicles for the match can range from comparatively simple agreements to more complicated 'second stories', which use analogies from the therapists' own current life. We find that these 'personal' disclosures are invariably rather ordinary but are made to bear visibly on the therapeutic business at hand, though not always in obvious ways. The ordinariness of therapist's self-disclosures underpins what seems to be one of their main actions-to 'normalize', for a number of disparate local interactional contingencies, the clients' experience. We discuss the practice of using one's own life experiences to bear on one's client's troubles, noting the recurrent features of extreme case formulations and explicit recipient design. We conclude with a brief discussion of the relation between our analyses and those which might be offered by members of the therapeutic community.

Communication↗
PubMed1993

Disclosing HIV seropositivity to significant others.

OBJECTIVES: To examine gay men's patterns of self-disclosure of HIV seropositivity to friends, lovers, relatives and colleagues; to assess the effects of disclosure; and to identify reasons for not disclosing to particular individuals. DESIGN: Longitudinal questionnaire survey of gay men. METHODS: A total of 163 HIV-positive men participating in the AIDS Behavioral Research Project, a longitudinal study of San Francisco gay men, completed questionnaires about their self-disclosure patterns, health status, and psychological well-being. RESULTS: HIV-positive men were most likely to disclose their status to lovers and closest gay friends. Asymptomatic men were less likely to disclose to relatives and colleagues than symptomatic men. Friends and lovers were rated as responding more helpfully than relatives and colleagues. Men who perceived their significant others as responding more helpfully were less depressed and anxious currently and 1 year later. A variety of reasons were given for not disclosing, including not wanting to worry others, fear of discrimination, fear of disrupting relationships, and emotional self-protection. CONCLUSION: While disclosure can have advantages for both HIV-positive individuals and their significant others, HIV-positive individuals must be assured that the benefits of doing so will outweigh the potential costs.

Adult↗
PubMed1982

Individual differences in the coming out process for gay men: implications for theoretical models.

One hundred ninety-nine self-defined homosexual males were asked about the ages at which milestone events occurred in the coming out process (i.e., initial awareness of same-sex attractions, same-sex acts, self-designation as homosexual, initial involvement in a long-term relationship, self-disclosures to significant others, and acquiring a positive gay identity). Overall findings indicated that an orderly developmental sequence underlies the coming out process; however, not all subjects progressed in a predictable fashion from an awareness of same-sex feelings through behavior to eventual self-labelling, self-disclosure, and final stabilization of a positive gay identity. A number of individual differences emerged: 18% of the sample labelled themselves "homosexual" in the absence of any overt same-sex sexual experience; 22% arrived at homosexual self-definitions while participating in a long-term relationship with another man; 23% adopted homosexual self-definitions only after involvement in such a relationship. Fifteen percent of the respondents indicated that they had not acquired a positive gay identity (i.e., were not glad to be gay). These individuals differed from the remainder of the sample on a number of significant measures reflective of psychological health. Significant differences were also found among three cohort groups with respect to age at occurrence of particular milestone events. Findings from the present investigation were explored in relation to both the theoretical conceptions and available empirical data concerned with homosexual identity formation.

Adult↗
PubMed1988

Folk hero modeling therapy for Puerto Rican adolescents.

Puerto Ricans are concentrated in the Northeastern United States in predominantly low socioeconomic status, urban Hispanic communities. Due to a constellation of stressors associated with their minority status, bilingualism and bicultural conflicts, Puerto Rican adolescents are at high risk of mental disorder. Research has shown that factors such as migration experiences, low socioeconomic status, and Hispanic values conflicting with Anglo culture (e.g., familism, spiritualistic and folk beliefs, orientation to time) are associated with higher rates of psychiatric symptomatology in the Hispanic population. Community mental health resources are under utilized, and traditional therapy modalities have had limited success in remedying the emotional and behavioural problems of Hispanics. This paper reviews several approaches to the delivery of culturally sensitive mental health services to Hispanic populations and describes the development of a new modality for Puerto Rican adolescents. The modality presents Puerto Rican folk heroes and heroines in a modelling therapy targeted towards enhancing adolescents' pride in their ethnic heritage, self-esteem, and adaptive coping with stress. The therapy was implemented on a small-group basis with 21 Puerto Rican adolescents, some of whom participated with their mothers. A clinical evaluation of the therapy was conducted by summarizing therapists' progress reports on each participant and by interviewing the participants about their impressions of the therapy experience. Progress reports and participants' self-reports indicated that the adolescents increased in self-disclosure and self-confidence; they gained pride in being Puerto Rican; they learned adaptive mechanisms for coping with stress; and they enjoyed learning about famous Puerto Ricans and their culture.

Adaptation, Psychological↗
PubMed1998

The economic value of caring.

A heuristic method for monetizing effects of caring is presented. Practitioners' caring behaviors have economic value to health care organizations through effects on patient satisfaction, physiology, self-disclosure, and self-esteem, and subsequent use of medications, laboratory tests, and procedures. These effects are monetized as revenues generated, costs avoided, costs reduced, and externalities.

Caregivers↗
PubMedDate not supplied

A pilot study using the group environment scale to evaluate first-year resident support groups.

BACKGROUND AND OBJECTIVES: Resident support groups are not universally accepted nor without controversy. Existing descriptive studies suggest the need for better evaluation methods. This study tests a quantitative method for assessing resident support groups using a standardized questionnaire to evaluate changes occurring during support group participation. METHODS: The Group Environment Scale (GES) was used to quantitatively assess premeasures and postmeasures of group functioning for two combined support groups. RESULTS: After analyzing the combined group's premeasures and postmeasures on 10 GES subscales, paired t tests revealed "expressiveness," "self discovery," and "anger and aggression " significantly increased, while "order and organization " decreased. The GES profile suggests that these intern support groups significantly promoted expression of feelings, self disclosure, and self-reflection about personal and professional problems and tolerance of anger in an environment that becomes significantly less formal and structured with strong leader support but low leader control. CONCLUSIONS: The GES is a useful tool for assessing intern support groups. This pilot study provides a quantitative baseline assessment of intern support groups for future comparisons.

Adult↗