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INTRODUCTION: While parents' and professionals' perceptions regarding children with autism spectrum disorder (ASD) have been studied extensively, limited data regarding the perspectives of children with ASD on their needs and the challenges they face are available. The study aimed to examine how children with ASD understand their condition and the aims of the interventions they undergo. METHODS: Nineteen children and adolescents (ages 5.7-14.2 years) formally diagnosed with ASD, with borderline to high intelligence (range 70-140), and able to converse verbally were interviewed in person at a child development clinic. A qualitative approach was used to capture children's perceptions of their strengths and challenges and their understanding of a novel ASD treatment. The interview included direct and projective open-ended questions on each topic. Interpretive content analysis was used to evaluate the children's answers. Medical data were extracted from medical records. The children's parents completed questionnaires on their children's disability levels, awareness of ASD diagnosis, and sociodemographic details. FINDINGS: Children spoke of their embodied sensations and feelings and discussed "normality" vs. "disability." They varied in their awareness of their diagnosis/symptoms, and only one boy named his diagnosis and described its consequences in detail. Most children lacked an understanding of the educational and therapeutic aspects of the goals set for them. DISCUSSION AND CONCLUSIONS: Children with ASD are aware of their unique emotional and behavioral challenges. Nevertheless, they are frequently excluded from the process of patient information provision and lack an understanding of the goals of interventions. Findings suggest the need to explore developmentally and emotionally adaptive ways to involve children with ASD in discussions of their condition and possible interventions.

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PURPOSE: This paper explores the impact of stillbirth among men in Israeli society, which is marked by strong pronatalist norms. It sought to evaluate the impact of perceived social expectations and interactions with family, friends, and healthcare providers on the experience of problematic levels of grief among men experiencing stillbirth. METHODS: Thirty men after stillbirth were interviewed using semi-structured interviews and transcripts, which were analysed using the phenomenological approach. RESULTS: Four core themes were identified. The first theme exposes the discrepancy between men's pain on the one hand and the lack of awareness towards them on the other. The second theme found that not only is the attention of others directed almost exclusively towards their partners, men are expected to take on complex and demanding roles related to the loss. The lack of recognition, coupled with the need to perform the roles imposed upon them, seems to cause men to suppress their grief. The third theme was the lack of support from their parents, underlining their need for empathy and recognition in this family-oriented society. The fourth theme focused on the need for an emotional space of their own, in which they could be seen and listened to. CONCLUSION: The findings demonstrate that many most interviewees (25 out of 30) focused on their spouse's grief and recovery, diminishing their own remorse while receiving little recognition and support. Our findings may contribute to the overarching understanding of this particular kind of loss, and promote the creation of specially targeted interventions.

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The aim of the present study, based on in-depth semistructured interviews conducted in Israel with 18 social workers (nine women and nine men), working as probation officers who diagnose and treat sex offenders, was twofold: The first goal was to examine how treating sex offenders affects the male and female practitioners' daily lives and specifically, their parenting. Second, in light of the claim that support of colleagues and family members is very important for coping with secondary traumatization, the study investigated how working with sex offenders influenced the practitioners' ability to share their experiences with their colleagues in the workplace and with their partners at home. The study findings, based on a phenomenological analysis, revealed that male and female probation officers working with sex offenders experienced anxiety, suspicion, and concern for their children's safety. Their spousal and collegial relationships were also affected by their work. In addition to not receiving support from their colleagues and partners, they experienced loneliness and attacks "from the inside and from the outside," expressed in criticism, loathing, and disgust in relation to their work. The findings reveal, for the first time, the common and the distinct effects of male and female practitioners' experiences on their spousal and parental relationships. It also expands the understanding of the connection between exclusion and loneliness experienced by them, due to their limited ability of sharing their experience with colleagues and family members. The discussion offers theoretical explanations for these implications and recommends how to provide relief for male and female practitioners, who work with sex offenders.

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BACKGROUND AND OBJECTIVE: Male breast cancer is a rare and understudied disease. In addition to coping with cancer, suffering from what is perceived as a "woman's disease" significantly burdens men's illness experience and can lead to stigmatization. The way men cope with these challenges has not been studied to date. Drawing on stigma, coping, and destigmatization theories, this study aims to explore how men experience and respond to the diagnosis of an illness typically associated with women. METHODS: In-depth interviews were conducted with 16 Israeli men who were diagnosed with breast cancer within the past 10 years. Thematic analysis was performed, focusing on participants' references to experiencing and managing the psychosocial implications of being a male breast cancer patient. RESULTS: Results demonstrated that participants faced stigmatizing situations both inside and outside healthcare settings. In addition, findings revealed four main responses to stigmatization: (1) selective disclosure, (2) concealment practices, (3) universalizing, and (4) making comparisons. Whereas the first two are strategic reactions to specific situations, the latter two are general conceptual destigmatizing responses. CONCLUSIONS: Men's coping styles reveal their efforts to disengage from the discrediting attributes of male breast cancer, to distance themselves from female breast cancer, and to avoid emasculation. They manage stigmatizing situations using disengagement situational responses, such as concealment and selective disclosure, and negotiate group boundaries with the goal of destigmatizing male breast cancer. Beyond broadening the understanding of coping with male breast cancer, this study also illustrates the significant place of boundary work as a destigmatization practice about illness-related stigma.

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Although there is a great deal of literature about the distress of therapists who work with sex offenders, little is known about possible gender differences in their distress. The article presents a systematic review and small-scale meta-analysis that address two questions: whether one gender is more susceptible than the other to the adverse effects of treating sex offenders and whether their distress is manifested similarly or differently. Findings of 36 measures of association reported in 10 eligible studies with a total of 1,754 sex offender therapists (785 males) indicate that males are somewhat more vulnerable to the adverse effects of treating sex offenders (d = .204, p = .002). Moderator analysis indicates that male therapists show similar levels of burnout and disruption of sexual life as their female counterparts, but a significantly higher level of vicarious traumatization (d = .365, p < .001). These findings challenge Farrenkopf's well-known claim that female therapists who work with sex offenders are more prone to experiencing adverse emotional reactions than their male counterparts.

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This study explores social workers' perceptions of inequalities in Israel's national health care system. Unlike previous studies, which relied on patients' and practitioners' reports, it is based on interviews with 60 social workers in hospitals and ambulatory clinics. The findings show that although Israeli law provides for (almost) free, universal medical care, the treatment of persons lacking in money, education, and social affiliation may be compromised by difficulties in paying for medications, treatments, and travel to and from hospital; by difficulties in understanding doctors' instructions; and by reluctance to ask questions. Most doctors tend to focus exclusively on patients' medical needs, seem to lack sympathy with less educated patients, have little understanding of the life circumstances that impinge on their compliance, and make little effort to speak to them in the language they can understand. Practical suggestions are made with regard to the need to turn doctors' attention to their patients' non-medical needs.

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This critical review shows that, despite increasing attention to fathers in social work practice and research, men are still largely the 'unheard gender'. Almost all the social work literature that deals with men discusses them as fathers, namely in terms of their function in the family. Very little of it looks at men in other roles or situations or concerns itself with men's experiences, feelings or needs. Similar neglect of men characterises social work practice and training. The review points to a vicious circle in which the neglect of men in research, practice and training reinforce one another. It offers explanations for the neglect and suggestions for how to better include men as social work clients.

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The paper presents an empirical examination of the role social workers play in tempering inequality in medical care. Data were collected in 2011 through face-to-face, semi-structured, in-depth interviews with 60 social workers employed in hospitals and clinics in Israel and selected through purposive sampling. The interviews probed the social workers' perceptions of the scope, causes and manifestations of inequality in health and healthcare and the actions they took to ameliorate it. The interviews were analysed using grounded theory. The findings show that all the social workers were acutely aware of the inequalities in their places of work, regarded reducing the inequalities as a major part of their role and made efforts to do so. They facilitated communication between doctors and patients of low socioeconomic status and advocated for such patients with medical staff and administration, as well as with the country's medical and social welfare bureaucracies. The paper details the means they used and the challenges they faced. The study highlights the important role that social workers play in reducing inequality in healthcare.

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The issue of gender is largely ignored in studies of secondary traumatization (STS). This article addresses the question of gender differences in susceptibility to STS among clinicians who treat traumatized clients. It does so by systematically reviewing the very limited body of published findings on this subject to date. These are 10 published studies that measure STS by post-traumatic stress disorder (PTSD) symptomatology and 4 studies that measure it using Stamm's Professionals Quality of Life Survey (ProQOL), which queries PTSD symptomatology along with other difficulties that may arise in helping traumatized clients. Almost all the studies based on PTSD symptomatology show greater female susceptibility. Although the pattern is less clear in the ProQOL studies, the article argues that the research to date does not really show mixed findings, as is repeatedly claimed, but greater susceptibility among female clinicians. It also points out that the findings do not mean that male clinicians are unaffected by their traumatized clients and notes the various manifestations of their distress reported in the reviewed studies. The article offers a variety of explanations for the heightened female susceptibility.

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Although secondary traumatization has been extensively studied, gender difference in susceptibility has received limited attention. This study addressed the issue by a meta-analysis of published findings on male and female persons in close, extended relationships with trauma victims, namely, their spouses, parents, children, and therapists. The analysis included peer-reviewed studies, written in English and published between 1990 and January 2012. Twelve studies reporting 17 findings on 1,623 subjects were identified. All the studies showed females' higher susceptibility to secondary traumatization, with a mean effect size of 0.48 (95% CI [0.35, 0.60]). Moderator analysis revealed that studies conducted in the United States reported lower gender discrepancies than studies conducted elsewhere. The consistent finding that females are considerably more susceptible to secondary traumatization than males means that professionals must be made aware of the special vulnerability of girls and women and help them adopt ways of caring for the traumatized family member or clients while maintaining their own psychological boundaries.

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This study explores the contribution of others in the workplace to the self-identity and job integration of persons with severe mental health problems. Thematic content analysis of in-depth, semi-structured interviews conducted in 2009 with 15 Israelis with severe mental health problems who work in a variety of frameworks (protected and supported employment and open market) revealed three main themes: (i) dissatisfaction with the protected work settings in which they were initially employed; (ii) the importance they attributed to their relationships with others in their workplace; and (iii) the change in self-identity they underwent from persons defined by their mental health problems to persons who had worth, abilities and being beyond their illness. The findings underscore the important role of managers and colleagues in integrating persons with mental health problems at work and in strengthening the self-identity of those individuals.

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This paper addresses the question of gendered receptivity to Secondary Traumatic Syndrome (STS) in the family. Unlike other manifestations of distress in the family, where gender comparisons are a matter of course, very few such comparisons are made in studies of STS. Review of the findings of 12 studies, the only studies, to date, that provide data enabling the comparison of STS in males and females, shows that females in the family, whether daughters, wives, or mothers, are consistently more likely than the males, whether sons, husbands, or fathers, to experience the Posttraumatic Stress Disorder (PTSD) symptoms of a traumatized family member without having experienced the traumatic event itself. This pattern pertains to whether the event that precipitated the primary trauma was a collective or individual trauma and whether the STS sufferer was a child or adult or living or not living with the PTSD casualty. The Discussion points out that gender is an important factor in the development of STS, whether in interaction with role, beyond role, or both.

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The first experience of sex is a significant life event for men and women. Studies investigating first-time sex focus largely on relationships at a young age and among teenagers, whereas studies of that experience in the context of marriage are extremely sparse and focus mainly on clinical population of unconsummated marriage. The authors explore the individual and mutual emotional effect of first-time intercourse among Modern-Orthodox newlywed couples in Israel. In-depth interviews with 36 men and women during their first year of marriage revealed unique challenges and difficulties related to sexuality in general and to first sex experience in particular. The findings indicate that first sexual intercourse is experienced by men and women as associated with emotional and behavioral difficulties, which appear to be rooted in the traditional nature of the religious Modern-Orthodox society in Israel. The authors explore reasoning and justifications for these challenges and detail different coping strategies-of the individual and of the couple. The findings might be relevant for other traditional societies in which couples experience sex only after marriage. The findings might also support professionals and sex therapists in addressing newlywed couples' needs in similar traditional populations.

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In this study I explored the perceptions and responses of Jewish Israeli social workers to the health inequalities facing their Arab clients. Findings drawn from face-to-face, in-depth interviews with 26 Jewish Israeli social workers employed in the health field show that they were highly aware of the health inequalities. Although they uniformly insisted that there was no discrimination in the hospitals where they were employed, they observed extensive structural and individual discrimination outside the hospital and linguistic and sociocultural impediments to health equality within it. The discrimination provoked feelings of anger and moral outrage, guilt, and shame. Both the discrimination and the linguistic and sociocultural impediments filled them with frustration and led them, both individually and in concert with colleagues, to try to alleviate, circumvent, correct, or compensate for the impediments. Suggestions are made for practice and further research.

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In this article we present the findings of a qualitative examination of 30 mothers of very-low-birth-weight babies. Interviews conducted with the mothers when the babies were still in neonatal hospitalization show that virtually all the mothers described their delivery both as a traumatic event, and as a nonevent in which they felt that they barely participated. Most of them blamed themselves for not carrying full term, some blamed others, and some believed the premature delivery saved their baby's life. Following their truncated pregnancies, their "nonparticipation" in the delivery, and their separation from their newborn immediately after the delivery, virtually all the women reported difficulty grasping that they were mothers. Many reported a sense of loss, emptiness, and frustration that the baby was no longer inside. The women took a variety of measures, including magical means and parenting behaviors, to safeguard their vulnerable babies and to become mothers within the constraints of the neonatal unit.

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The phenomenon variously termed "shared reality," "shared trauma," or "shared traumatic reality" refers to situations in which helper and helpee, psychotherapist and client, are exposed to the same communal disaster. This article has two aims. One, pursued in the first part of the article, is to trace the development of the concept; analyze the conditions under which it was acknowledged, articulated, and labeled; and review the changes in the term over time. The other, pursued in the second part, is to offer a conceptualization of the phenomenon based on analysis of the literature. Here, the article shows that the phenomenon is characterized by two distinct dynamics, one pertaining to professionals providing help in the emergency phase, the other to professionals conducting ongoing psychotherapy; to offer a preliminary definition of the phenomenon which covers the shared features of the two dynamics; and to present the distinct features of each.

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In this article, I suggest that postdivorce paternal disengagement may be rooted in the father's tendency to link his children and ex-wife as a single entity in consequence of his failure to adequately mourn the loss of his ex-wife and to redefine his paternal role and identity in distinction from his spousal role and identity. I also suggest that the ex-spousal conflict that disengaged fathers often blame for their disengagement is the product of these failures and shows the progress from conflict through disengagement. These claims are developed on the basis of findings of other authors and illustrated though a case analysis of an absent father.

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The paper argues that (1) full recognition of men's losses in divorce is an essential prerequisite to offering divorced men the emotional help they may need and (2) that since men mourn the losses of divorce differently from women, counselors should take their unique way of mourning into consideration in their treatment of divorced men. The article then offers practical suggestions for when and how to reach out with offers of help to divorced men, ways of facilitating the mourning process of divorced men in therapy, and issues to consider when terminating treatment with divorced men.

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This article is based on the view that the nature of the divorced father's involvement with his children is affected by psychological processes that enable him to separate his parental from his spousal role and identity. It argues that the ability to cope with the simultaneous absence of the spousal role and identity and presence of the paternal role and identity is a key factor in shaping the divorced father's behavior toward his children. The article illustrates the claim in 3 case studies showing (a) parental functioning marred by ongoing conflict with the children's mother, (b) disengagement, and (c) stable and consistent parental functioning within the inevitable limitations of noncustodial fatherhood.

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This study examines the association between two sets of divorce process variables, a) initiation of and responsibility for the divorce and b) difficulty and duration of the legal procedure, and divorced spouses' co-parental relationship and parental functioning. In a random sample of 50 former couples, in Israel, findings showed that the longer and more conflictual the legal proceedings, the worse the coparental relationship in the view of both parents. They also showed that mothers' parental functioning was not significantly associated with any of the divorce variables, but fathers' were. The more responsibility the father assumed for the divorce and the more he viewed himself as the initiator, the more he fulfilled his parental functions. The findings are interpreted in the discussion, and their theoretical and practical implications considered.

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