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Ezell JM. Rethinking and Reinforcing Cultural Humility Against the Culture Wars: A Framework For Addressing Receptivity to Diversity Initiatives. MEDICAL EDUCATION ONLINE 2024; 29:2307710. [PMID: 38300902 PMCID: PMC10836480 DOI: 10.1080/10872981.2024.2307710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Affiliation(s)
- Jerel M. Ezell
- Community Health Science, School of Public Health, University of California Berkeley, Berkeley, CA, USA
- Berkeley Center for Cultural Humility, University of California Berkeley, Berkeley, CA, USA
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Strand M, Hillerberg N. Transnational adoptees in healthcare: barriers, resources, and needs. Front Public Health 2024; 12:1426489. [PMID: 39238539 PMCID: PMC11374725 DOI: 10.3389/fpubh.2024.1426489] [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: 05/01/2024] [Accepted: 08/12/2024] [Indexed: 09/07/2024] Open
Abstract
Background After decades of research output, it is well established that transnational adoptees-i.e., individuals who are placed for adoption outside their country of birth-exhibit an increased risk of various negative mental health outcomes. Even so, there is a lack of suggestions for preventive measures or treatment interventions targeting the transnational adoptee population in the literature. Objective To explore experiences, opinions, and needs among adult transnational adoptees in Sweden concerning healthcare in general and mental healthcare in particular. Methods Sixty-six adult transnational adoptees residing in Sweden, born in 15 different non-European countries, were recruited for individual in-depth interviews about their experiences and opinions regarding psychosocial support and healthcare. The interview data were analyzed employing a codebook thematic analysis approach. Results Three overarching themes were identified: (a) barriers to adequate treatment, (b) helpful resources in dealing with health-related issues, and (c) health-related needs and suggestions for the development of adequate support. Identified barriers include a lack of insight into and interest in adoptee health, colorblindness and unwillingness to address racism, expectations of gratitude, steep financial costs, lack of support from adoptive parents, and mistrust of support structures that involve adoptive parents or adoption organizations. Participants also describe helpful resources, such as the community of fellow transnational adoptees. Health-related needs and suggestions include more well-defined and easily accessible structures of support, improved knowledge and competence, a broader psychotherapeutic repertoire that better addresses adoption-related themes, improved support in situations that can be particularly stressful for adoptees (such as during pregnancy and as new parents), routine follow-up during childhood and adolescence, and education targeting adoptive parents. The need for greater attention to the well-being of children of transnational adoptees is also highlighted. Implications Based on these findings, a number of recommendations can be made. For example, knowledge about adoptee health should be strengthened, and psychotherapeutic competence in addressing issues related to racism should become a priority. After over 20 years of discussion, one or more national research and knowledge hubs on transnational adoption should be created. Moreover, economic resources should be made available to support transnational adoptees in accessing adequate treatment.
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Affiliation(s)
- Mattias Strand
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Transcultural Centre, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Natte Hillerberg
- Northern Stockholm Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Kleinschmitt A. Research on psychotherapy for refugees in Germany: A systematic review on its transdisciplinary and transregional opening. Transcult Psychiatry 2024; 61:151-167. [PMID: 38234182 PMCID: PMC10996299 DOI: 10.1177/13634615231187255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Recently, an increasing amount of research has focused on adapting psychotherapy concepts for refugees moving to Germany. For a long time, research from disciplines like anthropology and cultural studies has problematized the eurocentrism of psychology's theoretical premises and methodologies. Currently, scholarship around Global Mental Health and decolonization emphasizes how knowledge production from various disciplines and regions relates to this topic and could contribute to improving respective approaches. Consequently, this review aims at evaluating the actual transdisciplinary and transregional opening of studies on psychotherapeutic interventions for refugees in Germany. It provides a theoretically as well as empirically informed basis for looking at disciplinary premises, practices, and boundaries as well as the regional locatedness of respective research. Fourteen relevant studies, published between January 1, 2007 and March 4, 2022, were identified by systematically searching the databases PubPsych and Web of Science. The studies were reviewed regarding study design, choice and characterization of target groups, regional origin and target group specific adaptations of the therapeutic concepts, integration of elements from and connections to other disciplines, and use of references to scholarship from the Global South. The findings show a pronounced focus on the development of trauma therapy approaches and moreover a broad variety of concept adaptations in response to the assumed characteristics, situations, and needs of the target groups. While the findings reveal a complex transregional pattern of development and adaptation of the therapeutic concepts, transdisciplinary opening and reference to the Global South appear scarce.
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Hubbard A, Harris S, Dick M, McGee D. Understanding African American help-seeking for romantic relationships: Advocacy, barriers, and considerations. JOURNAL OF MARITAL AND FAMILY THERAPY 2024; 50:348-367. [PMID: 38383948 DOI: 10.1111/jmft.12692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 11/19/2023] [Accepted: 01/30/2024] [Indexed: 02/23/2024]
Abstract
African American couples experience greater levels of relationship distress than other racial/ethnic groups, but they are less likely to seek formal couple counseling. Existing literature highlights the importance of community support in the form of church, family, and friends. While the literature suggests that African Americans encounter unique barriers, we do not know how racism and discrimination impact the couple help-seeking process. This study seeks to address this gap and better understand unique barriers in the African American couple help-seeking (AACHS) process via a grounded theory-informed qualitative study. Findings from interviews with 11 African American individuals in committed relationships highlighted mistrust as a significant barrier to AACHS, while community supports are frequently sought out. Our findings add to current understandings about AACHS and highlight important areas for future research. In the clinical implications section, the authors outline tangible steps that clinicians can take based on the findings from this study.
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Affiliation(s)
- Aimee Hubbard
- Kansas City Relationship Institute, Independence, Missouri, USA
- Family Social Science, University of Minnesota, St. Paul, Minnesota, USA
| | - Steven Harris
- Family Social Science, University of Minnesota, St. Paul, Minnesota, USA
| | - Mary Dick
- Human Development and Family Sciences, Texas Tech University, Lubbock, Texas, USA
| | - DasJohn McGee
- Build Wealth, Minnesota, Minneapolis, Minnesota, USA
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Wijeratne C, Sharma S, Large M. Understanding and addressing racism in clinical encounters. Aust N Z J Psychiatry 2024; 58:297-299. [PMID: 38131317 DOI: 10.1177/00048674231219854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Affiliation(s)
- Chanaka Wijeratne
- Euroa Centre, Prince of Wales Hospital, Randwick, NSW, Australia
- School of Clinical Medicine, University of New South Wales, Kensington, NSW, Australia
| | - Swapnil Sharma
- Euroa Centre, Prince of Wales Hospital, Randwick, NSW, Australia
- School of Clinical Medicine, University of New South Wales, Kensington, NSW, Australia
| | - Matthew Large
- Euroa Centre, Prince of Wales Hospital, Randwick, NSW, Australia
- School of Clinical Medicine, University of New South Wales, Kensington, NSW, Australia
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Karadzhov D, Lee J, Hatton G, White RG, Sharp L, Jalloh A, Langan Martin J. Identifying core global mental health professional competencies: A multi-sectoral perspective. Glob Ment Health (Camb) 2024; 11:e24. [PMID: 38572254 PMCID: PMC10988164 DOI: 10.1017/gmh.2024.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/21/2024] [Accepted: 02/11/2024] [Indexed: 04/05/2024] Open
Abstract
Concerned with sustainably alleviating mental distress and promoting the right to health worldwide, global mental health (GMH) is practised across various contexts spanning the humanitarian-development-peace nexus. The inherently intersectoral and multidisciplinary nature of GMH calls for competency frameworks and training programmes that embody diversity, decolonisation and multiprofessionalism. Existing competency frameworks have failed to capture the multi-sectoral, inter-professional nature of contemporary GMH practice. In response to these needs, a qualitative content analysis of relevant job advertisements was conducted to distil a comprehensive set of professional competencies in contemporary GMH practice. Approximately 200 distinct skills and competencies were extracted from 70 job advertisements and organised into four meta-dimensions: 'skills', 'sector', 'self' and 'subject'. The first known systematic attempt at a multi-sectoral GMH competency framework, it offers a springboard for exploring vital yet overlooked professional competencies such as resilience, self-reflection, political skills and entrepreneurialism. On this basis, recommendations for building a competent, agile and effective GMH workforce with diversified and future-proof skillsets are proposed. The framework can also inform inter-professional training and curriculum design, and capacity-building initiatives aimed at early-career professional development, particularly in low- and middle-income settings.
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Affiliation(s)
- Dimitar Karadzhov
- School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Joanne Lee
- UNICEF, Eastern and Southern Africa Regional Office, Nairobi, Kenya
| | - George Hatton
- School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Ross G. White
- School of Psychology, Queen’s University Belfast, Belfast, UK
| | - Laura Sharp
- School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Abdul Jalloh
- School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Julie Langan Martin
- School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Phiri P, Sajid S, Delanerolle G. Decolonising the psychology curriculum: a perspective. Front Psychol 2023; 14:1193241. [PMID: 37388662 PMCID: PMC10300435 DOI: 10.3389/fpsyg.2023.1193241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/24/2023] [Indexed: 07/01/2023] Open
Abstract
Decolonisation seeks to reverse the impact of colonisation on minoritised groups. Governments, healthcare institutions, criminal justice and education systems have procedures and protocols deep-rooted in colonisation and operate through a western lens. Decolonisation reaches beyond increasing inclusivity and aims to re-establish history through the experiences and perspective of those most affected. As with many disciplines, core theories, practices and interventions within Psychology, an ethnocentric viewpoint has been used, continuously reinstated through its curriculum. With awareness around diversification and increase in varying demands, it is important that the Psychology curriculum evolves to suit the needs of its' users. Many recommendations for decolonising the curriculum are trivial surface changes. These involve including required bibliography from diverse minority authors within the modules syllabuses or organising a one-off lecture or workshop from a minority ethnic speaker. Some universities have also suggested that lecturers participate in self-awareness practices to ensure they understand decolonisation to appropriately address it through their teaching, whilst others have provided checklists against which they can check the inclusivity of their modules. All these alterations fail to target the root of the problem. To properly reverse the effects of colonisation within the curriculum it would be necessary to re-evaluate the Westernised history that has been retold for years and teach past events through the experiences of those who suffered. Research into how decolonisation can occur in a structured and comprehensive way is necessary to enable the redress for abolition of colonial practices on a global scale.
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Affiliation(s)
- Peter Phiri
- Research and Innovation Department, Southern Health NHS Foundation Trust, Southampton, United Kingdom
- Psychology Department, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Sana Sajid
- Research and Innovation Department, Southern Health NHS Foundation Trust, Southampton, United Kingdom
| | - Gayathri Delanerolle
- Research and Innovation Department, Southern Health NHS Foundation Trust, Southampton, United Kingdom
- Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, United Kingdom
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Abstract
In this paper, we examine a number of approaches that propose new models for psychiatric theory and practices: in the way that they incorporate 'social' dimensions, in the way they involve 'communities' in treatment, in the ways that they engage mental health service users, and in the ways that they try to shift the power relations within the psychiatric encounter. We examine the extent to which 'alternatives' - including 'Postpsychiatry', 'Open Dialogue', the 'Power, Threat and Meaning Framework' and Service User Involvement in Research - really do depart from mainstream models in terms of theory, practice and empirical research and identify some shortcomings in each. We propose an approach which seeks more firmly to ground mental distress within the lifeworld of those who experience it, with a particular focus on the biopsychosocial niches within which we make our lives, and the impact of systematic disadvantage, structural violence and other toxic exposures within the spaces and places that constitute and constrain many everyday lives. Further, we argue that a truly alternative psychiatry requires psychiatric professionals to go beyond simply listening to the voices of service users: to overcome epistemic injustice requires professionals to recognise that those who have experience of mental health services have their own expertise in accounting for their distress and in evaluating alternative forms of treatment. Finally we suggest that, if 'another psychiatry' is possible, this requires a radical reimagination of the role and responsibilities of the medically trained psychiatrist within and outside the clinical encounter.
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Affiliation(s)
- Diana Rose
- Australian National University, Canberra, Australia
| | - Nikolas Rose
- Australian National University, Canberra, Australia
- Institute of Advanced Studies, University College London, London, UK
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Levy-Fenner E, Colucci E, McDonough S. Lived Experiences of Mental Health Recovery in Persons of Culturally and Linguistically Diverse (CALD) Backgrounds within the Australian Context. JOURNAL OF PSYCHOSOCIAL REHABILITATION AND MENTAL HEALTH 2022:1-26. [PMID: 36533215 PMCID: PMC9735058 DOI: 10.1007/s40737-022-00319-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/01/2022] [Indexed: 06/17/2023]
Abstract
Lived experience research related to mental health recovery is advancing, but there remains a lack of narrative material from the perspectives of people from under-represented, non-dominant cultural backgrounds in this domain. This study aimed to explore the lived experiences of mental health recovery in people of culturally and linguistically diverse (CALD) backgrounds in the Australian context. The current study involved a secondary analysis of audio and visual data collected during the digital storytelling project Finding our way in Melbourne, Australia. Thematic analysis was used to understand the lived experience narratives of nine participants in relation to mental health recovery. Five themes were identified through an iterative process of analysis, including Newfound opportunities and care, Family as key motivators and facilitators, Coping and generativity, Cultivating self-understanding and resilience, and Empowerment through social engagement. First person lived experience narratives offer deep insight into understanding the ways in which individuals of marginalised communities conceptualise and embody recovery. These findings further the literature and understanding on how to better serve the needs of people with mental health challenges from CALD communities through informed knowledge of what may be helpful to, and meaningful in, individuals' recoveries.
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Affiliation(s)
- E. Levy-Fenner
- Department of Psychology, Middlesex University, London, UK
| | - E. Colucci
- Department of Psychology, Middlesex University, London, UK
- Global and Cultural Mental Health Unit, The University of Melbourne, Melbourne, Australia
| | - S. McDonough
- Victorian Transcultural Mental Health, St. Vincent’s Hospital, Melbourne, Australia
- Australian Institute for Primary Care and Ageing, La Trobe University, Melbourne, Australia
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Levin L. Perspective: Decolonizing postmodernist approaches to mental health discourse toward promoting epistemic justice. Front Psychiatry 2022; 13:980148. [PMID: 36276325 PMCID: PMC9582654 DOI: 10.3389/fpsyt.2022.980148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Currently, it is possible to observe a slowly (but surely) growing volume of claims seeking to disprove Foucauldian ideas about knowledge and power as overlapping basic theories of epistemic justice. Prompted by these claims, alongside adopting tenets of Critical Race Theory to address injustices inflicted upon people facing mental health challenges, I propose applying decolonizing deconstruction to Foucault's terminology, toward identifying opportunities to enhance epistemic justice, primarily in direct interventions in mental health services.
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Affiliation(s)
- Lia Levin
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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