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Lowe J, Kelley M, Wimbish-Tompkins R. Sustainability of an intervention for the prevention of substance use within Native American communities. Arch Psychiatr Nurs 2024; 51:287-292. [PMID: 39034091 DOI: 10.1016/j.apnu.2024.06.013] [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] [Received: 09/07/2023] [Revised: 06/15/2024] [Accepted: 06/20/2024] [Indexed: 07/23/2024]
Abstract
The outcomes of this study revealed the importance of recruiting local Native American tribal community members as participants in an Adult Facilitator Trainee Program for a cultural based intervention, Intertribal Talking Circle (ITC), that addresses prevention of substance use among Native American youth. Survey results indicate that Native-Reliance (cultural identity) and self-efficacy increased among the trainees from base-line to 3-months post the training session. Themes emerged from qualitative interviews conducted with the participants that described their readiness to implement and sustain the Talking Circle intervention program within their tribal communities after the research project was completed.
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Affiliation(s)
- John Lowe
- University of Texas at Austin School of Nursing, United States of America.
| | - Melessa Kelley
- University of Texas at Austin School of Nursing, United States of America.
| | - Rose Wimbish-Tompkins
- University of Texas at Austin Steve Hicks School of Social Work, United States of America.
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2
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Huggett C, Peters S, Gooding P, Berry N, Pratt D. A systematic review and meta-ethnography of client and therapist perspectives of the therapeutic alliance in the context of psychotherapy and suicidal experiences. Clin Psychol Rev 2024; 113:102469. [PMID: 39098267 DOI: 10.1016/j.cpr.2024.102469] [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: 10/06/2023] [Revised: 05/28/2024] [Accepted: 07/26/2024] [Indexed: 08/06/2024]
Abstract
This review aimed to develop a conceptual model of the therapeutic alliance in the context of psychotherapy and suicidal experiences from therapist and client perspectives. The protocol was pre-registered on PROSPERO (CRD42021268273). MEDLINE, PsycINFO, Web of Science, Embase and CINAHL were systematically searched from database inception to April 2024. Eligible studies were peer-reviewed, qualitative, and included client and/or therapist's perspectives of the therapeutic alliance in the context of psychotherapy and suicidal experiences. Studies were critically appraised and analysed using a meta-ethnography approach involving a reciprocal translation of studies and line of argument synthesis. Thirty-seven papers were included, generating two overarching themes; 'Working on the edge' and 'Being ready, willing, and able to build an alliance in the context of suicidal experiences'. Therapeutic alliance in the context of suicidal experiences is unique, fluid, potentially lifesaving, and influenced by multiple inter-connected internal and external processes and systems. Clinical implications emphasise the need to improve training, supervision, and support for therapists to equip them with the additional skills required in navigating the intricacies of the therapeutic alliance with clients who have suicidal experiences. Flexibly interweaving risk assessment into therapeutic conversation was beneficial to the alliance with suicidal clients and enhanced their safety.
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Affiliation(s)
- Charlotte Huggett
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, UK.
| | - Sarah Peters
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, UK
| | - Patricia Gooding
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, UK
| | - Natalie Berry
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, UK
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, UK
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Kaslow NJ, Clarke C, Hampton-Anderson JN. Culturally humble and anti-racist couple and family interventions for African Americans. FAMILY PROCESS 2024; 63:512-526. [PMID: 37712380 DOI: 10.1111/famp.12938] [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: 07/17/2022] [Revised: 08/09/2023] [Accepted: 08/26/2023] [Indexed: 09/16/2023]
Abstract
Anti-Black racism including structural racism and racism-related disparities have come to the foreground in recent years with the increasingly frequent and brutal police killings of innocent African Americans, the disproportionate impacts of the pandemic on the Black community, and the effectiveness of the Black Lives Matter movement. There have been calls to action to ensure cultural effectiveness of couples and family therapy for African Americans. As one response to these calls, this article provides recommendations for culturally humble and anti-racist couple and family interventions. These best practices focus on the necessity of embracing a systemic stance and a strengths-based culturally responsive lens when assessing and intervening with African American couples and families. They focus on the need for therapists to be intentional about and consistent in engaging in self-exploration and taking the necessary steps to be not just competent but also capable. The final set of best practices detailed relate to assessing and intervening using a strengths-based approach in a culturally responsive, anti-racist, and socially attuned fashion. The article concludes with recommendations for couple/family therapists to develop a critical consciousness, engage in anti-racist practices, and address oppression while advancing healing and liberation, all of which are essential to ensuring the resilience and well-being of African American couples and families.
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Affiliation(s)
- Nadine J Kaslow
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
| | - Christina Clarke
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
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Mabeza RM, Legha RK. Reimagining Medical Education Toward Antiracist Praxis. Health Equity 2023; 7:598-602. [PMID: 37731791 PMCID: PMC10507935 DOI: 10.1089/heq.2023.0135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 09/22/2023] Open
Abstract
Medicine has a longstanding history of racism that promulgates existing health inequities. Current medical education, largely based on the biomedical framework, omits critical discourse on racism and White supremacy, which continue to harm individuals and communities of color. Such ahistorical and apolitical orientation inadequately trains learners to identify and address racism in clinical practice. Although curricula on racial health disparities, social determinants of health, cultural competency, and implicit bias have been operationalized by several medical schools, they do not identify the racism embedded in systems of care, nor do they provide transformative steps toward true health equity and justice. As such, this article proposes bold radical frameworks as the foundation for reimagining medical education in the United States. Founded on critical race theory, abolition, and decolonization, the authors provide a view of an antiracist medical education, one that highlights the history and legacy of racism in medicine and positions medical trainees and practicing physicians as active agents in medicine's antiracist transformation.
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Affiliation(s)
- Russyan Mark Mabeza
- Department of Surgery, University of California, San Francisco, San Francisco, California, USA
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5
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Bergkamp J, O’Leary Sloan M, Krizizke J, Lash M, Trantel N, Vaught J, Fulmer T, Waite I, Martin AM, Scheiderer C, Olson L. Pathways to the therapist paragon: a decolonial grounded theory. Front Psychol 2023; 14:1185762. [PMID: 37457084 PMCID: PMC10343956 DOI: 10.3389/fpsyg.2023.1185762] [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: 03/13/2023] [Accepted: 05/09/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction While many professional associations within clinical and counseling psychology have made an aspirational call for clinician awareness of social position, there is a lack of research into how socially-conferred privilege impacts psychotherapy. Specifically of interest is the differences in race and gender within the therapeutic dyad, in which there is a BIPOC (Black, Indigenous, and Persons of Color)/white or male/female-identified dynamic. Method The authors utilized a Grounded Theory approach to analyze qualitative interviews with practicing psychologists to construct a process model regarding how socially-conferred privileged identity domains impact the therapeutic relationship and the participants' professionalization process. Results The analysis identified the core conceptual theme of the Therapist Paragon, representing an idealized version of what a perfect therapist should be. This replicated the foundational figures of our field - primarily older, white men. The process model consisted of two distinct pathways toward the Therapist Paragon, one for BIPOC psychologists and one for white psychologists. The female BIPOC pathway consisted of imposter syndrome, persistent feelings of inadequacy, and tendencies to over-credential their professional identity to seek credibility in the eyes of clients and colleagues. The white pathway consisted of down-playing whiteness and attempting to initially modify behavior toward client cultural norms. Discussion The results point to a distinct professionalization and practice process for BIPOC psychologists compared to white counterparts. This dynamic may have implications beyond increasing support for BIPOC clinicians specifically, but instead indicate a lack of acknowledgement of the psychological impact of socially-conferred privilege in the psychotherapy enterprise overall. Recommendations are offered for revisions to training models, continuing education, and supervision/consultation.
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Affiliation(s)
- Jude Bergkamp
- Antioch University Seattle, Seattle, WA, United States
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E. Conlin S, P. Douglass R. Feminist Therapy with Gender Questioning Adolescents: Clinical Case Example. WOMEN & THERAPY 2023. [DOI: 10.1080/02703149.2023.2189777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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7
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Lebow JL. Welcoming Melanie M. Domenech Rodríguez. FAMILY PROCESS 2023; 62:1-5. [PMID: 36914426 DOI: 10.1111/famp.12860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/12/2023] [Indexed: 06/18/2023]
Affiliation(s)
- Jay L Lebow
- Family Process and Family Institute at Northwestern, Evanston, Illinois, USA
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Morrison T, Ferris Wayne M, Harrison T, Palmgren E, Knudson-Martin C. Learning to Embody a Social Justice Perspective in Couple and Family Therapy: A Grounded Theory Analysis of MFTs in Training. CONTEMPORARY FAMILY THERAPY 2022; 44:408-421. [PMID: 35194316 PMCID: PMC8830980 DOI: 10.1007/s10591-022-09635-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 12/03/2022]
Abstract
This action research study explores how four MFT students shifted from a cognitive understanding of equity and power to an intrinsic and automatic internalized process as we participated in research in which we observed, coded, and engaged in structured reflexive conversations about relational power using a data bank of Socio Emotional Relationship Therapy sessions. We reviewed and analyzed ten of our recorded two-hour reflexive conversations to develop grounded theory that explains our experience of learning to embody a relational power lens, which consists of five interconnected phases: (a) developing a theoretical understanding of relational power, (b) critically observing live therapy, (c) noticing and attending to the felt sense of witnessing power, (d) engaging in transformative conversation, and (e) applying to personal practice. Our findings provide guidance for clinical training programs who wish to facilitate the experience for clinicians-in-training to understand and address societal power processes in clinical practice.
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Affiliation(s)
- Tori Morrison
- Lewis & Clark College, (Marriage, Couple, and Family Therapy), Portland, OR USA
| | - Midori Ferris Wayne
- Lewis & Clark College, (Marriage, Couple, and Family Therapy), Portland, OR USA
| | - Tahlia Harrison
- Duke University, (Bioethics, Tech Ethics & Policy), Durham, NC USA
| | - Emily Palmgren
- Lewis & Clark College, (Marriage, Couple, and Family Therapy), Portland, OR USA
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Morris F, Rawlings ZW. Race in the Space: Clinical Considerations for Cross-Racial Treatment. COGNITIVE AND BEHAVIORAL PRACTICE 2022. [DOI: 10.1016/j.cbpra.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Ng C. Meaning-oriented narrative reconstruction: navigating the complexities of bereaved families. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2021. [DOI: 10.1080/03069885.2021.1983157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Carolyn Ng
- Portland Institute for Loss and Transition, Singapore, Singapore
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Holyoak D, McPhee D, Hall G, Fife S. Microlevel Advocacy: A Common Process in Couple and Family Therapy. FAMILY PROCESS 2021; 60:654-669. [PMID: 33247429 DOI: 10.1111/famp.12620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Advocacy is an essential element to mental health practitioners' professional identity. Some scholars contend that many couple and family therapists lack the skill set needed to effectively advocate. However, these researchers often discuss advocacy solely on the macrolevel, which makes advocacy appear unidimensional and may feel out of reach for many practitioners. In this article, we argue that advocacy is not unidimensional, but consists of two levels: macro- and microlevel advocacy. Microlevel advocacy is client-centered and is effectively performed by couple and family therapists on a regular basis. By broadening the definition of advocacy to include the microlevel, we argue that advocacy is a common process of couple and family therapy that cuts across therapy models and is interwoven into the very being of a couple and family therapist. We present in this article a comprehensive case vignette to illustrate how microlevel advocacy may be performed by CFTs. Clinical and training implications are offered to help clinicians begin to bridge the gap between micro- and macrolevel advocacies.
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Affiliation(s)
| | | | - Greg Hall
- Texas Tech University, Lubbock, TX, USA
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Addressing Concealed Suicidality: A Flexible and Contextual Approach to Suicide Risk Assessment in Adults. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2021. [DOI: 10.1007/s10879-021-09493-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kleiner-Paz II, Nasim R. Dissociative Collusion: Reconnecting Clients with Histories of Trauma in Couple Therapy. FAMILY PROCESS 2021; 60:32-41. [PMID: 32294803 DOI: 10.1111/famp.12535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This paper introduces the concept of "dissociative collusion" as a helpful theoretical and clinical tool for understanding and working with clients with histories of trauma in couple therapy. The paper describes ways to diagnose and treat dissociative collusion based on the integration of an object relations approach, a relational approach, and a narrative approach. Dissociative collusion, a unique version of the well-documented "couple collusion," describes relational unconscious dynamics where split-off aspects of one or both partners are mutually dissociated in a complementary fashion that becomes a part of the shared unconscious and is reenacted in destructive ways. The dissociative collusion concept is especially relevant to couple therapists who work with clients with histories of trauma, who frequently use dissociation as a primary defense mechanism. We suggest that the challenge and goal for couple therapy with this population are to help them reconnect and better oscillate between dissociated self-other configurations. A case of couple therapy of a wife who had been a victim of childhood sexual abuse and her husband who displayed frequent use of dissociative defenses is presented.
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Affiliation(s)
| | - Ron Nasim
- Bar Ilan University, Tel-Aviv, Israel
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Sosoo EE, Bernard DL, Neblett EW. The influence of internalized racism on the relationship between discrimination and anxiety. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2020; 26:570-580. [PMID: 31886684 PMCID: PMC7359777 DOI: 10.1037/cdp0000320] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES This study used 2 waves of data to longitudinally examine whether internalized racism moderated the association between racial discrimination and anxiety symptom distress. METHOD Participants were 157 Black college students attending a predominantly White institution who completed measures of racial discrimination, internalized racism, and psychological distress. RESULTS Using hierarchical linear regression, results indicated a positive association between racial discrimination and subsequent anxiety symptom distress for individuals with moderate and high levels of internalization of negative stereotypes and hair change. CONCLUSIONS Findings suggest that experiences of anxiety symptom distress, in the context of racial discrimination, may differ as a function of one's acceptance and internalization of dominant White culture's actions and beliefs toward Black people. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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