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Introducing the System for Observing Medical Alliances (SOMA): A Tool for Studying Concordance in Patient-Physician Relationships. 介绍医学联盟观察系统(SOMA):一个研究医患关系一致性的工具。
IF 3.4 3区 心理学 Q2 Psychology Pub Date : 2019-12-16 DOI: 10.1177/0011000019891434
Myrna L Friedlander, Kelsey Kangos, Kieran Maestro, Hannah Muetzelfeld, Scott T Wright, Nicole Da Silva, Justin Kimber, Drew A Helmer, Lisa M McAndrew
We developed the System for Observing Medical Alliances (SOMA) to study relationships between medical providers and patients with medically unexplained symptoms (MUS). Based on literature in health psychology, medicine, and the psychotherapeutic alliance, the SOMA operationalizes three medical alliance dimensions: Engagement in the Consultation Process, Trust in the Provider, and Concordance of Illness Beliefs and Treatment Recommendations. Specific behavioral indicators, tallied as observed by trained judges, are used as the basis for rating each dimension. In a sample of 33 medical consultations with veterans who had MUS, interrater reliabilities ranged from .79 to .94. Notably, the other dimension ratings accounted for 40% of the variability in Concordance, with Trust in the Provider contributing unique variance. In addition to research, psychologists in integrated health settings can use the SOMA to consult and train medical providers on communication skills that enhance concordance.
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引用次数: 4
Empirical Evaluation of Veterans' Perceived Non-Concordance with Providers Regarding Medically Unexplained Symptoms. 退伍军人在医学上无法解释的症状方面与医疗服务提供者认知不一致的实证评估。
IF 3.4 3区 心理学 Q2 Psychology Pub Date : 2019-07-01 DOI: 10.1177/0011000019890317
L Alison Phillips, Lisa M McAndrew

Medically unexplained symptoms (MUS) are common among veterans and are difficult to treat. Optimal treatment entails continued care from providers, including primary care and counseling psychologists. Non-concordance between veterans' and providers' views of MUS may contribute to poor veteran satisfaction with care and possibly disengagement with care (e.g., non-adherence to treatment recommendations, including counseling and graded exercise). The current study surveyed 243 veterans with MUS post-deployment and evaluated the degree of non-concordance perceived by veterans with their primary care providers regarding their MUS and the effect of perceived non-concordance on treatment behaviors and outcomes. Many veterans in the current sample perceived non-concordance with their provider regarding their MUS (19% reporting quite a bit or complete disagreement). Perceived non-concordance (regarding MUS overall and specific causal perceptions) predicted important outcomes of interest, particularly veterans' satisfaction with their provider. Perceived concordance with primary care doctors may be required for sufficient adherence to MUS treatment recommendations, such as seeking and maintaining psychological counseling. Research should evaluate the effect of perceived concordance with the counseling psychologist on adherence to and outcomes from counseling for MUS.

医学上无法解释的症状(MUS)在退伍军人中很常见,而且很难治疗。最佳治疗需要来自提供者的持续护理,包括初级保健和咨询心理学家。退伍军人和提供者对MUS的看法不一致可能导致退伍军人对护理的满意度不高,并可能导致对护理的不参与(例如,不遵守治疗建议,包括咨询和分级锻炼)。本研究以243名退伍军人为调查对象,评估了退伍军人与初级保健提供者对他们的MUS的感知不一致程度以及感知不一致对治疗行为和结果的影响。在当前的样本中,许多退伍军人认为他们的MUS与他们的提供者不一致(19%的人报告相当多或完全不同意)。感知的不一致性(关于MUS总体和具体的因果感知)预测了重要的结果,特别是退伍军人对其提供者的满意度。与初级保健医生的认知一致性可能需要充分遵守MUS治疗建议,例如寻求和维持心理咨询。研究应评估与咨询心理学家的感知一致性对MUS咨询依从性和结果的影响。
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引用次数: 4
Medically Unexplained Physical Symptoms: What They Are and Why Counseling Psychologists Should Care about Them. 医学上无法解释的身体症状:它们是什么,为什么心理咨询师应该关注它们。
IF 3.4 3区 心理学 Q2 Psychology Pub Date : 2019-07-01 DOI: 10.1177/0011000019888874
Lisa M McAndrew, Myrna L Friedlander, David Litke, L Alison Phillips, Justin Kimber, Drew A Helmer

Medically unexplained symptoms and syndromes (MUS) affect the health of 20%-30% of patients seen in primary care. Optimally, treatment for these patients requires an interdisciplinary team consisting of both primary care and mental health providers. By developing an expertise in MUS, counseling psychologists can improve the care of patients with MUS who are already in their practice, expand the number of patients they help, and enhance the integration of counseling psychology into the broader medical community. Additionally, counseling psychologists' expertise in culture, attunement to therapeutic processes, and our focus on prioritizing patients' perspectives and quality of life can fill the gap in research on MUS and bringing increased attention to counseling psychologists' unique contributions to health service delivery.

医学上无法解释的症状和综合征(MUS)影响着 20%-30% 的初级保健患者的健康。对这些患者的最佳治疗需要一个由初级保健和心理健康服务提供者组成的跨学科团队。通过发展 MUS 方面的专业知识,心理咨询专家可以改善对已在其执业范围内的 MUS 患者的护理,扩大他们所帮助的患者人数,并加强心理咨询与更广泛的医疗社区的融合。此外,心理咨询师在文化、对治疗过程的适应性方面的专业知识,以及我们对优先考虑患者观点和生活质量的关注,可以填补有关 MUS 研究的空白,并使人们更加关注心理咨询师在提供健康服务方面的独特贡献。
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引用次数: 0
Black Lives Matter: A Call to Action for Counseling Psychology Leaders. 黑人的生命也很重要:对咨询心理学领袖的行动呼吁。
IF 3.4 3区 心理学 Q2 Psychology Pub Date : 2017-08-01 Epub Date: 2017-09-25 DOI: 10.1177/0011000017733048
Candice Crowell, Della Mosley, Jameca Falconer, Reuben Faloughi, Anneliese Singh, Danelle Stevens-Watkins, Kevin Cokley

Police brutality and widespread systemic racism represent historical and current sources of trauma in Black communities. Both the Black Lives Matter movement and counseling psychology propose to confront these realities at multiple levels. Black Lives Matter seeks to increase awareness about systemic racism and promote resilience among Black people. Counseling psychology states values of multiculturalism, social justice, and advocacy. Executive leadership in counseling psychology may seek to promote racial justice, yet struggle with how to participate in Black Lives Matter movements and address racial discrimination within larger systems spontaneously and consistently. However, counseling psychology trainees and professionals are actively involved in the Black Lives Matter movement, leading the way forward. Through the framework of spontaneity in social movements, this manuscript highlights what counseling psychologists are currently contributing to Black Lives Matter and makes recommendations that build on the opportunity counseling psychologists have for further involvement in the movement.

警察暴行和普遍存在的系统性种族主义是黑人社区历史和当前创伤的根源。“黑人的命也是命”运动和咨询心理学都提出要在多个层面上面对这些现实。“黑人的命也是命”旨在提高人们对系统性种族主义的认识,并促进黑人的适应能力。咨询心理学强调多元文化、社会公正和倡导的价值观。咨询心理学的行政领导可能会寻求促进种族正义,但如何参与“黑人的命也重要”运动,以及如何在更大的系统内自发地、持续地解决种族歧视问题,这些都是他们的奋斗目标。然而,咨询心理学学员和专业人士积极参与“黑人的命也是命”运动,引领着前进的道路。通过社会运动的自发性框架,本手稿强调了咨询心理学家目前对“黑人的命也是命”的贡献,并根据咨询心理学家进一步参与运动的机会提出建议。
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引用次数: 66
Studying Sex: A Content Analysis of Sexuality Research in Counseling Psychology. 研究性:咨询心理学中性研究的内容分析。
IF 3.4 3区 心理学 Q2 Psychology Pub Date : 2017-05-01 Epub Date: 2017-07-10 DOI: 10.1177/0011000017713756
Candice Crowell, Della V Mosley, Danelle Stevens-Watkins

Using a sex positive framework, the authors conducted a 61-year (1954-2015) content analysis of sexuality research in the flagship counseling psychology journals, the Journal of Counseling Psychology and The Counseling Psychologist. Given counseling psychology's core strengths- and multiculturalism-related values, this study aimed to uncover which human sexuality topics were published most, whether publications aligned with a sex positive, neutral, or negative discourse, what methodologies were used, and differences in how populations were investigated across race. Researchers used an integrative approach to content analysis and human coding (Neuendorf, 2011). Results highlighted that out of 188 articles meeting criteria, a slight majority (38.05%) focused on sexual orientation, identity, and minorities topics. Only 4.78% utilized a sex-positive perspective. Quantitative and conceptual pieces were most published, and publications disproportionately focused on primarily White populations. When people of color were included, the discourse was sex negative. Implications for research and practice are discussed.

使用性积极框架,作者对咨询心理学旗舰期刊《咨询心理学杂志》和《咨询心理学家》上的性研究进行了61年(1954-2015)的内容分析。鉴于咨询心理学的核心优势和与多元文化相关的价值观,本研究旨在揭示哪些人类性主题发表得最多,出版物是否与性别积极、中性或消极的话语相一致,使用了什么方法,以及如何跨种族调查人群。研究人员使用了一种综合的方法来进行内容分析和人类编码(Neuendorf, 2011)。结果显示,在188篇符合标准的文章中,大多数(38.05%)关注的是性取向、身份和少数民族话题。只有4.78%的人从积极的角度看待性。数量和概念方面的文章发表得最多,而且出版物不成比例地主要集中在白人群体上。当有色人种被包括在内时,话语是否定性的。讨论了对研究和实践的启示。
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引用次数: 30
Acculturative Stress, Psychological Distress, and Religious Coping Among Latina Young Adult Immigrants. 拉丁裔年轻成人移民的文化适应压力、心理困扰和宗教应对。
IF 3.4 3区 心理学 Q2 Psychology Pub Date : 2017-02-01 Epub Date: 2017-03-14 DOI: 10.1177/0011000017692111
Nicole Da Silva, Frank R Dillon, Toni Rose Verdejo, Mariana Sanchez, Mario De La Rosa

Religion is a source of strength in Latina/o culture during challenging life transitions, such as the immigration process. Guided by a sociological stress-process model, this study examines relations between dimensions of religious coping, acculturative stress, and psychological distress among 530 young Latina women (ages 18-23 years) who recently immigrated to the United States (i.e., approximately 12 months prior to assessment). Higher levels of acculturative stress were associated with higher levels of psychological distress. Negative religious coping (i.e., the tendency to struggle with faith) moderated the relation between acculturative stress and psychological distress. Participants experiencing higher levels of acculturative stress reported greater psychological distress when they indicated more negative religious coping. Positive religious coping (i.e., the tendency to relate to faith with comfort and certainty) was not linked with acculturative stress or psychological distress. Implications for culturally tailored counseling interventions for this underserved and understudied population are discussed.

在具有挑战性的人生转变过程(如移民过程)中,宗教是拉美裔文化的力量源泉。在社会学压力过程模型的指导下,本研究对最近移民到美国的 530 名拉丁裔年轻女性(18-23 岁)(即评估前约 12 个月)的宗教应对、文化适应压力和心理困扰之间的关系进行了研究。文化适应压力越大,心理压力越大。消极的宗教应对(即与信仰抗争的倾向)调节了文化适应压力与心理困扰之间的关系。文化适应压力较高的受试者在表示出较多消极宗教应对时,其心理困扰程度也较高。积极的宗教应对方式(即倾向于以舒适和确定的方式与信仰建立联系)与文化适应压力或心理困扰没有关系。本文讨论了针对这一服务不足和研究不足的人群进行有文化针对性的咨询干预的意义。
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引用次数: 0
A Latent Profile Analysis Investigating Factors Impacting Latino Adolescents' Attendance in Treatment. 一项调查影响拉丁裔青少年治疗出勤率因素的潜在分析。
IF 3.4 3区 心理学 Q2 Psychology Pub Date : 2016-08-01 Epub Date: 2016-09-14 DOI: 10.1177/0011000016642843
Karina A Gattamorta, Brian E McCabe, Maite P Mena, Daniel A Santisteban

In this study, we examined data from 200 families to investigate whether family functioning and adolescent psychiatric symptomatology were associated with differential attendance in a family-based or individually focused intervention for Latino adolescents. Latent profile analysis was used to identify families, and regression models were used to examine whether profiles exhibited differential attendance. Overall, three latent profiles were observed. The first described families where parents and adolescents reported discrepancies on psychiatric symptoms and family conflict. The second profile described families with elevated adolescent psychiatric symptoms but no family conflict. The third profile described families with low family cohesion and high levels of adolescent psychiatric symptoms. For this third profile, attendance in family-based treatment was significantly higher than in individual treatment. Results indicate that a family-based intervention may be better able to address issues of poor family cohesion.

在这项研究中,我们检查了来自200个家庭的数据,以调查家庭功能和青少年精神症状学是否与以家庭为基础或以个人为重点的拉丁裔青少年干预的不同出勤率有关。使用潜在剖面分析来识别家庭,并使用回归模型来检查剖面是否表现出不同的出勤率。总的来说,观察到三个潜在特征。第一组描述了父母和青少年在精神症状和家庭冲突方面存在差异的家庭。第二份档案描述了青少年精神病症状加重但没有家庭冲突的家庭。第三个侧面描述了家庭凝聚力低和青少年精神症状高的家庭。对于第三种情况,以家庭为基础的治疗的出席率明显高于个人治疗。结果表明,以家庭为基础的干预可能能够更好地解决家庭凝聚力差的问题。
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引用次数: 0
Integrating Professional and Indigenous Therapies: An Urban American Indian Narrative Clinical Case Study. 整合专业与本土疗法:美国城市印第安人叙事临床个案研究。
IF 3.4 3区 心理学 Q2 Psychology Pub Date : 2016-07-01 Epub Date: 2016-06-29 DOI: 10.1177/0011000016638741
Dennis C Wendt, Joseph P Gone
The authors present a narrative case study of an urban American Indian male college student who integrated Indigenous and professional therapies during an acute period of stress, loss, and depression. As the first published case of an American Indian in an urban context, this article expands on previous clinical cases by focusing on the client’s perspective relative to his own conceptions of help-seeking behaviors. Based on qualitative analysis of five audio-recorded interviews, this case utilizes an innovative methodology to portray four approaches to healing (medication, counseling, bonding, and spirituality) that contribute to holistic well-being. Implications for counseling psychologists include being aware of how some American Indian clients may (a) view professional treatment dynamics through a Native cultural lens (e.g., seeing ideal communication as a “rhythm”), (b) utilize an expanded range of therapeutic agents, (c) resist medication for cultural and spiritual reasons, and (d) refrain from discussing spiritual matters with professionals.
我们提出了一个叙事案例研究,一个美国城市印第安男大学生在急性期的压力、失落和抑郁中结合了土著和专业治疗。这是美国印第安人在城市环境中首次发表的病例,本文通过关注客户相对于他自己的寻求帮助行为概念的角度,扩展了以前的临床病例。基于对五次录音访谈的定性分析,本案例采用了一种创新的方法来描述四种治疗方法(药物、咨询、联系和灵性),这些方法有助于整体健康。对咨询心理学家的启示包括了解一些美国印第安人来访者可能会:(a)通过土著文化的视角来看待专业治疗动态(例如,将理想的交流视为一种“节奏”);(b)使用范围更广的治疗剂;
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引用次数: 7
Potentially Harmful Therapy and Multicultural Counseling: Bridging Two Disciplinary Discourses. 潜在有害治疗和多元文化咨询:连接两个学科话语。
IF 3.4 3区 心理学 Q2 Psychology Pub Date : 2015-04-01 DOI: 10.1177/0011000014548280
Dennis C Wendt, Joseph P Gone, Donna K Nagata

In recent years psychologists have been increasingly concerned about potentially harmful therapy, yet this recent discourse has not addressed issues that have long been voiced by the multicultural counseling and psychotherapy movement. We aim to begin to bring these seemingly disparate discourses of harm into greater conversation with one another, in the service of placing the discipline on a firmer foothold in its considerations of potentially harmful therapy. After reviewing the two discourses and exploring reasons for their divergence, we argue that they operate according to differing assumptions pertaining to the sources, objects, and scope of harm. We then argue that these differences reveal the discipline's need to better appreciate that harm is a social construct, that psychotherapy may be inherently ethnocentric, and that strategies for collecting evidence of harm should be integrated with a social justice agenda.

近年来,心理学家越来越关注潜在的有害治疗,然而,最近的讨论并没有解决长期以来由多元文化咨询和心理治疗运动所提出的问题。我们的目标是开始将这些看似不同的伤害话语带入彼此之间的更大对话,以使该学科在考虑潜在有害治疗方面有更坚实的立足点。在回顾了这两种说法并探讨了它们分歧的原因之后,我们认为它们是根据与伤害的来源、对象和范围有关的不同假设来运作的。然后我们认为,这些差异揭示了这门学科需要更好地认识到伤害是一种社会结构,心理治疗可能本质上是种族中心主义的,收集伤害证据的策略应该与社会正义议程相结合。
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引用次数: 49
Mexican-origin Early Adolescents' Ethnic Socialization, Ethnic Identity, and Psychosocial Functioning. 墨西哥裔早期青少年的族群社会化、族群认同与社会心理功能。
IF 3.4 3区 心理学 Q2 Psychology Pub Date : 2014-02-01 DOI: 10.1177/0011000013477903
Adriana J Umaña-Taylor, Megan O'Donnell, George P Knight, Mark W Roosa, Cady Berkel, Rajni Nair

The current study examined how parental ethnic socialization informed adolescents' ethnic identity development and, in turn, youths' psychosocial functioning (i.e., mental health, social competence, academic efficacy, externalizing behaviors) among 749 Mexican-origin families. In addition, school ethnic composition was examined as a moderator of these associations. Findings indicated that mothers' and fathers' ethnic socialization were significant longitudinal predictors of adolescents' ethnic identity, although fathers' ethnic socialization interacted significantly with youths' school ethnic composition in 5th grade to influence ethnic identity in 7th grade. Furthermore, adolescents' ethnic identity was significantly associated with increased academic self-efficacy and social competence, and decreased depressive symptoms and externalizing behaviors. Findings support theoretical predictions regarding the central role parents play in Mexican-origin adolescents' normative developmental processes and adjustment and, importantly, underscore the need to consider variability that is introduced into these processes by features of the social context such as school ethnic composition.

本研究在749个墨西哥裔家庭中调查了父母种族社会化如何影响青少年的种族认同发展,进而影响青少年的心理社会功能(即心理健康、社会能力、学业效能、外化行为)。此外,学校的种族构成被视为这些协会的调节因素。研究发现,母亲和父亲的民族社会化是青少年民族认同的显著纵向预测因子,尽管父亲的民族社会化与青少年五年级的学校民族构成显著相互作用,影响青少年七年级的民族认同。此外,青少年的种族认同与学业自我效能感和社会能力的提高、抑郁症状和外化行为的减少显著相关。研究结果支持了关于父母在墨西哥裔青少年的规范性发展过程和调整中发挥核心作用的理论预测,重要的是,强调了考虑由社会背景特征(如学校种族构成)引入这些过程的可变性的必要性。
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引用次数: 76
期刊
Counseling Psychologist
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