Clinical psychology: Diversity and Additional Topics

Acculturation (Berry)

A person’s level of acculturation can be described in terms of 4 categories reflect the person’s adoption of their own culture and the culture of the dominant group:

Integration, assimilation (accept dominant) , separation, marginalization (reject both)

Acupuncture

A traditional Asian method for restoring health and involves stimulating anatomical points on the body, usually with a thin metallic needle.

The traditional explanation for its effects is that illness is due to a blockage of qi (vital life energy) and that acupuncture unblocks the flow of qi along the pathways through which it circulates the body.

Research suggests that its benefits may be due to the release of pain-suppressing substances or an alteration of blood flow in areas around the needle or in certain regions of the brain

alloplastic vs autoplastic interventions

refer to the focus of an intervention with regard to environment.

Alloplastic intervention: to make changes in the environment, so it better accommodates the individual

Autoplastic: make changes in the individual so they are better able to function effectively in their environment

Black racial (nigrescence) identity development model

Cross

4 stages.

1. Pre-encounter: race and racial identity have low salience

2. Encounter: person has greater racial/cultural awareness and is interested in developing a black identity

3. Immersion/emersion: race and racial identity have high salience and the person moves from intense Black involvement (immersion) to strong anti-White attitudes (emersion).

   1. Internalization: race continues to have high salience and the person adopts an Afrocentric, biculturalist, or multiculturalist orientation

Cultural competence

sue and sue (2003)

Involving 3 competencies:

1. therapist’s awareness of their cultural assumptions, values, and beliefs

2. Knowledge about the worldviews of culturally diverse clients

3. Skills that enable them to provide interventions that are appropriate and effective for culturally different clients

Cultural encapsulation (wrenn)

culturally encapsulated counselors interpret everyone’s reality through their own cultural assumptions and stereotypes and disregard cultural differences and their own cultural biases

cultural vs functional paranoia (Ridley)

described nondisclosure by African American therapy clients as being due to 2 types of paranoia

A client is exhibiting cultural paranoia (which is a heathy reaction to racism) when they do not disclose to a white therapist due to a fear of being hurt or misunderstood.

A client is exhibiting functional paranoia (which is due to pathology) when they are unwilling to disclose to any therapist, regardless of race or ethnicity, as a result of mistrust and suspicion.

Cybernetics (positive and negative feedback loops)

Concerned with communication processes and distinguishes between negative and positive feedback loops.

A negative feedback loop reduces deviation and helps a system, maintain the status quo

A positive feedback loop amplifies deviation or change and thereby disrupts the system

Diagnostic overshadowing

originally used to describe the tendency of healthcare professionals to attribute all of a person’s psychiatric symptoms to their intellectual disabilities. Subsequent research found that diagnostic overshadowing also applies to other conditions and diagnoses

Double-bind communication

etiological factor for schizophrenia and involves conflicting negative injunctions with one injunction often being expressed verbally and the other nonverbally. In addition, the recipient of the contradictory injunctions is not allowed to comment on them or seek help from someone else.

efficacy vs. Effectiveness research

ongoing debate in psychotherapy outcome research is over the best ay to evaluate the effects of psychotherapy.

Efficacy (clinical trials)

Effectiveness (correlational or quasi-experimental)

Eric vs Eric Orientation

Different orientations to understanding and describing cultures

Eric: culture-specific and involves understanding the culture from the eprspective of members of that culture

Eric: Culture-general and assumes that universal principles can be applied to all cultures

Health belief model

proposes that health behaviors are influenced by:

1. The person’s readiness to take a particular action, which is related to their perceived susceptibility to the illness or perceived severity of its consequences.

2. Person’s evaluation of the benefits and costs of making a particular response

3. The internal and external “cues to action” that trigger the response

Health promotion

several methods of encouraging healthy behaviors, such as advertising and increased education

High vs low context communication

members of many culturally diverse groups in America exhibit high context communication, which relies on shared cultural understanding and nonverbal cues. It helps unify a culture and is slow to change.

in contrast, white people are more likely to exhibit low-context communication, which relies primarily on the verbal message, is less unifying that high-context communication, and can change rapidly and easily. Differences in communication style can lead to misunderstandings in cross-cultural therapy.

Affectional Orientation Identity Development Model (updated from homosexual identity development model)

Troiden (1988), distinguishes between 4 stages Sensitization/feeling different

Self-recognition/identity confusion

Identity assumption

Commitment/identity commitment

Howard and Collegues (Doese Dependent effect; phase model)

1996

About 75% of px show measurable improvement by 26 sessions, increases to abouse 85% at 52 sessions. Phase model predicts that the effects of psychotherapy are related to the number of sessions and distinguishes between 3 phases: demoralization, remediation, and rehabilitation .

Hypnosis (repressed memories)

Oren and Dinges propose that hypnosis involves experiencing alterations of memory, perception, and mood in response to suggestions and characterize its essential feature as a “subjective experienctial change”

Although hypnosis has been used to help people recover repressed memories, the research suggests that it does not seem to enhance the accuracy of memories, may produce more pseudo memories that accurate memories, and may exaggerate a person’s confidence in the validity of uncertain memories, especially for those that are inaccurate

Mental health consultation (Caplan)

4 types

1. Client-centered case consultation: focuses on helping the consulted work more effectively with a particular client

2. Consulted-centered: focuses on enhancing the consultee’s ability to deliver services to a particular group or population of clients.

3. Program centered administrative consultation: involves working with one or more administrators to resolve problems related to a particular program.

4. Consulted centered administrative consultation: involves enhancing the ability of administrators to develop, implement, and evaluate programs.

Multisystems model (Boyd-franklin)

ecostructural approach to African American families that addresses multiple systems, intervenes at multiple levels, and empowers the family by utilizing its strengths. Systems that may be incorporated into treatment include extended family and nonblood kin, the church, and other community resources, and social service agencies.

Parallel process

occurs in clinical supervision when the therapist (supervisee)behaves toward their supervisor in ways that mirror how the client is behaving towards their supervisor therapist

Psychiatric inpatient (demographic characteristics)

1. For both men and women, admission rates are lowest among widowed, intermediate for those who are married/divorced, and highest for the never married

2. Whites represent the largest number of psychiatric inpatients, when population proportions are taken into account, patients from other races are overrepresented.

3. For both men and women, the largest proportion of admissions is in the 25-44 age range

Racial/cultural identity development model

(1998)

5 stages that people experience as they attempt to understand themselves in terms of their own culture (from a community of color), the dominant culture, and the oppressive relationship between the two cultures.

1. Conformity: positive attitudes for the dominant group

2. Dissonance: confusion and conflict over contradictory attitudes

3. Resistance and immersion: active rejection of the dominant group

4. Introspection: uncertainty about the rigidity of stage 3’s beliefs.

5. Integrated awareness: adoption of a multiculturalist perspective

Resilience

psychological capacity to cope with socio-environmental challenges

Sexual orientation and gender diversity (internalized homophobia, coming out)

internalized homophobia occurs when LBGTQIA+ individuals accept negative stereotypes about sexual orientation and gender diversity and incorporate them into their self-concept.

Consequences include low self-esteem, self-doubt, and self-destructive behaviors.

Coming out to family, friends, and others is associated with rejection and other negative consequences as well as with higher levels of self-esteem and positive affectivity, lower levels of anxiety, and other positive consequences.

Research suggests that the age of coming out is about the same for gay males and lesbians.

Telepsychology

the use of the telephone, text, email, chats, interactive video-conferencing, or virtual reality for mental health assessment and treatment

Therapist-client matching

in terms of race, ethnicity, and culture has produced inconsistent results. Matching may reduce premature termination for members of some groups (Asian and latinx) some research suggests that other factors (similarity in values and world view) are more important than similarity in terms of race, ethnicity, or culture

Treatment manuals

originally developed to standardize psychotherapeutic treatments so their effects could be empirically evaluated and to provide guidelines for training therapists. They specify the theoretical underpinnings of the treatment along with treatment goals and strategies. A potential limitation of treatment Manuel’s is that they may oversimplify the therapeutic process.

Triangular model

form of supervision that emphasizes providing service to clients that include organizational policies, professional knowledge, and the supervisory relationship

White racial identity development model

Helms 1990

2 phases: abandoning racism (1-3) and developing nonracial white identity (4-6)

1. Contact: little awareness of racism

2. Disintegration: increasing awareness of race and racism which leads to confusion and conflict

3. Reintegration: idealization of white society and denigration of people of color

4. Pseudo-independence: questioning of racist views

5. Immersion-emersion: confrontation of own biases

6. Autonomy: internalization of nonracial white identity

Worldview (Sue)

1978

A person’s worldview is affected by their cultural background and is determined by 2 factors: locus of control and locus of responsibility

Differences in worldview can affect the therapeutic process. White middle class therapists typically have an internal locus of control and internal locus of responsibility (IC-IR) and are likely to have problems working with a black client with and internal locus of control and an external locus of responsibility (IC-ER) who may challenge the therapist’s authority and trustworthiness and be reluctant to self-disclose