Review of Strategies for building multicultural competence in mental health and educational settings.

Reviews the book, Stategies for building multicultural competence in mental health and educational settings edited by M. G. Constantine and D. W. Sue (2005). Strategies for Building Multicultural Competence in Mental Health and Educational Settings is an excellent resource designed for mental health professionals who may lack knowledge and expertise in working with diverse clients. It provides hands-on strategies and suggestions in a variety of contexts, using the Multicultural Guidelines as a framework. This book is strongly recommended for clinicians working with culturally diverse populations. The Surgeon General's report Mental Health: Culture, Race and Ethnicity (U.S. Department of Health & Human Services, 2001) clearly demonstrates the disparity in the mental health care of racial and ethnic minorities as compared with Whites. This book is useful not only to novices exploring diversity but also to those who are already cross-culturally competent. The authors successfully apply the APA Multicultural Guidelines in clinical practice and educational, training, and organizational settings while providing specific strategies for clinicians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Work Stress in America.

Historical and contemporary discourses on American culture were applied to work stress for the purpose of identifying the cultural assumptions, values, and beliefs that may predispose Americans to certain types of distress and, by association, stress-related illnesses within the context of work. Six primary American (albeit democratic) values and beliefs were identified and applied to work stress. The findings suggest that for work stress to be addressed effectively, professionals who study and seek to ameliorate it should understand the cultural underpinnings and assumptions that drive American business specifically, and all democratic societies generally; influence worker behaviors; shape employee-employer cognitions; and bias work stress research. Suggestions for future research are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward reflective practice: A multicultural competence training model from a community mental health center.

Despite the importance of multicultural competence in clinical practice and training, there is a surprising dearth of innovative training models from fieldwork sites that would be replicable in other practicum settings. The authors illustrate a multicultural competence training model from a community mental health center that highlights the Guidelines on Multicultural Education, Training, Research, Practice, and Organization Change for Psychologists (American Psychological Association, 2003). The model focuses on providing multicultural training through two separate but linked training teams for the dual purposes of internal reflection and reflective practice. The authors conclude with a discussion of the implications of this training model for practice, research, and organizational change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Building a world-class mental health care system for America.

This article examines our current mental health care system, and what can be done to expand this current system. It focuses on the mental health needs of our children, and makes some suggestions to improve their care. Some things discussed are putting more mental health professionals in schools, affordable and convenient treatment options for parents, and flexible treatment arrangements. (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)     

Continuing education in cultural competence for community mental health practitioners.

Continuing education in cultural competence is a key strategy for enhancing provider effectiveness in working with culturally diverse clients. In the mental health field, a majority of published works address training issues related to students in graduate programs. Few articles, however, discuss specific models or methods of continuing education for practitioners working in community-based settings. The authors present a case example of an interactive workshop in cultural competence for community mental health practitioners. They discuss key modules of this workshop, including (a) cultural competence and outreach principles, (b) cultural identity and worldview, (c) stereotyping and automatic thinking, (d) dynamics of difference, and (e) application exercises. Recommendations are offered for administrators, direct care staff, trainers, and researchers who may be interested in undertaking or participating in cultural competence continuing education efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The reliability and validity of a multicultural assessment instrument developed for a graduate program in psychology.

The Diversity Mission Evaluation Questionnaire (DMEQ) was developed to assess attitudes, beliefs, and experiences pertaining to multicultural matters at a graduate program in psychology. Using scores of 247 students, 57 faculty, and 19 staff, the authors revealed three latent traits through exploratory factor analysis: Overall Success, Open Discussion of Diversity Issues, and belief that multicultural activities were Freely Undertaken. The high internal consistency of all of these scales, (as > .81), coupled with expected between-groups differences and significant correlations with experiences of prejudice, suggests that the instrument assessed diversity issues in a precise and valid manner. It was concluded that the DMEQ could be used by institutions desiring to assess their multicultural climates. Evaluative data from a graduate school that has adopted and implemented a diversity mission are presented, and issues related to multicultural change are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to the special section on assessment in psychological treatment: A necessary step for effective intervention.

Great changes are taking place in mental health treatment, because health care providers are placing constraints on therapists. Yet psychologists have been slow to react to these demands and have not incorporated personality measurement in treatment planning to address therapeutic effectiveness. Many therapists initiate therapy without obtaining a personality assessment in the early stages of therapy. Psychological assessment can, however, provide an effective means of detecting problems and motivation for therapy and can, if therapist test feedback is provided, serve to bring about desired behavior change more effectively than if assessment is not used. This Special Section is devoted to the potentially fruitful role psychological assessment can play in treatment planning. The contributors who were invited to write articles were chosen for their expertise in using psychological procedures in treatment planning. Their contributions provide important insights into methods for facilitating psychological therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Loss, psychosis, and chronic suicidality in a Korean American immigrant man: Integration of cultural formulation model and multicultural case conceptualization.

Culture shapes the nature, experience, and expression of psychopathology and help-seeking behavior across ethnically diverse groups. Although the study of psychopathology among Asian Americans has advanced, clinicians remain in need of culturally appropriate tools for the assessment and diagnosis of severe mental disorders including psychotic symptoms among Asian Americans. In this article, we present a brief overview of two culturally relevant conceptual tools: a) the Cultural Formulation Model, and b) the Multicultural Case Conceptualization approach. We use a case scenario to illustrate the integration of these two approaches in providing culturally responsive clinical conceptualization, assessment and treatment of a Korean American immigrant suffering from prominent psychiatric symptoms. We intend this discussion to engender further empirical work to advance our knowledge of the manifestation and experience of severe mental illness including psychotic disorders among Asian Americans, and contribute to culturally competent prevention and intervention of chronic and persistent mental illness within this group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward cultural competence in child intake assessments.

As cultural diversity within the U.S. population increases, cultural competence in service delivery to children, youths, and families is a growing necessity. This article presents a process for integrating assessment of cultural data with the traditional intake assessment in children's mental health. The purpose and process of integrating cultural assessment throughout the child intake are presented. By using the cultural formulation guidelines proposed in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994), the content of a culture-integrated assessment is conceptualized and organized. The purpose of this article is to assist child, youth, and family psychologists with developing applied cultural competency skills in the context of the intake assessment with children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parental adherence to child psychologists' recommendations from psychological testing.

Nonadherence to prescribed regimens is a significant cause of treatment failure across pediatric and psychological/psychiatric childhood conditions. Although a modest literature exists for medical conditions, the literature on adherence to psychologists' recommendations is sparse. We review the extant literature on this topic, highlighting areas for further study and intervention. Implications for policy and the practice of psychoeducational assessment are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Guess who's coming to therapy? Getting comfortable with conversations about race and ethnicity in psychotherapy.

Despite the fact that clinical psychology training programs now typically offer course work in multicultural issues, many professional psychologists may continue to feel unsure about how and when to incorporate multicultural awareness into their everyday clinical work. Having open discussions with clients regarding issues of race and ethnicity is one way to actively include a multicultural element into psychotherapy, as well as to strengthen the therapeutic alliance and promote better treatment outcome. The authors make several recommendations designed to provoke thought and stimulate conversation about race and ethnicity in the context of psychotherapy. (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)     

Psychiatric disorders and sexual risk among adolescents in mental health treatment.

Objective: To examine the relationship between psychiatric disorders and sexual behaviors among adolescents receiving mental health treatment. Adolescents in mental health treatment have been found to have higher rates of HIV risk behavior than their peers, but data concerning the relationship between psychopathology and risk are inconsistent and limited. Method: Eight hundred and forty adolescents (56% female, 58% African American, mean age = 14.9 years) and their parents completed computerized assessments of psychiatric symptoms via the Computerized Diagnostic Interview Schedule for Children (Shaffer, 2000a, 2000b). Adolescents also reported on sexual risk behaviors (vaginal/anal sex, condom use at last sex) and completed urine screens for a sexually transmitted infection (STI). Results: Adolescents meeting criteria for mania, externalizing disorders (oppositional defiant, conduct, and attention-deficit/hyperactivity disorders), or comorbid for externalizing and internalizing disorders (major depressive, generalized anxiety, and posttraumatic stress disorders) were significantly more likely to report a lifetime history of vaginal or anal sex than those who did not meet criteria for any psychiatric disorder (odds ratio [OR] = 2.0, 2.3, and 1.9, respectively). Adolescents meeting criteria for mania were significantly more likely to have 2 or more partners in the past 90 days (OR = 3.2) and to test positive for a STI (OR = 4.3) relative to adolescents who did not meet criteria for a psychiatric disorder. Conclusions: The presence of internalizing and externalizing disorders, especially mania, suggests the need for careful screening and targeting of adolescent sexual behavior during psychiatric treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using evidence-based treatments: The experiences of youth providers working under a mandate.

Whether as clinicians, administrators, or evaluators, psychologists are increasingly involved in efforts to implement evidence-based treatments (EBTs) within clinical practice settings. The state of Texas has undertaken what may be the largest EBT implementation effort to-date. A survey was conducted to understand the experiences of 197 children’s service providers working within this effort. Providers’ own attitudes toward the EBTs and their perceptions of their colleagues’ support for the EBTs were somewhat negative, although they gave positive ratings of the quality of their EBT training and of their agencies’ support for the EBTs. Significant, independent predictors of providers’ attitudes toward the EBTs included provider views of their colleagues’ and their agencies’ support for the EBTs, their opinions of the quality of their training in the EBTs, and their perceptions of institutional barriers to EBT use (all ps     

How Changes in Population Demographics Will Impact Health Psychology: Incorporating a Broader Notion of Cultural Competence Into the Field.

U.S. population demographics are undergoing striking changes that will impact health care and the research and practice of health psychology. An increase in the number of people who are older; belong to an ethnic minority group; have disabilities; identify as lesbian, gay, bisexual, or transgendered; or live in poverty will influence definitions of aging, health, and illness, and will challenge current psychological and medical treatment models. The authors argue that health psychologists need to become context competent for the field to be relevant and viable over the course of this new century. Health psychologists need to become aware of the multiple, overlapping contexts in which people live and apply this knowledge on a regular basis to research, practice, education and training, and policy in health psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

From adolescence to adulthood: Age-related changes in beliefs about cigarette smoking in a Midwestern community sample.

The current study used a cohort-sequential design to examine age-related changes in health-relevant beliefs from the middle school years through age 37 in a large, midwestern, community sample (N?=?8,556). Results suggest systematic age-related changes such that beliefs in the personalized risks of smoking declined in middle school and then increased, beliefs in generalized health risks increased beginning in the middle school years, and values placed on health as an outcome decreased in the high school years and then increased. These findings suggest that intervention programs must counter declining personalized risk perceptions among middle school students and declining values placed on health among high school age students, (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship adjustment, PTSD symptoms, and treatment utilization among coupled National Guard soldiers deployed to Iraq.

Although combat-related posttraumatic stress disorder (PTSD) is associated with considerable impairment in relationship adjustment, research has yet to investigate how PTSD symptoms and relationship distress uniquely and jointly predict utilization of a range of mental health services. The present study sought to examine these issues utilizing a longitudinal sample of National Guard soldiers surveyed 2–3 months following return from deployment to Iraq and again 12 months later (N = 223). Results indicated that PTSD symptom severity, but not relationship adjustment, uniquely predicted greater odds of utilizing individual-oriented mental health services. A significant interaction was found indicating associations between PTSD symptoms and the odds of using services were increased when soldiers reported greater relationship adjustment. For utilization of family-oriented care, greater relationship distress was significantly correlated with greater odds of using services, but associations with PTSD symptoms were nonsignificant. The association between relationship distress and utilization of family-oriented services did not vary significantly with severity of PTSD symptoms. Results suggest supportive intimate relationships facilitate mental health treatment utilization for soldiers with PTSD symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)