Transformative learning through international immersion: building multicultural competence in family therapy and counseling

Integration of teaming therapy and mixed-reality simulation as remote learning modality for couple and family therapy graduate training programs

In response to COVID-19, a couple and family therapy (CFT) graduate training program integrated a teaming therapy model with virtual technology using mixed-reality simulation software. By utilizing teaming therapy--a model with strong roots in systemic theory and practice-- combined with cutting-edge simulation technology, this distance learning modality provides distinctly relational therapy supervision and training for students at a time when their internships sites are struggling to offer remote clinical services due to the pandemic. This integrative framework offers a high degree of both realism and safety, allowing experiential learning to be appropriately scaffolded for optimum creativity and engagement in an online setting. This paper describes the conceptual, systemic basis for the learning modality, steps for implementation, benefits of the model, and the authors plan for further evaluation.

International allied health student placements: A meta-synthesis

BACKGROUND

Increasingly universities are offering international student placements as part of the global internationalisation movement. This review sought to synthesize the findings of studies to further understand the learning outcomes described by allied health students.

AIMS/OBJECTIVES

To contribute to the understanding of the learning outcomes described by allied health students who have undertaken an international placement.

METHODS

A qualitative meta-synthesis was conducted. From six databases, twenty-one studies were identified and critically appraised. Data were meta-aggregated, integrated and interpreted to develop new themes, with the experiences of over 259 allied health students synthesized.

RESULTS

Themes include: the intertwined personal and professional development experienced by the students; confidence and independence, relationship building, insight into culture, service provision and differences in socio-economic and political contexts.

CONCLUSION

Universities offering students international placements provide their students with opportunities to achieve unique learning outcomes with significant personal and professional transformational development that cannot be replicated by local placements.

Microaggressions and Islamophobia: Experiences of Muslims Across the United States and Clinical Implications

This mixed methods exploratory study illustrates the influence of pervasive misconceptions about Islam on the experiences of 314 adult Muslims across the United States. Quantitative results suggest that Muslim stress levels are comparable to the stress levels of other marginalized groups in the United States. Qualitative analysis revealed four themes that highlight the challenges faced by Muslims as well as their resiliency in the face of microaggressions and marginalization. Family therapists may utilize these personal accounts to expand their understanding of Muslim experiences, and to reflect on their own implicit biases toward Muslims in order to reduce chances of premature termination. Clinical implications include using resiliency-based models and creating collaborative partnerships with community leaders when working with this religious minority group.

Global Mental Health: A Call for Increased Awareness and Action for Family Therapists

Global mental health (GMH) is an emerging field that focuses on the need for culturally sensitive mental health services in low- and middle-income countries (LMICs). While many new initiatives have been established worldwide to understand GMH needs and to provide care in LMICs, family therapists have primarily worked with families in high-income countries. The few existing family-based initiatives in GMH focus on psychoeducation and are typically not based on general systems theory. However, emerging trends in family therapy may enable family therapists to impact mental health issues in LMICs. These trends, which are shared interests of both family therapy and GMH, include collaborative care, a growing emphasis on the importance of culture in understanding and treating mental health issues, recognition of the ability of families to support or impede recovery from mental illness, and the use of strength-based and evidence-based treatments. This paper describes ways for family therapists to become active in the GMH community.

Till the ocean do us part: Italian and American therapists' representations of stepfamilies in treatment

Research often focuses on the characteristics of stepfamilies and their differences with first-union families; however, few studies take into account the therapist's perspective with regards to the treatment of such families. Also, cross-cultural research on the topic is limited. To fill these gaps, a content analysis of responses from 125 Italian and 45 American therapists regarding their representations of stepfamilies and stepfamily therapy was undertaken. Results show that American therapists emphasized specific stepfamily characteristics (e.g., the lack of a shared family history, the occurrence of conflict between former spouses, the presence of unrealistic expectations towards treatment) to a greater extent if compared to Italian therapists. By contrast, besides being more general in their definition of stepfamilies, Italian therapists focused more on themselves, their theoretical models, and their professional and personal skills. The study provides insights on both the differences in the clinical cultures of the two countries and implications for stepfamily therapy and training.

Using critical consciousness to inform health professions education : A literature review

PURPOSE

To explore how, in health professions education (HPE), the concept of critical consciousness has been defined and discussed, and to consider and suggest how critical pedagogy could be applied in practice. This exploration responds to increasing calls in the literature for HPE to foster compassionate care and social consciousness through the social sciences and humanities.

METHOD

The authors searched Medline/PubMed, ERIC and Web of Science for articles focusing on critical consciousness and/or critical pedagogy involving health professions. A thematic analysis aimed to identify key themes of critical consciousness in HPE literature.

RESULTS

The authors included 30 papers in their review. Key themes related to defining and discussing core attributes of critical consciousness in HPE were: 1) appreciating context in education and practice; 2) illuminating power structures; 3) moving beyond 'procedural'; 4) enacting reflection; and 5) promoting equity and social justice.

CONCLUSIONS

Critical consciousness may inform an appropriate critical pedagogy for fostering compassionate, humanistic, socially conscious health professionals who act as agents of change. While the authors share critical teaching practices for educators, considerable care must be taken in efforts to use critical pedagogy within the current structures of HPE programmes. The authors suggest attending to the philosophical and theoretical origins of critical consciousness and those of the dominant models of contemporary HPE (e. g. competency-based approaches) in order to ensure the tenets of critical pedagogy can be enacted authentically.

Closing The Gap between Two Countries: Feasibility of Dissemination Of An Evidence-Based Parenting Intervention in México

In this manuscript, we describe the initial steps of an international program of prevention research in Monterrey, México. Specifically, we present a feasibility study focused on exploring the level of acceptability reported by a group of Mexican mothers who were exposed to a culturally adapted parenting intervention originally developed in the United States. The efficacious intervention adapted in this investigation is known as Parent Management Training, the Oregon Model (PMTO(®)). Following a description of our international partnership, we describe the implementation of the pilot study aimed at determining initial feasibility. Qualitative data provided by 40 Mexican mothers exposed to the culturally adapted parenting intervention illustrate the participants' high level of receptivity toward the intervention, as well as the beneficial impact on their parenting practices.

Don't end up in the fields: identity construction among Mexican adolescent immigrants, their parents, and sociocontextual processes

This grounded theory study of 16 Mexican immigrant adolescents and 20 of their parents examines how they construct relational identities within their families, at school, with friends, and in the larger society. Results focus on a core identity bind faced by the adolescents: immigration messages from parents that say, "don't be like me" and the societal message, "you're not like us." Response to this bind was guided by two contrasting sets of identity narratives: Empowering narratives invited an intentional approach to school and life choices. Restricting narratives maintained an ambivalent approach to school and life choices. Resolution of the identity bind was a collective, ongoing process that has implications for Mexican immigrant families and the professionals who work with them.

Results of Immersion Service Learning Activism With Peers

Despite the emphasis on multicultural counseling competence and social justice in counseling psychology, the mechanisms behind building skills related to effective work remain elusive. This qualitative study explored the experiences of student-participants during a service learning course based on social justice principles in Belize. The researchers sought to inform how a non-traditional teaching methodology—immersion service learning activism—might affect these students’ development. The researchers used Consensual Qualitative Research to analyze interviews and journals through a collaborative and reflective process. Eleven domains emerged from the analysis. Results confirmed past research related to immersion and service learning, including personal and professional development and changes in diversity attitudes. There were also unanticipated themes related to complex interpersonal and group dynamics. These findings demonstrate the influence of immersion, service learning, and group process in intra- as well as interpersonal development and skill building related to cultural competency and social justice activism.

Critical patriotism: incorporating nationality into MFT education and training

Topics such as national identity, patriotism, nationalism, and international issues often lead to polarization within the United States and as a result, critical dialogue about these complex topics often does not occur in a meaningful way. The lack of critical inquiry and interaction about these topics is manifest at the macro and the micro level, including within the context of marriage and family therapy training and practice. While the field of MFT has devoted greater attention to addressing issues of diversity in recent years, limited attention has been focused on examining nationality and nationalism. This article presents a critical patriotism framework that training programs can use to examine nationality and expand awareness of international issues and perspectives. Special attention is focused on examining how nationalism, a problematic extreme version of patriotism, infiltrates MFT training and practice. Recommendations are provided for how training programs can focus on nationality, expand awareness of international issues and perspectives, and guide trainees in exploring how their national identity, beliefs about patriotism, and nationalistic attitudes may influence their clinical work.

The Experience of Becoming a Therapist in a Foreign Culture

This phenomenological study explores the experience of becoming a therapist in a foreign culture. The purpose is to better understand the issues adjusting to a new culture and give voice to the lived experience of immigrant therapists. Few studies explore the experience of foreign therapists. Most focus on the experience of mainstream mental health professionals dealing with populations from specific cultural backgrounds. A total of eight therapists, who emigrated from another country to the United States, were asked to describe situations when practicing was challenging because of cultural differences. The descriptive phenomenological psychological approach was used to analyze the collected protocol. The findings focused on four main themes: (a) facing cultural shock and threats on identity, (b) adjusting professionally to a different culture, (c) developing a new identity, and (d) counseling across cultures. These experiences both challenged their professional identity and also developed competencies. The experiences also turned out to be beneficial for the therapist–client relationship and for the client. Not sharing the same culture as clients was not always a limitation, and sometimes an advantage for their professional development and performance.