"If You Don't Eat, You Can Get Drunk Faster": A Qualitative Investigation of Food and Alcohol Disturbance (FAD) Expectancies

Background: Food and alcohol disturbance (FAD; i.e., use of any compensatory behavior within the context of a drinking episode to offset alcohol-related calories and/or enhance the effects of alcohol) is prevalent among U.S. college students and associated with negative consequences. Expectancies for anticipated outcomes of alcohol use and thinness/restriction behaviors, which comprise FAD, serve as promising targets of intervention for these behaviors individually; however, no study to date has identified or examined FAD expectancies, specifically. Objectives: The purpose of this study was to qualitatively examine the positive and negative FAD expectancies described by students experienced with FAD. Methods: Semi-structured open-ended interviews were conducted with 22 undergraduates with a lifetime history of FAD behavior (72.7% female, 77.3% white non-Hispanic, Mage=20.14). Results: Positive FAD expectancy themes included: Mood Improvement, Appearance/Weight-related Benefits, Alcohol Enhancement, and Social Approval and Connectedness. Negative FAD expectancy themes included: Reputational and Social Concerns, Negative Physical Consequences, Negative Psychological Consequences, and Cognitive and Behavioral Impairment. Conclusions: Results suggest that while there are many similarities, FAD expectancies are distinct from existing alcohol and thinness/restriction expectancies. Specifically, the Mood Improvement theme conceptualizes mood-related improvement within the context of both positive and negative reinforcement and both the Social Approval and Connectedness and Social and Reputational Consequences themes focus on the ways in which one's peers may view and interact with others. Findings lay the groundwork for identifying expectancies that underlie FAD behaviors and provide directions for future research and intervention efforts.

Explaining the barriers faced by veterinarians against preventing antimicrobial resistance: an innovative interdisciplinary qualitative study

BACKGROUND

Considering the significance of increased antimicrobial resistance (AMR) and its adverse effects on individual and social health and the important and effective role that veterinarians play in controlling this growing issue worldwide, it is essential to have effective preventive control programs. To this aim, the first step is to identify the factors behind the prevalence of AMR in Iran and the barriers veterinarians face to controlling this problem. Thus, the present study was conducted to explain the barriers veterinarians faced in the prevention of AMR from an Iranian veterinarian's perspective.

METHODS

The present research was done in three cities in Iran in 2021. The data were collected through in-depth interviews with 18 veterinarians selected through purposive and snowball sampling and analyzed using conventional qualitative content analysis.

RESULTS

The data analysis results were classified into 4 main categories and 44 subcategories. The former included: educational factors, administrative/legal factors, client-related factors, and veterinarian-related factors.

CONCLUSIONS

The increased AMR can be approached from multiple aspects. Considering the different factors that affect the increased AMR, it is necessary to consider them all through effective planning and policy-making at multi-level and multidisciplinary dimensions. There is special attention needed to scientific and practical interventions at the individual, interpersonal, social, and even political levels. At the same time, measures should be taken to rehabilitate and maintain the health of society to strengthen supervision and attract the full participation of interested organizations.

Functions of disordered eating behaviors: a qualitative analysis of the lived experience and clinician perspectives

BACKGROUND

One method to improve treatment outcomes for individuals with eating disorders (EDs) may be understanding and targeting individuals' motives for engaging in DE behaviors-or the functions of DE behaviors. The goal of this study was to investigate and categorize the various functions of DE behaviors from the perspectives of adults who engage in DE behaviors and clinicians who treat EDs.

METHODS

Individuals who engage in DE behaviors (n = 16) and clinicians who treat EDs (n = 14) were interviewed, and a thematic analysis was conducted to determine key functions of DE behaviors.

RESULTS

Four main functions of DE behaviors were identified by the authors: (1) alleviating shape, weight, and eating concerns; (2) regulating emotions; (3) regulating one's self-concept; and (4) regulating interpersonal relationships/communicating with others.

CONCLUSIONS

Differences in participant responses, particularly regarding the relevance of alleviating shape and weight concerns as an DE behavior function, highlight the importance of individualized conceptualizations of DE behavior functions for any given client.

COVID-19 related psychosocial problems among university students in Mexico - a longitudinal qualitative examination

Research on the impact of the COVID-19 pandemic among college students around the world has primarily focused on their mental health symptoms and COVID-specific worry. However, contextually specific understanding of outbreak impacts is key to inform directed public health messaging and programming to improve wellbeing and coping. The current study aimed to identify the main psychosocial problems college students experienced during the first 6 months of the COVID-19 pandemic in Monterrey, Mexico. Participants were 606 college students (71% female) enrolled in a private university. Participants described COVID-related problems in an open-ended prompt as part of a longitudinal online survey: initially in May 2020, and then every 2 weeks for 3 months. Thematic analyses were conducted within a longitudinal inductive qualitative approach to rank responses by frequency across themes. Five major categories emerged. At baseline, over 75% of participants noted the outbreak negatively impacted their daily activities and responsibilities, 73% their mental health, 50% their physical health, 35% their interpersonal relationships, and 22% their economic situation. Concerns remained relatively stable throughout the follow-up period, with interpersonal and economic concerns becoming more prevalent as the pandemic progressed. Problems identified in this study can inform preventative measures for future health crises, including tailoring public health messaging and expanding access to contextually sensitive mental and behavioral health programming.

Toward a socially just diversity science: Using intersectional mixed methods research to center multiply marginalized Black, Indigenous, and People of Color (BIPOC)

OBJECTIVE

Plaut's breakthrough 2010 publication on diversity science-the study of meaningful human differences-set in motion a generative field of theory and research. Yet, to move diversity science forward, innovative methods that explicitly center the experiences of Black, Indigenous, and People of Color (BIPOC) who encounter multiple forms of marginalization must be adopted. One such approach is intersectional mixed methods research-a methodological approach that uses intersectionality theory to guide the use of both quantitative and qualitative methods within a single study.

CONCLUSIONS

We argue that intersectional mixed methods research includes four tenets: (1) research questions prioritize multiply marginalized BIPOC individuals, (2) the multiple realities of BIPOC individuals are honored and embraced, (3) identity-related variables (e.g., self-reported discrimination) are studied alongside systems-level variables (e.g., structural racism), and (4) scholars engage in critical reflexivity. We also propose that intersectional mixed methods research can advance scholarship on multiply marginalized BIPOC individuals by fulfilling one of five purposes: Triangulation, complementarity, expansion, development, and initiation. We close with a discussion of tensions and recommendations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Experience of Sexual Violence Among Women of Mexican Heritage Raised in the United States

Sexual violence against women is a significant public health crisis that is understudied among Mexican American communities. Yet, there has been little attention directed to sociocultural factors that shape conceptualizations of and responses to sexual violence among Mexican American women. Guided by an integrative contextual framework, this qualitative study aimed to expand knowledge of how second generation Mexican American women conceptualize, experience, and respond to sexual violence. Semistructured interviews focused on conceptualizations of sexual violence, socialization concerning gender, sex, and sexual violence, experiences, and impact of sexual violence, coping, and help-seeking were conducted with 16 women between 20 and 38 years of age ( M = 27.13). The interview data, analyzed using qualitative conventional content analysis, revealed four broad domains: (a) implicit and explicit messages about sexuality and sexual violence, (b) psychological consequences of sexual violence, (c) barriers to disclosing violence and seeking help, and (d) sources of resilience and healing. Findings indicated that conceptualizations of sexual violence and coping were influenced by complex interactions among several sociocultural contexts, including families, religious and ethnic communities, and the mainstream U.S. context.

LGBTQ Qualitative and Mixed Methods Research in Counseling Psychology: A Content Analysis

Given that qualitative and mixed methods have been used to address social justice issues, counseling psychologists have been drawn to these research designs to advance knowledge in the field. However, qualitative and mixed methods are rarely used in counseling psychology to examine the experiences of LGBTQ individuals. This content analysis reviewed all qualitative and mixed methods studies conducted with LGBTQ individuals between 2009 and 2019 in three leading counseling psychology journals. Results from 24 studies revealed: (a) an increase in LGBTQ-related topics; (b) an overreliance in grounded theory as a research design, diverse analytical approaches, overreliance on semi-structure interviews, and increased disclosure of reflexivity and trustworthiness; and (c) an overwhelming representation of White, cisgender, gay and lesbian, middle class, college educated, English-speaking, Christian, mainland United States residents. We pose a call to action for the next decade of qualitative and mixed methods research with LGBTQ individuals in counseling psychology.

Navigating the “Dual Pandemics”: The Cumulative Impact of the COVID-19 Pandemic and Rise in Awareness of Racial Injustices among High School Students of Color in Urban Schools

We explored the psychological and educational impact of distance learning during the COVID-19 and racial injustice pandemics. The sample included 19 urban high school students of Color from the San Francisco Bay Area. Interview data were analyzed using Reflexive Thematic Analysis revealing seven themes: (1) challenges learning from home; (2) shifts that impact students’ experience with school; (3) emotions emerging from the COVID-19 pandemic; (4) increased awareness and engagement related to racial injustices; (5) emotional reactions to the rise in awareness to racial injustices; (6) shifts in identity due to social isolation; and (7) coping strategies and support needed.

Creating safe spaces to prevent unintentional childhood injuries among the Bedouins in southern Israel: A hybrid model comprising positive deviance, community-based participatory research, and entertainment-education

BACKGROUND

Despite several intervention programs, the Bedouin population living in the Southern District of Israel has the highest mortality rate among children and adolescents from unintentional injuries. Our research questions asked: (1) How does increasing the involvement and participation of Bedouin community members influence the issue of unintentional injuries among children? (2) How does reframing of the technical issue of safety into security influence community involvement and cooperation?

OBJECTIVES

1) To identify effective and efficacious positive deviance practices through community-based participatory research with adults, children, and professionals in the Bedouin community. 2) To create wider and deeper connections and cohesion between and among diverse Bedouin communities by seeding and sparking opportunities for social networking and cross-learning.

METHODS

The study used a qualitative multi-method approach to generate a hybrid intervention model for reducing unintentional childhood injuries among the Bedouins. To frame the issue of unintentional injuries from the lived perspective of the Bedouins, we employed the Positive Deviance (PD) and Community Based Participatory Research (CBPR) approach. Drawing upon theatrical traditions, entertainment-education (EE), was employed as a way to narratively engage and persuade the Bedouins.

RESULTS

Our research resulted in: (1) the emergence of several PD ideas and practices for preventing and avoiding children's injuries; (2) the actual creation of a safe and secure playroom for children at a neighborhood mosque; and (3) the creation of cascading and cross-learning social networks between and among members of the Bedouin community spread across various locations.

CONCLUSION

This study helped in reframing the technical issue of accidents and safety into the notion of sacredness and security, enhanced the association between emotions and cognition by means of experiential and EE methods, and stimulated creative thinking and the emergence of new culturally and contextually relevant ideas and practices through the PD process. It demonstrated the synergistic power of using a hybrid model that combined the rigor and vigor of different health communication approaches to address a significant disparity in the burden of child accidents faced by the Bedouins. Our study generated solutions that emerged from, and directly benefitted, Bedouin children-those, who face overwhelming risk of injury and death from preventable accidents.

When Politics Meets Pandemic: How Prime Minister Netanyahu and a Small Team Communicated Health and Risk Information to the Israeli Public During the Early Stages of COVID-19

BACKGROUND

The coronavirus brought the world's leaders to the center of the media stage, where they not only managed the COVID-19 pandemic but also communicated it to the public. The means they used to communicate the global pandemic reveal their strategies and the narratives they chose to create in their nation's social consciousness. In Israel, the crisis broke out after three election cycles, such that the government in charge of the crisis was an interim government under the leadership of Prime Minister Benjamin Netanyahu, who was operating under three criminal indictments. This study sought to examine the ways in which Prime Minister Netanyahu and two senior Israel Ministry of Health officials-Director General Moshe Bar Siman Tov and Prof. Sigal Sadetsky, Head of Public Health Services-communicated information about the health crisis in Israel during what has been termed the first wave and the beginning of the second wave.

METHODS AND SAMPLE

The research adopted qualitative methods (discourse, content and thematic analysis) to analyze the communication strategies and compare them to health and risk communication. Triangulated data collection from different data sources was used to increase the credibility and validity of the results. The research sample comprised the following sources from March 3 through June 21, 2020: transcripts of 19 press conferences and 12 press interviews, 95 emergency regulations signed by Prime Minister Netanyahu, and 52 articles in major Israeli newspapers.

RESULTS

Netanyahu and the Health Ministry Director General used an apocalyptic narrative to communicate COVID-19 to the public. The main strategies used in constructing this narrative were intimidation, lack of information transparency, giving the public conflicting instructions contrary to the health and risk communicating approach, and using a health crisis to promote political intentions and actions.

CONCLUSION

Communicating health crises to the public, particularly ongoing crises like COVID-19, requires that leaders implement the health and risk communication approach and create a cooperative narrative that does not rely on a strategy of intimidation, but rather on empathy and on fact-based and transparent information.

‘No One . . . Saves Black Girls’: Black University Women’s Understanding of Sexual Violence

Although research has found that sexual violence is a serious issue on college campuses, the lack of diversity in previous samples calls into question the findings’ generalizability to non-White populations. Consequently, little is known about how Students of Color conceptualize sexual violence. Using an intersectional and phenomenological approach, we examined how Black/African American university women understand sexual violence, as well as their perceptions of cultural barriers to help-seeking and reporting this violence. Seven themes emerged: (a) Historical Legacy of Racialized Trauma Against Black Women, (b) Stereotypes of Hypersexualized Black Women, (c) Silence and Community Protection, (d) Duality of Black Spirituality and/or Religiosity, (e) Racial Injustice and Systemic Barriers to Help-Seeking and Reporting, (f) Stereotypes of Strong Black Women, and (g) Grassroots Healing and Empowerment of Black Communities. We provide recommendations for counselors and university staff to develop culturally grounded campus prevention initiatives for Black women.

Using Kahoot! as a formative assessment tool in medical education: a phenomenological study

BACKGROUND

Gamification is an increasingly common phenomenon in education. It is a technique to facilitate formative assessment and to promote student learning. It has been shown to be more effective than traditional methods. This phenomenological study was conducted to explore the advantages of gamification through the use of the Kahoot! platform for formative assessment in medical education.

METHODS

This study employed a phenomenological design. Five focus groups were conducted with medical students who had participated in several Kahoot! sessions.

RESULTS

Thirty-six categories and nine sub-themes emerged from the focus group discussions. They were grouped into three themes: attractive learning tool, learning guidance and source of motivation.

CONCLUSIONS

The results suggest that Kahoot! sessions motivate students to study, to determine the subject matter that needs to be studied and to be aware of what they have learned. Thus, the platform is a promising tool for formative assessment in medical education.

Experiences of Arab heritage youth in US schools and impact on identity development

To fulfill the promise of inclusive school environments that support all students, it is necessary to understand the mechanisms by which discrimination and support occur in the school setting and how these mechanisms impact student development. The current study explored ways schools facilitate supportive or marginalizing experiences for first generation Arab heritage youth in the United States and investigated how these experiences impact acculturative experiences and identity negotiation for these students. Focus groups were conducted with 21 Arab American early college students and community dwellers. Qualitative analyses revealed three mechanisms by which the school setting uniquely impacts Arab heritage student's identity negotiation in high school: 1) peer and teacher discrimination; 2) school curriculum treatment of Arab history and culture; 3) and broader school structures that allow for student cultural expression. Implications and suggestions for School Psychologists are discussed.

What Does “Good Adjustment” Mean for Chinese International Students? A Qualitative Investigation

In this study, we aimed to provide a rich description of Chinese graduate international students’ ways of coping with adjustment challenges and their subjective appraisal of adjustment. Nine Chinese graduate international students (six women, three men) from different institutions and disciplines reported their perceptions of the broad sociopolitical context, cultural adjustment experiences, and subjective evaluation of adjustment. We analyzed the data using consensual qualitative research method. Findings were summarized into three domains: (a) Perceived Sociopolitical Context, (b) Cultural Adjustment Challenges, and (c) Coping and Adjustment. We found frequent long-standing challenges in social and professional domains. Furthermore, interviewees reported an ongoing evaluative process where they negotiated host culture participation expectations in the context of adjustment challenges to achieve a subjective sense of satisfaction. Our findings have implications for professionals working with Chinese international students to help them mitigate internalized oppression and develop purpose and well-being.

Eating Disorders in the Workplace: A Qualitative Investigation of Women’s Experiences

Though employment is typically associated with positive mental health outcomes for individuals with disabilities, the ubiquity of stress and stigma at work may complicate the relation between work and well-being for women with eating disorders (EDs). To date, however, the experiences of women with EDs in the workplace have not been examined. By utilizing a qualitative methodology to form an initial framework for the examination of EDs in the workplace, we address this gap in the literature. Seventy adult women with anorexia, bulimia, and binge eating disorder discussed the relation between work and their condition. The data analysis led to the delineation of a theoretical model, which we propose explains the interconnections between key study constructs, including individual characteristics; workplace stressors; identity, stigma, and stress management techniques; and related personal and organizational outcomes. Our research suggests that, depending on how stress is managed, the workplace can serve as a bridge or a barrier to ED recovery. This study lays the groundwork for understanding the ways in which workplace life interacts and interferes with ED management, opening up a new line of investigation for researchers working to enhance the lives of individuals with EDs across life domains.

The Dynamic Paradigm of Ethnic Culture: Variations Across Context, Time, and Meaning

In this article, we argue that counseling psychology research on ethnic culture can be enhanced by drawing upon advancements in conceptual and methodological approaches from other fields. Accordingly, we present the dynamic paradigm of culture to provide counseling psychologists with a useful conceptualization of ethnic culture that serves as the impetus for developing novel research agendas. Grounded in interdisciplinary scholarship from social psychology, developmental psychology, political science, and sociology, this paradigm’s core concept is ethnic culture’s malleable nature; that is, ethnic culture varies across social contexts, across time, and in its meaning across individuals. These three dimensions of ethnic culture are elaborated within three perspectives: (a) the contextual perspective focuses on the situational and domain-specific nature of cultural influences, (b) the temporal perspective characterizes ethnic culture and individuals’ cultural orientation as continually evolving through time, and (c) the constructionist perspective emphasizes the fragmented, subjective, antiessentialist, and performative nature of ethnic culture.

"I couldn't change the past; the answer wasn't there": A case study on the subjective construction of psychotherapeutic change of a patient with a Borderline Personality Disorder diagnosis and her therapist

BACKGROUND

Qualitative research has provided knowledge about the subjective experiences of therapists and patients regarding the psychotherapy process and its results. Only few studies have attempted to integrate both perspectives, considering the influence of a patient's characteristics and diagnosis in the construction of this experience.

AIM

To identify aspects of psychotherapy that contribute to therapeutic change based on the experience of a patient and her therapist, and to construct an integrated comprehension of the change process of a patient with Borderline Personality Disorder.

METHOD

A single case was used to carry out a qualitative analysis of follow-up interviews of the participants of a long-term psychotherapy. Two qualitative approaches were combined into a model entitled "Discovery-Oriented Biographical Analysis" to reconstruct an integrated narrative.

RESULTS

This method yielded an integrated narrative organized into four "chapters" that reflect the subjective construction of both the patient's and the therapist's experience of psychotherapy in terms of meaning.

DISCUSSION

The understanding of psychotherapy as a multilevel process, in which different themes occur and develop simultaneously, is discussed. From this perspective, psychotherapy can be characterized as a process that involves the recovery of trust in others through corrective emotional experiences and the construction of a shared implicit relational knowledge. Clinical or methodological significance of this article: Research on the subjective experiences of psychotherapy must consider both patient and therapist as privileged but always complementary witnesses of their interaction. In addition, it should be noted that the experience of studying this biographical reconstruction generates a space where research and practice converge. The analysis of participants' narratives provides fascinating windows into their perceptions of psychotherapy and the process of change (Safran, 2013); here, the researcher is not merely a advantaged observer or a good summarizer: He/she has the chance to imbue the psychotherapy with a new meaning by connecting it with a common set of knowledge and a body of socially shared experience.

Parental Involvement and Child and Adolescent Eating Disorders: Perspectives from Residents in Psychiatry, Pediatrics, and Family Medicine

OBJECTIVES

Best practice guidelines encourage the involvement of parents in the assessment and treatment of child/adolescent eating disorders (ED). This study investigated medical residents' perspectives regarding parental involvement as well as their expectations for future practice in the assessment and treatment of ED.

METHOD

Five hundred and eighty-four medical residents from 17 Canadian residency programs specializing in family medicine, pediatrics, and psychiatry completed a web-based survey. Questions pertained to assessment and treatment practices for child/adolescent ED. Analyses included ANOVAs, paired t-tests, and, for residents who endorsed family involvement (N = 444), qualitative content analysis.

RESULTS

Overall, residents reported that they "mostly" agreed with the involvement of family in the assessment and treatment of ED. Residents' endorsement of family involvement in both domains increased according to the extent of ED training received. Four major themes emerged from the content analysis of family involvement and included recommendations in line with evidence-based models and unspecified, passive involvement in the assessment and recovery process.

CONCLUSIONS

Many residents endorse family involvement in both assessment and treatment; however, understanding of the nature of such involvement is often vague. Training in evidence-based protocols is necessary for residents planning to engage in multi-disciplinary assessment, referral, and/or treatment in their future practice.

Women physicians as healthcare leaders: a qualitative study

Purpose - The purpose of this paper is to explore the under-representation of women physicians in clinical leadership by examining the issue from their perspective. Design/methodology/approach - The authors used large group engagement methods to explore the experiences and perceptions of women physicians. In order to capture common themes across this group as a whole, participants were selected using purposeful sampling. Data were analysed using a structured thematic analysis procedure. Findings - This paper provides empirical insights into the influences affecting women physicians' decision to participate in leadership. The authors found that they often exclude themselves because the costs of leadership outweigh the benefits. Potential barriers unique to healthcare include the undervaluing of leadership by physician peers and perceived lack of support by nursing. Research limitations/implications - This study provides an in-depth examination of why women physicians are under-represented in clinical leadership from the perspective of those directly involved. Further studies are needed to confirm the generalizability of these findings and potential differences between demographic groups of physicians. Practical implications - Healthcare organizations seeking to increase the participation of women physicians in leadership should focus on modifying the perceived costs of leadership and highlighting the potential benefits. Large group engagement methods can be an effective approach to engage physicians on specific issues and mobilize grass-roots support for change. Originality/value - This exploratory study provides insights on the barriers and enablers to leadership specific to women physicians in the clinical setting. It provides a reference for healthcare organizations seeking to develop and diversify their leadership talent.

Female Masculinity at Work

In this study, the author interviewed 49 self-identified masculine women in the United States to examine how they negotiate stigma in the workplace. Masculine women often negotiate dual stigmas due to both their gender nonconformity and perceived sexual orientation. Participants used a variety of strategies to cope with their stigmatized identity including modifying clothing; incorporating feminine behaviors to counteract masculine appearance; working in high-demand, undesirable jobs; working in male-dominated settings; and opting out of formal work organizations. While some participants experienced mistreatment in male-dominated settings, many reported positive outcomes including strong relationships with male coworkers, opportunities for advancement, and a general comfort in the work environment. Participants challenge Goffman’s notion of sexual orientation as a concealable status, showing that sexual orientation minority women who are gender nonconforming employ strategies similar to members of other visibly stigmatized groups. Findings from this study suggest that researchers addressing sexual orientation minorities should include gender expression as a variable that can influence individual experiences and outcomes. Online slides for instructors who want to use this article for teaching are available on PWQ's website at http://journals.sagepub.com/page/pwq/suppl/index .

Expanding the Methodological Imagination

This article contains reflections provoked by the articles in this volume of The Counseling Psychologist. As a relative outsider to counseling psychology, the author thoroughly enjoyed immersing herself in these contributions and then extracting a set of thoughts inspired by the writers.

Effectively Communicating Qualitative Research

This article is a guide for counseling researchers wishing to communicate the methods and results of their qualitative research to varied audiences. The authors posit that the first step in effectively communicating qualitative research is the development of strong qualitative research skills. To this end, the authors review a process model for developing such competence and emphasize the importance of research paradigm and philosophy-of-science knowledge for the competent researcher. The authors present characteristics of strong qualitative writing and highlight the concept of “thick description.” The article includes a recommended structure for presenting the qualitative study and provides suggestions for targeting writing for different audiences. The authors conclude with suggestions for graduate students considering conducting qualitative dissertations.

Teaching Qualitative Research

Qualitative research has become increasingly perceived as well suited to the advancement of counseling psychology, yet opportunities for formal training in qualitative inquiry remain inconsistently available within and across graduate programs. For the potential contribution of this approach to counseling psychology to be realized, graduate students need routine access to adequate and appropriate coursework. In this article, the author shares a design and rationale for an introductory course in qualitative research, describes typical challenges faced by students, and offers strategies for fostering student learning and success. Limitations of the approach are discussed and recommendations offered based on lessons learned from practice.

Counselors’ Current Counseling Practice

The purpose of this qualitative study was to explore counselors’ efforts to implement a culturally responsive counseling practice in mainland China. Twenty-two counselors were interviewed about their perceptions of cultural discrepancies between Western-based counseling theories and approaches and the Chinese counseling context, as well as about the participants’ attempts to address these discrepancies in practice. Grounded theory was used as the method for data analysis, resulting in the identification of two main themes: Awareness of Cultural Discrepancies and Culture-Related Practice Strategies. For the latter theme, six subthemes were found: (a) relationship-oriented accommodation, (b) skill integration, (c) internal focus, (d) identifying commonalities, (e) employing accommodative approaches, and (f) theoretical integration. Implications for counselor education and practice in China, as well as further directions for research, are presented.

Perceptions of Race-Based Discrimination Among First-Generation Asian Indians in the United States

The current study examined how historical, social, and political contexts in their country of origin and their host country have influenced first-generation Asian Indians’ racialized experiences in the United States. We conducted nine separate focus groups with a total of 50 first-generation Asian Indian participants (20 men and 30 women). In a semistructured interview, participants were asked about the factors that influence their perceptions of and coping with race-based discrimination. The data were analyzed using grounded theory. A theoretical model was developed based on factors that influence Asian Indian individuals’ conceptualizations of race-based discrimination, the variables that influence their coping strategies, and the insights gained in coping with discrimination. Pre- and postimmigration experiences seem salient to race-based experiences of Asian Indians in the United States. Attempts at making meaning of Asian Indian race-based experiences were strongly influenced by the caste system, preimmigration colonial influence, and the model minority myth.

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.

Couples’ Relationship Self-Regulation Narratives After Intervention

Relationship self-regulation is a way for couples to work on their relationships by becoming reflective about them, by setting goals for improvement, and by following up with efforts to be a better partner. Reflection is an important process in relationship self-regulation addressed in this study. The aim of this study is to analyse relationship self-regulation narratives after a relationship education intervention. Ten married partners (age 33-43 years) participated in a four-day reflective experiential relationship education programme intervention. The study investigated couples’ experiences of working on their relationship after the intervention. Two focus groups were conducted and narrative analysis was used. Four common themes emerged: becoming aware of one’s inner reactions and re-appraisals, learning to be sensitive, noticing one's own habitual responses and making choice, and experimenting in the relationship. These themes are discussed by applying a couple relationship self-regulation conceptual framework. We revealed that relationship self-regulation emerged as a process of regulation of intrapersonal emotional reactions to partner. Reflectivity in relationship self-regulation may be defined as focusing on oneself, trying to understand one’s own feelings and needs, experimenting to meet these needs, and exploring resources. The research focuses on the study of meaning making and on the reflection processes of partners in couple relationship self-regulation.

Mental Health Implications in Mormon Women’s Experiences With Same-Sex Attraction

Given research suggesting that individuals in conservative religions experience conflict between religious beliefs and feelings of same-sex sexuality, this study explores the mental health impact of Mormon women who experience same-sex sexuality. Twenty-three Mormon women participated in semi-structured individual interviews about their experiences with same-sex sexuality. Interview questions asked about participants’ experiences with same-sex sexuality and the LDS Church (The Church of Jesus Christ of Latter-day Saints), how this experience affected their mental health, and what types of mental health treatment they engaged in during their process of reconciliation. Data were analyzed following phenomenological methodology. Themes included the following: experiences with mood disorders, self-worth, suicidality, treatment attempts, reparative therapy, counselor’s agenda, impact of family and community, and mental health recovery. When treating women who experience conflict, counselors should assess self-worth, suicidality, and the level of community and familial support. Referral to group counseling can support self-acceptance of same-sex sexuality through normalization. Future research should examine specific practice interventions and explore impacts of other intersecting identities.

A neglected issue on sexual well-being following breast cancer diagnosis and treatment among Chinese women

Background

Changes to sexual well-being can be one of the most problematic quality of life issues following the diagnosis and treatment of breast cancer. The objectives of the present study were to evaluate changes to sexual well-being following breast cancer, to expand upon the existing body of knowledge pertaining to breast cancer and sexuality, and to provide the necessary information for implementing future interventions that may help improve the quality of life in breast cancer patients.

Methods

This study was mixed with qualitative and quantitative designs. Twenty patients with breast cancer were recruited for in-depth interviews. The central questions covered a patient’s cancer experience and perceptions of sexual activities following breast cancer. According to the findings of the qualitative study, we performed a quantitative study using a structured questionnaire to collect data on patient’s experience and attitude to sexual well-being following breast cancer diagnosis and treatment.

Results

Based on the qualitative analysis, seven main themes emerged: (1) Decrease in sexual frequency; (2) Lack of sexual interest; (3) Menopausal symptoms; (4) Body image changes; (5) Effects on marital relationship; (6) Misconceptions about sex; (7) The need for professional consultation. Results from the quantitative study further supported the findings from the qualitative analysis, where changes to sexual well-being were common following cancer diagnosis and treatment and it was a neglected issue among Chinese women.

Conclusions

The present study highlights the significant changes to sexual well-being following breast cancer, in addition to the lack of knowledge and misconceptions of sexual activity among patients. Addressing these problems will help improve a patient’s quality of life. The findings of this study could help healthcare professionals recognize the sexual issues faced by women with breast cancer and ultimately promote a healthy life.

"Why we stay": immigrants' motivations for remaining in communities impacted by anti-immigration policy

Although restrictive immigration policy is intended to reduce incentives for unauthorized immigrants to remain in the United States, many immigrants remain in their U.S. community despite the anti-immigration climate surrounding them. This study explores motivations shaping immigrants' intentions to stay in Arizona after passage of Senate Bill 1070 in 2010, one of the most restrictive immigration policies in recent decades. We conducted three focus groups in a large metropolitan city in Arizona with Mexican immigrant parents (N = 25). Themes emerging from the focus groups described multiple and interlocking personal, family and community, and contemporary sociopolitical motivations to stay in their community, and suggest that some important motivating factors have evolved as a result of immigrants' changing environment. Implications for research and social policy reform are discussed.