Health is a Family Affair

by Charity Shumway

Mother Teresa once asked rhetorically, “What can you do to promote world peace?” She answered, “Go home and love your family.” Our family members are our first teachers, mentors and, often, friends. How we are treated by our families influences our self-esteem and actions toward others. Sustaining families, therefore, is essential to a healthy and peaceful world. Fortunately, researchers across Adelphi are examining the pressing issues facing modern families and offering new solutions to vexing challenges, such as caring for aging relatives , addressing substance abuse, balancing career and family and finding intimacy.

Self-Employment and Work-Family Balance

Is being your own boss the ticket to eliminating work-family conflict? Or is working for an organization with family-friendly policies the secret to balance? Adelphi Robert B. Willumstad School of Business Associate Professor David Prottas, Ph.D., studies exactly these issues.

Working with a large data set collected by the Family and Work Institute, Dr. Prottas has looked extensively at self-employment and family-related workplace benefits.

“We have this idea that self-employment is the avenue to wonderful work-family balance,” he says. “And the data…suggest that it works. Self-employed people in general have less work-to-family conflict than people who work for organizations.”

But he’s quick to add that it’s not as simple as that. “What seems to make a difference is not some magical quality to self-employment. It’s the job autonomy. If you compare organizational versus self-employed people, similar levels of autonomy equal similar levels of conflict.”

In fact, Dr. Prottas points out, self-employed people are, on average, happier and earn more money than the organizationally employed, but the self-employed also tend to be older, more highly educated and, more often, men, all characteristics that correspond with higher job satisfaction and earnings. “The data suggest that the self-employed earn more on average, but the particular type of workers likely to choose self-employment would actually earn more had they remained employees,” says Dr. Prottas. “You can think of it as the tax on not having a boss.”

If self-employment in and of itself isn’t the magic bullet, perhaps a family-friendly workplace is. Dr. Prottas says that, once again, the answer is yes and no. “The data show that family-friendly programs in the workplace make a bit of a difference, but what really seems to count in an institutional setting are the intangibles,” he says. “Formal programs don’t do that much, but the supportiveness of your colleagues and your boss does.”

Maybe in the end, that tax on not having a boss is a small price to pay for having an employer—yourself— whom you can count on to support your family- related choices.

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Substance Abuse, Internet Abuse and Family Intervention

Errol Rodriguez, Ph.D., Gordon F. Derner Institute of Advanced Psychological Studies assistant dean and director of the master’s program in general psychology and mental health counseling, has spent much of the last decade studying families who have been affected by addiction. “Somewhere between four and five significant others are affected by one person’s addiction,” explains Dr. Rodriguez. “We know that somewhere around 23 million people are substance abusers annually, so that’s about one-third of the country each year that’s affected.”

One way Dr. Rodriguez hopes to reach more of the people affected by substance abuse is through Community Reinforcement and Family Training (CRAFT) interventions. Rather than the traditional model of intervention, which involves a surprise confrontation with the addict, the CRAFT model is a strategically planned intervention where family members first discuss their role in enabling abuse and then determine what they can do so the using person begins to feel the consequences of his or her substance abuse.

“It’s a powerful behavioral therapy approach,” Dr. Rodriguez says. “With over 80 percent of the people who begin the CRAFT model, their significant other enters treatment.”

“That doesn’t mean they stop using,” Dr. Rodriguez clarifies, “but family members often feel a great sense of relief knowing that their loved one has started to get help.”

Dr. Rodriguez’s most recent research focuses on a new type of abuse: Internet addiction, particularly among adolescents.

“Some young adults are really glued to their phones, to the Internet, in a way that becomes problematic for their lives and their families,” Dr. Rodriguez says. “It’s different from other teenagers who enjoy their phones but don’t seem obsessed with them.”

Dr. Rodriguez is examining vulnerabilities to this type of compulsivity. “Is it similar to other addictions, like alcohol or marijuana?” Dr. Rodriguez wonders. “Are some of the same markers that put teens at risk for other behaviors, things like low self-esteem and eagerness to fit in, involved in compulsive Internet use?” In the coming year, he’ll begin to find out.

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Aging Family Members and Hidden Mental Health Issues

Associate Professor of Social Work Richard Francoeur first became interested in hidden mental health issues early in his career, as a medical social worker at a Veteran’s Administration hospital in Pennsylvania. He went on to compare the financial strain-related coping processes of patients over 65 who were undergoing outpatient palliative radiation for cancer with those of younger patients undergoing similar treatment.

Dr. Francoeur’s study revealed that older patients were more concerned about not having enough resources for the future, while younger patients were more concerned with difficulty meeting their current obligations. “Most screening for financial vulnerability and stress focus on present issues [like] paying bills,” says Dr. Francoeur, “so clinicians can miss older patients who are struggling, but who frame the issue differently.”

Similarly, in research with epidemiological data from an inner-city outpatient population receiving palliative care, Dr. Francoeur has found that screens for depression often miss older minority men. “Older adults are less likely to say that they feel sad, and yet they very much may be depressed even though they don’t use those kinds of terms,” Dr. Francoeur explains.

As an outgrowth of his work on hidden mental health issues, Dr. Francoeur’s research has more recently turned to symptom clusters. In his latest study, the experience of pain predicts depressive affect more strongly when pain occurred with fatigue and weakness or with sleeping difficulties, but only in patients reporting fever. When pain and either of these symptoms manifest together, interventions to relieve fever could reduce pain sensitivity and sickness malaise, which are concerns to multidisciplinary healthcare teams and smoking cessation programs.

Dr. Francoeur’s recent work has also focused on methodological advancement, in particular statistical innovations in moderated regression that make detecting and analyzing symptom clusters easier. Using his new methods, he plans next to look at symptom clusters in nonmalignant conditions that are related to the abuse of prescription drugs.

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Intimacy and Power in Relationships

For many years, Derner Institute Professor Janice Steil’s research focused on power in close relationships, particularly marriage. “Historically, marriage is associated with more benefits for men than for women, and unhappy marriages are associated with more costs for women than they are for men,” she explains. “I wanted to know under what conditions relationships are mutually beneficial.”

Her research showed that women who have more equal voices, who feel that housework and childcare are fairly shared, and whose husbands are supportive of their paid work are less depressed and benefit more from their relationships, says Dr. Steil.

Several years ago, however, at the urging of one of her graduate students, Dr. Steil’s interests began to shift from power to intimacy. Her first research in the area, a collaborative study with Derner alumna (then Ph.D. candidate) Susan Rosenbluth, M.A. ’89, Ph.D. ’92, looked at influence strategies in relationships and perceptions of intimacy. “We found that the more reciprocal the relationships, the more intimate the relationships, the better the well-being for both partners,” Dr. Steil says.

In a more recent study, Dr. Steil looked at expectation of intimacy and attachment styles in engaged couples and followed up with the same couples five years later to determine how their intimacy expectations and attachment styles had played out in their marital satisfaction and psychological well-being after marriage. She found that greater intimacy was associated with lower depression rates, both for the engaged and the married.

“People think that women are more relationship oriented and men less,” Dr. Steil says. “But, actually, men are clearly equally dependent upon intimate relationships. The benefits of intimacy were the same for both women and for men in this study.”

Dr. Steil’s most recent research focuses on cross-cultural conceptions of intimacy. “What’s different in today’s relationships from past relationships is that they’re more individualistically oriented,” Dr. Steil explains. “We put a huge burden on our partners to fulfill our intimacy needs. In a non-Western, more collectivist culture, you might have a much broader range of people who are fulfilling these intimacy needs.” To test her ideas, Dr. Steil, in collaboration with Derner alumna Beth Turetsky, M.A. ’84, Ph.D. ’90, is comparing intimacy expectations among students from China who are studying English at the Adelphi-based ELS program with intimacy expectations among master’s students in other programs at the University. In the coming year, she hopes to have her first early results.