UCCS

I successfully defended my thesis last Friday. Although it was somewhat nervewracking, the meeting went really well. It felt more like a discussion than a presentation by the end and I got lots of good feedback and suggestions from my committee. The next step is to try to publish a journal article using the findings from the study.

The gist of the results is that problem- and emotion-focused coping appear to be adaptive, whereas dysfunctional coping appears to be somewhat less related to resilience to suicide. Implications of the study are that some coping strategies may serve as protective factors against suicide and coping strategies should be evaluated as part of a thorough assessment of at-risk older adults.

Thanks again to my committee for their guidance and to those who participated in the study.

Today marked the end of the fifth and final Aging and Mental Health Conference, hosted by the Gerontology Center at UCCS. The topic of this year's conference was "Integrated Health Care for Older Adults." The conference co-chairs were Sara Honn Qualls, Ph.D. and Deborah King, Ph.D. of the University of Rochester Medical Center in Rochester, NY.

Integrated mental health care essentially referrs to mental health services that are delivered in non-traditional settings, such as primary care clinics and long-term care facilities. This can make mental health services accessible to individuals who may not otherwise access mental health treatment because of barriers such as inadequate financial resources, stigma associated with mental health, and limited transportation. In a primary care clinic, for instance, the idea is that physical and mental health are treated together to help improve the quality of life of patients, breaking down the separation of body and mind that often exists in Western medicine.

I finished the second year of my PhD program last week (that's me in the photo jumping for joy). Julio and I celebrated by camping at the Sand Dunes over the week-end.

I've been in my PhD program for just over 3 semesters now. Last year was a huge transition for me and it took a while to adjust to being a student again and living in a new part of the country. But what made the transition go more smoothly were the other students in my program.

We had our PhD applicant interviews last week. As I was getting to know each of the applicants, I thought about what it was like to be in that position two years ago. It's a bit of a leap of faith to pick up and start a new life in a new city where you know no one, which is what many of us do for graduate school.

I feel really lucky to have found a program where I've been able to form great friendships. Very often, the support I get (and give) to my peers (some of whom are in the photo) is what has helped me through the inevitable rough spots of progressing through a graduate program.

Older adults have a disproportionally high rate of completed suicide as compared to the general population, but relatively little is known about the extent to which coping styles and beliefs serve as protective factors against suicide in this population.

We had a group of community-dwelling older adults complete questionnaires on coping, reasons for living, and suicidal ideation. Some of the findings include:

- Suicidal ideation had a significant negative relationship with both problem- and emotion-focused coping and a significant positive relationship with dysfunctional coping.

- Suicidal ideation had a significant negative relationship with survival and coping beliefs, responsibility to family, child-related concerns, and total reasons for living score and a significant positive relationship with fear of suicide.

The findings suggest that a full assessment of coping styles and reasons for living should be part of a thorough evaluation of at-risk older adults. Future research should test the extent to which interventions that bolster coping skills and reasons for living reduce suicidal ideation and suicidal behaviors.

A substantial literature has documented that sexual abuse relates to suicidal behaviors but relatively less is known about resilience to suicide, especially cognitive deterrents to suicide.

The present study investigated the effects of a history of sexual victimization on reasons for living. Female participants (N = 138; M age = 24.4 years, SD = 7.3 years; range = 18 to 53 years; 79% Caucasian) completed the Sexual Experiences Survey (SES) and the Reasons For Living (RFL) Inventory. According to SES responses, participants were classified into 5 mutually exclusive groups: no victimization, sexual contact, sexual coercion, attempted rape, and rape. ANOVAs showed that degree of sexual victimization had a significant effect on the RFL Total scale and 2 subscales (Survival and Coping Beliefs; Moral Objections). The general pattern was that mean RFL scores in the no victimization group were significantly higher than the mean scores in the sexual coercion and rape groups.

An implication is that having a history of sexual victimization, especially sexual coercion and rape, limits one’s later reasons for not committing suicide. Bolstering these modifiable deterrents to suicide should be part of suicide prevention efforts among at-risk women.

The topic of this year's National Clinical Geropsychology Conference, hosted by the Gerontology Center at UCCS, was "End-of-Life Care and Bereavement." The conference co-chairs were Sara Honn Qualls, PhD and Julia Kasl-Godley, PhD. The keynote speaker, Shirley Otis-Green, MSW, spoke about "Building Your Legacy: Making Time Count," and urged the audience to consider what we can do now to influence our professional and personal legacy.

One of programs I was involved in at the CU Aging Center this year was the At Home Mental Health Service program. We partner with a local social service agency for seniors to provide therapy for clients in their homes. These individuals typically have a number of physical or emotional problems that make it difficult for them to leave their homes to obtain services.

Some things I learned through my work in this program:

1) It's OK to set boundaries: For example, asking clients to put pets in another room or not to smoke during the session is not selfish or too demanding, rather it's a way for me to take care of myself in order to give my full attention to the needs of my clients.

2) Therapy goals can never be too clear: This is particularly relevant with older clients who are dealing with loneliness. Sometimes I was seen as a "visitor" coming for social reasons. While increased social contact may be helpful in and of itself this may not be the best use of a therapist's skills.

3) Good supervision is essential: Of course supervision is always necessary, but it's especially important when dealing with complex clients. It was extremely helpful to have a team of peers and more experienced clinicians to discuss cases with and a place where I could admit I had no idea of what I was doing!

4) A lot of older adults who could benefit from therapy are out of the "reach" of traditional services: Several of the clients who I worked with through this program probably would have never engaged in therapy if it meant weekly trips to a clinic to meet with a therapist.

Though challenging, my participation in the At Home program was a valuable experience in helping me to develop as a therapist.

Last week I successfully proposed my thesis project titled, "Coping Strategies, Suicidal Risk, and Protective Factors Against Suicide in Older Adults." The goals of this study are to investigate coping abilities in older adults and how those relate to suicidal ideation and cognitive deterrents to suicide. We've already begun data collection and hope to have the study completed by the end of the year. Thank you to my committee (Daniel L. Segal, Ph.D., Frederick L. Coolidge, Ph.D., and Brian Yochim, Ph.D.) for all of their thoughtful comments and questions.

I'm happy to report that I've officially survived the first year of my PhD program! A few of my Clinical Neuropsychology classmates, our professor, Brian Yochim, PhD, and I went out to celebrate after our final was finished.