Researcher says “cultural expression starts in early childhood”

One of the ethical standards for psychologists is to provide culturally sensitive services. Multicultural Guidelines have also been developed in the past (see below) after the ethics code was revised in 2002.

  • Guideline 1: Psychologists are encouraged to recognize that, as cultural beings, they may hold attitudes and beliefs that can detrimentally influence their perceptions of and interactions with individuals who are ethnically and racially different from themselves.
  • Guideline 2: Psychologists are encouraged to recognize the importance of multicultural sensitivity/responsiveness to, knowledge of and understanding about ethnically and racially different individuals.
  • Guideline 3: As educators, psychologists are encouraged to employ the constructs of multiculturalism and diversity in psychological education.
  • Guideline 4: Culturally sensitive psychological researchers are encouraged to recognize the importance of conducting culture-centered and ethical psychological research among persons from ethnic, linguistic, and racial minority backgrounds.
  • Guideline 5: Psychologists are encouraged to apply culturally appropriate skills in clinical and other applied psychological practices.
  • Guideline 6: Psychologists are encouraged to use organizational change processes to support culturally informed organizational (policy) development and practice.

diversityGiven the growing diversity of the population, it’s more important than ever before to be “culturally competent.” Culturally competency has been defined as a system that acknowledges the importance of and incorporates culture, assessment of cross-cultural relations, vigilance toward the dynamics that result from cultural difference, expansion of cultural knowledge, and adaptation of interventions to meet the culturally unique needs at all levels of service (Whaley & Davis, 2007). During a session (chaired by Shamin Ladhani, PsyD) titled Culturally Sensitivity in Health: Health Psychology’s Role, Health Beliefs, and Assessment (held on Saturday morning), the presenters discussed key components of being culturally sensitive in a health care setting and outlined practical approaches to meeting the needs of a diverse population.

Tips to be more culturally sensitive may include:

  • Understanding communication methods
  •  Recognizing and responding to language barriers
  •  Clarifying cultural identification
  • Identifying religious and spiritual beliefs
  • Managing your own biases and prejudice
  • Being aware of your body language and privilege

diversity2All of these aspects of cultural sensitivity are important. The panel also highlighted that we need to be careful about not recognizing variation and diversity within ethnic groups. For example, Gurung noted that Latino might include individuals who are Mexican-American, Puerto Rican, Cuban or Dominican. Each of these groups has its own traditions, beliefs and rituals that may affect how you work with members to address their needs. According to Regan Gurung, PhD, “cultural expression is a developmental process that starts in early childhood.” Given the developmental nature of cultural expression, you can imagine that for anyone different from someone else could have a different world view on causes and coping for a particular concern.

Sessions to See: Making the Most of the Last Day

at APA 2014

at APA 2014

Convention is winding down and many people are preparing for the last day of sessions before heading home. After a busy three days of activities, most people are ready to skip out on sessions to sleep in or go to the airport to beat the afternoon madness.

However, the convention still offers lots of exciting and interesting sessions. Plus, it’s a great time to visit the bookstore to make your purchases. As the convention comes to a close, below are some sessions that may be interesting to see if you’re still wondering, “What session should I go to?”

8AM

Therapist Self-Care – A Lifespan Perspective: Evidence-based Expressive Writing as a Tool

CC Room 145A (1 hour, 50 minutes)

The session will cover empirical studies of expressive writing, an experiential portion involving expressive writing, and discussion.

How Do Psychologists with Privilege Respond to the Stigmatized Others?

CC 209A (50 minutes)

The session will focus on individual, cultural and contextual barriers and assets, as well as training implications for working with culturally stigmatized others.

9AM

Integrating Individual, Family and Systems- Focused Interventions: A Video Illustration

CC 101 (50 minutes)

The session will illustrate the interdependent nature of individual-, family- and systems-based interventions in a program focusing on family-based treatment of adolescent substance abuse and delinquency.

Taking a Stand? Sport Psychology, Media and GLBT Athletes in Sochi

CC 158 (1 hour, 50 minutes)

The session will focus on the experiences of GLBT athletes competing in the 2014 Olympic Games in Sochi.

Autism Spectrum Disorder and the Criminal Justice System

CC 209A (50 minutes)

The session will present on overview of ASD by a psychologist and a parent of a child with autism who is also a former judge.

10AM

Children’s Resilience in the Context of Military Deployment and Their Aftermath

CC 204C (1 hour, 50 minutes)

The session will discuss how scientific knowledge about resilience can provide the evidence base for programs to support and enhance the resilience of military-connected families.

11AM

Influence of Culture and Context on Family: School Partnerships

CC 209A (1 hour, 50 minutes)

The session will explore various influences of culture and context on the development and implementation of family-school partnerships.

12PM

Global Violence Toward Women: Interventions and Strategies for Change

CC 152A (1 hour, 50 minutes)

The session will explore global violence toward women through an examination of sexual assault and rape in Africa, domestic violence and international sex trafficking, emphasizing treatment methods and interventions.

1PM

Interprofessional Training: Preparing Psychology Students for the Changing Health Care Market

CC 154B (50 minutes)

The session will showcase an interprofessional training program for psychology graduate students and interns to address changes in health care.

Healthy Food Choices and Safety: Can You Have It All?

That was the question that stuck with me most after leaving the paper session “Influences on Healthy Eating Decisions.”

163118519According to the research led by Anthony G. Salerno, PhD, feeling safe may encourage people to eat larger amounts of unhealthy foods, outside of their awareness. “Feelings of safety increase people’s perception that they are protected from danger, which consequently decreases their sensitivity to harmful behaviors,” he said. Unhealthy eating is one of them, and can lead to harmful consequences. When people feel safe, they are less sensitive to these harmful consequences and are more likely to consume unhealthy foods, which can lead to weight gain and obesity.

This implies that our environment can play a crucial role in our determination of adhering to a healthy eating pattern. However, does that mean that you should move to an unsafe neighborhood to shed the pounds more easily? I’d say not so fast.

I caught up with Dr. Salerno this week, and here is what he had to say:

“While it obviously would not be a good idea for people to start seeking out harmful environments, I do think people may benefit from being mindful of the fact that just because they are in a safe environment, it does not mean that this protects them from their own unsafe behaviors. In general, it is of great importance to a person’s psychological well-being that they feel safe. However, people should also be mindful of the fact that feeling safe can sometimes increase our willingness to engage in behaviors with potentially harmful consequences (in this case the consumption of unhealthy food). So by simply being aware of the influence of safety on our behavior, we are more likely to undermine the undesirable consequences it has on us.”

122401671Stress is also linked to overeating, weight gain and obesity. The evidence that feeling safe may be a contributing factor when it comes to food choices and weight makes me wonder, where is the balance between the two when it comes to eating healthy? Constant stress can lead to suboptimal food choices, but so can the feeling of safety, according to Salerno. So does a golden mean between how we feel on a regular basis regarding our safety, and how much (as well as how healthy) we eat even exist?

While this may be more of a philosophical question, I think that it might be the intensity of the feelings that prompts the consumption of unhealthy foods. In other words, feeling very secure and at ease, as well as feeling very stressed, could be leading to overeating and weight gain. It is also important to recognize other behaviors and feelings that accompany feeling safe or stressed, which can also be contributors to unhealthy eating.

After all, eating is much more than merely satisfying hunger. We eat in response to a variety of emotions, both positive and negative. It is thus essential to recognize our feelings that trigger eating and overeating. Once eating triggers are identified, further steps can be taken to break the emotional eating habit and adopt a healthier eating pattern, which in turn can help reduce overweight and obesity.

Have more thoughts on this topic? Reply below. Dr. Salerno is also happy to answer questions via email. You can reach him at Anthony.salerno@uc.edu

Nicole Avena, PhD studies appetite and addiction at the NY Obesity Research Center, at Columbia University. You can learn more about her work at DrNicoleAvena.com. She can also be found on Twitter and Facebook, or on her Psychology Today blog.

How Can Psychologists Help Men and Boys?

463536557Five people were wounded overnight in shootings on Chicago’s West and South sides, according to a report in this morning’s Chicago Tribune. It’s a headline that appears almost daily in my city, and the victims, all men age 16 to 32, are among the most disadvantaged in the city – and frankly, in the country. Perhaps more importantly, this violence, and the stress and trauma that it leads to, is taking a serious toll on the health of men and boys in poor, urban communities throughout our nation, according to presenters at a symposium today.

At the session, members of APA’s working group on health disparities in boys and men discussed reasons why this population and other underserved groups of men have some of the worst health outcomes in the country.

Working group chair Wizdom Hammond, PhD, of the University of North Carolina at Chapel Hill pointed to several psychosocial factors that contribute to these health disparities, including a need among men to endorse and demonstrate traditional traits of masculinity, including toughness, self-reliance, confidence and aggression.

“It’s likely that the strains and conflicts associated with trying to live up to this masculine ideal is at least partly responsible for producing the kinds of health disadvantages we’re seeing,” Hammond said.

The researchers explained that, compared to women, males are more likely to take health behavioral risks, delay preventive health screenings and care-seeking for health problems, minimize their physical and mental health symptoms and signs of distress and have higher rates of substance abuse. These behaviors are even more widespread among men of low socioeconomic status, those who are ethnic and racial minorities, those who are gay or bisexual, and those who have been incarcerated.

Particularly when it comes to mental health, men and boys are socialized very early not to talk about their emotions around traumatic experiences, said presenter Waldo Johnson, PhD, of the University of Chicago.

“Therefore, they tend to suffer in silence,” he said.

The group is now finalizing an evidence-based report and a series of best practices and recommendations on the topic, for dissemination to psychologists and other health providers. One thing is clear, Johnson said:

“Any prevention or treatment program for this population must account for the unique circumstances of men and boys.”

Chimps Driven to Distraction

We all know how hard it can be to hold out for a big reward rather than take a smaller reward right now. But while pigeons, rats, monkeys and chimps show the similar behavior when offered food treats, only chimps can learn to distract themselves to sustain their self-control.

In a session called “Worth Waiting For — The Evolutionary and Developmental Foundations of Self-Control,” Michael Beran, PhD, of Georgia State University, described experiments he has conducted with chimps, orangutans and rhesus and capuchin monkeys.78779344

Orangutans could learn to wait about a minute if it meant they’d get a larger food treat, Beran said. But “rhesus monkeys were terrible – they just never got good at this.” And capuchin monkeys also struggled – but they could exert some self-control under certain conditions.

Beran and his colleagues designed an experiment in which capuchin monkeys were presented with two pieces of banana on a turntable, one small that was close to the monkey and a larger one that was farther away. The monkeys could see both pieces and they were able to stick their hands out of the cage to take the food. The monkeys would initially impulsively grab the smaller, closer piece of banana but eventually they learned to wait for the turntable to spin around and present the bigger piece, Beran said — although some capuchins were better at the task than others.

89792548Chimps, on the other hand, could learn to wait almost as long as children. (Remember Walter Mischel’s marshmallow experiments in which preschoolers had to wait to get two marshmallows instead of one now?) Beran created an accumulation test where chimps would get more food treats if they could wait. The food was given to them through a delivery tube that went into their cages.

“All the chimpanzees learned quickly to wait,” he said, but some would touch or pick up the food (or the food delivery tube) but not eat, having learned that they would still get more as long as they didn’t eat anything. That led Beran to theorize that touching the food or tube might be a distraction that enabled them to wait longer. So he devised another experiment where some chimps were given toys to play with, some could not reach the food delivery tube and some were given no distractions and could reach the tube. The chimps with the toys could wait an additional 500 seconds to get the treats.

“I would make a pretty strong case that this is self-distracting,” he said.

 

 

Integrative Primary Care & Psychologists

integrative healthI attended a session Friday morning titled “Improving Outcomes for the Underserved: The Role of Integrated Primary Care.” The panel provided an overview of models of service delivery and highlighted key components to make integrative systems work effectively. I assume that this is an important topic for many psychologist and mental health professionals as the room was packed with standing room only (or floor seats for those who chose).

Why is this important to psychologists?

Health care reform and integrative primary care have been hot topics for several years. The Obama administration and Congress have played a major role in integrating mental health into primary care. The APA has also been involved in these discussions and highlighting the role of psychologists who work in primary care settings. You can visit the APA website for more information on health care reform and APA’s priorities (http://www.apa.org/health-reform/index.html).

Psychologists are experts in behavioral change. Therefore, it is imperative that they have a seat at the table when policymakers are discussing ways to improve mental and physical health. Psychologists have been working in integrated primary care settings for decades, providing behavioral health services. According to the APA, psychologists play a vital role in health promotion and disease prevention.

Roles of psychologists in integrative care include:

  • Psychologists possess the essential therapeutic skills for delivering treatment to substance abuse clients, including empathy, good listening skills and training in evidence-based methods known to curb addictive behaviors.
  • By assessing a client’s needs, abilities or behavior using a variety of methods, including psychometric tests, interviews and direct observation of behavior, psychologists help tobacco users quit smoking.
  • Psychologists have the ability to address factors associated with risky sexual behaviors and devise strategies for patients to meet their individual needs.
  • Psychologists possess the ability to devise and monitor appropriate programs of treatment, including therapy, counseling or advice, in collaboration with colleagues to assist adults and children in coping with the psychological factors associated with injury and violence.
  • Psychologists possess the skills necessary to assist patients in making behavioral changes to adopt physical activity to increase their mental well-being.
  • Psychologists can address both parent and infant anxiety before and during the immunization process and can develop materials and information on the behavioral aspect of immunization.

How is this important to meeting the needs of the underserved?

According to Dr. Dennis Freeman, under-served populations are the highest users of primary care services. “To improve cost and outcomes, we need to understand the impact of psychosocial factors,” he said. Given the shift in intgrative2health care reform to from traditional care to  community mental health centers, psychologists need to know how to be involved in these changes.

Whereas underserved populations over-use primary care and emergency room services, we know from the literature that they often under-utilize mental health services. Integrating mental and physical health care bridges a gap for psychologists to work with underserved groups. Dr. Freeman also noted “patients with mental disorders often have co-morbid medical conditions,” which may another reason why underserved seek medical care before seeking behavioral health services.

Stronger Together: How to Build Resilience to Community Violence

riskandresilience

What strengths-based solutions can psychologists develop in response to community violence? A panel of psychologists who work with widely disparate groups tackled this question for the Public Interest collaborative program — “Risk and Resilience – Overcoming Exposure to Community Violence.” What common thread united each of the panelists’ work? The importance of resilience in addressing each group’s needs.

Dr. Karen Roberto found that intimate partner violence (IPV) directed at older women was a little understood issue in the New River Valley community of rural Virginia. Many community members held inaccurate and ageist notions about older women being targets of IPV – “old people don’t do that.” Dr. Roberto joined forces with the local Women’s Resource Center and developed a three-tiered action plan with short-, medium- and long-term goals for providing direct services and educational materials to older IPV victims and training on late life IPV for volunteers at the center. This local collaborative effort strengthened the response to IPV at both individual and systemic levels.

Violence in rural communities is understudied, perhaps due to the nostalgic view of rural areas as crime free and pastoral, according to Dr. Velma McBride Murry. Her research focused on how community violence affects rural African-American parents’ psychological functioning and their parenting processes. Drawing on data from the Family and Community Health Study (involving 897 families), she found supportive community connections create a protective function for these families by enhancing parents’ abilities to parent well.

Dr. Alexandra Pierce, a member of APA’s Task Force on Trafficking of Women and Girls, echoed the consistent theme of gaps in the research. “Nothing has been published on sexual trafficking of American Indian girls.,” Her Oshkiniigikwe program had to start from scratch. This community-based program in Minnesota works with homeless American Indian females ages 12-21, many with histories of abuse, trauma or exposure to commercial sexual exploitation. The program draws on American Indian cultural teachings such as “survive and resist” and offers intensive case management along with programs on healthy sexuality and relationships and mind-body medicine. In encouraging news, at six month follow-up, 90 percent of the girls stayed in or graduated from high school, and 80 percent reported avoiding sexual exploitation.

Dr. Muninder Ahluwahlia focused on the resilience that the Sikh community has had to develop post-9/11. Sikhs have become targets of record high discrimination, racial profiling and hate crimes from Americans directing their vitriol at anyone they perceive as Muslim — wrongly in this case. In response, the Sikh community draws resilience from religious and cultural resources such as gurdwaras (i.e., places of worship and community gatherings), youth camps, and online communities that strengthen geographically scattered groups.

Dr. Ann Masten, as discussant, closed the session by applauding how each case presented reflected resilience at work, or, as she phrased it the ability of dynamic systems to adapt successfully to disturbances that threaten their function, viability and development.”