Professional Psychology-Research and Practice最新文献

Individuals who identify as transgender or gender diverse (TGD) are presenting at mental health clinicians' offices with increasing frequency. Many TGD clients are seeking care related to affirming their gender identity but also may present with anxiety, depression, trauma, substance abuse, or other problems for which a clinician may commonly provide services. Some clinicians may hesitate to accept TGD clients into their practice if they have little specialized training to work with this population in an affirming manner, especially in more underserved areas where a generalist practice is the norm. Numerous professional associations and experts have developed guidelines for affirmative behavioral health care for TGD people. However, what is needed are community informed recommendations to bridge from the official guidelines to clinicians' in-session activities. The Trans Collaborations Practice Adaptations for Psychological Interventions for Transgender and Gender Diverse Adults are derived from iterative interviews with TGD community members and affirming mental health clinicians in the Central United States. The 12 practice adaptations are intended to guide clinicians to adapt their usual treatment approach to be TGD affirming, especially in underserved and rural areas. The practice adaptations cover numerous aspects of practice including the office setting and paperwork, understanding gender identity and incorporating it into the case conceptualization, therapist's self-awareness, and referrals. The Trans Collaborations Practice Adaptations will help clinicians work confidently and competently with adult TGD clients, regardless of the presenting problem, to ensure TGD communities receive the best interventions for their behavioral health concerns.

We conducted a systematic review to characterize features and evaluate outcomes of cultural competence trainings delivered to mental health providers. We reviewed 37 training curricula described in 40 articles published between 1984-2019 and extracted information about curricular content (e.g., cultural identities), as well as training features (e.g., duration), methods (e.g., instructional strategies), and outcomes (i.e., attitudes, knowledge, skills). Training participants included graduate students and practicing professionals from a range of disciplines. Few studies (7.1%) employed a randomized-controlled trial design, instead favoring single-group (61.9%) or quasi-experimental (31.0%) designs. Many curricula focused on race/ethnicity (64.9%), followed by sexual orientation (45.9%) and general multicultural identity (43.2%). Few curricula included other cultural categorizations such as religion (16.2%), immigration status (13.5%), or socioeconomic status (13.5%). Most curricula included topics of sociocultural information (89.2%) and identity (78.4%), but fewer included topics such as discrimination and prejudice (54.1%). Lectures (89.2%) and discussions (86.5%) were common instructional strategies, whereas opportunities for application of material were less common (e.g., clinical experience: 16.2%; modeling: 13.5%). Cultural attitudes were the most frequently assessed training outcome (89.2%), followed by knowledge (81.1%) and skills (67.6%). To advance the science and practice of cultural competence trainings, we recommend that future studies include control groups, pre- and post-training assessment, and multiple methods for measuring multiple training outcomes. We also recommend consideration of cultural categories that are less frequently represented, how curricula might develop culturally competent providers beyond any single cultural category, and how best to leverage active learning strategies to maximize the impact of trainings.

This article explores the potential of using systems methods for better conceptualizing the unexpected and complex sets of hurdles and opportunities that practicing psychologists frequently encounter. Examples are provided involving two distinct types of important clinical issues: 1) understanding how individuals maintain recovery from substance use disorders following treatment and 2) better understanding patients with chronic, unexplained post-viral illnesses. Traditional research methods used to explore these types of intricate social and medical issues have often lacked sophisticated dynamic systems-based perspectives, which could provide new insights into understanding how patient treatment gains can be maintained and how unexplained post-viral illnesses can be better understood. Our examples will demonstrate that systems-oriented approaches have the potential to provide psychologists unique opportunities to capture a fuller and richer depiction of a variety of clinical and community topics and thus provide new lenses that ultimately could provide better care for our patients.