Multicultural applications of cognitive-behavior therapy.

The purpose of this article is to discuss the need for greater attention to cultural influences and minority cultures in the field of cognitive-behavior therapy. Ethnic minority cultures and concerns are emphasized, although consideration is also given to a range of cultural influences including age, religion, socioeconomic status, gender, sexual orientation, and disability. The strengths and limitations of cognitive-behavior therapy in relation to its use with culturally diverse populations are outlined. Finally, suggestions are offered for integrating cultural concerns and addressing cultural influences in cognitive-behavioral practice with diverse clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Cultural Mosaic: A Metatheory for Understanding the Complexity of Culture.

Workforce population trends have increased the numbers and kinds of culturally diverse people who work together. Researchers in organizational behavior have often examined culture through values; however, cultural values can be based on collections of people other than traditional nation states. A cultural mosaic is presented as a framework to identify demographic, geographic, and associative features underlying culture. An individual's unique collage of multiple cultural identities yields a complex picture of the cultural influences on that person. Developments in chaos and complexity theories are proposed as a theoretical base for study on the complexity of culture at the individual level. Additional developments in network theory serve as a theoretical base for cultural research at the group level. The cultural mosaic is described as a complex system with localized structures, linking cultural tiles in ordered and chaotic ways. Research propositions examining multiple cultural identities at individual and group levels are discussed. (PsycINFO Database Record (c) 2010 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)     

How does context affect assessments of facial emotion? The role of culture and age.

People from Asian cultures are more influenced by context in their visual processing than people from Western cultures. In this study, we examined how these cultural differences in context processing affect how people interpret facial emotions. We found that younger Koreans were more influenced than younger Americans by emotional background pictures when rating the emotion of a central face, especially those younger Koreans with low self-rated stress. In contrast, among older adults, neither Koreans nor Americans showed significant influences of context in their face emotion ratings. These findings suggest that cultural differences in reliance on context to interpret others' emotions depend on perceptual integration processes that decline with age, leading to fewer cultural differences in perception among older adults than among younger adults. Furthermore, when asked to recall the background pictures, younger participants recalled more negative pictures than positive pictures, whereas older participants recalled similar numbers of positive and negative pictures. These age differences in the valence of memory were consistent across culture. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Living with a concealable stigmatized identity: The impact of anticipated stigma, centrality, salience, and cultural stigma on psychological distress and health.

The current research provides a framework for understanding how concealable stigmatized identities impact people’s psychological well-being and health. The authors hypothesize that increased anticipated stigma, greater centrality of the stigmatized identity to the self, increased salience of the identity, and possession of a stigma that is more strongly culturally devalued all predict heightened psychological distress. In Study 1, the hypotheses were supported with a sample of 300 participants who possessed 13 different concealable stigmatized identities. Analyses comparing people with an associative stigma to those with a personal stigma showed that people with an associative stigma report less distress and that this difference is fully mediated by decreased anticipated stigma, centrality, and salience. Study 2 sought to replicate the findings of Study 1 with a sample of 235 participants possessing concealable stigmatized identities and to extend the model to predicting health outcomes. Structural equation modeling showed that anticipated stigma and cultural stigma were directly related to self-reported health outcomes. Discussion centers on understanding the implications of intraindividual processes (anticipated stigma, identity centrality, and identity salience) and an external process (cultural devaluation of stigmatized identities) for mental and physical health among people living with a concealable stigmatized identity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between acculturation orientations and work-related well-being: Differences between ethnic minority and majority employees.

Today's organizations are becoming more and more ethnically diverse. It is important to understand what constitutes the well-being of ethnic minority employees. This study explored the extent to which acculturation orientations (assimilation, integration, separation, and marginalization) were related to the well-being of 79 ethnic minority and 124 ethnic majority employees working in two different organizations. In line with predictions based on social identity theory and the acculturative stress paradigm, results showed that an integration orientation relates positively to work-related well-being, whereas a marginalization attitude relates negatively to well-being. Moreover, the relationship between acculturation orientations and work-related well-being is much stronger for ethnic minority employees than it is for ethnic majority employees. The findings underline the need to take cultural issues into account when studying well-being in culturally diverse organizations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining the relationship between multiple internalized oppressions and African American lesbian, gay, bisexual, and questioning persons' self-esteem and psychological distress.

[Correction Notice: An erratum for this article was reported in Vol 56(2) of Journal of Counseling Psychology (see record 2009-04542-008). The DOI was incorrect. The correct DOI is 10.1037/a0013317.] Lesbian, gay, bisexual, and questioning (LGBQ) persons come from diverse cultural groups with diverse racial and ethnic identities. However, most research on LGBQ persons has used primarily White samples, and most research on African Americans has used largely heterosexual samples. Thus, research has largely failed to attend to and investigate the complexity of African American LGBQ persons' experiences. This study examined the relations between multiple internalized oppressions and African American sexual minority persons' self-esteem and psychological distress. Results indicated that when examined together, internalized racism and internalized heterosexism (also known as internalized homophobia) were both significant negative predictors of self-esteem, but only internalized heterosexism was a unique positive predictor of psychological distress. The interaction of internalized racism and internalized heterosexism was not a significant predictor of self-esteem or psychological distress. Finally, the authors' findings indicate that self-esteem partially mediates the relationship between internalized heterosexism and psychological distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural factors considered in selected diagnostic criteria and interview schedules.

Researchers have argued that diagnostic criteria and interview schedules inadequately reflect cultural influences in the definition and expression of psychopathology. In this study, 11 widely used diagnostic criteria and interview schedules for schizophrenia, affective disorders, and personality disorders were examined to assess the extent to which they refer to cultural factors. The results indicated that 8 of 11 instruments referred to cultural influences in psychopathology at least once. The consideration of cultural factors, however, was primarily limited to the identification of delusions and hallucinations in schizophrenia. Very few cultural references were made in the diagnostic instruments of affective and personality disorders. The clinical implications of these findings are discussed with respect to the evaluation of cultural minority group members residing in the United States. Specific recommendations are offered to increase the attention given to culture in diagnostic instruments and to increase our understanding of how culture influences psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identity-based motivation and health.

People do not always take action to promote health, engaging instead in unhealthy habits and reporting fatalism about health. One important mechanism underlying these patterns involves identity-based motivation (D. Oyserman, 2007), the process by which content of social identities influences beliefs about in-group goals and strategies. Seven studies show the effect of identity-based motivation on health. Racial-ethnic minority participants view health promotion behaviors as White middle class and unhealthy behaviors as in-group defining (Studies 1 and 2). Priming race-ethnicity (and low socioeconomic status) increases health fatalism and reduces access to health knowledge (Studies 3 and 4). Perceived efficacy of health-promoting activities is undermined when racial-ethnic minority participants who identify unhealthy behavior as in-group defining are asked to consider their similarities to (middle-class) Whites (Studies 5-7). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A two-dimensional model of intergroup leadership: The case of national diversity.

The model presented argues that leadership involves bringing together not only diverse individuals but also the subgroups to which they belong. The model further argues that this does not require replacing people’s subgroup identities with a superordinate group identity (turning “us” and “them” into “we”); bringing together diverse individuals and their subgroups can be accomplished by promoting positive relations among subgroups, even as their distinctive identities (their senses of “us” and “them”) remain. The model conceptualizes positive and negative intergroup attitudes as two independent dimensions of intergroup relations, each with distinct antecedents and distinct associated outcomes. Leaders seeking to create a collective from diverse subgroups must therefore (a) reduce negative intergroup attitudes and (b) increase positive intergroup attitudes. The author applies the model to organizational contexts of national diversity, but it can be applied to leadership across other forms of diversity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Filipino elder: implications for nursing practice. Knowledge of heritage essential

1. Ethnic identity is an important variable in health promotion and care. Knowledge of cultural heritage is necessary to assess the unique needs of the individual. 2. Culture affects how one perceives and defines the meaning of illness. In turn, the way in which one defines the meaning of an illness will influence the expectations of both caregivers and clients within the nurse-client relationship. 3. Broadening our understanding of a diverse ethnic population is central to the concept of transcultural nursing. The importance of understanding differences in cultural heritage cannot be ignored by the nurse who cares for a new elderly Filipino immigrant.     

"Examining the relationship between multiple internalized oppressions and African American lesbian, gay, bisexual, and questioning persons’ self-esteem and psychological distress”: Correction.

Reports an error in "Examining the relationship between multiple internalized oppressions and African American lesbian, gay, bisexual, and questioning persons' self-esteem and psychological distress" by Dawn M. Szymanski and Arpana Gupta (Journal of Counseling Psychology, 2009[Jan], Vol 56[1], 110-118). The DOI was incorrect. The correct DOI is 10.1037/a0013317. (The following abstract of the original article appeared in record 2009-00624-002.) Lesbian, gay, bisexual, and questioning (LGBQ) persons come from diverse cultural groups with diverse racial and ethnic identities. However, most research on LGBQ persons has used primarily White samples, and most research on African Americans has used largely heterosexual samples. Thus, research has largely failed to attend to and investigate the complexity of African American LGBQ persons' experiences. This study examined the relations between multiple internalized oppressions and African American sexual minority persons' self-esteem and psychological distress. Results indicated that when examined together, internalized racism and internalized heterosexism (also known as internalized homophobia) were both significant negative predictors of self-esteem, but only internalized heterosexism was a unique positive predictor of psychological distress. The interaction of internalized racism and internalized heterosexism was not a significant predictor of self-esteem or psychological distress. Finally, the authors' findings indicate that self-esteem partially mediates the relationship between internalized heterosexism and psychological distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using a multicultural lens to understand illnesses among Haitians living in America.

Currently, ethnic and racial minority individuals represent a large proportion of the U.S. population, and researchers expect that they will represent the majority of the population by 2050. This shift in U.S. demographics calls for a greater awareness and integration of cultural issues into the assessment and treatment of ethnically and linguistically diverse clients. This article examines the unique beliefs and manifestations of illnesses among Haitians in connection with the American Psychological Association's (APA, 2002) Multicultural Guidelines. The authors use a common culture-bound syndrome, Séizisman, to illustrate the cultural beliefs, assessment, and treatment of illnesses among Haitians. In so doing, they demonstrate how to incorporate the APA Multicultural Guidelines into treatment with clients of diverse cultural and racial backgrounds. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethnic minority issues in psychology: A reexamination.

Argues that 2 tasks need to be addressed in view of psychology's growing commitment to cultural pluralism in research, theory, and professional practice: The 1st is that ethnic minority group issues are analogous to antinomies in which cherished values and principles are pitted against one another and need to be recognized as such. These paradoxes are evident in at least 5 conflicts: emic vs etic studies, mainstreaming vs pluralism, equal opportunity vs equality of outcome, modal personality vs individual differences, and presence vs absence of racism today. Attempts to find a single, permanent solution are fruitless; the resolution of these issues should be an ongoing process requiring divergent reasoning and diverse solutions. The 2nd task involves the acquisition of power and influence, since means for implementing proposed solutions are necessary. A brief history is provided of ethnic minority efforts in the governing structure of the American Psychological Association. It is suggested that the search for diverse solutions and the attainment of institutionalized influence are vital in increasing pluralism. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Monitor chamber backscatter for intensity modulated radiation therapy using multileaf collimators

Children are entitled to their cultural heritage and it is important to their development. Cultural considerations must be incorporated in devising custody and parenting plans. Several generalizations are useful. Children are capable of integrating highly diverse and even contradictory cultural and religious identity fragments. The more distinctly a child's cultural inheritance varies from that of the dominant society, the more it must be taken into account. The more bias or hostility that exists against an aspect of the child's cultural inheritance, the more that cultural component is to be considered. The value of culture to the child is best seen in a developmental context. We are limited in our ability to ensure children's rights to cultural inheritance by our own ethnocentrism or ignorance, by bureaucratic or legalistic definitions of cultural identity, by the desire of one parent to reduce the contribution of the other parent, and by a tendency to rely on consistency as a value in and of itself.     

Talking about interpersonal violence: Cultural influences on Latinas' identification and disclosure of sexual assault and intimate partner violence.

Low rates of disclosure among Latina survivors of sexual assault and intimate partner violence may be related to cultural influences that stigmatize disclosure and make identifying instances of sexual assault and intimate partner violence difficult. In an effort to add to existing literature, the current study conducted a series of 10 focus groups with Spanish-speaking Latinas of varying educational, immigration, and generational statuses to identify the range of cultural influences that affect Latinas' ability to identify and disclose instances of sexual assault and intimate partner violence. Results suggested that gender role ideologies, traditional beliefs about marriage, familism, taboos against talking about sex, respect for authority, lack of community resources, and fear of violence operate in different ways to obscure and justify acts of sexual assault and intimate partner violence and to maintain silence when such acts do occur. Yet, most participants also felt that other people, particularly Latinos living abroad and the older generation of Latinas living in the United States, held far more conservative and traditional beliefs than the participants themselves did, suggesting that important differences exist in both the acceptance of cultural beliefs and the mechanisms through which these beliefs affect Latinas' ability to identify and disclose instances of sexual assault and intimate partner violence. Implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Therapy and self-actualization in the later years via nontraditional approaches.

A substantial minority of older people have mental health problems, but several studies agree that less than 5% seek treatment from private practitioners or community clinics. Nontraditional therapists have devised various new approaches to circumvent this resistance: groups for the widowed, assertiveness training courses, and peer counseling programs. It is noted that few clinical psychologists have been trained to work with the aging. Training should include life-span development and community psychology. Older people are not likely to make up a large part of a psychologist's private practice, but an expressed interest in the over-50 age group could bring in referrals. Nontraditional approaches can aid the psychologist in reaching and helping older people. Psychologists can also function as trainers of volunteers, as consultants to agencies for seniors, as teachers and speakers, and as key persons in research studies of work with the aging. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comment: Can some interpersonalists be more different than alike? Implications for method in practice and research.

The paper provides a commentary on two qualitative case studies of therapist use of immediacy in two brief interpersonal psychotherapies involving two senior White male clinicians and two young female patients with diverse identities (Hill et al., 2008; see record 2008-13167-001; Kaspar, Hill, & Kivlighan, 2008; see record 2008-13167-002). The commentary proposes an alternative interpersonal model by which the data collected could be examined. The model suggests that therapist and patient interact in a complex process of power and affection toward mutual recognition, which is further shaped by their respective gender and cultural identities. Several implications for the study of the psychotherapeutic situation based on this interpersonal model are presented, including using observer-based measures that can assess power plays and therapist immediate awareness, as well as another qualitative strategy that would capture the richness of clinical process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A cultural accommodation model for cross-cultural psychotherapy: Illustrated with the case of Asian Americans.

As an extension of F. T. L. Leong's (1996) integrative model, this article presents the cultural accommodation model (CAM), an enhanced theoretical guide to effective cross-cultural clinical practice and research. Whereas F. T. L. Leong's model identifies the importance of integrating the universal, group, and individual dimensions, the CAM takes the next step by providing a theoretical guide to effective psychotherapy with culturally different clients by means of a cultural accommodation process. This model argues for the importance of selecting and applying culture-specific constructs when working with culturally diverse groups. The first step of the CAM is to identify cultural disparities that are often ignored and then accommodate them by using current culturally specific concepts. In this article, several different cultural "gaps" or culture-specific constructs of relevance to Asian Americans with strong scientific foundations are selected and discussed as they pertain to providing effective psychotherapy to this ethnic minority group. Finally, a case study is incorporated to illustrate application of the CAM. (PsycINFO Database Record (c) 2010 APA, all rights reserved)