Psychological care for persons of diverse religions: A collaborative continuum.

The purpose of this paper is to describe to psychologists and other clinicians a continuum of mental health care for persons of diverse religions. The continuum delineates boundaries between clinical care provided by mental health professionals and religious care provided by clergy, as well as describes pathways of collaboration across these boundaries. A prevention science based model of Clergy Outreach and Professional Engagement (COPE) is offered to guide this collaboration. The model describes a continuum that moves from the care already present in religious communities, through professional clinical care provided in response to dysfunction and returns persons to their own spiritual communities. One challenge for clinicians is that in addition to a wide diversity of beliefs and practices across religions, there is great ethnic diversity within religions. These diversities are reflected in varied correlations with mental health outcomes. Therefore, we recommend that clinicians assess religious beliefs and their cultural variations when designing religious inclusive psychotherapy specific to the client. There are ethical concerns as to the place of religion in clinical care. The “Resolution on Religious, Religion-Based and/or Religion-Derived Prejudice” adopted by the American Psychological Association has stated that it is not the role of professional psychologists to be spiritual guides. Through spiritual assessment of clients and strategic collaboration with religious leaders via COPE, mental health professionals can focus their efforts on clinical care that respects and incorporates the religious views of clients and does not attempt to recreate the lived religions of the clients' communities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

To use or not to use: Clinicians' perceptions of telemental health.

Equal access to mental health services is necessary for healthy individuals and communities. However, due to geographical distances and other barriers, some clients cannot easily access mental health professionals. Technologies such as videoconferencing for clinical purposes (i.e., telemental health) may help to bridge these gaps to connect clients and clinicians at geographically diverse locations. However, despite its potential utility, telemental health has not been widely adopted in Canada. This study is an exploratory investigation into mental health professionals' attitudes toward telemental health, factors that affect the frequency with which they use this technology, and their perceptions of individual characteristics that make clients more or less suitable candidates for telemental health. This study has a particular focus on remote and rural and Operational Stress Injury (OSI) contexts. One hundred sixty mental health workers across Canada participated in an online survey, and 25 mental health workers from Operational Stress Injury clinics across Canada participated in in-person interviews. The data were examined using qualitative and quantitative analysis methods. Findings suggest that mental health workers have overall positive attitudes toward the use of telemental health—particularly for clients in remote and rural locations. Additionally, receiving training in telemental health, being in the mental health field for longer, and perceiving the technology as easy to use are associated with more frequent use of telemental health. Finally, clinicians reported specific client characteristics that they perceive to make some clients unsuitable candidates for telemental health. Implications of these findings and directions for future research are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Empirical research on religion and psychotherapeutic processes and outcomes: A 10-year review and research prospectus.

A decade of research on religion and counseling, consisting of 148 empirical articles, was reviewed. Methodological sophistication, poor a decade ago, has approached current secular standards, except in outcome research. Religious people cannot be assumed to be mentally unhealthy. Nonreligious and religious counselors share most counseling-relevant values but differ in the value they place on religion. Those religious differences affect clinical judgment and behavior, especially with religious clients. Religious interventions have been techniques imported from formal religious traditions and used as adjuncts to counseling or traditional theories of counseling adapted to religious clients. The authors suggest a research agenda and speculate about future mental health practices. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Achieving a Mental Health Bill of Rights.

The Mental Health Patient's Bill of Rights was the culmination of a meeting of the presidents of 9 national associations of mental health professionals to examine how to best educate the public, policy makers, and benefit managers about ensuring the availability of quality mental health and substance abuse treatments. The principles to which they unanimously agreed hold that mental health clients must have guaranteed confidentiality, a real role in determining their treatment, and a choice of provider. The clients have the right to full information about their coverage as well as parity of mental health and physical health coverage. The actual text of the Mental Health Patients' Bill of Rights is provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Issues in the treatment of dual diagnosis clients who have chronic mental illness.

Examines several issues relevant to treating dual diagnosis clients who have coexisting chronic mental illness and substance abuse diagnoses. The development of various theoretical viewpoints on the relationship between substance abuse and mental illness is described along with a critical review of current research efforts. Suggestions are made for professionals to devote more attention to coordinating services and resources within mental health systems, adjusting academic training and professional development, and developing research efforts that will provide practical guidelines for clinicians. Until more definitive research is available, administrators, clinicians, and professional training programs are advised to adopt a broad clinical perspective of work with dual diagnosis clients that incorporates both mental health and substance abuse treatment modalities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk management with the suicidal patient: Lessons from case law.

Suicide continues to account for a comparatively large proportion of all lawsuits filed against mental health professionals. However, despite the prominence of suicide in mental health malpractice litigation, clinicians must resist resorting to defensive clinical practices in an attempt to shield themselves from potential lawsuits. By using accepted tenets of suicide management as a starting point, the author aims in this article to inform and educate practitioners about clinical malpractice from a legal, as well as a clinical, point of view. Hence, this article aims to demystify relevant case law for practitioners by offering informative, real life examples of how therapeutic practice is interpreted in the courtroom, as well as examples of how juries and judges typically view the treatment decisions clinicians routinely make regarding their suicidal patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical Web pages: Do they meet expectations?

Many practitioners struggle with how best to use Internet technology to market and support their practice. Unfortunately, the empirical literature offers little guidance. This study compared existing mental health clinicians' Web sites to content areas identified as essential and ideal by mental health professionals and prospective consumers. The findings reveal that prospective consumers place a high value on what clinical Web pages may offer, more so than even clinicians themselves. In comparison to clinicians, consumers also have higher expectations for the content of these sites. Only a minority of surveyed clinician Web sites included all of the content endorsed by participants. Results should guide mental health clinicians in the development of their Web pages so that content provided meets consumers' needs and expectations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religion and spirituality.

We define religion and spirituality and discuss five scenarios in which they will probably emerge in psychotherapy. We review empirical research on religion and spirituality as they pertain to psychotherapy outcomes and relationships. Most research has been unsophisticated relative to the general status of psychotherapy research. Nonetheless, therapists are urged to assess for religion. and spirituality and, if possible, intervene in religiously and spiritually sensitive ways. Nine empirical studies of religiously accommodative Christian (n = 6) and Muslim (n = 3) psychotherapy have provided limited support for its efficacy, especially with depressed clients. Highly religious clients appear to desire therapy that respects (if not integrates) their religion, but research is unclear about the degree to which they can benefit from secular therapies, especially when they request religious therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Program evaluation for organizational cultural competence in mental health practices.

Mental health practices that lack cultural competence prevent diverse clients from receiving the care they deserve. As providers and program administrators, psychologists currently have a responsibility to ensure high quality of care for diverse clients at the clinic level. This article deciphers extant empirical research, organizational theory, public policy literature, and best practices to identify which recommendations are most relevant for those in small mental health practices and clinics. The authors present 10 components for culturally appropriate care, ranging from policies and procedures to needs and satisfaction level of clients. This overview can be used to help evaluate and develop a mental health practice's ability to meet the needs of diverse clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religiosity of psychotherapists: A national survey.

Explored the religiosity of 425 marriage and family therapists, clinical social workers, psychiatrists, and clinical psychologists. Although 80% of the Ss indicated a religious preference, only 41% regularly attended religious services. According to the Religious Orientation Inventory, 230 of 425 Ss were classified as religious. This is consistent with findings of previous studies (e.g., A. E. Bergin; see record 1980-05877-001). The potential for change toward greater empathy for religious clients is underscored by the significant levels of unexpressed religiosity found among mental health professionals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bilingual professionals in community mental health services

OBJECTIVE: This paper presents results from research that explored the roles of bilingual professionals in community mental health services in the Sydney metropolitan area of New South Wales. There were two main objectives to the research: (i) to identify and describe the roles of bilingual professionals that are important in improving the quality of community mental health services for clients from non-English-speaking backgrounds (NESB); and (ii) to identify and describe the factors that facilitate and inhibit the conduct of these roles. METHOD: Data collection involved indepth interviews with bilingual professionals and team leaders in community mental health services and various other community health services; and various staff responsible for policy and service development with regard to cultural diversity. RESULTS: Bilingual mental health workers were found to have at least four critical roles. These were (i) direct clinical service provision to NESB clients; (ii) mental health promotion and community development; (iii) cultural consultancy; and (iv) service development. Respondents reported that the latter three roles were seriously underdeveloped compared to the clinical service provision role. CONCLUSIONS: It is critical that service managers implement strategies to make better use of the linguistic and cultural skills of bilingual professionals. In addition to their role in clinical service provision ways must be found to facilitate the community-focused, cultural consultancy and service development roles of bilingual professionals employed in mental health services.     

Pentecostal perspectives on causes and cures of depression.

Religious beliefs about mental illness represent one potential influence on the choice to utilize or avoid professional help. For example, believing that devout spirituality assures mental health and/or that mental illness indicates spiritual failure may discourage religious individuals from seeking help. Such beliefs have traditionally been attributed to Pentecostals, but no research has assessed this assumption. This study examined Pentecostal perspectives on depression's causes and treatments. Contrary to the Pentecostal theological literature, participants endorsed a variety of causal factors. Regarding cures, however, faith was endorsed as the most effective option. Implications are provided and recommendations are offered to practitioners working with Pentecostals, including consultation and collaboration with clergy and religiously sensitive psychoeducational programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religious/spiritual psychotherapy behaviors: Do we do what we believe to be important?

Professional psychologists have recently been encouraged to sensitively address religious/spiritual issues in psychotherapy. But how frequently do practitioners make religiously/spiritually informed interventions with their clients, and how important do they think it is to do so? Based on the existing literature, the authors identified 29 recommended religious/spiritual psychotherapy behaviors and surveyed 96 psychologists regarding perceived importance and use of these behaviors. The most and least frequently endorsed behaviors were identified. The greater the practitioners' religious/spiritual self-identification, the more likely they were to report using these behaviors in psychotherapy. However, overall, and for 90% of the individual items, clinicians engaged in these religious/spiritual psychotherapy behaviors less frequently than their importance ratings suggested they should. Practice implications and suggestions for educators are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Professional and nonprofessional mental health workers' modes of persuading clients to seek institutional services.

Used questionnaires to assess 38 professional and 31 nonprofessional mental health workers' choice of persuasive appeals to low-income clients. The following variables characterized the appeals offered to Ss: conformity, acceptance of the established order, participatory help or verbal instruction from the worker, present or future reward, and punishment. Results indicate that the professionals offer didactic help, and nonprofessionals threaten clients with punishment or stress immediate rewards. Nonprofessionals, compared to professionals, indicated that they would return more frequently to uncooperative clients. The 2 worker groups' preferences in appeals were related to their respective socioeconomic status and associated value systems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health clinicians' attitudes about reporting threats against the president

OBJECTIVE: A recent review by the United States Secret Service of cases involving threats against the President indicated that about 50 percent of subjects had received mental health care. However, only 12 percent of referrals for investigation came from mental health professionals. This study explored reasons for this discrepancy by examining mental health clinicians' attitudes about reporting threats against the President to the Secret Service. METHODS: A questionnaire developed using findings from a series of focus groups was mailed to a stratified sample of 1,200 psychiatrists, psychologists, and social workers in four states. The instrument included questions about their experience with threats against the President, factors that influence reporting of threats, and knowledge about the Secret Service and its functions. RESULTS: A total of 592 questionnaires were returned, for a response rate of 49.3 percent. Therapists know very little about the Secret Service and are unclear about how to appropriately respond to threats against the President by their clients. The majority of respondents (89.9 percent) indicated they would report a threat against the President only if they thought the threat was "real," contingent on situational and patient variables and elements of the threat itself. Most of the respondents (62.4 percent) indicated that regardless of what information they considered clinically relevant to the investigation. CONCLUSIONS: Given the importance of clinical information for assessing risk to the President, the Secret Service should consider increased educational efforts to inform the mental health community about the functions and mission of the Secret Service and to clarify professional obligations to report threats against the President.     

Practicing clinical psychologists’ provision of sexual health care services.

Practicing clinical psychologists are likely to work with sexual health concerns as part of their clinical practice because of high prevalence rates and sexual problems as symptoms of mental or physical health problems and their pharmacological treatment. However, the majority of clinicians do not receive didactic or supervised clinical training. This survey of 188 practicing clinical psychologists in one Canadian city confirmed that, despite lack of training, many clinicians discussed sexual health concerns with their clients and used a variety of sex therapy techniques. This survey also revealed, however, that 60% of clinicians did not ask, or very infrequently asked, clients about sexual health. In general, lack of training affected level of comfort, and both may result in inadequate application of sex therapy techniques and treatment. The results of this survey indicate an ethical imperative to included sexuality training in current graduate curricula to adequately prepare psychologists to assess, refer, and treat sexual health concerns. The inclusion of sexuality-related topics in existing clinical graduate courses, an increase in sexuality-specific courses focused on assessment and intervention in graduate curricula, and broader options for continuing education for practicing clinical psychologists are recommended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy—is it safe, effective, and appropriate? The beginning of an evolutionary dialogue.

Discusses efforts made by the US Congress in the late 1970's and early 1980's to explore the extent to which those seeking psychotherapeutic services could be assured that the care they would receive would be beneficial. It is contended that psychology, psychiatry, and the mental health field have presented few summary statements to guide the educated consumer or enlightened 3rd-party payers in decision making about mental health care. The mental health field is still young, and there has been insufficient time to evaluate the efficacy of all forms of therapy for all the problems for which patients/clients seek help. But the knowledge gained from clinical experience can be used in a tentative fashion to direct more rigorous empirical investigation. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nuclear arms escalation and the role of psychologists.

Contends that although efforts to end the nuclear arms race have raised public awareness, none of the arms reduction goals have been met. It is suggested that psychologists have the research skills and clinical expertise to identify the misconceptions and debilitating emotional patterns associated with nuclear arms preparation. Psychologists can educate the public about the implications of existing research, examine how the threat of imminent omnicide clinically affects clients, and help clients work through their numbing so that effective action can be initiated. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparing professional and lay expectations of psychotherapy.

Compared 25 mental health professionals whose primary duties involved psychotherapy with 52 laypersons aged 18–51 yrs to determine similarities and differences in their expectations of psychotherapy. Ss were administered the Therapy Expectations Scale. Differences between the 2 groups were found in degree of expected change, importance of self in problem-solving, financial emphasis, and expected duration of psychotherapy. Similarities were found in socioenvironmental areas and in emphasis on the early years of life. Laypersons tended to appreciate the active role of the client in psychotherapy and viewed therapists as experts in problem-solving. It is suggested that greater efforts be made to educate the general public as well as individual clients about the realities of psychotherapy. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)