The mental health of culturally and linguistically diverse offenders - what do we know?

OBJECTIVE

A key challenge facing justice health service providers is addressing and treating the high rates of mental illness among offenders. It is well documented that rates of mental illness are substantially higher within prison populations compared to the general population. As such, the need to provide ongoing treatment to prisoners experiencing mental health issues is of fundamental importance. Prisoners experiencing mental health disorders are more likely to have poorer social outcomes on release, including a greater likelihood of recidivism and poorer health outcomes. The growing numbers of justice-involved individuals from culturally and linguistically diverse (CALD) backgrounds signal the need for justice systems to adapt to the changing demographic.

CONCLUSIONS

In this commentary, we argue that greater efforts to explore the nature and prevalence of mental illness among CALD groups in custody, where such concerns are often intertwined with additional complex personal, environmental and historical criminogenic risk factors, are desperately needed to improve system responses and reduce recidivism.

Thematic Mapping in Case Conceptualization: An Introduction to the Special Section

Case conceptualization is an essential clinical activity in which clinicians, in one form or another, gather and synthesize data about their clients in order to formulate clinical pictures and maximize therapeutic gains. However, a myriad of methods of case conceptualization that vary in complexity and theoretical bases currently reflects an almost complete lack of standardization in this most fundamental activity of mental health treatment. The lack of standardization in case conceptualization is especially daunting to trainees and clinicians who are early in their careers. This special section, comprising 5 articles, introduces thematic mapping, a transtheoretical and transdiagnostic method of case conceptualization. The method aims to overcome or minimize many of the problems inherent in current practice. In this first article, we provide a rationale for the special section and lay the groundwork for the subsequent four articles. Overall, we assert that thematic mapping holds promise as a systematic method of case conceptualization.

The Conceptual Framework of Thematic Mapping in Case Conceptualization

This article, the 3rd in a series of 5, introduces the conceptual framework for thematic mapping, a novel approach to case conceptualization. The framework is transtheoretical in that it is not constrained by the tenets or concepts of any one therapeutic orientation and transdiagnostic in that it conceptualizes clients outside the constraints of diagnostic criteria. Thematic mapping comprises 4 components: a definition, foundational principles, defining features, and core concepts. These components of the framework, deemed building blocks, are explained in this article. Like the foundation of any structure, the heuristic value of the method requires that the building blocks have integrity, coherence, and sound anchoring. We assert that the conceptual framework provides a solid foundation, making thematic mapping a potential asset in mental health treatment.

Case Mis-Conceptualization in Psychological Treatment: An Enduring Clinical Problem

Case conceptualization, an integral component of mental health treatment, aims to facilitate therapeutic gains by formulating a clear picture of a client's psychological presentation. However, despite numerous attempts to improve this clinical activity, it remains unclear how well existing methods achieve their purported purpose. Case formulation is inconsistently defined in the literature and implemented in practice, with many methods varying in complexity, theoretical grounding, and empirical support. In addition, many of the methods demand a precise clinical acumen that is easily influenced by judgmental and inferential errors. These errors occur regardless of clinicians' level of training or amount of clinical experience. Overall, the lack of a consensus definition, a diversity of methods, and susceptibility of clinicians to errors are manifestations of the state of crisis in case conceptualization. This article, the 2nd in a series of 5 on thematic mapping, argues the need for more reliable and valid models of case conceptualization.

Ethical and Professional Issues in Career Assessment With Diverse Racial and Ethnic Groups

This article examines the recent contributions in the vocational psychology and counseling psychology literature in the areas of multicultural and career assessment. The foundational skills that are essential for culturally competent assessment are presented, and a process model for culturally appropriate vocational assessment with ethnically diverse individuals is presented. The components in the model include culturally encompassing information gathering, culturally appropriate consideration of assessment instruments, culturally sensitive administration, and culturally appropriate interpretation of the data. Issues relevant in the vocational assessment process with ethnically diverse populations and professional considerations are reviewed at each stage of the culturally appropriate career assessment model.

The Cultural Context of Career Assessment

In this article, we propose that the major challenge facing career assessment scholars and practitioners in the 21st century is the need to affirm cultural diversity. Beginning with a discussion of social constructionist theory, we suggest that existing career assessment practice needs to embrace the "local" realities that exist within diverse cultural contexts. We then present the unificationist perspective as a conceptual lens with which to consider career assessment. Building on the need for psychometric tools that can address the changing cultural context of career assessment, we also advance generalizability and item response theories as viable approaches to developing culturally affirming measures and practice standards for diverse clients. The article concludes with an integrative view of how these conceptual and methodological tools can enhance career assessment in the 21st century.

Houston, 2001

This article presents an overview of the Houston 2001 National Counseling Psychology Conference. The authors discuss the context for the 4th National Counseling Psychology Conference, documentthe process of decision makingaboutthe conference, andexamine the content of the conference. The authors also examine a unique feature of the conference, the social action groups, discussing their philosophical underpinnings as well as how they were organized, what took place, and recommendations drawn from the groups. The authors evaluatethe outcomes of the Houston Conference andalso assess the conference within the context of the legacy of the three other counseling psychology conferences held at Northwestern University in 1951, in the Greyston Conference Center at Teachers College in 1964, and in Atlanta in 1987. Finally, the authors make recommendations for the field to move the conference’s initiatives forward and plan for future conferences.

An Investigation of European American Therapists’ Approach to Counseling African American Clients

Interviews were conducted with 9 European American psychologists, asking them to recall their first 12 counseling sessions with a current or recent successful case with an African American client. Using consensual qualitative research (CQR) methodology, the psychologists revealed that they generally attended to differences in race between themselves and clients directly and openly within the first two sessions. This was done to acknowledge this difference and convey to the client comfort and trust; psychologists also intended to engender client trust and participation in therapy. The psychologists saw race as a central component to be discussed and continually attended to in establishing and maintaining a trusting and solid working relationship. They typically saw race-related issues as relevant to clients’ concerns. Despite wide variability in theoretical orientations and variety of client presenting problems, they typically reported using Rogerian core skills to engage the client and establish the relationship. However, they also reported using more culture-specific and sensitive interventions to deepen and strengthen the therapy relationship. These interventions included relying on their level of racial identity development to understand the client, being attuned to the client’s racial identity development and worldview, and attending to client reports of racism.

Individual Psychological Assessment: A Practice and Science in Search of Common Ground

During the past 30 years, individual psychological assessment (IPA) has gained in use and in value to organizations in the management of human resources. However, even though IPA is considered a core competency for industrial–organizational (I–O) psychology, its practice is not without critics. This article is written not only to address several criticisms of IPA but also to discuss a variety of issues that must be taken into consideration if IPA is to advance as a major component of the I–O scientist–practitioner model. We rely upon a working definition of IPA in general but, when possible, focus on executive assessment in particular, given its high level of complexity and growing popularity. We discuss the effectiveness of assessment practice, including the ongoing statistical versus clinical prediction argument and the difficulties with establishing validity. Although we are confident that IPA has many strong research and practice underpinnings, we also propose some important research questions, training guidelines, and opportunities for assessing psychologists to improve their practices.

The Relationship Between Mental Health, Cultural Identity and Cultural Values in Non-English Speaking Background (NESB) Australian Adolescents

In Australia, acculturating adolescents from a non-English speaking background (NESB) face two important challenges: developing a cultural identity and establishing a set of cultural values. These challenges are achieved by balancing a native and Australian orientation. It was expected that NESB adolescents who did not achieve these tasks would experience poor mental health. This study focused on adolescents because a significant relationship between cultural identity, cultural values and mental health in this group will highlight a need for sensitivity to such cultural and developmental issues. Two hundred and sixty-three NESB adolescents completed questionnaires that assessed cultural identity (Australian and native), cultural values (individualism and collectivism), state mental health (depression, anxiety and stress) and trait mental health (positive affectivity [PA] and negative affectivity [NA]). Results indicated that high Australian pride and high native pride are associated with lower depression, anxiety, stress and NA, and higher PA. Results also indicated that adolescents high on individualism and collectivism reported lower depression and stress, and higher PA. Furthermore, adolescents with a separated cultural identity (high native pride and low Australian pride) reported the highest levels of depression, but adolescents with separated cultural values (high collectivism and low individualism) reported the lowest levels of depression and anxiety. We concluded that cultural identity and cultural values are differentially related to mental health, and such relationships, albeit moderate, emerge during adolescence.

The Meta-Analysis of Clinical Judgment Project

Clinical and educational experience is one of the most commonly studied variables in clinical judgment research. Contrary to clinicians' perceptions, clinical judgment researchers have generally concluded that accuracy does not improve with increased education, training, or clinical experience. In this meta-analysis, the authors synthesized results from 75 clinical judgment studies where the experience of 4,607 clinicians was assessed in relation to the accuracy of their judgments about mental health (e.g., diagnosis, prognosis, treatment) and psychological issues (e.g., vocational, personality). The authors found a small but reliable effect, d = .12, showing that experience, whether educational or clinical, is positively associated with judgment accuracy. This small effect was robust across several tested moderator models, indicating experienced counselors and clinicians acquire, in general, almost a 13% increase in their decision-making accuracy, regardless of other factors. Results are discussed in light of their implications for clinical judgment research and for counseling psychology training and practice.

Time Keeps on Ticking

In this rejoinder, the authors respond to reactions by Ridley and Shaw-Ridley and by Lichtenberg to their meta-analysis on the effects of experience on clinical judgment decision making accuracy.

Clinical Judgment Accuracy

Clinical judgment is foundational to psychological practice. Accurate judgment forms the basis for establishing reasonable goals and selecting appropriate treatments, which in turn are essential in achieving positive therapeutic outcomes. Therefore, Spengler and colleagues' meta-analytic finding—clinical judgment accuracy improves marginally with traditional education, training, and clinical experience—is disconcerting and should serve as a wake-up call. Now is the time to move with urgency. The authors urge the development of a comprehensive, standardized, and scientifically based metatheory to inform clinical judgment. A metatheory should describe the content of clinical judgment, the process of clinical judgment, and the self-reflection of clinicians. Without employment of such a metatheory and concomitant improvement in clinicians' judgment, professional psychologists are on soft footing in extolling their claim as scientist—practitioners and ethical professionals.

The validity and reliability of the Tertiary Student Values Scale (TSVS)

OBJECTIVE

To explore the factorial composition of an instrument developed to assess value orientations in tertiary students, the Tertiary Student Values Scale (TSVS), using data from culturally diverse undergraduate dental students.

METHODS

A 68-item questionnaire was used to collect the data. The questionnaire included 15 3-item subscales developed in a manner consistent with the Kluckhohn and Strodtbeck value orientation model. The psychometric properties were evaluated using a sample of students from 4 Australian dental schools. The questionnaire was administered to 364 students aged 18-50 years, mean age 21.3 years (SD 3.45 years), using a convenience sampling method. Scores on the 45 items were factor analysed using the maximum-likelihood estimation method for factor extraction with oblique rotation (oblimin). Internal consistency was examined on all of the 3-item subscales, using Cronbach's alpha.

RESULTS

The analysis indicates that the TSVS reflects the hypothesised 15-dimension construct of value orientation. Furthermore, the analysis showed that the identified 15 factors were independent of one another and were sufficiently reliable for group comparisons. With 1 exception, all subscales yielded a Cronbach's alpha > or = 0.55, the exception being 1 subscale with alpha = 0.40 (range 0.40-0.80).

CONCLUSION

Results indicated that value orientation is a complex construct, but that it is quantifiable along multiple dimensions in a psychometrically valid manner. Further refinement of this instrument would increase its value as a tool for policy makers designing educational programmes and services for culturally diverse student groups.

What's missing from multicultural competency research: review, introspection, and recommendations

Much of the multicultural counseling research has pointed out the need for counselors to become culturally competent to appropriately address the needs of an emerging diverse community. To date, however, this body of research has largely focused on counselor competencies, with little attention being given to the client perspective of multicultural counseling competencies. This article discusses the importance of integrating the client perspective within the historical context of the multicultural literature by examining client preferences and expectations, as well as the adequacy of the current empirical data. The authors also raise the issue of politics inherent in multiculturalism and discuss how this affects the research. A number of recommendations are made as a guide for future research.