Cultural competence and evidence-based practice in mental health services: A complementary perspective.

The need for cultural competence and the need for evidence-based practice in mental health services are major issues in contemporary discourse, especially in the psychological treatment of people of color. Although these 2 paradigms are complementary in nature, there is little cross-fertilization in the psychological literature. The present article illustrates the complementary nature of these 2 paradigms. A main point of convergence is related to the development of culturally adapted interventions in the move from efficacy research to effectiveness studies. The implications of cultural adaptations of empirically supported treatments for mental health services in terms of research and practice with ethnic/racial minority populations are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Race/ethnicity, color-blind racial attitudes, and multicultural counseling competence: The moderating effects of multicultural counseling training.

Increasing trainees' multicultural counseling competence (MCC) has been a hot topic in counseling. Scholars have identified predictors (e.g., race/ethnicity, color-blindness) of MCC, and educators provide multicultural training for trainees. Using a sample of 370 psychology trainees, this study examined whether multicultural training (a) moderated racial/ethnic differences on MCC and (b) changed the relationship between color-blindness and MCC. Results indicated a significant interaction effect of race/ethnicity (i.e., White vs. ethnic minority) and multicultural training on multicultural awareness, but not on multicultural knowledge. Specifically, at lower levels of training, racial/ethnic minority trainees had significantly higher multicultural awareness than their White counterparts; at higher levels of training, no significant difference was found. Described differently, more training significantly enhanced Whites' multicultural awareness, but did not enhance racial/ethnic minority trainees' awareness. Additionally, there was a significant interaction effect of color-blindness and multicultural training on multicultural knowledge, but not on multicultural awareness. The association between color-blindness and multicultural knowledge was stronger at higher levels of multicultural training than at lower levels of training. Alternatively, the effect of training on enhancing knowledge was stronger for those with lower color-blindness than for those with higher color-blindness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Seventeen years later: Clinical psychology in light of the 1947 Committee on Training in Clinical Psychology Report.

"Clinical psychology is both a basic and an applied area. Because of the undeveloped state of both psychology and clinical psychology, research is by far the most important responsibility of the clinical psychologist. The university has primary responsibility for integrating training in both the basic and the applied areas. The private practice of clinical psychology is of minor importance. It should be restricted." Clinical psychology "is important both because of the contribution it has made and is making to basic psychology, and because of the potential social significance of its practical contribution." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Assessing and treating culturally diverse clients: A practical guide.

Reviews the book, Assessing and treating culturally diverse clients: A practical guide by Freddy A. Panaigua (see record 1996-97152-000). This book is a timely and provocative delineation of highly relevant considerations to be made by counselors, psychotherapists, and other mental health professionals in the delivery of services to multicultural groups. The book deals with four ethnic populations in the United States—African American, Hispanic, Asian, and American Indian. Panaigua's contribution is part of a series on Multicultural Aspects of Counseling by Sage Publications. The purpose of the series is to increase the mental health practitioner's knowledge and sensitivity to cultural differences and to assist in alleviating bias in the therapeutic process. This purpose is accomplished with precision and insight by Panaigua. Unlike some other books dealing with cultural diversity, Panaigua's work offers specific treatment methods which have been demonstrated to be successful in treating members of the targeted groups. Problem solving and social skills training are recommended in some cases. In other instances, assertiveness training, music therapy, or direct advice are the modalities of choice. In other cases, education, medication, or behavioral approaches are preferred. Assessing and Treating Culturally Diverse Clients can serve the educational needs of graduate students in the fields of psychology, counseling, family therapy, and social work. It is an excellent guide for use in either the training or practice of these helping professions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to the special section on multicultural and community psychology: Clinical psychology in context.

Human behavior occurs in the contexts of culture and community. Yet, clinical psychology has traditionally focused on the individual, neglecting the individual's context. The purpose of this Special Section is to address the underlying conceptual issues in integrating multicultural and community psychology within a common framework. The integration of etic and emic approaches distinguishes the research programs in these articles from others that have solely focused on universal or culture-specific approaches. Issues facing ethnic minority populations are addressed, including identification of risk and protective factors, obstacles to mental health service use, and optimal treatment effectiveness. The integration of culture and community contexts into clinical psychology is necessary for it to remain relevant in an increasingly diverse 21st century. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Self and object in the postmodern world": Response to Gene Bocknek’s letter.

Responds to Gene Bocknek's comments (see record 2009-17405-001) on the author's original article "Self and object in the postmodern world" (see record 1997-04589-001). While acknowledging Bocknek's comments in regard to his original article, the author maintains the position that he cannot find any disagreement between their viewpoints on the features of ego and the self. However, he does acknowledge that there is real disagreement between them on the subject of the intrapsychic versus interpersonal school or the ongoing discussion as to whether psychotherapy concerns a one-person or a two-person psychology. After restating his position on this matter, the author concludes by extending his appreciation to Bocknek for his comments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intersectionality, power, and relational safety in context: Key concepts in clinical supervision.

In this paper, we articulate foundational concepts for a supervision framework from a critical postcolonial perspective: intersectionality, power, and relational safety in context. We identify opportunities, challenges, and dilemmas encountered when engaging with students and colleagues in examining dimensions of privilege and oppression in supervision-of-supervision and supervision of clinical work conducted by clinicians in training. We highlight experiences of supervisees and supervisors of color throughout the paper, bringing together our own voices as a supervisor of color and White supervisor via our shared postcolonial lens to advance dialogue among scholars of all ethnicities. We also differentiate our experiences, purposefully centering the voices of supervisors of color to further a critical postcolonial agenda. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Key competencies of the psychodynamic psychotherapist and how to teach them in supervision.

Four of Rodolfa et al.’s (2005) competencies in professional psychology—relationship, self-reflection, assessment-case conceptualization, and intervention—are key for the psychodynamic psychotherapist. Relationship lies at the heart of what is understood to be curative about psychodynamic psychotherapy. Self-reflection implies a complex and highly developed process that includes but goes beyond Rodolfa et al.’s and Kaslow, Dunn, and Smith’s (2008) definitions. Competent assessment, diagnosis, and case conceptualization entails making inferences about unconscious processes by observing the client and also one’s own experience, and integrating these inferences with theory. Effective psychodynamic intervention is derived from what the psychotherapist has experienced, processed, and conceptualized about the relationship with the client and about the client’s internal object world. An extended vignette shows these competencies emerging in a psychotherapist-in-training, facilitated by an intense interaction with a supervisor. Although the supervisory and clinical tasks are different, the supervisor provides a relationship experience that models these same competencies for the supervisee and catalyzes their development in the supervisee. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A survey of clinical psychology training in Canadian federal corrections: Implications for psychologist recruitment and retention.

Although survey results seem to indicate an abundant interest among Canadian psychology graduate students in pursuing training in criminal justice psychology, the recruitment and retention of psychologists in the Correctional Service of Canada (CSC) has been of some concern. The present study is a 2008 survey of sites within CSC that provide opportunities for clinical psychology training with offender clientele. Survey findings demonstrated that a broad range of clinical psychology training opportunities were available across 16 sites. The most frequently cited barrier to providing training was lack of time by prospective trainers, and sites reported retaining relatively few of their trainees for subsequent psychologist positions. Information was also obtained regarding vacant psychologist positions across CSC regions. In light of survey findings, substantive discussion is devoted toward the issues of psychologist recruitment and retention in Canadian federal corrections, including a discussion of both potential and existing training initiatives. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Multicultural Considerations in the Delivery of Play Therapy Services.

It is estimated that by the year 2025, the number of minority children will outnumber the number of majority children in the United States. Play therapists have an increasing need to be able to provide culturally sensitive services. This article discusses issues of culture, ethnic identity, and minority status and their relevance to the practice of play therapy. Play therapists can improve their cultural sensitivity through (a) expanding their knowledge of specific cultures of children they serve, (b) increasing their ability to understand the variety of cultural influences on a child and assessing the impact of the various influences, and (c) increasing their understanding of the ways children from minority cultures are taught to cope with minority status. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A preliminary report on a new measure: Internalization of the Model Minority Myth Measure (IM-4) and its psychological correlates among Asian American college students.

This investigation is a preliminary report on a new measure of internalization of the model minority myth. In 3 studies, there was evidence for the validation of the 15-item Internalization of the Model Minority Myth Measure (IM-4), with 2 subscales. The Model Minority Myth of Achievement Orientation referred to the myth of Asian Americans’ greater success than other racial minority groups associated with their stronger work ethics, perseverance, and drives to succeed. The Model Minority Myth of Unrestricted Mobility referred to the myth of Asian Americans’ greater success than other racial minority groups associated with their stronger belief in fairness of treatment and lack of perceived racism or barriers at school or work. The 2-subscale structure of the IM-4 was supported by a combination of exploratory and confirmatory factor analyses, with support of discriminant, convergent, and incremental validity, as well as internal reliability and stability over 2 weeks. The IM-4 is a new measure that taps into a uniquely racialized experience of Asian Americans with research and clinical implications. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An exploratory examination of the associations among racial and ethnic discrimination, racial climate, and trauma-related symptoms in a college student population.

In this study, we examined the association among perceptions of racial and/or ethnic discrimination, racial climate, and trauma-related symptoms among 289 racially diverse college undergraduates. Study measures included the Perceived Stress Scale, the Perceived Ethnic Discrimination Questionnaire, the Posttraumatic Stress Disorder Checklist—Civilian Version, and the Racial Climate Scale. Results of a multivariate analysis of variance (MANOVA) indicated that Asian and Black students reported more frequent experiences of discrimination than did White students. Additionally, the MANOVA indicated that Black students perceived the campus racial climate as being more negative than did White and Asian students. A hierarchical regression analysis showed that when controlling for generic life stress, perceptions of discrimination contributed an additional 10% of variance in trauma-related symptoms for Black students, and racial climate contributed an additional 7% of variance in trauma symptoms for Asian students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward understanding ethnic and cultural factors in the interviewing process.

The clinical interview is critical in the diagnostic assessment undertaking in clinical settings, and cultural/ethnic influences have been shown to influence the outcome of this process. Specifically, a number of studies have reported that proportionally far more ethnic minorities than Caucasians are likely to be misdiagnosed when assessed for psychiatric disorders. This particularly is the case when open clinical interviews are used. Semistructured interviews, on the other hand, result in an increase in diagnostic accuracy with ethnic minorities. Parameters associated with bias in the clinical interview of ethnic minorities and its impact on assessment, diagnosis, and treatment decisions are examined. Although the current discussion focuses primarily on African Americans, many examples are provided that pertain to other ethnic groups. Strategies for addressing these issues are explored and recommendations for increasing cultural competence are made. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Racial/ethnic differences in the criterion-related validity of cognitive ability tests: A qualitative and quantitative review.

The correlation between cognitive ability test scores and performance was separately meta-analyzed for Asian, Black, Hispanic, and White racial/ethnic subgroups. Compared to the average White observed correlation ( = .33, N = 903,779), average correlations were lower for Black samples ( = .24, N = 112,194) and Hispanic samples ( = .30, N = 51,205) and approximately equal for Asian samples ( = .33, N = 80,705). Despite some moderating effects (e.g., type of performance criterion, decade of data collection, job complexity), validity favored White over Black and Hispanic test takers in almost all conditions that included a sizable number of studies. Black–White validity comparisons were possible both across and within the 3 broad domains that use cognitive ability tests for high-stakes selection and placement: civilian employment, educational admissions, and the military. The trend of lower Black validity was repeated in each domain; however, average Black–White validity differences were largest in military studies and smallest in educational and employment studies. Further investigation of the reasons for these validity differences is warranted. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Religiosity, alcohol use attitudes, and alcohol use in a national sample of adolescents.

The purpose of this study was to investigate alcohol use attitudes as a mediator of the relationship between religiosity and the frequency of past month alcohol use in a national sample of adolescents. Data were drawn from 18,314 adolescents who participated in the 2006 and 2007 National Survey on Drug Use and Health. Variables included religiosity, alcohol use attitudes, and past month frequency of alcohol use. Structural equation modeling was used to test alcohol use attitudes as a mediator of the relationship between religiosity and frequency of alcohol use and to test model invariance across 4 racial/ethnic groups. Results suggest that alcohol use attitudes partially mediate the relationship between religiosity and frequency of alcohol use. Furthermore, while the pattern of these relationships is similar across racial/ethnic groups, the magnitude of alcohol use attitudes on frequency of alcohol use differed. Implications for prevention programs include targeting alcohol use attitudes in a variety of settings. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Retrospectives from three counseling psychology predoctoral interns: How navigating the challenges of graduate school in the face of death and debilitating illness influenced the development of clinical practice.

Death and debilitating illness can have a significant impact on one's understanding of self, others, and society. When a counseling or clinical psychology graduate student experiences such hardships during the course of his or her clinical training, there can be several potential implications. The stressors of graduate school may exacerbate the emotional responses to an already painful situation. Additionally, clinical skill development can be negatively affected if the student has difficulty acknowledging how hardship influences his or her capacity to be an effective therapist. However, the same tribulations can also help new therapists to realize their inner strength, develop beneficial coping skills, and apply this knowledge when working with clients. Highlighted in this article are three cases of loss and hardship that underscore the importance of supportive clinical supervision, psychological hardiness, humor, and optimism during times of personal crises. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

First impressions: A multicultural content analysis of professional psychology program Web sites.

With the ascension of the Internet as an information resource, Web sites are likely to be the first exposure applicants have to specific programs. The authors evaluated professional psychology program Web sites for ethnic and sexual orientation minority content, discovering that diversity content of Web sites was considerably less than in previously examined paper application materials. Clinical psychology programs were more likely to state a commitment to diversity training while counseling psychology programs were more likely to state a diversity minor/track. School psychology programs had the lowest diversity content on their Web pages. This article explores how graduate psychology program Web sites communicate multicultural information and offers recommendations on using the World Wide Web as a cost-effective tool to attract a diverse student body. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural themes in the psychotic symptoms of African American psychiatric patients.

Professional psychologists need to recognize ethnic/racial differences between African Americans and European Americans in psychotic symptom expression to treat individuals with severe mental illness from various cultural backgrounds. Specifically, they need to understand confluent paranoia or the interaction between culture and pathology in psychotic symptom expression. To assist mental health professionals, the present study identified cultural themes in the delusions and hallucinations of a sample of 156 African American psychiatric patients via content analysis. Race-related themes and religious themes were observed in the psychotic symptoms of these patients assessed with the Structured Clinical Interview for DSM IV. Race-related and religious content were manifested in different types of delusions. Race-related themes were more common in persecutory delusions, whereas religious themes occurred more often in other delusions. Race-related themes were associated more with delusions, while religious themes correlated with both delusions and hallucinations. Implications for the treatment of confluent paranoia in African Americans are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Culture wars in the workplace: Interpersonal subtlety, emotional expression, and the self-concept.

Culture wars can occur when the beliefs and habits of one cultural group come to dominate the norms of the workplace, making it difficult for members of other groups to be included, understood, and to attain success. It is proposed that a role for psychology is to find applications for the knowledge and understanding the psychologists have gained from decades of research on interpersonal communication, emotional expression, and the self-concept, and how culture influences each of these. Consulting psychologists are increasingly being called upon to address the challenge of working effectively in global and diverse teams. To respond at a state-of-the-art level, the consultants need to provide research-based training materials and knowledge to managers and other leaders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)