Journal of Counseling Psychology最新文献

Mental health researchers have focused on promoting culturally sensitive clinical care (Herman et al., 2007; Whaley & Davis, 2007), emphasizing the need to understand how biases may impact client well-being. Clients report that their therapists commit racial microaggressions-subtle, sometimes unintentional, racial slights-during treatment (Owen et al., 2014). Yet, existing studies often rely on retrospective evaluations of clients and cannot establish the causal impact of varying ambiguity of microaggressions on clients. This study uses an experimental analogue design to examine offensiveness, emotional reactions, and evaluations of the interaction across three distinct levels of microaggression statements: subtle, moderate, and overt. We recruited 158 adult African American participants and randomly assigned them to watch a brief counseling vignette. We found significant differences between the control and three microaggression statements on all outcome variables. We did not find significant differences between the microaggression conditions. This study, in conjunction with previous correlational research, highlights the detrimental impact of microaggressions within psychotherapy, regardless of racially explicit content. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Refugees and asylum seekers who identify as sexual minorities and/or who have been persecuted for same-sex acts maneuver through multiple oppressive systems at all stages of migration. Sexual minority refugees and asylum seekers (SM RAS) report experiencing a greater number of persecutory experiences and worse mental health symptoms than refugees and asylum seekers persecuted for reasons other than their sexual orientation (non-SM RAS). SM RAS are growing in numbers, report a need and desire for mental health treatment, and are often referred to therapy during the asylum process. However, little research has been conducted on the treatment needs of SM RAS in therapy or the strategies therapists use to address these needs. This study sought to identify these factors through qualitative interviews with providers at a specialty refugee mental health clinic (N = 11), who had experience treating both SM RAS and non-SM RAS. Interviews were transcribed and coded for themes of similarities and differences between SM RAS and non-SM RAS observed during treatment and factors that could be leveraged to reduce mental health disparities between SM RAS and non-SM RAS. Clinicians reported that compared to the non-SM RAS, SM RAS reported greater childhood trauma exposure, increased isolation, decreased support, identity-related shame, difficulty trusting others, and continued discrimination due to their SM identitiy. Suggested adaptations included reducing isolation, preparing for ongoing identity-based challenges, creating safe spaces to express SM identity, and a slower treatment pace. Providers reported benefits and drawbacks to centering the client's SM identity in treatment and encouraging community involvement for SM RAS, and noted additional training in cultural awareness would be beneficial. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Rumination is an established transdiagnostic factor in mental illness, but there remains a significant gap in understanding the subjective experiences of those affected by it. This study explored the lived experiences of depressive rumination in early adulthood, a population notably susceptible to its effects. We interviewed 20 participants aged between 18 and 35 years using a semistructured approach and generated five distinct but interconnected themes using reflective thematic analysis. The first theme delved into recurrent narratives of past traumas and unresolved pain, with participants unable to move on from their past. The second theme illustrated how participants, due to real or perceived pressure, often equated their self-worth with their ability to meet expectations, leading to a distorted self-view and diminished self-esteem. The third theme captured the relentless pursuit of mental peace, with tranquility remaining ever elusive despite the frequent use of distraction. The fourth theme highlighted the profound isolation stemming from internalized mental health stigma, with participants grappling with fears of being perceived as burdensome and facing rejection from their close ones. Finally, the fifth theme underscored the far-reaching and interconnected repercussions of rumination on mental, emotional, and physical health and individuals' ability to achieve their life goals. These findings emphasize the intertwined nature of psychological, physiological, and social risk factors for the development and maintenance of rumination, advocating for a holistic treatment approach to rumination and paving the way for more timely, tailored care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Health service psychology (HSP) programs, encompassing clinical, counseling, and school psychology, play a pivotal role in shaping the U.S. health care workforce. Practicum and internship sites are critical gatekeepers within this training. However, there is limited empirical evidence available regarding the prevalence of clinical dismissal and its consequences for affected trainees. To bridge these gaps in our understanding of clinical dismissal during HSP training, Study 1 conducted an analysis of a quantitative survey involving training directors (N = 123) from HSP academic programs. The results revealed that 28% of programs reported at least one trainee having been dismissed from a practicum or internship site within the past seven years, with an overrepresentation of racial minority and international trainees. In addition, PsyD programs (56%) exhibited a significantly higher likelihood of having dismissed trainees compared to PhD programs (23%) over the same period. In Study 2, qualitative interview data were collected from ten trainees who had experienced dismissal during their HSP training. Using the Consensual Qualitative Research method, we identified six distinct domains, each comprising unique categories and subcategories: Antecedents to dismissal, reasons for dismissal, process of dismissal, chain reactions, trainee impact, and recommendations. Taken together, this mixed-method study highlights that clinical dismissal is not an uncommon occurrence in HSP training and raises significant concerns about the current implementation process. We illuminate structural issues and offer recommendations to improve the process of clinical dismissal within the HSP field. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The aims of this practice-based evidence study were to (a) examine clients' trajectories of psychological and spiritual distress over the course of spiritually integrated psychotherapies (SIPs) and (b) explore the role of varying types of spiritual interventions in these outcomes. In total, 164 practitioners of SIPs from 37 settings in a practice-research network administered the Clinically Adaptive Multidimensional Outcome Survey (Sanders et al., 2018) at each session with 1,227 clients and reported their use of theoretical orientations and spiritual interventions on an after-session summary checklist. Focusing on sessions over an initial 12-week period, latent growth curve modeling analyses revealed that clients, on average, experienced significant reduction of psychological distress during their engagement in SIPs with improvements occurring most sharply in the first month. Further, other findings revealed a salient reciprocal interplay with spiritual distress throughout treatment, such that clients who were struggling with their religious faith and/or spirituality were more psychologically distressed and displayed a more attenuated and gradual pattern of symptom reduction. In such cases, clinicians frequently utilized spiritual interventions involving basic skills (e.g., spiritual assessment), virtues (e.g., discuss self-control), and religious attachment (e.g., encourage acceptance of divine love) that were uniquely associated with clients' rate and duration of decline in psychological and spiritual distress. The present findings affirm the routine effectiveness of SIPs along with highlighting the potential value of certain spiritual interventions in supporting holistic recovery among clients who want clinicians to be culturally responsive to their spiritual and/or religious identities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

We sampled routinely collected measures of role and outcome expectations, the expanded therapeutic alliance, and relationship satisfaction completed by 253 heterosexual couples seen by 35 therapists in the Marriage and Family Research Practice Network (Johnson et al., 2017) and investigated these variables as interdependent dyadic processes using the latent congruence model (Cheung, 2009) and the mediated actor-partner interdependence model (Ledermann et al., 2011). Taken together, we found a direct association between a couple's mean role and outcome expectation scores at Session 1 and individual partners' alliance perceptions at Session 3. Further, men rated the alliance more favorably when their outcome expectations were higher and the partners' outcome expectations were less discrepant. In terms of role expectations, both men and women began therapy expecting to be more actively engaged in the process than their partner. Whereas women rated the alliance more favorably when they had high role expectations for their partner as well as themselves, men rated the alliance more favorably when they had high expectations for their female partner's engagement in the therapy. Notably, alliance at Session 3 did not mediate the association between initial expectations and Session 4 relationship satisfaction due to a strong association (r = 0.85) between relationship satisfaction rated prior to Sessions 1 and 4. In other words, although the best predictor of relationship status before the fourth session was how the relationship was perceived before couple therapy began, men's and women's initial role and outcome expectations were important contributors to the early alliance. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Cultural humility is important in supervision; however, studies have primarily sampled White supervisees. Racially and ethnically minoritized trainees experience microaggressions during their training, yet cross-racial supervision is less often studied. We examined a moderated mediation model to test whether the supervisory working alliance mediated the relationship between frequency of racial microaggressions and satisfaction with supervision, and whether the impact of racial microaggressions on the supervisee and supervisor cultural humility moderated the relationship between racial microaggression frequency and the supervisory working alliance. In a sample of supervisees of color (N = 102; majority cisgender women, 86.2%, and heterosexual, 59.8%; 35.3% Black/African American, 28.4% Asian/Pacific Islander, 18.6% Hispanic/Latine) receiving clinical supervision from White supervisors, we found that racial microaggression frequency was negatively associated with satisfaction with supervision, and this relationship was fully accounted for by the supervisory working alliance. Racial microaggressions in supervision were found to be detrimental to the supervisory working alliance, which was then related to lower satisfaction with supervision. Further, racial microaggression impact and cultural humility moderated the relationship between racial microaggression frequency and the supervisory working alliance; this relationship was strongest when racial microaggression impact was high and cultural humility was average or high. The social bond hypothesis suggests we are more likely to allow ourselves to be vulnerable when we assess cultural humility to be high. We posit that the observed moderation effect may be due to supervisees experiencing greater shock when experiencing racial microaggressions from supervisors whom they perceived to be culturally humble. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Vocational psychologists have called for greater attention to different forms of capital, any resource or asset that confers profit and power, to better understand the vocational development process, particularly for those who lack resources and power. However, previous research has had several conceptual and measurement limitations, such as the use of less inclusive frameworks; a focus on more privileged populations; and the overuse of categorical, dummy coded, and objective measures. To address these limitations, the present study aimed to (a) develop an inclusive, subjective, continuous, and multidimensional work capital scale and (b) validate the new scale with representative samples of working adults and job seekers across two studies. We developed a 16-item four-factor Work Capital Scale that consists of Economic Work Capital, Human Work Capital, Social Work Capital, and Cultural Work Capital. Scores from the Work Capital Scale were invariant across household income, social class, gender, race, and employment status. We found that the correlational model fit best to the data and provided evidence for convergent and divergent validity by relating the subscales to subjective social class, objective socioeconomic indicators, and existing measures of capital. The present study advances theory and research in work capital and provides a tool for practitioners to use. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Trans young adults of color experience systemic harm that contributes to negative health outcomes and hinders their ability to live freely. The present study used a grounded theory qualitative methodology rooted in a critical-ideological paradigm to understand the intersections of racial and gender oppression. Trans young adults of color from across the United States (N = 15; ages 20-29; majority racial identities: Asian, Black, and multiracial; majority gender identities: nonbinary and transmasculine) participated in a semistructured interview. Analyses identified a six-category empirical framework explaining major dimensions and processes of intersectional experiences of trans people of color. The core category, Reclaiming Creativity, reflected how trans communities of color use creativity to build their identities and communities beyond intersectional oppressive societal norms and imagine a better, more liberated world. The remaining five categories were Creating and Recreating Identity, Experiencing Discrimination and Its Impacts on Wellness, Surviving Oppression and Compromising Authentic Self, Embracing Identity Strengths, and Finding Liberation. They provided insights into the role of creativity within the intersectional experiences of trans young adults of color. In doing so, they provided directions to address structural injustice, pursue liberation, and allow creativity to flourish. (PsycInfo Database Record (c) 2024 APA, all rights reserved).