Enhancing psychosocial competence among black women in college.
Many black women in the United States experience unique stressors
that often impede their ability to interact and cope effectively in
their psychosocial environment. The study in this article examined
factors affecting the ability of black women to cope with everyday
stressors and to master situations that induce psychological distress.
Using an experimental design composed of an intervention group and a
nontreatment control group with pretest and posttest measures, the study
tested three hypotheses concerning the effectiveness of a
psychoeducational group intervention involving 58 undergraduate black
college women. Results revealed that after the eight-week group program
the level of perceived stress among intervention group participants was
reduced significantly compared with members of the control group. The
difference remained statistically significant after control variables
were taken into account. However, the data failed to support the
hypotheses that the intervention would have a statistically significant
effect on reducing the participants' external locus of control and
increasing active coping. Although this study was conducted with a small
sample of black college women, the findings offer preliminary data on
the effectiveness of culture-based group interventions with black women
aimed at enhancing psychosocial competence.
Key words: black Americans; college students; group work; psychosocial competence; women
|Author:||Jones, Lani V.|
|Publication:||Name: Social Work Publisher: National Association of Social Workers Audience: Academic Format: Magazine/Journal Subject: Sociology and social work Copyright: COPYRIGHT 2004 National Association of Social Workers ISSN: 0037-8046|
|Issue:||Date: Jan, 2004 Source Volume: 49 Source Issue: 1|
Black women who surfer from a variety of mental health symptoms,
which are persistent and at times debilitating, comprise a large target
population for social workers. Although social work has a history of
intervening with black women in mental health, there is a lack of
theoretical and empirical knowledge concerning what is most effective
with this population (Gutierrez, 1990; Hopps & Pinderhughes, 1999;
Lewis & Ford, 1991; Padgett, Patrick, Burns, & Schlesinger,
1994). Most of the clinical studies concerning black women were based on
a pathological perspective. These studies focused on maladaptive
behaviors and negative mental health outcomes of black women and
included academic problems, substance abuse, dysfunctional family
cohesion and adaptation and coping responses to stress, domestic
violence, and problems associated with single parenthood (Belle, 1990;
Brown, 1990; Neighbors, Jackson, Bowman, & Gurin, 1983; Taylor,
Chatters, Tucker, & Lewis, 1990).
Few practice or research models have focused on the ability of black women to deal competently with their oppressive realities, which often lead to psychological and social dysfunction. Mental health researchers have identified the concepts of psychosocial competence (that is, locus of control, coping, and self-efficacy) and cultural diversity (that is, race, sex, and culture) as constructs central to improving models for understanding and enhancing the psychological well-being of black Americans in mental health treatment (Tyler, Brome, & Williams, 1991; Tyler & Pargament, 1981).
This article examines the effectiveness of a psychoeducational group program for black undergraduate college women to enhance psychosocial competence, including locus of control, active coping, and stress reduction. The model used literary works authored by black women as an innovative technique for enhancing the group process.
College Experience as a Stressor
College is a stressful experience for most students. Generally, college years are a time when young adults struggle with newfound freedom and negotiate developmental tasks, focusing on interpersonal relationships and academic concerns (Beard, Elmore, & Lange, 1982). Although black college students typically encounter similar developmental tasks as their white counterparts, they also experience additional stressors at predominantly white institutions, such as recurrent problems of hostility and racism, poor rapport with faculty, inadequate social lives, and academic failure. These developmental stressors are said to be indications of a crisis in psychosocial adjustment symptomatic of a more serious identity crisis. Thus, black college women provide an appropriate sample with which to study the nature and development of coping patterns.
The concept of psychosocial competence has received increasing attention in the mental health practice literature because it emphasizes positive mental health or adaptive functioning rather than psychopathology (Germain, 1977; Maluccio, 2000; Tyler, 1978). Psychosocial competence is derived from the ecological paradigm for viewing human functioning, which draws from fields such as psychodynamic psychology, family systems, anthropology, organizational behavior, and learning and development theories (Maluccio, Washitz, & Libassi, 1999). Whereas ecology provides a way of perceiving and understanding human beings and their functioning in their environment, knowledge about competence development offers specific guidelines for professional practice and service delivery.
In social work, as in other fields, competence is generally defined as the repertoire of skills that enable a person to function effectively. Thus, competence-centered social work practice is conceptualized as a multifaceted configuration that includes a set of self attitudes, world attributes, and behavioral attributes designed to promote effective functioning in human beings by focusing on their unique coping and adaptive patterns, actual or potential strengths, natural helping networks, life experiences, and environmental resources as major instruments of intervention (Maluccio, 2000; Tyler, 1991). In this configuration a competent individual has an active agent stance of personal control and responsibility, a realistic but optimistic level of interpersonal trust in relating to the world, and an active coping orientation toward life's events and problems (Tyler, 1978).
The findings of studies conducted by Tyler and others (Jarama, Belgrave, & Zea, 1996; Tyler, 1991; Tyler & Pargament, 1981; Zea, Reisen, Beil, & Caplan, 1997) indicate that competent individuals are more self-directed and goal-directed than less competent individuals, and they believe that the world can offer relatively favorable possibilities within which to actualize themselves. Furthermore, these studies suggest that each individual interacts and functions in his or her environment on the basis of his or her own personal history and acquired knowledge, as well as on the basis of his or her perception of a particular situation. It is clear that factors such as race, gender, and culture must be taken into consideration in the development of competence-based interventions for different groups.
In the past many researchers who investigated the concept of psychosocial competence did so from a narrowly focused point of view. In particular, earlier practice literature omitted the intersection of race and gender on the ability to develop and maintain a healthy sense of competence. In response to such limitations, Tyler and colleagues (1991) developed a model that builds on earlier definitions of this construct. This revised conceptualization takes into account relevant personal dimensions as well as environmental qualities (for example, gender, race, culture, and ethnicity) in the ability to enhance and maintain a healthy sense of competence.
It has been posited that group work bas the potential for being an effective intervention for the enhancement of psychosocial competence with black women (Boyd-Franklin, 1991; Denton, 1990; Francis-Spence, 1994; Hopps, Pinderhughes, & Shankar, 1995). Group work can facilitate the empowerment of black women who have not experienced the validation of their perceptions or the value of their contributions in traditional mental health settings (Denton; Gutierrez, 1990; Hopps & Pinderhughes, 1999). In addition, group work can serve as a vehicle to help black women gain the skills to develop a healthy sense of competence by providing an environment in which participants can engage in consciousness-raising discussions and develop a sense of connectedness through positive identification, validation, mutual sharing, and bonding (Brown, 1981; Copeland, 1982; Garvin, 1997).
Although psychosocial competence theory undergirds the group process described in the model presented here, the use of literature written by black women serves as a catalyst in helping members to achieve the aforementioned goals in a nonthreatening, self-reflective manner. This literature is not only a self-reflective tool, but also an impetus to address both personal and societal problems. It helps members repair the effects of discrimination and negative self-images and provides concrete approaches to problem solving.
The use of literary works in group interventions is reported to be useful with people across age groups, in both inpatient and outpatient settings, and with healthy people who wish to share their interpretations of literature as a means of personal growth and development (Barker, 1987; Hebert & Kent, 2000; Pardeck, 1998). Recent research gives support for its effectiveness (Baber, 1992; Herbert & Kent; Holman, 1996; Jones, 2000; Zipora, 2000). Schrank and Engels (1981) round the use of bibliotherapy to positively affect attitude change, assertiveness, self-development, and other forms of psychosocial gain. Riordan and Wilson (1989) reported changes in inappropriate behaviors, improved self-esteem, and increased interpersonal growth and development. Bibliotherapy has also been round to be effective in increasing feelings of self-worth and self-efficacy with adults struggling with depression (Cuijpers, 1998; Scogin, 1998). Given these positive findings, the use of literature clearly constitutes a useful treatment tool for enhancing group work. Incorporation of facial, cultural, and gender stress factors on black women's psychosocial competence development is advocated in this group model. Attention is given to integrating group treatment and psychosocial competence enhancement in ways that are sensitive and empowering to black women who use mental health treatment services.
The sample consisted of black undergraduate college women between ages 18 and 24. Sixty participants were recruited through the use of flyers and mailings at three Boston-area colleges and randomly assigned to three intervention and three no-treatment control groups during the fall of 1999. Each intervention and control group consisted of 10 participants. In the three intervention groups, 30 participants were exposed to the psychoeducational group intervention program once a week for eight sessions. The three control groups were not exposed to the intervention program; their participation was limited to completion of a pretest and posttest measure. Two control group members withdrew before completion of both measures.
The group intervention consisted of eight weekly, 90-minute sessions. All groups used the same standardized intervention protocol to minimize confounding protocol effects. The sessions were led by a licensed clinical social worker with experience working with groups and black women. The protocol included psychoeducational, support, and problem-solving approaches to competence enhancement. The sessions moved from a highly predetermined structure, focusing on assigned readings, to a progressively more open format and moved to more intimate topics while integrating supportive intervention techniques.
The psychoeducation component of the group program included the following topics and discussions in relation to black women and psychosocial competence development:
* session 1, introduction to the psychoeducational group process
* session 2, oppression and psychological well-being
* session 3, perception of control
* session 4, stress and coping
* session 5, self-concept
* session 6, love
* session 7, social support
* session 8, reconciliation and spirituality
Whereas the initial session focused on the development of relationships, the remainder of the sessions focused on themes derived from the literature. Although specific themes were covered each week, the group process was such that themes were recurrent throughout each session and that more than one theme could surface at one time. For instance, in using the book sistahs of the yam: black women and self-recovery (hooks, 1993), session 3 of the group program focused on the theme of perceived control and psychological wellness, toward enhancement of their "self-attitudes." This construct of competence was further explored in session 5, in which participants once again engaged in exploration and insight regarding development of a positive black female self-concept.
Healing occurred for participants in this culturally specific group intervention, which involved the acknowledgment and validation of their current and historical realities of unrecognized or devalued relationships, denigration of success, and undue destructive criticism of normative difficulties. Group members learned to hear each other's deepest fears, insecurities, and mistakes in the context of informed, nonjudgmental, and caring relationships. They learned to develop self-empathy and compassion for their own vulnerabilities, imperfections, and mistakes. Throughout this process members often felt empowered to take control of their life outcomes and to cope actively with difficult life circumstances. This culture-specific group engendered change through the use of three strategies: (1) exploration of stressors that affected their ability to develop competence, (2) sharing and validation of each other's experiences, and (3) development of problem-solving skills necessary to cope with stressors of daily living. This process of change requires that members be engaged in a supportive, therapeutic environment in which they can hear, see, acknowledge, and affirm perceptions, needs, values, and experiences.
The use of literature in this group model provided an effective technique for intervening with this population and at the same time reached beyond traditional methods of treatment to affirming and integrating the values and worldviews of black Americans. Consistent with competence development, the use of literary works facilitated the group process by enabling self-identification with others, by providing feedback, and by encouraging the participants to face personal challenges. Once members identified and processed themes in the readings that have played a negative or positive role in their own lives, they were able to raise these issues for discussion in relation to their own personal experiences. This process of developing insight and exploring personal affective experiences occurred among different group members at different stages. The benefits of the readings were that they allowed members to put themselves in a vulnerable position that was also safe: Initially they were able to focus outside themselves and to direct their discussion around characters in the book. Overall, the use of literature in the group process allowed members to see black women in the readings survive by adjusting, readjusting, and adapting to an ever-changing reality. These readings provided a model of cultural adaptation to sudden, constant, and future change.
The following group work vignette illustrates the benefits of the use of literature to help members enhance their sense of control, mastery, and coping. During the discussion of a scenario in the book Mamma (McMillan, 1995), in which Freda (the daughter of Mamma) reveals to her mother, Mildred: "When I graduate next June, I want to leave Point Haven," Mildred replies, "Here we go with this mess, where you think you gon' go?" The group quickly agreed and understood that the mother wanted the best for her daughter but that she did not know how to appropriately convey a sense of caring, concern, and protection.
As the group began to identify possible emotional consequences for young adults who are faced with this dilemma, Tonya, a group member, raised the following question to the group leader: "Why is it so difficult for African American parents to support their children when they want to do things like go to college, especially girls?" The leader qualified to the group that this may not be true of all African American families but asked the group if anyone else experienced a similar situation. Without hesitation, Juliana responded, "I don't know why, but I understand how Freda feels. Not only did I get flak from family, but friends too." The group listened with open ears, as Juliana made a connection between her personal struggle with negative feelings of "deserting" her family to pursue a college education and the character Freda in the book.
As Tonya recounted her experience, she acknowledged that her decision to leave home created mixed emotions for her, including pain and guilt. She described herself as being "selfish for wanting more for herself." Such a response seemed to be mutual among group members. Alisha, another group member aligned with Tonya, said "Initially, I felt guilty too, until I forced myself to realize that I was going to college to improve myself and that it would ultimately benefit my family. I had to remind my mother that I was only a phone call away and that I would be home on the holidays. I felt better, and she did too." The group leader pointed out that initially the character Freda struggled with a similar issue but was able to overcome her "fears and concerns by following her dreams."
By reframing Freda's issue as one shared by most group members, Tonya felt supported. The group also gained some additional tools and strategies to manage similar feelings as well as a sense of power for moving beyond self-oppressive behaviors and beliefs. By the end of the session, with supportive feedback and identification with other members in the group, Tonya became less self-blaming and more hopeful about her future life decisions and outcomes.
As illustrated here, this group program provided members the opportunity to gain insight into their personal and environmental stressors and helped them acquire new skills such as assertiveness and constructive confrontation and negotiation skills that are associated with a healthy sense of competence. Through interpersonal learning involving feedback and experimentation, the group provided its members with opportunities to explore both maladaptive and adaptive ways of competent functioning in the group and, ultimately, outside the group. Leaders facilitated this process by making observations and comments about the process, themes, and dynamics underlying the content of the group and teaching members to do the same (Yalom, 1995).
Three outcome measures were used to evaluate the effectiveness of the group intervention. It was hypothesized that the group intervention would reduce feelings of perceived stress, decrease feelings of external locus of control, and increase the participants' active coping style.
Perceived stress was measured using the Perceived Stress Scale (PSS; Cohen, Kamarck, & Mermelstein, 1983). The PSS measures the degree to which individuals perceive life as uncontrollable, unpredictable, and overwhelming. Conversely, it also serves as a measure of perceived ability to cope with stressful life events. Total scores range from 0 to 54 across the 14 items, with higher scores representing greater stress and a diminished belief in one's ability to cope. Cohen and colleagues reported a coefficient alpha reliability of .91 for the PSS. The scale has high predictive validity with life event scores, depressive symptoms, physical symptoms, use of health services, social anxiety, and smoking reduction maintenance.
Locus of control was measured using the Internal-External Locus of Control Scale (I-E; Rotter, 1966). The I-E scale is a standardized measure for the assessment of the degree to which an individual perceives reinforcement as contingent on his or her actions. The instrument contains 23 forced-choice items and is reported to possess adequate internal reliability and test-retest reliability.
The locus of control construct is assumed to be a continuous variable ranging from an internal to external stance. The scale score ranges from 0 to 23, with a higher score indicating the number of external attributes endorsed. Results of initial testing indicate that people scoring high on external locus of control tend to believe that the responsibility for and control over one's life reside largely with fate, luck, chance, or powerful others. This measure follows the assumption that it is not beneficial to exert personal effort in the service of goals or in their actualization (Rotter, 1966). Rotter reported a Kuder-Richardson internal consistency reliability coefficient of .70 from a sample of 400 college students. In addition, Rotter and other early users of the I-E scale have reported recent norms. Strickland and Haley (1980) found M = 11.3 (SD = 4.4) for 113 men and M = 12.2 (SD = 4.2) for 146 women. Similarly, Parkes (1985) found M = 11.6 (SD = 3.3) for 146 male students and M = 12.6 (SD = 3.7) for 260 female students. There is limited information about whether normative efforts for this measure included ethnically diverse populations.
Active coping style was measured using the Behavioral Attributes of Psychosocial Competence Scale-Condensed Form (BAPC-C) (Tyler, 1978). The BAPC measures an individual's proactive coping style. This scale is derived from Tyler's BAPC-Revised. The scale consists of a 13-item forced-choice questionnaire, eight items of which assess active coping style, three of which assess emotional coping style, and two of which are loaded on a factor analysis to assess both. Active coping is measured in terms of the degree to which an individual manifests an active and planful coping orientation, high initiative in the pursuit of set goals, and a capacity for experiencing and building from successes and failures. Individual items are scored 1 for competent coping style or 0 for less competent. Item scores are added to forma total score ranging from 0 to 13. A higher score is associated with a more active coping orientation.
The BAPC has been found to be moderately correlated at -.38 with the I-E scale developed by Rotter (1966). Tyler (1978) reported a Kuder-Richardson reliability coefficient of .76 for the condensed version of the BAPC. Although data have supported that the BAPC-C can be used reliably and validly with different ethnic groups and with college students, published normative data on the BAPC-C were not found.
Pretests were administered before the first group session to intervention group participants, and posttests were administered at the end of the final group session. Control group participants completed the pretest and posttest questionnaires in the same amount of time that they were completed by the intervention group participants. The standardized instruments required approximately 20 to 30 minutes to complete.
Differences between groups at pretest and posttest were analyzed for the main effects of condition, time, and their interaction using random effects regression models for each dependent variable (perceived stress, locus of control, and coping). The interaction effects of condition of the intervention by time were of particular interest because they reveal the differential effectiveness of the two intervention conditions at pretest and posttest.
Chi-square and paired-sample t tests showed no statistically significant differences between the intervention and control variables of age, college class, parents in the home, hours of work, socio economic status, and previous counseling experience. (Table 1 shows the general characteristics of the participants.)
There was a significant interaction effect of condition by time for the variable measuring perceived stress [F(1, 56) = 6.45, p < .01] (Table 2). For the intervention group, the mean at pretest was 27.50 (SD = 6.14) and the mean at posttest was 25.30 (SD = 5.99). For the control group, the mean at pretest was 26.46 (SD = 5.84) and the mean at posttest was 27.89 (SD = 6.22). Thus, the results revealed that after the eight-week group program the intervention group participants' level of perceived stress was reduced significantly compared with the control group. Given these statistical results the research hypothesis is supported by the data.
No significant differences were found between the intervention and control groups for the interaction effects of condition by time for the variables of locus of control [F(1, 56) = 2.43, p < .05] or coping [F(1, 56) = 0.31, p < .05]. These findings indicate that after the eight-week group program the intervention group did not experience a significant decrease in external locus of control or an increase in active coping compared with the control group.
The findings of this study indicate that this culture-specific psychoeducational group program decreased perceived stress for black undergraduate college women who participated in the intervention compared with the control group. As supported by earlier research on the use of group work with black women (Boyd-Franklin, 1991; Denton, 1990; Fenster, 1996; Hopps & Pinderhughes, 1999), these results suggest that the group intervention program provided a supportive environment in which participants could feel comfortable discussing their difficulties in relation to their daily life stressors. The program may have provided both a direct and an indirect buffering of stress, helping participants alter their perception of stress and helping them alleviate stress once experienced.
There were no statistically significant findings on either measure of locus of control or coping orientation. Participants brought into the group process personality and behavioral traits that had been developed on the basis of their experiences and socialization into a society that hinders their ability to develop a healthy internal frame of reference and actively cope. It can be postulated that given the barriers to developing a healthy internal frame of reference experienced by black people in U.S. society, locus of control may be a personality trait that is not amenable to statistically significant change in an eight-week period. It should be noted that over time participants began to change their perceptions of locus of control, which warrants an investigation over an extended period.
In relation to coping, black women can be characterized as trying to understand and deal (actively cope) with their realities in ways that permit them to survive in a perceived hostile environment. As seen in both the intervention and control groups at pretest, individuals who have difficulty coping may find it more difficult to deal with lire tasks productively or really enjoy the rewards of their labors, much less their relationships with others. Folkman and Lazarus (1985) suggested that coping with stressors is not perceived as an unchanging attribute but as one undergoing change over time. As a result of the aforementioned factors, a longer intervention (10 to 15 weeks) may have been more appropriate for this population in reducing external locus of control and increasing active coping.
Future Research and Limitations
Recommendations for future study emerge from recognition and acknowledgment of the limitations of this study. Notwithstanding the contribution of this study to the notion that culturally specific psychoeducational group work aimed at increasing psychosocial competence may be useful with black women, several limitations may pose a problem for generalizing these findings beyond the study group.
First, this study did not permit longitudinal follow-up past eight weeks. A more extensive interval beyond eight weeks with follow-up measures would help establish whether the benefits of the group intervention program are maintained over time. In view of the diversity that exists among black women, studies conducted in a variety of settings and on a more varied sample of black women in terms of ethnicity, age, and socioeconomic and geographic status are also needed to confirm the study's generalizability.
Given that the participants volunteered, there may be an effect for self-selection into the study, which suggests that individuals who volunteer and are primed to benefit from the group program would have outcomes different from those of involuntary participants. Furthermore, to improve the validity of the intervention, future studies need to repeat the study with the same sample and expand the study to include other racial and ethnic groups.
Social Work Implications
Policy, practice, and educational decisions about mental health services for black women will be influenced largely by the demonstration of effective interventions. Although researchers have posited the need for mental health interventions that help black women cope with stress, isolation, and other oppressive realities, there is little research on methods that positively affect their psychological well-being (Boyd-Franklin, 1991; Francis-Spence, 1994).
Culturally specific psychoeducational groups with black women to enhance psychosocial competence can help black women cope with the tasks of lire and contribute to their ability to master life events. This supportive method provides a process in which an empathic interpersonal environment functions as a catalyst and encourages participants toward self-exploration, insight, and behavioral change.
The findings of this study offer preliminary data on the effectiveness of a culturally specific group intervention with black college women. It demonstrates that significant psychosocial changes can be generated in a relatively short period. This study is a starting point for replication and continuation of the development of culturally relevant group intervention models using a similar research protocol.
A pressing need exists for social work students to become racially and culturally competent, because many of the services and much of the research on ethnic and racial groups will be carried out by white practitioners and researchers. The group model described here can serve as a tool to train social workers to work with ethnically diverse populations.
Given the psychological, social, and cultural complexities black women face, it is imperative that researchers explore the relationship of strengths-based concepts, such as psychosocial competence, to mental health interventions. Continued development and evaluation of competence-focused treatment approaches is essential if the social work profession is going to be responsive and effective in providing services to black women into the 21st century.
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Lani V. Jones, PhD, LICSW, is assistant professor, University at Albany, State University of New York, 135 Western Avenue, Richardson Hall, Room 206, Albany, NY 12222; e-mail: firstname.lastname@example.org.
Original manuscript received Match 3, 2002
Final revision received October 3, 2002
Accepted December 12, 2002
Table 1 Demographic Characteristics of Black Female Undergraduate Students (N = 58) Intervention Comparison Group (a) Group (a) Characteristic (n=30) (n=28) Age (M/SD) 19.3 (1.49) 18.9 (3.56) Ethnicity (%) African American 46.7 64.3 Other (Caribbean, Haitian, African, and other black populations) 53.3 35.7 College class (%) Freshman 36.7 17.9 Sophomore 36.7 39.3 Junior 10.0 25.0 Senior 16.7 17.9 No. of parents in home (%) Single parent 46.7 46.4 Two parents 53.3 53.6 Work (%) Yes 73.3 85.7 No 26.7 14.3 Hours of work per week (M/SD) 12.0 (9.55) 15.8 (9.15) Socioeconomic group (%) Lower 0 10.7 Working 33.3 32.1 Lower middle 23.3 21.4 Middle 40.3 21.4 Upper middle 3.3 10.7 Upper 0 3.6 Previous group counseling experience (%) Yes 36.7 28.6 No 63.3 71.4 Characteristic Total Test Age (M/SD) 19.4 (1.40) t = .58 Ethnicity (%) African American 55.2 [chi square] = .17 Other (Caribbean, Haitian, African, and other black populations) 44.8 College class (%) Freshman 27.6 [chi square] = .28 Sophomore 37.9 Junior 17.2 Senior 17.2 No. of parents in home (%) Single parent 46.6 [chi square] = .98 Two parents 53.4 Work (%) Yes 79.3 [chi square] = .24 No 20.7 Hours of work per week (M/SD) 13.8 (9.47) t = .12 Socioeconomic group (%) Lower 5.2 [chi square] = .21 Working 32.8 Lower middle 22.4 Middle 31.0 Upper middle 6.9 Upper 1.7 Previous group counseling experience (%) Yes 32.8 [chi square] = .51 No 67.2 Note: t = results of paired sample t test for continuous variables. (a) % or M(SD) as indicated. (b) There were no statistically significant differences between groups on the control variables. Table 2 Change in Psychosocial Competence Perceptions of Black Female Undergraduate Students Baseline 8-Week Variable and Group M SD M SD Perceived stress Intervention 27.53 6.14 25.30 5.99 Control 26.46 5.84 27.99 6.22 Locus of control Intervention 11.60 4.30 9.90 4.04 Control 11.92 3.78 11.20 3.43 Coping Intervention 9.10 2.82 10.20 2.29 Control 8.82 3.17 9.53 2.96 F Variable and Group Condition Time Interaction Perceived stress Intervention 3.44 0.31 6.45 ** Control Locus of control Intervention 0.29 10.83 2.43 * Control Coping Intervention 0.01 6.95 0.31 * Control NOTE: All three outcome measures were included as dependent variables in separate random effects models. * p < .05. ** p <.01.
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