Religiously integrated psychotherapy with Muslim clients: From research to practice.

In this paper, we attempt to translate empirical findings from a program of research that developed a Psychological Measure of Islamic Religiousness (PMIR) into practical clinical applications. The findings from this program of research are complemented and illuminated by findings from other empirical research and clinical work with Muslims. Our recommendations can be summarized as follows. First, clinicians should inquire directly about the place of religion in the lives of their Muslim clients. Second, mental health professionals should ask about what Islam means to their clients and educate themselves about basic Islamic beliefs and practices. Third, clinicians should help their Muslim clients draw on Islamic positive religious coping methods to deal with stressors. Fourth, we recommend that clinicians assess for religious struggles, normalize them, help clients find satisfying solutions to these struggles and, if appropriate, refer clients who struggle to a Muslim pastoral counselor or religious leader. Finally, in order to overcome stigma associated with mental health issues, mental health professionals should educate the Islamic public about psychology, psychopathology, and psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethical considerations in treatment of personality dysfunction: Using evidence, principles, and clinical judgment.

Clinical work with clients suffering from personality disorders can be among the most challenging for psychologists. These clients may have a wide range of clinical presentations, and many practitioners may lack the specialized training needed to provide successful treatment to these clients. Clinicians are faced with several challenges in making treatment decisions that are ethically informed and based on available research findings. Because of the relative dearth of evidence-based treatments for these clients, clinicians are encouraged to use a cost–benefit analysis approach when weighing the benefits versus disadvantages of specific interventions and treatment approaches. Recommendations for effective and ethical treatment of clients with personality dysfunction are provided that are based on an empirically grounded framework. Three expert commentators provide insights into the state-of-the-art of clinical work with these clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Working with foreign language interpreters: Recommendations for psychological practice.

Given the growing linguistic diversity in the United States, many practicing psychologists will work with foreign language interpreters. However, few clinicians receive formal training in providing interpreter-aided psychological services. By federal law (88th Congress, 1964; PL-88-352), psychologists or their agencies are responsible for providing interpreter services. To maintain a patient-centered, rather than interpreter-centered dialogue, psychologists should initiate pre- and postsessions to orient the interpreter to the pending encounter, clarify expectations, and discuss cultural issues. Psychological testing, diagnostic interviewing, crisis intervention, family, child, and individual adult therapy present distinct challenges when an interpreter is involved. Mental health is a specialized area requiring advanced interpreter knowledge and skills. According to the American Psychological Association’s (2002) “Ethical Principles,” psychologists are responsible for ensuring that interpreters demonstrate competence and professionalism. Because there are relatively few interpreters trained specifically for mental health practice, psychologists and health care institutions may need to assist in providing specialized interpreter education. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Telehealth Brain Injury Training for Rural Behavioral Health Generalists: Supporting and Enhancing Rural Service Delivery Networks.

Rural psychologists are frontline primary behavioral health care providers for nearly 60 million Americans, but they face limited access to peer consultation and continuing education. This article describes a program that matched 70 rehabilitation inpatients who had new brain injury with rural clinicians from patients' home communities. Neuropsychologists provided one-on-one training for clinicians through telehealth video teleconferencing. Clinicians showed gains in brain injury knowledge, and clients rated trained providers higher than untrained providers. Families seeking brain injury services can connect with these trained rural providers through a Web site, which receives more than 800 hits per month. Telehealth offers potential for rural clinicians to receive support, reduce professional isolation, gain working knowledge of specialty conditions, and deliver high-quality services for their rural clients. (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)     

When psychologists work with religious clients: Applications of the general principles of ethical conduct.

Psychologists become more effective and relevant when they appreciate that many clients hold religious values and commitments. Greater awareness of religion and religious values in the lives of clients may aid clinicians' efforts to provide more accurate assessments and effective treatment plans. The authors use the American Psychological Association's (1992) "Ethical Principles of Psychologists and Code of Conduct" as a framework to examine many of the ethical issues relevant when psychologists work with religious clients. This article also provides suggestions for ways in which clinicians may obtain the skills needed to offer competent assessments and interventions with religiously committed clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural control in psychotherapy with minority clients.

Reviews the literature on mental health services for minority clients, suggesting that these persons experience special problems with the traditional mental health delivery system. Epidemiological and attitude studies have indicated that minority client and majority therapist expectations for psychotherapy are often discrepant. Counseling and psychotherapy outcome research on therapist–client racial pairing has yielded inconclusive results at present. It is hypothesized that the therapist–client racial pairing may interact with level of therapist dominance in affecting psychotherapy outcome. Dominant majority clinicians may manipulate minority persons toward majority values, which may comprise a form of cultural control. Highly dominant clinicians are posited to function more effectively with culturally similar clients than with culturally different clients in that domination may be appropriate to a certain degree in culturally homogeneous settings. Low dominant clinicians are posited as being more effective than highly dominant clinicians with culturally different clients in that they would be more likely to attempt to understand the client's cultural perspective in a nonmanipulative manner. (100 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural and linguistic bias in mental health evaluations of deaf people.

Examines assessment issues related to deaf clients, focusing on cultural and linguistic bias. Reliability and validity problems encountered when administering intellectual and personality assessments to hearing-impaired Ss are discussed. Factors influencing psychological assessment are addressed, including inaccurate beliefs and problems with rapport, miscommunication, and using interpreters. It is recommended that research be conducted to refine the psychometric properties of assessment instruments used, that psychologists become more sophisticated about deaf culture, and that psychologists interested in working with deaf clients need to become more skilled in the use of sign language. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Working with multiracial clients in therapy: Bridging theory, research, and practice.

The growing multiracial population has resulted in a need for professional psychologists to become knowledgeable about unique identity issues that may influence therapy with multiracial clients. The overarching goal of this article is to provide clinicians with current theory and research, as well as particular therapeutic strategies that will be useful in their work with multiracial clients. Specifically, this article (a) provides a brief review of some prevalent models of multiracial identity; (b) discusses several common themes derived from theory and research about multiracial identity, which should be taken into account when working with this population; and (c) offers some specific techniques and strategies that may be used in therapy to develop more accurate conceptualizations of multiracial clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Vicarious traumatization, spirituality, and the treatment of sexual abuse survivors: A national survey of women psychotherapists.

Should psychotherapists limit their clinical work with trauma survivors to avoid being traumatized themselves? Vicarious traumatization (VT—the symptoms similar to posttraumatic stress disorder and the disruption in cognitive schemas reported in clinicians who are exposed to the trauma material of their clients—was assessed in a national survey of 1,000 women psychotherapists. Therapists with higher levels of exposure to sexual abuse material reported significantly more trauma symptoms but no significant disruption of cognitive schemas. Spiritual well-being, a key area thought to be damaged by VT, was found to be higher for those clinicians who saw more sexual abuse survivors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical intervention with bisexuals: A contextualized understanding.

Many clinicians, situated in a culture that privileges a dichotomous understanding of sexual orientation, are often challenged by the complex issues presented by bisexual clients. The aim of this article is to provide an expanded and contextualized understanding of bisexuality that will inform effective intervention with the clinical concerns presented by this frequently marginalized population. An overview of evolving perspectives on sexual orientation and bisexuality is followed by a discussion of treatment concerns relevant to bisexuals. A review of treatment approaches offers clinicians a fundamental framework to begin to effectively address the unique clinical concerns of bisexual clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What information do clinicians value for monitoring adolescent client progress and outcomes?

Despite the proliferation of outcomes measurement systems in managed care, there has been no systematic attempt to discover what information clinicians find useful. 539 mental health clinicians who serve adolescent clients responded to a mail survey. They rated the value of 29 categories of information describing adolescent clients. Results show how clinician background and experience influence the kind of information they prefer and how and when clinicians prefer to receive information. If outcomes measurement systems are ever to become useful tools, they must provide information that clinicians need and are willing to use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tarasoff and confidentiality in AIDS-related psychotherapy.

We investigated whether clinicians employ the Tarasoff factors (dangerousness and identifiability of victim) when deciding to break confidentiality in acquired immune deficiency syndrome (AIDS)-related psychotherapy situations. Practicing clinicians were provided with a series of hypothetical psychotherapy scenarios depicting different AIDS clients (prostitute, IV drug user, homosexual, and bisexual). Within each type of scenario, degree of dangerousness and identifiability of victim were systematically varied. Results indicated that clinicians do use both of these factors when deciding to break confidentiality, although dangerousness appeared to be more relevant than identifiability of victim. Clinicians who had psychotherapy contact with AIDS clients were less likely to break confidentiality than those who did not have such contact. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Review of Adapting cognitive therapy for depression.

Reviews the book, Adapting cognitive therapy for depression by Mark A. Whisman (see record 2008-03297-000). The goal of this volume is to provide detailed, empirically supported instructions for adapting CT for complex, comorbid presentations in depression. All of the chapters follow a similar format, which makes them very easy to read and absorb. They are all written by experts in the field using clear, jargon-free language. Each chapter provides instructions for adapting the assessment, case conceptualization, and cognitive treatment of clients presenting with a number of types of complexity. For the most part, these instructions are supported by the research literature. As such, this is a work that is readily accessible to professionals at all levels of training and expertise, and represents an invaluable resource for clinicians working with depressed clients. Furthermore, this text is an excellent scholarly resource of the most up-to-date research literature on the applicability of CT to complex populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Statistical versus clinical lie detection.

Argues that studies conducted to date have tended to ignore the single most important variable of polygraph validity: the human judge. The present study focused on clinicians' interpretations of polygraph protocols and showed that clinicians performed less accurately than statistical analyses. Ss included 30 undergraduates administered a polygraph test by 4 examiner-trainees and 30 experienced polygraph interpreters. Statistics outperformed human judges because they used information optimally and applied decision rules consistently, while clinicians tended to add error variance to their protocol interpretations. Unfortunately, current empirical evidence suggests that the prospects for improving clinicians' consistencies are not promising; the possibility of applying statistical methods to interpreting polygraph data is recommended. It is suggested that psychologists become more active researchers in this area, a domain that is properly within their scientific purview. (41 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Detecting malingering and deception: Forensic distortion analysis.

Reviews the book, Detecting malingering and deception: Forensic distortion analysis by Harold V. Hall and Joseph G. Poirer (see record 2001-18575-000). Therapists who often see clients presenting with posttraumatic stress disorder, memory difficulties, substance abuse questions, and "potential-for-harm" (to self or others) problems can benefit from this text. It is interesting, given their orientation to the field of malingering and deception, that the authors do not dwell specifically on the issues of treatment as such. Instead, they address the concerns of therapists genetically at first, remarking on the assumptions often made about clients by clinicians, and then more specifically, in the context of various forensic topics. Hall and Poirier unfold their approach without rancor toward other clinicians or toward clients, and they do much to rectify the stuffy, over litigious image of forensic psychology in their humane and sensible stance. They do a marked service by reassuring therapists generally that forensic science need not mean decimation of the patient or the therapeutic relationship; in the process of seeking the truth, forensic specialists do not have to abandon decency. The reviewer recommends this carefully written and thorough text to all therapists who may themselves be drawn, or see clients who may be drawn, into the forensic arena. (PsycINFO Database Record (c) 2010 APA, all rights reserved)