Parent-child attachment and mental health in young adolescents: a moderated mediation analysis

Introduction

The parent-child attachment has a significant impact on adolescents' mental health. However, the influence of psychological quality and coping styles on this connection remains unknown. This study examined the relationship between parent-child attachment and adolescent mental health, by exploring the mediating role of psychological quality and the moderating role of coping styles.

Methods

A total of 633 young adolescents participated in this study after signing informed consent. They anonymously completed questionnaires including the Parent and Peer Attachment Scale (Parent Attachment Section), the Coping Styles Inventory for Middle School Students, the Brief Version of the Psychological Quality Inventory for Middle School Students, and the Chinese Middle School Students'Psychological Quality Inventory. After controlling for gender, grade, left-behind category, only-child status, and family structure.

Results

The moderated mediation model yielded the following findings: (a) parent-child attachment significantly and positively predicted adolescents'mental health; (b) psychological quality partially mediated the relationship between parent-child attachment and adolescents' mental health; (c) the association between psychological quality and mental health was moderated by task-focused coping.

Discussion

This moderation effect was more substantial for students with low task-focused coping behaviors, which aligns with the "exclusionary hypothesis" model. Therefore, our results indicate that parent-child attachment indirectly impacts mental health, influenced by internal and external factors. These findings carry significant implications for safeguarding and promoting adolescents' mental well-being.

Managing the negative impact of workforce diversity: The important roles of inclusive HRM and employee learning-oriented behaviors

The workforce has become more diverse than it used to be. Although organizations actively capitalize on workforce diversity to enhance team innovation and organizational performance, it is found that workforce diversity also has potential risks, among which interpersonal conflict is the most salient one. However, we still know relatively less about why workforce diversity may link to higher interpersonal conflict and, more importantly, how to mitigate the negative impact of workforce diversity. Based on the workplace diversity theories (e.g., the categorization-elaboration model), this study examined how workforce diversity was positively related to interpersonal conflict through impacting one's affective states, and to what extent this indirect effect can be weakened by organization-initiated practices (i.e., the inclusive human resources management (HRM) practices) and employee-initiated behaviors (i.e., employee learning-oriented behaviors). Using two-wave surveys from 203 employees from various organizations in China, we confirmed our hypotheses. Our results showed that perceived workforce diversity was positively related to interpersonal conflict through increasing negative affect (after we controlled for the objective diversity level calculated by the Blau index), and this indirect effect was weakened when the levels of inclusive HRM practices and employee learning-oriented behaviors were high. Our study suggests that it is important for organizations to be aware of the detrimental impact of workforce diversity. In addition, it is essential to use both the top-down (e.g., inclusive HRM practices) and bottom-up (e.g., employee learning-oriented behaviors) approaches to managing the challenges presented by diversity so as to unlock more potential of diversity in the workplace.

Domains of competence in midwifery students: a basis for developing a competence assessment tool for iranian undergraduate midwifery students

BACKGROUND

Current study was conducted with the aim of explaining domains of clinical competence in undergraduate midwifery students so that it addresses the challenges in midwifery curriculum and improving clinical assessment methods in Iranian undergraduate midwifery students.

METHODS

Qualitative approach and conventional content analysis were used in the design of the present study. The research setting included midwifery and nursing schools and hospitals and health centers affiliated to Tehran and Guilan universities of medical sciences in Iran. The target population consisted of undergraduate midwifery students in the fourth to eighth semesters of school, midwives working in hospitals and health centers, midwifery faculty members, and obstetricians. The participants were selected through purposive maximum variation sampling, which continued until data saturation. After in-depth semi-structured interviews, the content of the interviews was analyzed according to the steps proposed by Zhang & Wildemuth.

RESULTS

Twenty-four people participated in this study, including seven midwifery students, seven midwives, nine midwifery and reproductive and sexual health faculty members, and one obstetrician. The participants were aged 20-56 years and their mean age was 39.75 years. Their level of education varied from midwifery student to PhD. The mean work experience of the participants was 13.62 years and the mean duration of the interviews was 48 min. The analysis of the data obtained from the experiences of the participants led to the formation of the four categories of ethical and professional function in midwifery, holistic midwifery care, effective interaction, and personal and professional development, along with ten subcategories.

CONCLUSION

The findings of the present study showed that clinical competence in midwifery students involves different domains that correspond well overall to the general definitions of clinical competence in different sources. These findings can be used as a basis for the design and psychometric assessment of a clinical competence assessment tool for undergraduate midwifery students.

The Wright-Constantine Structured Cultural Interview and Integration of Culture into Case Conceptualization

Although multicultural counseling competence is crucial to the field of counseling psychology and clinical assessment, there remains a gap in how cultural data can be collected and used in clinical case conceptualization. The present study evaluated the case conceptualizations of doctoral-level trainees and focused on whether the integration of culture into the conceptualizations/formulations was influenced by the use of the Wright-Constantine Structured Cultural Interview (WCSCI), as compared to the use of one of two other cultural interviews (the Patient Cultural Identity Assessment and the DSM-5 Cultural Formulation Interview). Unsurprisingly, clients with minoritized identities and supervisors (but not trainees) with minoritized identities produced case conceptualizations that integrated culture at higher rates. Further, those conceptualizations that utilized the WCSCI were around 3.5 to 4.5 times more likely to integrate culture than those that used one of the other two cultural interviews. Implications for psychology practice are discussed.

Counseling Across Cultures: A Half-Century Assessment

As the Special Issue of the Journal of Cross-Cultural Psychology celebrates the 50th anniversary of the International Association for Cross-Cultural Psychology (IACCP), this article aims to summarize and track the development of counseling and psychotherapy in cultural contexts over the past half-century. When the edited volume, Counseling Across Cultures (CAC) first appeared nearly half a century ago, it sent an innovative message that culture matters in counseling and psychotherapy. The CAC editors produced six more updated editions in the succeeding years by 2016. The CAC authors examined the cultural context of accurate assessment, meaningful understanding of culture-relevant concepts, and appropriate interventions in each of the seven editions. They have surveyed universal and cultural aspects of counseling and psychotherapy according to such themes as emic and etic approaches to models of mental health, therapeutic relationships and techniques, assessment and interventions, and training needs against the IACCP’s ever-growing academic and professional activities. Research on the cultural adaptation of specific psychotherapies for specific clients should enhance access to culturally sensitive and evidence-based assessments and interventions. The need for training in multicultural awareness is expected to accelerate in the age of rapid globalization. This article affirms the contribution of the foundation-building approaches of CAC and the need for developing the interface between cross-cultural psychology and related clinical and counseling fields.

Trainee perceptions of multicultural climate and supervision in neuropsychology

INTRODUCTION

Mentor relationships are important in developing and supporting professional self-efficacy among psychology trainees. Additionally, the rapid diversification of the United States calls for the preparation of clinical neuropsychology trainees to work within a multicultural context. The present study aimed to assess neuropsychology trainees' perceptions of multicultural climate and supervision and if these perceptions differ based on trainee demographics. We also sought to identify aversive experiences of trainees, program strengths or weaknesses, and how programs support trainees.

METHOD

Participants were 310 neuropsychology trainees (Mean age = 30.27, SD = 5.67) from clinical psychology graduate (n = 136), pre-doctoral internship (n = 38), and post-doctoral (n = 71) programs across the United States and Canada who completed a survey assessing perceptions to multicultural climate and supervision. 64.5% self-identified as women, 60.3% as heterosexual, and 46.1% as non-Hispanic White. 34.5% of trainees reported at least one American Disabilities Act (ADA) recognized disability.

RESULTS

Though satisfied with general supervision, trainees reported overall dissatisfaction with multicultural supervision. Satisfaction with multicultural supervision did not differ by demographics. Trainees also reported various aversive experiences with supervisors, clients, and research participants that negatively impacted their training. These experiences were at times due to an aspect of the trainee's multicultural identity, with Black and Hispanic trainees being more likely to report an aversive experience. Trainees reported ways in which they felt unsupported by their programs.

CONCLUSIONS

Important areas of growth for programs are discussed. Issues raised by neuropsychology trainees overlap to some degree with the experiences of trainees in other fields. Recommendations of approaches that have been successfully adopted in other fields to improve trainee satisfaction are provided. Early identification of needs that go above and beyond clinical training will allow programs to respond promptly, improve trainee satisfaction, and potentially improve the retention of trainees from diverse backgrounds.

Standing Up for Culturally Competent Care in Portugal: The Experience of a “Health in Equality” Online Training Program on Individual and Cultural Diversity

Health professionals play an essential role in the protection and promotion of health rights without distinction of sex, sexual orientation, gender identity and expression, ethnicity/race, nationality and migration status, age, functional diversity, or any other individual and/or cultural positions. With the growing diversity of patient populations, health professionals must be able to identify and be responsive to individual and cultural diversity, ensuring equity in access to high-quality individually-centered care. For this, it is fundamental to promote training in cultural competence, understood as responsivity and the ability to work the valorization of multiple and intersectional identities throughout life. The paper aims to describe the experience of the implementation of the program “Health in Equality”, aimed at training the primary healthcare workforce in Portugal, which was based on Sue and Sue’s (2008) three-dimensional model of multicultural skills, which champions cultural best practices in an intersectional perspective. Based on the trainees’ and trainers’ evaluation of four completed editions developed online between March and July 2021, this study discusses ways to improve the impact of the training program and amplify the number of leaders and role models for other health care providers towards culturally competent healthcare systems and organizations.

The Impact of the Multicultural Education on Students’ Attitudes in Business Higher Education Institutions

The research aims to assess the cultural diversity of international students studying in higher education institutions. The results of the research provide an overview of the attitude of students studying in institutions of higher education to learning, the factors influencing their studies, and their expectations for their studies abroad. One type of quantitative research method, the questionnaire, was chosen for the primary research. The research results reflect the perspectives of students from different cultural backgrounds in institutions of higher education and focus on the phenomena and situations they experience. Following the hypothesis test results, an outcome can be seen that students believe that their studies in higher education provide a good foundation for their personal development. The results also confirmed that learning in a multicultural environment could positively affect students’ working abilities.

Adaptation of the TEAM Mental Healthcare Delivery Model: A Mixed-Methods Evaluation

We report on the adaptation and evaluation of an existing approach to multicultural education into an eight-session online, modular curriculum for psychiatric mental health nurse practitioner students (n = 6) and psychology interns (n = 10). Training participants were invited to complete verbal feedback, self-report questionnaires, and a high-fidelity patient simulation before and after the training. Self-report questionnaire results revealed no changes in knowledge or attitudes, but qualitative analysis of verbal feedback reflected improvements in attitudes and behaviors relevant to cultural competence. Results from the simulation also demonstrated an increase in measurable cultural competence behavioral indicators.

"It's Not Only about Clinical Tools but Also Our Role as Agents of Social Change": Implementing a LGBT Competency Training for Future Mental Health Practitioners in Mexico

Recent studies recommend implementing a curriculum that is inclusive of lesbian, gay, bisexual, and transgender (LGBT) identities in health-related higher education programs. Inclusive health services are a means to address stigma-related adverse health outcomes in these populations. In Mexico, research has revealed that sexual and gender minority individuals experience discriminatory conditions that put them at risk for mental health problems. The present study tested the impact of a LGBT training protocol in Mexico; 17 psychology majors living in Mexico City received 12-plus hours of training on LGBT multicultural competencies. A quantitative retrospective assessment of participants' attitudes toward LGBT individuals, knowledge of LGBT issues, and willingness to work with LGBT clients, alongside qualitative data collected from a focus group, provided evidence on the impact of this training strategy. Implications for LGBT multicultural competency training in undergraduate and graduate programs in psychology are discussed herein.

Representation of Race and Ethnicity in Counseling and Counseling Psychology Journals

Literature reviews have concluded that People of Color are underrepresented in psychological literature; however, the fields of counseling and counseling psychology have taken a clear affirmative stance with respect to human diversity. This study sought to evaluate the representation of People of Color in four key journals across the 2000–2019 timespan: The Counseling Psychologist, Journal of Counseling Psychology, Journal of Counseling & Development, and Counselling Psychology Quarterly. Journal articles were coded for variables including focus on racial/ethnic minority (REM) groups and article content topics. Results indicated that 26.3% of the articles were coded as REM-focused (3.8% focused on African Americans, 4.1% on Asian Americans, 3.1% on Latinxs, and 0.7% on Native Americans). The need for additional research is especially notable in the case of Latinxs (the least represented REM group relative to United States Census estimates) and for several multicultural topics that remain underrepresented in the literature.

Educating nursing students for cultural competence in emergencies: a randomized controlled trial

BACKGROUND

Racial and ethnic minorities suffer significantly more than others in the wake of disasters. Despite the growing recognition of the importance of culturally competent health services, systematic cultural competence training in the medical education system is still scarce, especially in the field of emergency. The current study aimed to examine the effectiveness of an online culturally informed intervention for increasing cultural competence in emergencies among nursing students.

METHODS

A randomized controlled trial was used to test the intervention effectiveness in increasing nursing students' cultural competence in four domains: attitudes, knowledge, skills, and encounters. The study included 72 undergraduate nursing students recruited from two academic institutes. Participants were randomized (1:1 ratio) to an intervention (n = 34) and control group (n = 38). The study adheres to the Consolidated Standards of Reporting Trials (CONSORT). Data analysis was based on multivariate analysis of variance with repeated measures, followed by post hoc analyses with Bonferroni correction for multiple comparisons.

RESULTS

Results showed that the intervention was effective in increasing the participants' culturally competent knowledge. The effect of the intervention on the skills domain approached significance. No group differences were identified in the attitudes and the encounters domains.

CONCLUSIONS

An online culturally informed intervention, incorporated in the curriculum, was effective in enhancing the cognitive aspect of cultural competence (especially at the basic knowledge and understanding levels), but not other domains. Our results encourage the development of future intervention programs that are based on a deep understanding of local values, needs, and preferences.

Designing diversity training program for business executives

Purpose

In today’s corporate world, effective management of diversity is a critical business and social imperative. This paper aims to identify relevant issues connected to diversity training and suggest course content that can be useful in corporate and academia while offering diversity training.

Design/methodology/approach

The authors have conducted a literature review on primary aspects connected to diversity training. Specifically, papers published in recent times are given focus to come up with relevant diversity training content and other connected concerns.

Findings

In this paper, the authors focus on how academicians and practitioners can develop an effective diversity training initiative, based on some of the critical nuances discussed in the literature. Suggested training content includes sensitivity, awareness, behavioral approach, policy guidelines and diversity impact analysis. This training content can further be customized based on the corporate context where the training is to be delivered.

Originality/value

Based on the literature review, the paper suggests a holistic diversity training program that is hopefully going to be useful for both practitioners and academicians.

Midwives' experiences of cultural competency training and providing perinatal care for migrant women a mixed methods study: Operational Refugee and Migrant Maternal Approach (ORAMMA) project

BACKGROUND

The number of international migrants continues to increase worldwide. Depending on their country of origin and migration experience, migrants may be at greater risk of maternal and neonatal morbidity and mortality. Having compassionate and culturally competent healthcare providers is essential to optimise perinatal care. The "Operational Refugee and Migrant Maternal Approach" (ORAMMA) project developed cultural competence training for health professionals to aid with providing perinatal care for migrant women. This presents an evaluation of ORAMMA training and explores midwives' experiences of the training and providing care within the ORAMMA project.

METHODS

Cultural competence was assessed before and after midwives (n = 35) received ORAMMA compassionate and culturally sensitive maternity care training in three different European countries. Semi-structured interviews (n = 12) explored midwives' experiences of the training and of caring for migrant women within the ORAMMA project.

RESULTS

A significant improvement of the median score pre to post-test was observed for midwives' knowledge (17 to 20, p < 0.001), skills (5 to 6, p = 0.002) and self-perceived cultural competence (27 to 29, p = 0.010). Exploration of midwives' experiences of the training revealed themes of "appropriate and applicable", "made a difference" and "training gaps" and data from ORAMMA project experiences identified three further themes; "supportive care", "working alongside peer supporters" and "challenges faced".

CONCLUSIONS

The training improved midwives' knowledge and self-perceived cultural competence in three European countries with differing contexts and workforce provision. A positive experience of ORAMMA care model was expressed by midwives, however clearer expectations of peer supporters' roles and more time within appointments to assess the psychosocial needs of migrant women were desired. Future large-scale research is required to assess the long-term impact of the ORAMMA model and training on practice and clinical perinatal outcomes.

The professionalization and training of psychologists: The place of clinical wisdom

OBJECTIVE

The current study examines how clinical wisdom develops and how it both is and can be influenced by professional training processes. In this way, the project is studying the intersection of developmental and systemic processes related to clinical wisdom.

METHOD

Researchers analyzed the interviews of psychologists practicing in the USA and Canada who were nominated for their clinical wisdom by their peers. These interviews explored how graduate training and professionalization were thought to influence the development of clinical wisdom and were subjected to an adapted grounded theory analysis.

RESULTS

The findings described both professional and personal disincentives toward developing wisdom, including the dangers of isolation. Therapists reported concerns about educational systems that rewarded quick answers instead of thoughtful questioning in processes of admittance, training, and accreditation. Findings emphasized the importance of teaching multiple psychotherapy orientations, critical self- and professional-reflection skills, and openly supporting graduate students' curiosities and continued professional engagement.

CONCLUSIONS

Recommended principles for training are put forward for the development and evaluation of psychotherapy training programs that aim to foster clinical wisdom. These principles complement training models focused upon clinical competence by helping trainees to develop a foundation for clinical wisdom.

A multilevel framework for recruiting and supporting graduate students from culturally diverse backgrounds in school psychology programs

The lack of cultural diversity among practitioners and trainers in the field of school psychology has been recognized as a longstanding problem. In particular, individuals from racial, ethnic, and linguistic minority and international backgrounds often encounter a range of barriers to pursuing graduate study in school psychology. Given the urgent need to increase diversity among school psychologists, faculty and institutions must take proactive measures to deconstruct these barriers and to support the success of all students. This article outlines a multilevel framework for recruiting and supporting graduate students from culturally diverse backgrounds in school psychology programs. Within this framework, research-based strategies are presented at the primary, secondary, and tertiary levels of support. Moreover, considerations for assessing program and student outcomes are discussed, and applications to school psychology programs internationally are considered.

Interventions to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA: a systematic review

PURPOSE

This article describes the characteristics and reviews the methodological quality of interventions designed to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA.

DATA SOURCES

A total of 17 electronic databases and 13 websites for the period of 2002-13.

STUDY SELECTION

Studies were included if they evaluated an intervention strategy designed to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, the USA or Canada.

DATA EXTRACTION

Information on the characteristics and methodological quality of included studies was extracted using standardized assessment tools.

RESULTS OF DATA SYNTHESIS

Sixteen published evaluations of interventions to improve cultural competency in health care for Indigenous peoples were identified: 11 for Indigenous peoples of the USA and 5 for Indigenous Australians. The main types of intervention strategies were education and training of the health workforce, culturally specific health programs and recruitment of an Indigenous health workforce. Main positive outcomes reported were improvements in health professionals' confidence, and patients' satisfaction with and access to health care. The methodological quality of evaluations and the reporting of key methodological criteria were variable. Particular problems included weak study designs, low or no reporting of consent rates, confounding and non-validated measurement instruments.

CONCLUSION

There is a lack of evidence from rigorous evaluations on the effectiveness of interventions for improving cultural competency in health care for Indigenous peoples. Future evaluations should employ more rigorous study designs and extend their measurement of outcomes beyond those relating to health professionals, to those relating to the health of Indigenous peoples.

Evaluating the Effectiveness of an Undergraduate Multicultural Course

The American Psychological Association (APA) recently revised their Guidelines for the undergraduate psychology major in 2013. In this updated version diversity is included in the broad goal of ethical and social responsibility in a diverse world. Indicators associated with this goal include student awareness of prejudice within themselves and others, sensitivity to issues of power, privilege and discrimination, and knowledge of cultural diversity. Previous researchers have discussed the conditions necessary and processes by which intercultural learning and prejudice reduction occur. The current study utilized a measure of multicultural competence to assess the effectiveness of a semester-long undergraduate multicultural course. The results indicated the multicultural course was more effective than a personality course in increasing multicultural knowledge but had no impact on multicultural awareness. The discussion focused on the conditions that may have influenced the results.

When Religion Enters the Counseling Group

Religion is a diversity factor that comprises a significant component of identity for many clients. However, little attention has been paid to religion in the context of group counseling, especially process-oriented, nonthemed groups with heterogeneous membership. Using multicultural, process-oriented, and social justice theories of groups, we demonstrate the myriad ways religion is relevant to and influential in group counseling work. Together, these theories provide a solid justification for the need to ethically and effectively attend to religion in group work. Furthermore, they provide a strong foundation for developing counseling expertise in this area by highlighting typical conflicts, group dynamics, and needs that arise when religion is addressed in groups. Based on our review, we provide practical and ethical implications to assist group leaders in addressing religion in their group counseling work.

Interventions to improve cultural competency in healthcare: a systematic review of reviews

Background

Cultural competency is a recognized and popular approach to improving the provision of health care to racial/ethnic minority groups in the community with the aim of reducing racial/ethnic health disparities. The aim of this systematic review of reviews is to gather and synthesize existing reviews of studies in the field to form a comprehensive understanding of the current evidence base that can guide future interventions and research in the area.

Methods

A systematic review of review articles published between January 2000 and June 2012 was conducted. Electronic databases (including Medline, Cinahl and PsycINFO), reference lists of articles, and key websites were searched. Reviews of cultural competency in health settings only were included. Each review was critically appraised by two authors using a study appraisal tool and were given a quality assessment rating of weak, moderate or strong.

Results

Nineteen published reviews were identified. Reviews consisted of between 5 and 38 studies, included a variety of health care settings/contexts and a range of study types. There were three main categories of study outcomes: patient-related outcomes, provider-related outcomes, and health service access and utilization outcomes. The majority of reviews found moderate evidence of improvement in provider outcomes and health care access and utilization outcomes but weaker evidence for improvements in patient/client outcomes.

Conclusion

This review of reviews indicates that there is some evidence that interventions to improve cultural competency can improve patient/client health outcomes. However, a lack of methodological rigor is common amongst the studies included in reviews and many of the studies rely on self-report, which is subject to a range of biases, while objective evidence of intervention effectiveness was rare. Future research should measure both healthcare provider and patient/client health outcomes, consider organizational factors, and utilize more rigorous study designs.

Multicultural Grand Rounds: Competency-Based Training Model for Clinical Psychology Graduate Students

Preparing students to enter the field of psychology as competent professionals requires that multicultural practices be infused into all areas of training. This article describes how the Grand Rounds model was adapted to a graduate clinical psychology training program to foster applied learning in multicultural competence. This extension of Grand Rounds as A? student-driven program to enhance multiculturalism may help others in doctoral psychology training programs develop experiential learning opportunities to further enhance professional competence.

Multicultural Therapy Practicum Involving Refugees

Multicultural scholars have long noted the value and the need to incorporate multicultural counseling practica into diversity-social justice training. This article describes an ongoing, systematic model of multicultural therapy practicum in which clinical psychology trainees provide direct psychotherapy to community-referred, culturally and linguistically diverse refugee clients, under culturally grounded supervision. As a university–community collaboration, this practicum embodies the principles of multicultural counseling competencies, social justice, community outreach and service, experiential learning, and trauma therapy. In this article, we describe the target refugee population, the theoretical/conceptual bases, the learning conditions, the organizational structure, and the evaluative research of this practicum. Next, we present a former trainee’s narrative account of working with a male Afghan refugee from an autoethnographic qualitative framework to illustrate the dynamic learning process and the intricate cross-cultural interactions between the client and therapist. Finally, implications of this practicum for future practice and research on experiential multicultural training are discussed.

Heterosexual Ally Development in Counseling Psychologists

Fourteen pre-doctoral psychology interns and psychologists employed in university counseling settings who self-identified as heterosexual were interviewed concerning their experiences and development with ally work in the lesbian, gay, bisexual, and transgender (LGBT) community. Guided by the tradition of interpretive phenomenological qualitative approach with constant comparison analysis serving as the strategy for inductive analysis, results indicated a significant variation concerning how the counseling psychologists viewed the ally experience. However, common meaning, challenges, and training experiences within their ally development were evident, with five main themes emerging: (a) ally meaning and essence, (b) ally growth and development, (c) ally challenges, (d) relationship between social justice and training, and (e) diversity within the LGBT community. Results highlight ongoing discussion, research, and training concerning ally development, with particular focus on modeling and mentorship.