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Subhan BA, Johnson VE. The Strong Black Woman Archetype and Therapeutic Outcomes: Examining Relationships Among Women with Childhood Sexual Abuse Histories. J Racial Ethn Health Disparities 2023; 10:2957-2969. [PMID: 36469287 DOI: 10.1007/s40615-022-01472-7] [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] [Received: 08/25/2022] [Revised: 10/31/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
The Strong Black Woman archetype (SBWA) describes a cultural pattern where Black women are expected to and present as physically and mentally strong, regardless of past and ongoing stressors. The SBWA has served the historical purpose of aiding survival for Black women throughout years of racial and gender oppression. However, the practice has also been associated with adverse mental health and with behaviors, such as self-silencing, that could impede therapeutic process. The purpose of this empirical study was to investigate the relationships between adherence to the SBWA and therapeutic outcomes (i.e., satisfaction with therapy, satisfaction with therapist, perceptions of one's global improvement in therapy) among Black women with childhood sexual abuse histories-a subpopulation at increased need for mental health treatment and who may be susceptible to high levels of adherence to the SBWA. Black adult female participants (N = 103) completed an online survey including a demographic questionnaire, an assessment of SBWA endorsement, and treatment outcomes from their current or most recent therapy experience. Three hierarchical linear regressions were conducted with SBWA as the independent variable and (i) satisfaction with therapist, (ii) satisfaction with therapy, and (iii) global improvement as the dependent variables. Consistent with our hypotheses, we found that SBWA inversely predicted satisfaction with therapy and the therapist. While the relationship between SBWA and global improvement was statistically significant, the finding was not practically significant. Still, our study findings suggest that higher levels of SBWA predict less favorable therapy outcomes. Future research directions and clinical implications are discussed.
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Affiliation(s)
- Bibi Aneesa Subhan
- John Jay College of Criminal Justice, City University of New York, 524 West 59Th Street, 10.65.19 NB, New York, NY, 10019, USA.
| | - Veronica Elaine Johnson
- John Jay College of Criminal Justice, City University of New York, 524 West 59Th Street, 10.65.19 NB, New York, NY, 10019, USA
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Terry K, Nickman NA, Mullin S, Ghule P, Tyler LS. Implementation of implicit bias awareness and action training in a pharmacy residency program. Am J Health Syst Pharm 2022; 79:1929-1937. [PMID: 35880865 DOI: 10.1093/ajhp/zxac199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
DISCLAIMER In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE To implement an implicit bias awareness and action seminar program for the University of Utah Health pharmacy residency program and measure knowledge, awareness, and comfort around race-related topics. SUMMARY An implicit bias awareness training program was implemented with a pre- and post-training survey to measure knowledge, comfort, and confidence around understanding and addressing biases. Fifty-one residents and preceptors participated in the implicit bias training, and 47 (92.2%) consented to take the survey. Twenty pharmacy residents and 27 preceptors attended at least 1 of the 4 training modules and completed the pre- and/or post-training survey. Eighteen of 20 residents (90.0%) and 19 of 27 (70.4%) preceptors completed the pretraining survey (37 total), while 11 of 20 residents (55.0%) and 10 of 27 (37.0%) preceptors completed the post-training survey (21 total). On the post-training survey, more correct answers were obtained for knowledge-based questions and a higher number of responses of strongly agree or agree was observed when assessing participants' comfort and confidence in addressing personal biases, bringing marginalized people into a conversation, addressing biased situations, and intervening when bias is observed. CONCLUSION After training, higher scores were attained on the survey for overall comfort and confidence in addressing personal biases and identifying and acting on witnessed biases.
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Affiliation(s)
| | - Nancy A Nickman
- University of Utah College of Pharmacy, Salt Lake City, UT, and University of Utah Health, Salt Lake City, UT, USA
| | | | - Priyanka Ghule
- Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT, USA
| | - Linda S Tyler
- University of Utah College of Pharmacy, Salt Lake City, UT, USA
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Perceptions of Sexual Risk and HIV/STI Prevention Among Black Adolescent Girls in a Detention Center: an Investigation of the Role of Parents and Peers. J Racial Ethn Health Disparities 2022; 10:1224-1233. [PMID: 35595914 DOI: 10.1007/s40615-022-01309-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
Abstract
Black American adolescent girls constitute approximately one third of the US youth legal system population. Their overrepresentation in the youth punishment system is an indicator of significant physical, sexual, and/or behavioral health needs. Since less is known about perceptions of HIV/STI risk among Black girls with juvenile justice histories, we used intersectionality theory to explore the following: (1) how a sample of Black girls in detention endorse their perceptions of sexual safety given the multiple intersections of their race, gender, and SES and (2) how their endorsements align with interlocking systems of social inequality for system-involved Black at the social structural level. We examined relational and behavioral factors associated perceived HIV/STI risk. Among a sample of 188 Black girls (ages 13-17 years), we examined parent and partner sexual communication, fear of condom negotiation, a positive STI test, and partner risk profile as significant correlates. Major findings indicated that greater partner communication was associated with higher perceived HIV/STI risk, whereas having had a risky sexual partner, fear of condom negotiation, and having had a positive STI test were correlated with lower perceived risk. The significant factors identified in this study can be the focus of STI prevention and intervention programs for Black girls with youth punishment histories.
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Ribaudo J, Lawler JM, Jester JM, Riggs J, Erickson NL, Stacks AM, Brophy-Herb H, Muzik M, Rosenblum KL. Maternal History of Adverse Experiences and Posttraumatic Stress Disorder Symptoms Impact Toddlers’ Early Socioemotional Wellbeing: The Benefits of Infant Mental Health-Home Visiting. Front Psychol 2022; 12:792989. [PMID: 35111107 PMCID: PMC8802330 DOI: 10.3389/fpsyg.2021.792989] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/06/2021] [Indexed: 01/30/2023] Open
Abstract
BackgroundThe present study examined the efficacy of the Michigan Model of Infant Mental Health-Home Visiting (IMH-HV) infant mental health treatment to promote the socioemotional wellbeing of infants and young children. Science illuminates the role of parental “co-regulation” of infant emotion as a pathway to young children’s capacity for self-regulation. The synchrony of parent–infant interaction begins to shape the infant’s own nascent regulatory capacities. Parents with a history of childhood adversity, such as maltreatment or witnessing family violence, and who struggle with symptoms of post-traumatic stress may have greater challenges in co-regulating their infant, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, and depression. Early intervention that targets the infant–parent relationship may help buffer the effect of parental risk on child outcomes.MethodsParticipants were 58 mother–infant/toddler dyads enrolled in a longitudinal randomized control trial testing the efficacy of the relationship-based IMH-HV treatment model. Families were eligible based on child age (<24 months at enrollment) and endorsement of at least two of four socio-demographic factors commonly endorsed in community mental health settings: elevated depression symptoms, three or more Adverse Childhood Experiences (ACEs) parenting stress, and/or child behavior or development concerns. This study included dyads whose children were born at the time of study enrollment and completed 12-month post-baseline follow-up visits. Parents reported on their own history of ACEs and current posttraumatic stress disorder (PTSD) symptoms, as well as their toddler’s socioemotional development (e.g., empathy, prosocial skills, aggression, anxiety, prolonged tantrums).ResultsMaternal ACEs predicted more toddler emotional problems through their effect on maternal PTSD symptoms. Parents who received IMH-HV treatment reported more positive toddler socioemotional wellbeing at follow-up relative to the control condition. The most positive socioemotional outcomes were for toddlers of mothers with low to moderate PTSD symptoms who received IMH-HV treatment.ConclusionResults indicate the efficacy of IMH-HV services in promoting more optimal child socioemotional wellbeing even when mothers reported mild to moderate PTSD symptoms. Results also highlight the need to assess parental trauma when infants and young children present with socioemotional difficulties.
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Affiliation(s)
- Julie Ribaudo
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
- School of Social Work, Wayne State University, Detroit, MI, United States
- *Correspondence: Julie Ribaudo,
| | - Jamie M. Lawler
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, United States
| | - Jennifer M. Jester
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Jessica Riggs
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Nora L. Erickson
- Mother Baby Program, Department of Psychiatry, Hennepin Healthcare, Minneapolis, MN, United States
| | - Ann M. Stacks
- Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, United States
| | - Holly Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI, United States
| | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United States
| | - Katherine L. Rosenblum
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United States
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Therapists' Experiences of Working with Ethnic Minority Females with Eating Disorders: A Qualitative Study. Cult Med Psychiatry 2022; 46:414-434. [PMID: 33978867 PMCID: PMC8114017 DOI: 10.1007/s11013-021-09721-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2021] [Indexed: 11/10/2022]
Abstract
Ethnic minority females are less likely to receive a diagnosis or treatment for an eating disorder (ED). This study captured the experiences of therapists who have worked with ethnic minority females to improve outcomes for this group. Twelve therapists in the United Kingdom, London were recruited for semi-structured interviews and thematic analysis was used to analyse the data. Shame was cited as a barrier to accessing help. This influenced therapeutic work such as not challenging shame or linking this to a negative interpretation of parents. Emotional and interpersonal factors were thought to be more common risk factors for the ED. The minimising of weight and shape concern and non-fat-phobic anorexia was thought to lead to a complex and delayed route to accessing ED services. Therapists felt restricted by service management who they felt required them to deliver a narrow range of therapies that had not necessarily demonstrated therapeutic outcomes in ethnic minority females. Nevertheless, therapists reported using curiosity to guide their cultural adaptations when feeling uncertain. When working with ethnic minority females, therapists face challenges from the therapeutic and diagnostic framework that services are aligned to. Creative solutions to address this include adapting the patient care pathway, referral guides, cultural reflective practice, and the use of cultural genograms and scripts in therapeutic work to address unmet needs.
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Trevino AY, Tao KW, Van Epps JJ. Windows of cultural opportunity: A thematic analysis of how cultural conversations occur in psychotherapy. ACTA ACUST UNITED AC 2021; 58:263-274. [PMID: 33734742 DOI: 10.1037/pst0000360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A cultural opportunity is 1 of 3 pillars within multicultural orientation framework; it is defined as a moment in therapy when aspects of a client's background emerge, which can be deeply explored to better understand the salient aspects of a client's cultural identities. Research on cultural opportunities provides evidence that clients desire cultural conversations. However, no study to date has examined what cultural opportunities sound like in therapy and how therapists and clients utilize these opportunities. Accordingly, the purpose of this study was to examine the ways in which cultural conversations emerge during the first psychotherapy session and how clients and therapists engage in these cultural conversations. Psychotherapy sessions from diverse therapist-client pairings at a university counseling center (n = 22) were analyzed using (reflexive) thematic analysis. Qualitative findings revealed 4 themes around how cultural opportunities emerge (e.g., windowpane of feeling) and 3 themes in how they are responded to (e.g., look out the same window: using client's language to explore culture). Implications for therapist training and supervision are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Jones CT, Branco SF. The interconnectedness between cultural humility and broaching in clinical supervision: working from the multicultural orientation framework. CLINICAL SUPERVISOR 2020. [DOI: 10.1080/07325223.2020.1830327] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Connie T. Jones
- Department of Counseling and Educational Development, The University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Susan F. Branco
- Clinical Mental Health Counseling Program, The Family Institute at Northwestern University, Evanston, Illinois, USA
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Gries S, Longley M, Kästner D, Gumz A. Therapeutenmerkmale und Therapieabbruch. PSYCHOTHERAPEUT 2020. [DOI: 10.1007/s00278-020-00454-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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PettyJohn ME, Tseng C, Blow AJ. Therapeutic Utility of Discussing Therapist/Client Intersectionality in Treatment: When and How? FAMILY PROCESS 2020; 59:313-327. [PMID: 31281955 DOI: 10.1111/famp.12471] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Affiliation(s)
- Morgan E. PettyJohn
- Couple and Family Therapy Program HDFS Department Michigan State University East Lansing MI
| | - Chi‐Fang Tseng
- Couple and Family Therapy Program HDFS Department Michigan State University East Lansing MI
| | - Adrian J. Blow
- Couple and Family Therapy Program HDFS Department Michigan State University East Lansing MI
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King KM, Borders LD, Jones CT. Multicultural orientation in clinical supervision: examining impact through dyadic data. CLINICAL SUPERVISOR 2020. [DOI: 10.1080/07325223.2020.1763223] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Kelly M. King
- Department of Allied Professions, North Carolina Central University, Durham, North Carolina, USA
| | - L. DiAnne Borders
- Department of Counseling and Educational Development, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Connie T. Jones
- Department of Counseling and Educational Development, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
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Creating and Elaborating the Cultural Third: A Doers-Doing with Perspective on Psychoanalytic Supervision. Am J Psychoanal 2019; 79:352-374. [PMID: 31346247 DOI: 10.1057/s11231-019-09203-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Although recognized as highly crucial to supervision practice (e.g., Tummala-Narra, 2004), culture has been addressed minimally in the psychoanalytic supervision literature. Calls to remedy that limitation have been made and making culture matter has been identified as a most pressing need for psychoanalytic supervision. But how then do we as supervisors go about doing that? How might we better position culture in, and make culture central to, our psychoanalytic supervisory conceptualization and conduct? We subsequently take up those questions, expanding upon our earlier proposals about cultural humility and the Cultural Third (Watkins and Hook, 2016) by (a) proposing a tripartite multicultural perspective (i.e., cultural humility-cultural comfort-cultural opportunities) as supervision sine qua non; (b) using recognition theory as a way to better understand that very process of Third creation and elaboration; and (c) providing a rupture/repair case example that shows efforts to create and build the Cultural Third in supervision. The Cultural Third is conceptualized as a product of doers-doing with so as to culturally learn together through "not knowing".
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Watkins CE, Hook JN, DeBlaere C, Davis DE, Van Tongeren DR, Owen J, Callahan JL. Humility, ruptures, and rupture repair in clinical supervision: a simple conceptual clarification and extension. CLINICAL SUPERVISOR 2019. [DOI: 10.1080/07325223.2019.1624996] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Joshua N. Hook
- Department of Psychology, University of North Texas, Denton, USA
| | | | - Don E. Davis
- Department of Counseling and Psychological Services, Georgia State University, Atlanta, USA
| | | | - Jesse Owen
- Department of Counseling Psychology, University of Denver, Denver, USA
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Watkins CE, Hook JN, Owen J, DeBlaere C, Davis DE, Van Tongeren DR. Multicultural Orientation in Psychotherapy Supervision: Cultural Humility, Cultural Comfort, and Cultural Opportunities. Am J Psychother 2019; 72:38-46. [DOI: 10.1176/appi.psychotherapy.20180040] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C. Edward Watkins
- Department of Psychology, University of North Texas, Denton (Watkins, Hook); Department of Counseling Psychology, University of Denver (Owen); Department of Counseling and Psychological Services, Georgia State University, Atlanta (DeBlaere, Davis); Department of Psychology, Hope College, Holland, Michigan (Van Tongeren)
| | - Joshua N. Hook
- Department of Psychology, University of North Texas, Denton (Watkins, Hook); Department of Counseling Psychology, University of Denver (Owen); Department of Counseling and Psychological Services, Georgia State University, Atlanta (DeBlaere, Davis); Department of Psychology, Hope College, Holland, Michigan (Van Tongeren)
| | - Jesse Owen
- Department of Psychology, University of North Texas, Denton (Watkins, Hook); Department of Counseling Psychology, University of Denver (Owen); Department of Counseling and Psychological Services, Georgia State University, Atlanta (DeBlaere, Davis); Department of Psychology, Hope College, Holland, Michigan (Van Tongeren)
| | - Cirleen DeBlaere
- Department of Psychology, University of North Texas, Denton (Watkins, Hook); Department of Counseling Psychology, University of Denver (Owen); Department of Counseling and Psychological Services, Georgia State University, Atlanta (DeBlaere, Davis); Department of Psychology, Hope College, Holland, Michigan (Van Tongeren)
| | - Don E. Davis
- Department of Psychology, University of North Texas, Denton (Watkins, Hook); Department of Counseling Psychology, University of Denver (Owen); Department of Counseling and Psychological Services, Georgia State University, Atlanta (DeBlaere, Davis); Department of Psychology, Hope College, Holland, Michigan (Van Tongeren)
| | - Daryl R. Van Tongeren
- Department of Psychology, University of North Texas, Denton (Watkins, Hook); Department of Counseling Psychology, University of Denver (Owen); Department of Counseling and Psychological Services, Georgia State University, Atlanta (DeBlaere, Davis); Department of Psychology, Hope College, Holland, Michigan (Van Tongeren)
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Gainsbury SM. Cultural Competence in the Treatment of Addictions: Theory, Practice and Evidence. Clin Psychol Psychother 2016; 24:987-1001. [DOI: 10.1002/cpp.2062] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 11/07/2016] [Accepted: 11/08/2016] [Indexed: 11/08/2022]
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