HSCO 506
JOURNAL ARTICLE REVIEW: FOUNDATIONAL AND WORLDVIEW ISSUES OF INTEGRATION ASSIGNMENT
OVERVIEW
You will write 2 Journal Article Reviews, which will be based upon your choice of articles from
the professional, peer-reviewed journal articles provided in Canvas under the Journal Article
Review Resources. No outside articles will be accepted. Each Journal Article Review must be
3–5+ double-spaced pages (not including the title and reference pages) and created in a
Microsoft Word document. Use the following guidelines to create your paper:
INSTRUCTIONS
1. Start your paper with a title page, correctly formatted per current APA. Use the provided
template and the basic current APA components will be in place. Divide your paper into
sections with the following Level One headings: Summary, Reflection, and Application as
described on the template.
2. Develop a summary of the main concepts from the article. Do not duplicate the articleÂ’s
abstract. If the article describes a research study, include brief statements about the
hypotheses, methods, results, discussion, and implications. If any test measures or statistical
methods used are given in the article, do not provide detailed descriptions of these. Short
direct quotations from the article are acceptable but avoid long quotes in a paper this size.
This section is the foundation of your Journal Article Review (at least a third of your
paper). Make sure you include the core points from the article, even if it means a longer
section. Do not reference any additional articles in your summary.
3. In approximately 1+ page, reflect on the article using your own words. Appropriate
comments for this part of the paper could include, but are not limited to, your initial response
to the article, comments regarding the study’s design or methodology (if any), insights you
gained from reading the article, your reasons for being interested in this particular article, any
other readings that you may plan to do based upon having read the article, and other thoughts
you have that might further enhance the discussion of your article. Your subjective comments
in this section must be clearly tied to main points from the article, not peripheral ideas.
Again, do not reference any other article.
4. In your final section, in approximately 1+ page(s), write how you would apply the
information you have learned from this article to a particular counseling setting. Make this
setting one that would typically be seen in human services counseling—community services
agencies, adoption agencies, volunteer counseling settings such as in churches, etc. Develop
this section as if you are a pastor or clinician and your parishioner or client has come to you
with a problem—grief, depression, substance abuse, relationships problems, etc.— needing
your help. Adequately describe the counseling scenario including the presenting problem.
Draw out concepts from the article and apply them to the scenario as if you were guided only
Page 1 of 2
HSCO 506
by the content of the article. Show the reader how you expressly drew from the journal article
in this application section and cite correctly, per APA.
This assignment incudes an APA template for the current APA version. You simply need to put
your information into the various areas (running head, title, etc.) and the template itself instructs
you how to add your information and delete the instruction comment balloons. Using the APA
template with put you on a track of getting the “basics” of APA correct.
Note: Your assignment will be checked for originality via the Turnitin plagiarism tool.
Page 2 of 2
1
School of , Liberty University
Author Note
I have no known conflict of interest to disclose. “”
Correspondence concerning this article should be addressed to
Email:
2
Abstract
Keywords:
3
APA Headings
Level Format
1
Centered, Boldface, Title Case Heading
Text starts a new paragraph.
2
Flush Left, Boldface, Title Case Heading
Text starts a new paragraph.
3
Flush Left, Boldface Italic, Title Case Heading
Text starts a new paragraph.
4
Indented, Boldface Title Case Heading Ending With a Period. Paragraph text
continues on the same line as the same paragraph.
5
Indented, Boldface Italic, Title Case Heading Ending With a Period. Paragraph text
continues on the same line as the same paragraph.
Thus, if the article has four sections, some of which have subsections and some of
which donÂ’t, use headings depending on the level of subordination. Section headings
receive level one format. Subsections receive level two format. Subsections of
subsections receive level three format.
4
References
Reed, G. L., & Enright, R. D. (2006). The effects of forgiveness therapy on depression, anxiety,
and posttraumatic stress for women after spousal emotional abuse. Journal of Consulting
& Clinical Psychology, 74(5), 920-929. doi:10.1037/0022-006X.74.5920
:
The effects of forgiveness therapy on
depression, anxiety, and posttraumatic
stress for women after spousal emotional
abuse.
Authors:
Reed, Gayle L.. Department of Educational Psychology, University of
Wisconsin-Madison, Madison, WI, US, [email protected]
Enright, Robert D.. Department of Educational Psychology, University of
Wisconsin-Madison, Madison, WI, US
Address:
Reed, Gayle L., Educational Outreach, University of Wisconsin ExtensionMadison, 1050 University Avenue, Madison, WI, US, 53706,
[email protected]
Source:
Journal of Consulting and Clinical Psychology, Vol 74(5), Oct, 2006. pp.
920-929.
NLM Title
Abbreviation:
J Consult Clin Psychol
Publisher:
US : American Psychological Association
Other Journal
Titles:
Journal of Consulting Psychology
Other Publishers:
US : American Association for Applied Psychology
US : Dentan Printing Company
US : Science Press Printing Company
ISSN:
0022-006X (Print)
1939-2117 (Electronic)
Language:
English
Keywords:
spousal emotional abuse, forgiveness therapy, depression, anxiety,
posttraumatic stress
Abstract:
Emotionally abused women experience negative psychological outcomes
long after the abusive spousal relationship has ended. This study compares
forgiveness therapy (FT) with an alternative treatment (AT; anger validation,
assertiveness, interpersonal skill building) for emotionally abused women
who had been permanently separated for 2 or more years (M = 5.00 years,
SD = 2.61; n = 10 per group). Participants, who were matched, yoked, and
randomized to treatment group, met individually with the intervener. Mean
intervention time was 7.95 months (SD = 2.61). The relative efficacy of FT
and AT was assessed at p < .05. Participants in FT experienced significantly greater improvement than AT participants in depression, trait anxiety, posttraumatic stress symptoms, self-esteem, forgiveness, environmental mastery, and finding meaning in suffering, with gains maintained at follow-up (M = 8.35 months, SD = 1.53). FT has implications for the long-term recovery of postrelationship emotionally abused women. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Document Type: Journal Article Subjects: *Battered Females; *Emotional Abuse; *Emotional Trauma; *Forgiveness; *Psychotherapy; Anxiety; Domestic Violence; Major Depression; Posttraumatic Stress Disorder Medical Subject Headings (MeSH): Adult; Anxiety; Attitude; Battered Women; Depression; Female; Guilt; Humans; Interpersonal Relations; Middle Aged; Psychotherapy; Self Concept; Social Facilitation; Spouse Abuse; Stress Disorders, Post- : Traumatic; Surveys and Questionnaires PsycInfo Classification: Psychotherapy & Psychotherapeutic Counseling (3310) Population: Human Female Location: US Age Group: Adulthood (18 yrs & older) Thirties (30-39 yrs) Middle Age (40-64 yrs) Tests & Measures: Environmental Mastery Scale Psychological Abuse Survey Coopersmith Self Inventory Enright Forgiveness Inventory Reed Finding Meaning in Suffering Beck Depression Inventory–II DOI: 10.1037/t00742-000 State Trait Anxiety Inventory Methodology: Empirical Study; Quantitative Study Format Covered: Electronic Publication Type: Journal; Peer Reviewed Journal Publication History: Accepted: Jun 16, 2006; Revised: May 31, 2006; First Submitted: May 19, 2005 Release Date: 20120109 Correction Date: 20120109 Copyright: American Psychological Association. 2006 Digital Object Identifier: http://dx.doi.org.ezproxy.liberty.edu/10.1037/0022-006X.74.5.920 PMID: 17032096 PsycARTICLES ccp-74-5-920 Identifier: Accession Number: 2006-13014-013 Number of Citations in 44 Source: : The Effects of Forgiveness Therapy on Depression, Anxiety, and Posttraumatic Stress for Women After Spousal Emotional Abuse This content may contain URLs/links that would redirect you to a non-EBSCO site. EBSCO does not endorse the accuracy or accessibility of these sites, nor of the content therein. By: Gayle L. Reed Department of Educational Psychology, University of Wisconsin—Madison;; Robert D. Enright Department of Educational Psychology, University of Wisconsin—Madison Acknowledgement: Spousal emotional abuse is a significant problem, with approximately 35% of women reporting such abuse from a spouse or romantic partner (O'Leary, 1999); in addition, women often demonstrate negative psychological outcomes long after this abuse. Despite the frequent calls for efficacious therapies for these women, no empirically validated treatments have been clearly established (Enns, Campbell, & Courtois, 1997; Mancoske, Standifer, & Cauley, 1994; Miller, Veltkamp, & Kraus, 1997; Paul, 2004), and the literature still demonstrates a focus on the definition of and screening for spousal emotional abuse rather than empirical testing of therapeutic strategies (Follingstad, 2000; Gondolf, Heckert, & Kimmel, 2002; Tjaden, 2004). Spousal psychological abuse represents a painful betrayal of trust, leading to serious negative psychological outcomes for the abused partner (Dutton & Painter, 1993; Sackett & Saunders, 1999). According to Sackett and Saunders (1999), spousal psychological abuse functions with the purpose of causing emotional pain to the spouse and establishing an unequal distribution of power in the relationship. Sackett and Saunders (1999) have demonstrated negative outcomes of emotional abuse that are distinct from the impact of physical battery. Follingstad, Rutledge, Berg, Hause, and Polek (1990) and Sackett and Saunders (1999) have identified at least seven categories of spousal psychological abuse: criticizing, ridiculing, jealous control, purposeful ignoring, threats of abandonment, threats of harm, and damage to personal property, with ridicule associated most strongly with negative outcomes of psychological abuse. Moreover, Follingstad et al. (1990) found that 72% of participants : reported that emotional abuse had a more negative impact than physical abuse. The negative psychological outcomes of spousal psychological abuse include depression (O'Leary, 1999; Pimlott-Kubiak & Cortina, 2003; Sackett & Saunders, 1999), anxiety (Dutton & Painter, 1993), posttraumatic stress disorder (Astin, Lawrence, & Foy, 1993; Enns et al., 1997; Pimlott-Kubiak & Cortina, 2003; Woods, 2000), low self-esteem (Aguilar & Nightingale, 1994), learned helplessness (Follingstad et al., 1990; Launius & Lindquist, 1988), and an ongoing, debilitating resentment of the abuser (Seagull & Seagull, 1991). A number of researchers (Astin et al., 1993; Dutton & Painter, 1993; Sackett & Saunders, 1999; Woods, 2000) have demonstrated that these negative outcomes last well beyond the end of the abusive relationship. Considering the serious, enduring impact on the psychological health of the emotionally abused partner, the theoretical and empirical literature on efficacious postrelationship, postcrisis treatment for spousal psychological abuse is sparse. There is a lack of empirical evidence for the efficacy of one treatment that is currently recommended for these women: brief therapy with a focus on anger validation (with subsequent mourning of associated losses from the abuse), assertive limit-setting, and interpersonal skill building. Neither Mancoske et al. (1994) nor Rubin (1991) provided clear empirical support for the efficacy of this brief therapy for emotionally abused women. A review of the current literature did not produce empirical evidence for the efficacy of other therapeutic approaches for emotionally abused women. One promising new area of treatment is forgiveness therapy (FT). Research on FT has established a causal relation between forgiving an injustice and both the amelioration of anxiety and depression and an improvement in self-esteem (Al-Mabuk, Enright, & Cardis, 1995; Coyle & Enright, 1997; Freedman & Enright, 1996; Lin, Enright, Mack, Krahn, & Baskin, 2004; Rye et al., 2005). FT directly targets ongoing resentment, which can lead to depression, anxiety, and other negative psychological outcomes (Enright & Fitzgibbons, 2000), and it has been shown in one study to ameliorate the negative emotional effects of incest (Freedman & Enright, 1996). FT posits that although anger is a justifiable, initial problem-solving response to severe wrongdoing, as in the case of emotional abuse, lingering resentment can compromise a person's emotional health and decision making. In helping clients move toward forgiveness, clinicians need to differentiate forgiving (see : Enright & Fitzgibbons, 2000, for a discussion of defining forgiveness) from condoning, excusing, pardoning, forgetting, and reconciling. Forgiveness is a decision to give up resentment and to respond with goodwill (benevolence based on a desire for the ultimate welfare of the other person; North, 1987) toward the wrongdoer. Current research (see Rye et al., 2005) operationalizes forgiveness similarly as refraining from negative responses to the wrongdoer and fostering positive responses to him or her while also clearly distinguishing forgiveness from pardon and reconciliation. For women who have experienced spousal emotional abuse, FT promotes the reclamation of valued personal qualities, such as compassion, without neglecting the injustice of the abuse or encouraging interactions with the former partner, which may result in further abuse. FT assists the emotionally abused woman to examine the injustice of the abuse, consider forgiveness as an option, make the decision to forgive, do the hard work of forgiving (grieve the pain from the injustice, reframe the wrongdoer, relinquish resentment, and develop goodwill), find meaning in the unjust suffering, and discover psychological release and new purpose. These aspects of FT fall within the four phases of the Enright forgiveness process (Enright & Fitzgibbons, 2000)—uncovering, decision, work, and discovery—currently used in treatment and research. Robust results have been found in randomized experiments with FT. Lin et al. (2004), in their FT experiment in a drug rehabilitation unit, following Hedges and Olkin (1985), reported an effect size of 1.58 across all dependent measures after adjusting for intercorrelations among variables. Similar effect sizes (1.44 and 1.42, respectively) were reported in Freedman and Enright (1996) and in Coyle and Enright (1997). In all three studies, the sample sizes were relatively small, ranging from 10–14 participants per study. Other randomized experiments with FT have been reported (e.g., Rye et al., 2005). See Baskin and Enright (2004) for a meta-analysis of FT. Women who have experienced spousal emotional abuse present at least two unique challenges for recovery. First, learned helplessness (Sackett & Saunders, 1999) develops as a pattern of self-blame in response to the criticism and ridicule by the abusive spouse and often remains well beyond the end of the abusive relationship (Dutton & Painter, 1993). “If only I had done this to please him” quickly deteriorates in the ongoing, unpredictable stress of the abusive relationship to “I am trying to prevent this, but nothing is working” and remains in a residual “Maybe I am worthless and none of my decisions are valid.” : Therefore, any treatment for these women should demonstrate outcomes in practical decision making and moral decision making. This study tests these outcomes (environmental mastery and finding meaning in suffering) and suggests that FT ameliorates this problem more successfully than an alternative treatment (AT). Second, Seagull and Seagull (1991) described an obstacle to recovery for emotionally abused women labeled accusatory suffering, which entails maintaining resentment and victim status. The assumption in accusatory suffering is that healing the wounds of the abuse will somehow let the perpetrator off the hook. At a deeper level, accusatory suffering may be seen as a defense against the fear that the woman is somehow responsible for her own victimization, a fear that is often inculcated by the victimizer (Sackett & Saunders, 1999). Seagull and Seagull (1991) argued that although accusatory suffering (resentment and victim status) may function as a temporary strategy to help the woman adapt to the extreme experience of spousal emotional abuse, it seriously hinders substantial postrelationship, postcrisis recovery. Therefore, any treatment for these women should demonstrate a change in victim status. This study tests this outcome (story measure) and suggests that FT is more successful than AT. One current therapeutic approach recommended and tested in the literature (Enns et al., 1997; Mancoske et al., 1994; Miller et al., 1997) for postrelationship, postcrisis emotionally abused women includes anger validation about the wrongdoing of abuse, assertiveness, and interpersonal skill building (AT). During an early period of separation from the abusive relationship (perhaps 1 to 2 years), anger validation likely helps emotionally abused women confirm the injustice of the abusive spouse's behavior and thus provides support for the woman's choice to escape the abusive relationship. Moreover, as validation of anger after such a deep, personal injustice can be an important step toward helping women uncover and mourn the pain (Mancoske et al., 1994) from this unjust injury, the uncovering phase of FT addresses this as well. However, we suggest that anger validation (even with the subsequent mourning) over time without the inclusion of work toward forgiveness may inadvertently promote the accusatory suffering described by Seagull and Seagull (1991) and thus contribute to the debilitating resentment that maintains and likely even increases the negative psychological outcomes of the abuse. FT does have an overall, targeted focus on decreasing this resentment toward the abusing : former partner, which Seagull and Seagull (1991) suggested hinders optimal recovery. Moreover, the mourning work done in FT is for the specific purpose of aiding the recovering women to successfully relinquish resentment and revenge toward the former abuser and to develop goodwill. It is important, again, to reiterate that FT does not require nor encourage reconciliation (a critical concern that likely prevents recommendation of forgiveness in recovery strategies; Herman, 1997). FT, therefore, makes a safe and distinct contribution to postrelationship, postcrisis therapy for emotionally abused women by promoting the practice of a specific moral quality (choosing forgiveness, relinquishing resentment, developing goodwill) as a way of integrating the past traumatic experience of emotional abuse with current positive, empowering moral choices (Astin et al., 1993; Frankl, 1969; Reed, 1998). FT thus likely effectively ameliorates the negative psychological outcomes of emotional abuse because engagement in the forgiveness process does decrease resentment toward the former abuser (along with concomitant depression, anxiety, and low self-esteem, which are associated with emotional abuse; Sackett & Saunders, 1999) and validates the positive, moral decision to replace resentment with goodwill (thus addressing the learned helplessness associated with emotional abuse; Follingstad et al., 1990). We therefore hypothesized that individuals who participated in FT would demonstrate less depression, anxiety, and posttraumatic stress symptoms and more self-esteem, environmental mastery, and finding meaning in suffering than those who engaged in the more standard therapeutic procedure (AT), which does not directly target the amelioration of this resentment. To have as fair a comparison as possible between FT and AT, we addressed methodological problems in past AT studies for both treatment conditions by having a single presenting problem (psychological abuse), a single living arrangement (permanent separation from the abusive partner), postcrisis treatment (all women had been separated at least 2 years from the former abuser), and criterion ending (rather than brief therapy at 4–6 weeks). Method Participant Sample The participants were 20 psychologically abused women in a Midwest city who had been divorced or permanently separated for at least 2 years from their spouse or romantic partner. They ranged in age from 32 to 54 years (M = 44.95, SD = 7.01). Regarding ethnicity, 18 (90%) self-reported as European Americans, 1 (5%) was Hispanic American, : and 1 (5%) was Native American. Educational levels included 4 (20%) with a high school diploma or general equivalency diploma, 6 (30%) with some college education or an associate's degree, 4 (20%) who were college graduates, 3 (15%) who had some postgraduate education, and 3 (15%) who had postgraduate degrees. Three (15%) of the participants were unemployed, 5 (25%) had part-time employment, and 12 (60%) had fulltime employment. One participant (5%) held a job in service, 7 (35%) worked in clerical jobs, 2 (10%) worked in business or sales, and 7 (35%) had professional careers. Six (30%) participants had no children living with them, whereas 14 (70%) had one to four resident children. Five (25%) of the participants had remarried, and 15 (75%) had not remarried or started a new relationship with a live-in partner. These participants were all self-selecting volunteers; 2 (10%) responded to recruitment flyers (posted in domestic abuse resource centers), and 18 (90%) responded to newspaper advertisements (for women between the ages of 25 and 55 who had experienced spousal psychological abuse but not physical abuse and who had been permanently separated for at least 2 years). The participants reported the following psychological abuse: Eighteen participants (90%) reported criticizing, 20 participants (100%) reported ridiculing, 15 participants (75%) reported jealous control, 20 participants (100%) reported purposeful ignoring, 5 participants (25%) reported threats of abandonment, 6 participants (30%) reported threats of personal harm, and 4 participants (20%) reported threats of harm to property or pets. Six (30%) participants also disclosed experiences of sexual abuse (5 described ridicule followed by demands for sexual favors, and 1 described threats of physical harm combined with demands for sexual favors). We set the criterion that women be 2 years postseparation to prevent promoting “false forgiveness” (e.g., “He won't do it again”), which often occurs in the abuse cycle. Also, working on forgiveness too early in a separation might mistakenly encourage a woman to feel empathy and compassion for her abusive former partner in a way that would foster old patterns of reuniting, including inappropriate dependence on the part of the former partner and subsequent harm from further abuse. Actual time since separation ranged from 2 to 10 years (M = 5.00 years, SD = 2.61). Design A matched, yoked, and randomized experimental and control group design was used, with : 10 pairs formed after screening interviews and pretest measures. Participants in each pair were matched as closely as possible on age, duration of the abusive relationship, and time since permanent separation or divorce. Correlations for matching variables within pairs were duration of abuse (r = .91, p < .0001), time since permanent separation (r = .72, p < .02), and age (r = .76, p < .01). Duration of the abusive relationship ranged from 1 to 31 years (M = 16.65 years, SD = 9.01). Contact with the former partner (regarding children) ranged from no contact to more than once per week, with a moderate correlation between matched pairs of .356. Following matching, 1 participant from each pair was randomly selected for FT, and the other was assigned to AT. Testing Procedure Screening Screening measures included the Psychological Abuse Survey (Follingstad, 2000; Follingstad et al., 1990; Sackett & Saunders, 1999), a posttraumatic stress symptom checklist (PTSS; from the Diagnostic and Statistical Manual of Mental Disorders; 4th ed.; DSM–IV;American Psychiatric Association, 1994), and a psychological screening checklist. A participant was included in the study if she demonstrated psychological abuse in at least three categories with a score of at least four and demonstrated at least three symptoms on the PTSS checklist. A score of 41 or higher on the Psychological Abuse Survey was considered indicative of a present and serious pattern of emotional abuse. All participants reported scores of 41 or above. A participant was excluded from the study if she demonstrated current involvement in an abusive relationship, described a history of childhood physical abuse, or demonstrated evidence of significant ongoing psychiatric illness, such as suicidal ideation or psychosis. We excluded persons with a history of childhood abuse to fairly focus treatment (AT or FT) on only one major wrongdoing (i.e., the spousal emotional abuse). Exclusion for suicidal ideation and psychosis was done as such women would likely be better served with crisis care or counseling with the availability of psychiatric medical treatment. Appropriate referrals were offered. Dependent variables : Before administration of any pretest measure, all participants read and signed informed consent forms approved by the research program's human subjects board and consistent with American Psychological Association standards. Then a brief description of the study was offered. The participants were told that the purpose of the study was to promote coping strategies for women who had experienced emotional abuse and that it included weekly 1hr individualized therapy sessions. Each participant was then invited to fill out the nine pretest measures. Instruments All screening and dependent measures were presented to each participant in random order at pretest, posttest, and follow-up. All measures were given after signed informed consent. Psychological Abuse Survey This questionnaire (an adaptation from Follingstad, 2000; Follingstad et al., 1990; Sackett and Saunders, 1999) asks, “How often did your partner ____?” with seven categories of abuse: (a) criticizing behavior (e.g., “You don't do anything well enough”), (b) ridiculing of traits (e.g., “You are worthless”), (c) jealous control (e.g., “You can't maintain any outside social support”), (d) purposeful ignoring (e.g., “You don't exist”), (e) threats of abandonment, (f) threats of harm, and (g) threats to damage personal property. Frequency of each abuse category was scored on a Likert scale ranging from daily (8) to never (1). Total scores for participants ranged from 41 to 106 (M = 70.63, SD = 17.58). For the purposes of this study, a total score of 41 or above is considered a high level of abuse (Dutton & Painter, 1993; Sackett & Saunders, 1999). The Enright Forgiveness Inventory (EFI; Subkoviak et al., 1995) The EFI is a 60-item self-report measure of the degree of interpersonal forgiveness, equally divided in six components: Positive and Negative Affect (e.g., “I feel ____ toward him/her”), Positive and Negative Behavior (e.g., “Regarding the person who hurt me, I do or would ____”), and Positive and Negative Cognition (e.g., “I think she or he is ____”). Range is from 60 to 360, with high scores representing high levels of forgiveness. Subkoviak et al. (1995) reported an alpha coefficient of .98. Cronbach's alpha for this study at pretest (N = : 20) was .94. Coopersmith Self-Esteem Inventory (CSEI; Coopersmith, 1989) The adult form of the CSEI consists of 25 true-false statements (e.g., “This is like me or not like me”) evaluating attitudes toward the self in the following domains: general self, social self, self and peers, and self and parents. Range of scores is 0 (low score) to 100 (high score). Reliability and validity for this scale have been well documented (Coopersmith, 1989). The Cronbach's alpha for pretest scores (N = 20) for this study was .84. State-Trait Anxiety Inventory (STAI; Spielberger, 1983) The STAI, a common instrument in clinical work, is composed of two self-report questionnaires (20 items each) that assess state (e.g., “Right now at this moment I feel ____”) and trait (e.g., “Generally I feel ____”) anxiety. The range of scores for each questionnaire is 20 (low anxiety) to 80 (high anxiety). Cronbach's alphas for this study at pretest (N = 20) were .95 (state) and .92 (trait). Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) The BDI-II is a self-report measure of 21 items in a multiple choice format (four choices, ranging from “I do feel ____” to “I do not feel ____”). Scores can range from 0 (no depression) to 63 (high depression). This instrument has been used extensively in clinical research and demonstrates construct validity and reliability. Freedman and Enright (1996) reported a reliability of .84 for incest survivors. The Cronbach's alpha for pretest scores in this study (N = 20) was .90. Environmental Mastery Scale (Ryff & Singer, 1996) The Environmental Mastery Scale is one of six Scales of Psychological Well-Being (Ryff & Singer, 1996), which represent distinct concepts that are evaluated separately. It has 14 items rated from 1 (strongly disagree) to 6 (strongly agree)—for example, “I am the kind of person that ____” or “I am not the kind of person that ____.” The items contain questions about personal mastery in everyday decisions (high score indicates environmental mastery). The scale yields adequate reliability (Ryff & Singer, 1996). The Cronbach's alpha : at pretest for this study (N = 20) was .80. Reed (1998) Finding Meaning in Suffering This instrument assesses the participant's engagement in Viktor Frankl's (1969) concept of finding meaning in suffering. Thus, items are questions about moral decisions in response to unjust suffering and questions about support (identifying with persons and values) for these moral decisions (Astin et al., 1993; Frankl, 1969; Reed, 1998) Each of 22 items is rated from 1 (not true) to 5 (very true)—for example, “I find this experience ____” or “I see this experience as ____”—producing scores of 22 to 110. Internal consistency is high (Reed, 1998). The Cronbach's alpha at pretest for this study (N = 20) was .88. PTSS checklist This checklist was derived directly from the DSM–IV criteria checklist. The lead question reads, “Are the events (of psychological abuse) re-experienced in one or more of these ways?” The categories include (a) recurring and intrusive memories, (b) distressing dreams, (c) intense distress on reminders of the abusive events, (d) the avoidance or denial of emotional responses to the abusive events, (e) anxious feelings and thoughts, (f) trouble sleeping, and (g) difficulty concentrating. Participants were to answer yes (1 point) or no (0 points) to each category if the symptom had occurred in the last month. This DSM–IV symptom checklist was used not only for screening and measurement purposes but also to clearly validate to participants in both treatment groups that the treatment focus was on the effects of a past traumatic relationship (rather than on what is wrong with women who enter and remain in abusive relationships). This was done to promote a sense of interpersonal safety (Herman, 1997) and rapport with the intervener. Story measure This measure is a one-page narrative from the participant's current perspective about the role that spousal psychological abuse has in her life story. Two raters who were blind as to the identity of the participant rated a score for both the old story (victim status) and the new story (survivor status). One point was given for the following categories if they were present: for the old story, focuses on the power of abuser; describes self as victim of abuse; : describes abuse events but no decisions; abuse memories are resentful, repetitive, or intrusive; for the new story, focuses on her power to choose, puts abuse in context of other life events, describes abuse review as impetus for new decisions, contrasts memories of abuse to ongoin

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