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While an increasing number of clinical reports and descriptive studies have documented stress-related dysfunction in family caregivers of older adults with chronic dementia, little is known about specific factors that place members at risk for negative outcomes. This study examined the relative effects of psychological and social characteristics on well-being in spousal caregivers of older adults with chronic dementia. Fifty-one spouses completed questionnaires assessing dementia severity, distress in appraisal of dementia symptoms, perceived support from family and peers, reliance on specific coping strategies, and psychological well-being. The results of the path analysis showed that gender, appraisal of dementia symptoms, perceived peer support, and three types of coping strategies (problem-solving, positive focus, and wishful thinking) were significant predictors of well-being. Overall, the predictor variables accounted for 60.3 percent of the variance in psychological well-being. The findings document the salience of these characteristics in further study of caregiver functioning. More generally, results provide support for multi-dimensional models of stress, coping, and adaptation. The findings have implications for clinical intervention. (Author/NB)

Demonstrates how narrative perspectives provide means of conceptualizing brief psychotherapy following negative life outcomes. Representative case studies illustrate three types of narrative construction following adverse experiences and show how narrative perspectives shift focus from disability and dysfunction to concern for client strengths, coping, and adaptive potential. (Author/NB)