Forgiveness and wellbeing after spinal cord injury: Perceived stress and adaptation to disability as mediators.

PURPOSE/OBJECTIVE: Spinal cord injury (SCI) is a life-altering acquired disability. Understanding factors that contribute to adaption to disability and decreased SCI-related stress are critical to personal wellbeing and quality of life for SCI patients. Previous research suggests that forgiveness of others, self-forgiveness, and overall forgiveness are associated with psychological well-being in patients with other chronic illnesses. As such, dimensions of forgiveness may be relevant factors in restoring wellness in SCI patients. This study sought to examine a comprehensive model of the impact of forgiveness on multidimensional indicators of wellness. RESEARCH METHOD/DESIGN: We tested a path model of the impact of trait forgiveness on wellbeing outcomes in adults living with SCI (N = 312). Specifically, we examined 2 mediating pathways-lower perceived stress and higher adaption to disability-by which dimensions of trait forgiveness (self, others, and situations) may influence wellbeing outcomes (psychological wellbeing, satisfaction with life, and perceived physical health). RESULTS: The final path model (χ² = 41.3, p < .001; CFI = .97; RMSEA = .09) suggests that 2 dimensions of forgiveness-self and situations-were significant negative predictors of perceived stress and positive predictors of adaptation to disability. In turn, perceived stress was a significant negative predictor of all 3 wellbeing outcomes and adaptation to disability was a significant positive predictor of all 3 wellbeing outcomes. CONCLUSIONS/IMPLICATIONS: Forgiveness of self and situations are resilience factors in individuals with SCI, suggesting targets for future interventions to improve wellbeing in this population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Self-forgiving processes in therapy for romantic relationship infidelity: An evidence-based case study.

Self-forgiveness is related to positive connections with self and others and may be particularly important for clients who have hurt others. Relational hurt is heightened within the most intimate relationships and is particularly salient in cases of romantic relationship infidelity. Therefore, self-forgiveness may be indicated for romantic partners who have engaged in infidelity. This evidence-based case study examines the treatment of a Caucasian woman in her early 50s who presented with self-unforgiveness following marital infidelity. An 8-week manualized individual counseling program for self-forgiveness was used, which incorporates emotion-focused therapy techniques and principles of positive psychology to facilitate clients' engagement with a 4-component therapeutic model of self-forgiveness-responsibility, remorse, restoration, and renewal. This evidence-based case study demonstrated the importance of emotion-focused techniques in the client's emotional recovery, as well as the ways in which the intervention served as a eudaimonic process that resulted in the client's personal and relational well-being. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Seeking help despite the stigma: Experiential avoidance as a moderated mediator.

The help-seeking literature identifies a model wherein public stigma of seeking help is internalized as self-stigma of seeking help, which, in turn, decreases help-seeking outcomes. The current study considered whether experiential avoidance, or a tendency to avoid painful thoughts or emotions, moderates how strongly these stigmata relate to help-seeking intentions among university students. Specifically, this study tested whether experiential avoidance moderates (a) the direct relationship between self-stigma of seeking psychological help and help-seeking intentions and (b) the indirect relationship between public stigma and help-seeking intentions. Conditional process modeling in a university student sample (N = 235) supported these hypotheses. The direct relationship between self-stigma and help-seeking intentions was nonsignificant and weaker for those who reported low experiential avoidance than for those who reported high experiential avoidance. Results also demonstrated a moderated indirect effect wherein the relationship between self-stigma and intentions was nonsignificant among those reporting low levels of experiential avoidance. This suggests that self-stigma may predict help-seeking intentions when avoidance of therapy functions as a means for avoiding unpleasant emotions. These findings suggest that interventions designed to decrease experiential avoidance by increasing openness to unpleasant emotions may offer a novel avenue to attenuate the impact of self-stigma on help-seeking intentions without requiring the difficult task of reducing stigma altogether. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Modeling cohesion change in group counseling: The role of client characteristics, group variables, and leader behaviors.

Despite continued empirical support for a relationship between group cohesion and therapeutic gain, few studies have attempted to examine predictors of cohesion during the life of counseling groups. The present investigation explored the impact of client variables, group characteristics, and first-session leader behaviors on changes in cohesion across time. Participants were 128 volunteer clients and 14 group therapists participating in 23 separate 8-week-long counseling groups. Results of latent growth curve (LGC) analysis indicated that a piecewise, linear-quadratic model best fit the data at the individual level, while a simplified linear model best fit the data at the group level. Overall, individual differences accounted for 80-97% of the total variance in cohesion intercept and slope terms, with the included covariates explaining 9-39% of this variation. Significant individual-level covariates were gender and anxious and avoidant attachment. The only significant group-level predictor was an interaction effect between leadership behaviors in the first session. Specifically, when leaders performed a high number of structuring behaviors in the absence of facilitating emotional sharing, cohesion was lower at the end of the first session. Limitations, areas of future research, and implications for the theory and practice of brief group counseling are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Promoting forgiveness: Characteristics of the treatment, the clients, and their interaction.

Forgiveness-based group treatments to address interpersonal hurts have been shown to be efficacious across a range of therapy models (Wade, Hoyt, Kidwell, & Worthington, 2014). However, little is known about how treatment and individual characteristics may interact in predicting outcomes. The present study examined a sample of 162 community adults randomly assigned to three treatment conditions; an 8-week REACH Forgiveness intervention (Worthington, 2006), an 8-week process group, and a waitlist control. Hierarchical linear modeling (HLM) indicated that the forgiveness-based treatment was more effective than the waitlist control across a range of forgiveness-related constructs but no more effective than the process condition. Furthermore, attachment avoidance and anxiety interacted with treatment type to predict certain outcomes, indicating that the REACH Forgiveness model may be more helpful for promoting forgiveness with insecurely attached individuals. (PsycINFO Database Record

Can use of positive religious coping predict greater distress? An examination of Army soldiers on deployment.

Although positive religious coping is generally viewed as an adaptive, functional coping pattern, some studies have actually found positive religious coping to be associated with more distress in military populations. In the current study, we examined the role of positive religious coping on distress across 2 time points. Participants in this study were 192 Army soldiers (men = 90.4%) who were stationed in Iraq for a 1-year deployment in 2005. Using structural equation modeling, we conducted a cross-lag analysis of positive religious coping and distress. Results indicated that greater use of positive religious coping significantly predicted greater distress 1 month later, whereas distress at T1 did not predict positive religious coping 1 month later. Combat exposure was also a significant predictor of distress 1 month later. Implications of these results include the need to inquire about clients' use of religious coping and whether such coping methods are having the desired effect for them. (PsycINFO Database Record

Working through past wrongdoing: Examination of a self-forgiveness counseling intervention.

This pilot study examined the effectiveness of a new emotion-focused individual counseling intervention designed to increase self-forgiveness for regretted actions committed against another person. Exactly 26 adult participants (21 completers) who indicated they had unresolved emotions about a past offense enrolled in the study and were randomly assigned to a delayed or immediate treatment condition. Controlling for screening scores, participants who received the treatment had significantly lower self-condemnation and significantly greater self-forgiveness regarding their offense at the end of treatment than did participants who spent time on a waiting list. Again controlling for screening scores, participants who received the treatment had significantly lower general psychological distress and significantly greater trait self-compassion at the end of treatment than did participants who spent time on a waiting list. All treatment gains were maintained at 2-month follow-up. In addition, increases in state self-forgiveness over the course of the intervention predicted lower levels of general psychological distress follow-up. Results of this study demonstrate the utility of this new intervention for helping clients resolve the negative residual effects of unforgiveness toward the self, both for offense-specific and general well-being outcomes.

Understanding group therapists' use of spiritual and religious interventions in group therapy.

The current study examined therapist characteristics that are related to the use of spiritual and religious interventions in group therapy and to perceived barriers to attending to spirituality in group therapy among a sample of experienced group therapists. Results demonstrated that greater therapist spirituality was associated with more frequent use of both spiritual and religious interventions, as well as lower perceived barriers to attending to spirituality in group therapy. Religious commitment was only uniquely related to perceived barriers, such that therapists with higher religious commitment actually perceived greater barriers. Training in religion and spirituality and comfort with spiritual discussions was also related to therapists' use of religious and spiritual interventions and perceived barriers.

Substance misuse prevention and economic analysis: challenges and opportunities regarding international utility.

Economic analyses of substance misuse prevention assess the intervention cost necessary to achieve a particular outcome, and thereby provide an additional dimension for evaluating prevention programming. This article reviews several types of economic analysis, considers how they can be applied to substance misuse prevention, and discusses challenges to enhancing their international relevance, particularly their usefulness for informing policy decisions. Important first steps taken to address these challenges are presented, including the disease burden concept and the development of generalized cost-effectiveness, advances that facilitate international policy discussions by providing a common framework for evaluating health care needs and program effects.

Predictors of the change in self-stigma following a single session of group counseling.

One of the major obstacles to seeking psychological help is the stigma associated with counseling and therapy. Self-stigma, the fear of losing self-respect or self-esteem as a result of seeking help, is an important factor in the help-seeking process. In the present study, college students meeting a clinical cutoff for psychological symptoms participated in 1 session of group counseling that either contained therapist self-disclosure or did not. In general, participants reported significantly less self-stigma following the session. Working alliance-bond and session depth significantly predicted the change in self-stigma. Furthermore, self-stigma (as well as bond, depth, psychological symptoms, and being female) predicted the intention to seek help following the session. Self-stigma and session depth also predicted interest in continuing with counseling. The therapist self-disclosure condition, however, had no effect on the change in self-stigma, intentions to seek help, or interest in continuing with group counseling.