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Rudrabhatla A, Hendrix N, Gillespie S, Ulven K, Jergel A, Greenfield E, Guerra K, Pickard K. A Mixed-methods Examination of Culturally Responsive Adaptation to an Evidence-based Parent-mediated Intervention Implemented for Autistic Children. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:406-424. [PMID: 38261118 DOI: 10.1007/s10488-024-01343-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 01/24/2024]
Abstract
Parent-mediated interventions (PMIs) are considered an evidence-based practice for fostering social communication skills in young autistic children and for promoting parent responsivity and empowerment, yet barriers to caregiver engagement are evident when PMIs are implemented within historically underserved community settings. Issues of caregiver engagement can reflect a lack of fit between PMIs and the needs of diverse families. We used a mixed methods approach to examine barriers to participating in an evidence-based PMI, Project ImPACT (Ingersoll & Dvortcsak, 2019), within an outpatient setting, as well as strategies that clinicians reported using to deliver and adapt Project ImPACT for minoritized families. Participants included 134 caregivers of a child 13 to 48 months with autism or other social communication differences and six clinicians delivering Project ImPACT. Findings suggest that caregivers experience barriers to participating in Project ImPACT and that these barriers are associated with caregivers' ability to complete the program. Although quantitative findings indicate that adaptation to Project ImPACT did not differ by caregiver and child background, qualitative findings highlighted that clinicians attempt to deliver Project ImPACT to respond to the needs of families from minoritized backgrounds by actively considering the family's culture, psychosocial experiences, goals, and specific barriers. Further, both qualitative and quantitative findings suggest that culturally responsive care and adaptations may support caregiver engagement, including rapport, trust, buy-in, and attendance. Approaches to center cultural alongside contextual/psychosocial considerations within family-centered care in the implementation of PMIs are also highlighted.
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Affiliation(s)
- Asha Rudrabhatla
- Department of Pediatrics, Marcus Autism Center, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
- Current Affiliation: Department of Psychology, George Mason University, Fairfax, VA, USA
| | - Nicole Hendrix
- Department of Pediatrics, Marcus Autism Center, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Scott Gillespie
- Department of Pediatrics, Marcus Autism Center, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Kathryn Ulven
- Department of Pediatrics, Marcus Autism Center, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Andrew Jergel
- Department of Pediatrics, Marcus Autism Center, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Elizabeth Greenfield
- Department of Pediatrics, Marcus Autism Center, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Karen Guerra
- Department of Pediatrics, Marcus Autism Center, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Katherine Pickard
- Department of Pediatrics, Marcus Autism Center, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
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Williams MT, Holmes S, Zare M, Haeny A, Faber S. An Evidence-Based Approach for Treating Stress and Trauma due to Racism. COGNITIVE AND BEHAVIORAL PRACTICE 2023; 30:565-588. [PMID: 38037647 PMCID: PMC10686550 DOI: 10.1016/j.cbpra.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Racism can be stressful or even traumatizing. Psychological unwellness emerges out of the confluence of historical, cultural, and individual experiences, and resulting syndromes may or may not fit into a DSM-5 PTSD diagnostic framework. Although racial stress and trauma are common presentations in therapy, few therapists have the resources or training to treat these issues. Based on the empirical evidence to date, this article describes the essential components of treatment for racial stress and trauma from a cognitive-behavioral perspective, called the Healing Racial Trauma protocol. Each technique is described with reference to the literature supporting its use for racial stress and trauma, along with guidance for how therapists might implement the method with clients. Also provided is information about sequencing techniques for optimal outcomes. Critical therapist prerequisites for engaging in this work are also discussed, with an emphasis on an anti-racist, empathy-centered approach throughout.
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Machalicek W, Strickland-Cohen K, Drew C, Cohen-Lissman D. Sustaining Personal Activism: Behavior Analysts as Antiracist Accomplices. Behav Anal Pract 2022; 15:1066-1073. [PMID: 34093982 PMCID: PMC8171226 DOI: 10.1007/s40617-021-00580-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2021] [Indexed: 12/15/2022] Open
Abstract
One pervasive social issue that has received little attention within the behavior-analytic community is racism and the systemic oppression of Black, Indigenous, and non-Black people of color. The present article offers guidance and examples of how each of us as behavior analysts might build individualized self-management behavior change plans that support initiating and sustaining socially significant antiracism work as we move from allies to accomplices within our own sphere of influence. This article introduces the concept of self-managed antiracism behavior change plans that (a) operationally define antiracist action using measurable outcomes and strategies for data collection on specific antiracist and support actions, (b) provide choices to improve engagement and reduce barriers to adherence, and (c) use effective behavioral interventions to alter the availability of discriminative stimuli or reduce their influence, and increase the availability of reinforcers that are compatible with the goal of the behavior change plan for increasing antiracism behavior and dismantling structures perpetuating racial inequities.
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Affiliation(s)
- Wendy Machalicek
- Special Education and Clinical Sciences, University of Oregon, 860 Willow Ave, Eugene, OR 97404 USA
| | | | - Christine Drew
- Special Education, Rehabilitation, and Counseling, Auburn University, AL Auburn, USA
| | - Dana Cohen-Lissman
- Special Education and Clinical Sciences, University of Oregon, 860 Willow Ave, Eugene, OR 97404 USA
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Smith DT, Faber SC, Buchanan NT, Foster D, Green L. The Need for Psychedelic-Assisted Therapy in the Black Community and the Burdens of Its Provision. Front Psychiatry 2022; 12:774736. [PMID: 35126196 PMCID: PMC8811257 DOI: 10.3389/fpsyt.2021.774736] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/14/2021] [Indexed: 11/26/2022] Open
Abstract
Psychedelic medicine is an emerging field that examines entheogens, psychoactive substances that produce non-ordinary states of consciousness (NOSC). 3,4-methylenedioxymethamphetamine (MDMA) is currently in phase-3 FDA clinical trials in the United States (US) and Canada to treat the symptoms of posttraumatic stress disorder (PTSD). MDMA is used in conjunction with manualized therapy, because of its effectiveness in reducing fear-driven stimuli that contribute to trauma and anxiety symptoms. In 2017, the FDA designated MDMA as a "breakthrough therapy," signaling that it has advantages in safety, efficacy, and compliance over available medication for the treatment of trauma-, stress-, and anxiety-related disorders such as PTSD. In the US and Canada, historical and contemporary racial mistreatment is frequently experienced by Black people via a variety of macro and micro insults. Such experiences trigger physiological responses of anxiety and fear, which are associated with chronically elevated stress hormone levels (e.g., cortisol and epinephrine), similar to levels documented among those diagnosed with an anxiety disorder. This paper will explore the benefits of entheogens within psychedelic assisted-therapy and their potential benefits in addressing the sequelae of pervasive and frequent negative race-based experiences and promoting healing and thriving among Black, Indigenous and other People of Color (BIPOC). The author(s) discuss the ethical responsibility for providing psychedelic-assisted therapy within a culturally competent provider framework and the importance of psychedelic researchers to recruit and retain BIPOC populations in research and clinical training.
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Affiliation(s)
- Darron T. Smith
- Department of Sociology, The University of Memphis, Memphis, TN, United States
| | | | - NiCole T. Buchanan
- Department of Psychology, Michigan State University, East Lansing, MI, United States
| | | | - Lilith Green
- Department of Sociology, The University of Memphis, Memphis, TN, United States
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Stickl Haugen J, Bledsoe KG, Burgess M, Rutledge ML. Framework of anti‐racist school counseling competencies: A Delphi study. JOURNAL OF COUNSELING AND DEVELOPMENT 2021. [DOI: 10.1002/jcad.12422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Jaimie Stickl Haugen
- Department of Counselor Education, School of Education St. Bonaventure University St. Bonaventure New York USA
| | - Kenya G. Bledsoe
- Department of Leadership and Counselor Education The University of Mississippi MS USA
| | - Melanie Burgess
- Department of Counseling, Educational Psychology, and Research The University of Memphis TN USA
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Malott KM, Paone TR, Shannon J, Barr JJ. From awareness to commitment and action: A longitudinal study of a race‐based counseling course. JOURNAL OF MULTICULTURAL COUNSELING AND DEVELOPMENT 2021. [DOI: 10.1002/jmcd.12232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Krista M. Malott
- Department of Education and Counseling Villanova University Villanova PA USA
| | - Tina R. Paone
- Department of Educational Counseling & Leadership Monmouth University Monmouth NJ USA
| | - Jordan Shannon
- Department of Counselor Education Seattle Pacific University Seattle WA USA
| | - Jason J. Barr
- College of Education & Human Services Rider University Lawrenceville NJ USA
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Beyond the Work Environment: A Run-in With Racism. Holist Nurs Pract 2021; 35:239-241. [PMID: 34407020 DOI: 10.1097/hnp.0000000000000471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tyler KM, Stevens-Watkins D, Burris JL, Fisher SD, Hargons CN. Black Psychology and Whiteness: Toward a Conceptual Model of Black Trauma through the Prism of Whiteness. JOURNAL OF BLACK PSYCHOLOGY 2021. [DOI: 10.1177/00957984211034948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The main objective of this article is to introduce and examine whiteness as a source of trauma for Black people. We explore Black psychology scholarship to conceptually ground whiteness as the impetus for racism, while identifying it as an interpersonal, psychosocial, and contextual phenomenon that informs the race-based traumatic experiences of Black people. The primary factors constituting whiteness are ethnocentric monoculturalism, White standardization, ontological expansiveness, White emotions, attitudes, reactions to race, and White privilege. While racism operates through oppression and exclusion to produce trauma among Black people, we argue that whiteness operates similarly to produce race-based traumatic stress. With this premise, we offer and explain a conceptual model to promote empirical research that identifies and operationalizes whiteness and its components as observable contributors to the traumatic experiences of Black persons.
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Evans AM, Hemmings C, Ramsay‐Seaner K, Barnett J. Perceived Racism and Discrimination Among People of Color: An Ethnographic Content Analysis. JOURNAL OF MULTICULTURAL COUNSELING AND DEVELOPMENT 2021. [DOI: 10.1002/jmcd.12221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Carrie Hemmings
- Counselor Leadership and Special Education Department Auburn University, Montgomery
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Duden GS, Martins-Borges L. Psychologists’ perspectives on providing psychological care for refugees in Brazil. COUNSELLING PSYCHOLOGY QUARTERLY 2021. [DOI: 10.1080/09515070.2021.1933909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Gesa Solveig Duden
- Department of Psychology, University of Osnabrück, Osnabrück, Germany
- Departamento De Psicologia, Universidade Federal De Santa Catarina, Campus Universitário –trindade, Florianópolis, Brazil
| | - Lucienne Martins-Borges
- Departamento De Psicologia, Universidade Federal De Santa Catarina, Campus Universitário –trindade, Florianópolis, Brazil
- École De Travail Social Et De Criminologie, Faculté Des Sciences Sociales, Université Laval, Avenue Des Sciences-Humaines, Québec, Canada
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Implementing Anti-Racism Interventions in Healthcare Settings: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062993. [PMID: 33803942 PMCID: PMC8000324 DOI: 10.3390/ijerph18062993] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 11/21/2022]
Abstract
Racism towards Black, Indigenous and people of colour continues to exist in the healthcare system. This leads to profound harm for people who use and work within these settings. This is a scoping review to identify anti-racism interventions in outpatient healthcare settings. Searching the peer-reviewed and grey literature, articles were screened for inclusion by at least two independent reviewers. Synthesizing the socio-ecological levels of interventions with inductively identifying themes, a conceptual model for implementing anti-racism interventions in healthcare settings is presented. In total, 37 peer-reviewed articles were included in the review, with 12 empirical studies and 25 theoretical or conceptual papers. Six grey literature documents were also included. Healthcare institutions need to incorporate an explicit, shared language of anti-racism. Anti-racism action should incorporate leadership buy-in and commitment with dedicated resources, support and funding; a multi-level approach beginning with policy and organizational interventions; transparent accountability mechanisms for sustainable change; long-term meaningful partnerships with Black, Indigenous, and people of colour (i.e., racialized communities); and ongoing, mandatory, tailored staff education and training. Decision-makers and staff in healthcare settings have a responsibility to take anti-racism action and may improve the success and sustainability of their efforts by incorporating the foundational principles and strategies identified in this paper.
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Al'Uqdah SN, Hamit S, Scott S. African American Muslims: Intersectionality and Cultural Competence. COUNSELING AND VALUES 2019. [DOI: 10.1002/cvj.12111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Malott KM, Schaefle S, Paone TR, Cates J, Haizlip B. Challenges and Coping Mechanisms of Whites Committed to Antiracism. JOURNAL OF COUNSELING AND DEVELOPMENT 2019. [DOI: 10.1002/jcad.12238] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | - Scott Schaefle
- School of Education and Human Development, University of Colorado Denver
| | - Tina R. Paone
- Department of Educational Counseling and Leadership, Monmouth University
| | - Jennifer Cates
- Rueckert-Hartman College for Health Professions, Regis University
| | - Breyan Haizlip
- Department of Leadership, Technology, and Human Development, Georgia Southern University
- Now at Fairhaven College of Interdisciplinary Studies, Western Washington University
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Getting Comfortable with Discomfort: Preparing Counselor Trainees to Broach Racial, Ethnic, and Cultural Factors with Clients during Counseling. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2018. [DOI: 10.1007/s10447-017-9308-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Barden SM, Sherrell RS, Matthews JJ. A National Survey on Multicultural Competence for Professional Counselors: A Replication Study. JOURNAL OF COUNSELING AND DEVELOPMENT 2017. [DOI: 10.1002/jcad.12132] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Sejal M. Barden
- College of Education and Human Performance; University of Central Florida
| | - Renee S. Sherrell
- Department of Counseling and Applied Behavioral Studies; University of St. Joseph
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