Child Mental Health Services and Psychotherapy Attitudes Among Asian Indian Parents: An Exploratory Study

Assessing the Effectiveness of Multilevel Intervention Sequences on "Tension" Among Men Living with HIV: A Randomized-Control Trial

BACKGROUND

Tension (often times called "Tenshun" in Hindi) is a cultural expression used to convey feelings of distress and common mental disorders in India and among South Asia communities. This study compared the effectiveness of different intervention sequences in reducing tension among alcohol-consuming men living with HIV in India.

METHOD

This secondary data analysis paper utilized data from a randomized trial study titled "Alcohol and Antiretroviral Therapy (ART) Adherence: Assessment, Intervention, and Modeling in India." The multilevel interventions, including individual counseling (IC), group intervention (GI), and collective advocacy (CA), were conducted sequentially over three cycles at three ART centers. Additionally, another ART center, serving as a pilot site, received all three interventions simultaneously in the final cycle. Participants completed surveys assessing demographic characteristics, tension, and other variables including HIV stigma, a 4-day ART adherence, HIV symptoms, and depressive symptoms at four time points: baseline, 9 months, 18 months, and 24 months. General linear mixed models were employed to assess the intervention effects on tension.

RESULTS

Out of 940 participants, 666 reported experiencing tension, including 54% reporting high tension. At site 1, the GI-CA-IC sequence resulted in a slope of -0.06, indicating that this sequence reduced tension from T1 to T4 compared to the control group (p < 0.01). Additionally, the pilot site where the intervention package was conducted simultaneously had a slope of -0.06, indicating that the intervention package also reduced tension compared to the control group (p < 0.01). Conversely, the CA-IC-GI sequence resulted in a slope of 0.07, indicating that this sequence resulted in significantly higher tension levels than the control group (p = 0.008) contrary to the expectation that the sequence would reduce tension.

CONCLUSION

This study contributes valuable insights on the issue of tension among alcohol-consuming men living with HIV. The significant reduction in tension observed at the site using the GI-CA-IC sequence, which began with a group intervention, underscores the importance of intervention order and the importance of group intervention within multilevel intervention programs for tension reduction. Further research is needed to validate these observations and broaden our understanding of effective tension management strategies among people living with HIV in diverse settings.

TRIAL REGISTRATION

URL: clinicaltrials.gov.

REGISTRATION NUMBER

NCT03746457.

Asian Indian American Parental Help-Seeking Intentions for ADHD

Minoritized ethnic groups experience both delay to treatment and low rate of treatment contact for attention deficit/hyperactivity disorder (ADHD). To date, Asian Indian Americans have been excluded completely from ADHD help-seeking research. To fill this void, the Theory of Planned Behavior (TPB) was used to investigate the influence of race/ethnicity on parents' help-seeking intentions for their child's elevated ADHD symptoms. Parents (n = 191, 53% Asian Indian American, 47% European American; 63.9% fathers) of treatment naïve children at high risk for ADHD completed an online survey to assess their recognition of ADHD, knowledge of ADHD etiology, attitudes towards ADHD treatment, subjective norms regarding ADHD treatment, perceived control over their ADHD help-seeking behavior, and intention to seek help for their child's elevated ADHD symptoms. Hierarchical linear regressions demonstrated that perceived behavioral control independently predicted intention to seek help in the total sample and may be more impactful for European American parents than Asian Indian American parents. In contrast, subjective norms were more influential for help-seeking intentions among Asian Indian American parents. However, attitudes towards ADHD were not significantly associated with the intention to seek help among both ethnicities. Asian Indian American parents endorsed lower levels of biopsychosocial etiology beliefs. Together, the results inform possible methods of increasing treatment engagement for both groups of parents who have children at high risk for ADHD.

Ultra-Orthodox Parents' Perceptions of Arts Therapies for Their Children

Studies have underscored the complexity of psychotherapy for Ultra-Orthodox Jews, and cross-cultural therapy in particular, which evokes fear of disruption of basic values. Parents' sense of responsibility for their child's religious education exacerbates these problems in child therapy. However, there is scant research on child therapy for the Ultra-Orthodox, especially in the field of arts therapies. The present study examined the perceptions of 17 Ultra-Orthodox parents whose children were receiving arts therapies (including art therapy, dance/movement therapy, music therapy, psychodrama and bibliotherapy). Semi-structured interviews were conducted with the parents and analyzed based on the principles of Consensual Qualitative Research. The study covered five domains: (1) The parents' experiences in therapy; (2) The parents' perceptions of the child's experiences in therapy; (3) Implications of environmental-social factors on the parents' perceptions and experiences of therapy; (4) Effects of intercultural aspects on therapy; (5) Perceptions of the use of the arts in therapy. The findings show that the experiences of ultra-Orthodox parents in the arts therapies of their children is complex due to the influence of the socio-cultural context, which involves dealing with stigma and tensions in their relationship with the education system. This context also shapes their perceptions of therapy, which can be characterized as purpose-oriented. The findings also highlight the parents' challenges in coping with the intercultural therapeutic relationship, and emphasizes the parents' preference for a therapist from a similar religious/cultural background and for cultural supervision of therapy. However, the results also suggest that there are benefits inherent to intercultural therapy in general and arts therapies in particular, including a sense of security, openness and acceptance of the parents and children.

Factors Associated with Mental Health Help-Seeking Among Asian Americans: a Systematic Review

OBJECTIVE

Asian Americans are underutilizing mental health services. The aim of the current systematic review was to identify protective and risk factors of mental health help-seeking patterns among the disaggregated Asian Americans and to classify types of help.

METHODS

A systematic literature review was conducted using the PRISMA guidelines. The Health Belief Model served as the theoretical framework for this review. Thirty-four articles were reviewed, and the studies investigated one of the following Asian ethnic subgroups: Chinese, Filipino, Asian Indian, Korean, or Vietnamese. Data were extracted based on the study characteristics, sample characteristics, and protective and risk factors to mental health help-seeking patterns.

RESULTS

Predisposing factors like female gender, higher levels of English proficiency, and history of mental illness increased the likelihood for help-seeking across several ethnic groups. Interestingly, cues to action and structural factors were under-examined. However, cues to action like having a positive social network did increase the likelihood of using formal support services among Chinese and Filipinx participants. Structural factors like lacking ethnic concordant providers and access to healthcare served as barriers for Korean and Vietnamese participants.

DISCUSSION

The findings showed a need for ethnic tailored approaches when supporting mental health help-seeking patterns. Asian ethnic group's immigration status, acculturation level, and psychological barriers to help-seeking should continue to be emphasized. Psychoeducational groups can be beneficial to expand the knowledge base surrounding mental illness and to link group members to culturally responsive resources.

Correlates of help-seeking by parents for the socioemotional development of their 3-year-old children: a longitudinal study

OBJECTIVES

Timely parental help-seeking regarding their child's socioemotional development is associated with a lower rate and lower severity of psychosocial problems in later life. This study aimed to examine the correlates of parental help-seeking for the socio-emotional development of 3-year-old children.

DESIGN

Retrospective cohort study.

SETTING

Community-based survey in Rotterdam.

PARTICIPANTS

Of 2305 parents and their 2-year-old children at baseline, 1507 who completed follow-up questionnaires were included in the analyses when children were 3 years old.

OUTCOME MEASURES

Parental help-seeking regarding their child's socioemotional development and types of formal and informal help sources (eg, general practitioner, internet) used in the past 12 months were measured. Hierarchical logistic regression models were applied to identify factors correlates of parental help-seeking among 13 predisposing, enabling and need factors according to Andersen's behavioural model.

RESULTS

In total, 22.6% of parents reported help-seeking in the past 12 months for socioemotional development of their 3-year-old child; 6.8% addressed formal help sources and 17.5% addressed informal help sources. General practitioner (2.7%) and family (12.5%) were the most frequently used formal and informal sources, respectively. In the full model, predisposing factors associated with higher odds of parental help-seeking were child's other western ethnic background (OR=1.66, 95% CI 1.02 to 2.68) and parental age ≤29 years old (OR=1.71, 95% CI 1.01 to 2.92). No associated factors were found among enabling factors. The need factors associated with higher odds of parental help-seeking were having previous help-seeking (OR=2.52, 95% CI 1.83 to 3.48) and discussing child's socioemotional development in the well-child visit (OR=2.47, 95% CI 1.73 to 3.53).

CONCLUSIONS

Predisposing and need factors were associated with parental help-seeking for socioemotional development of 3-year-old children. The findings can be used to further develop support for parents accessing adequate information, prevention and anticipatory care with regards to the child's socio-emotional development.

Therapy Fears and Help-Seeking Behaviors among Mothers: Examining Racial Differences in Mental Health Services

In the United States, approximately 20% of children and adolescents meet diagnostic criteria for a mental health diagnosis, but few receive treatment. The purpose of the current study was to explore the factors that contribute to help-seeking among mothers from diverse ethnic groups (52.5% European American/White, 23% African American/Black, and 24.6% Latinx). Participants were 122 mothers recruited from 2014 to 2017 through a convenience sample in Central Texas. Using MANOVA, results indicated that mother with no history of therapy use reported more fears about seeking therapy for children. Additionally, there was a trend towards African American mothers reporting more fears about therapists' responsiveness and image concerns. Finally, therapy fears significantly predicted mother's intentions to delay seeking therapy in the future. Implications for research and practice are discussed.

Factor Structure and Psychometric Properties of the Thoughts About Psychotherapy Survey in a Parent Sample

Researchers have noted that treatment fearfulness (e.g., embarrassment or negative attitudes) causes individuals to avoid seeking therapy. The purpose of this study was to examine the psychometric properties of the Thoughts About Psychotherapy Survey (TAPS; Kushner and Sher in Prof Psychol Res Prac 20(4):251-257, 1989) in a sample of parents. This study also examined differences in therapy fears among parents with and without a history of using mental health services. Using a sample of 138 parents (87% female), findings indicated that a three factor structure of the TAPS was a good fit for the data. Furthermore, the scales demonstrated "good" internal consistency ranging from .86 to .93. Finally, parents that reported previous use of mental health services reported fewer treatment fears. Given these findings, the TAPS appears to be a valid measure to assess treatment fears among parents. Implications for research and practice will be discussed.

Complementary Medicine & Spirituality: Health-Seeking Behaviors of Indian Immigrants in the United States

Over 3 million India-born immigrants live in the United States, yet their health-seeking behaviors are little understood. Information on health and access to care was collected from 20 adult Indian immigrants living in the United States. Participants preferred complementary and alternative medicine home remedies to address their health needs, although they accessed health services more quickly for their children. They also reported barriers in using insurance and accessing healthcare.