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.

Terrence Roberts Speaks on Racism, Resilience

American Psychological Association Annual Conference APA Washington DC

Photo by Lloyd Wolf

In 1957, Terrence James Roberts and eight other teenagers became the first black students to attend classes at Little Rock Central High School in Little Rock, Arkansas.

“The nine of us were subjected to a year of sheer hell,” said Roberts at APA’s Committee on Ethnic and Minority Affairs’ breakfast Saturday, where he was awarded a presidential citation by APA President Nadine J. Kaslow, PhD. “Whatever you might possibly consider that one human being could do to another, that happened to us — daily.”

Through resilience and faith, Roberts eventually graduated from Los Angeles High School and went on to earn bachelor’s and master’s degrees, as well as a PhD in clinical psychology in 1976. In 1999, he and the other members of the Little Rock Nine were awarded the Congressional Gold Medal by President Bill Clinton. Roberts is now retired from the faculty of the Antioch University Los Angeles and is principal of the management consulting firm Terrence Roberts Consulting.

Although things have changed for black Americans in the United States since Roberts’ high school days – and have changed in large part due to his and others’ courage – they haven’t changed enough, he said.

“The law is now on my side, but still I am forced daily to contend daily with the ongoing violence of social and cultural exclusion, demeaning ideological belief systems, invidious institutional practices, implacable psychological barriers, ahistorical and pseudoscientific research designed to support claims of white supremacy and well-meaning others who suggest that I ‘overreact,’” he said.

Roberts challenged the audience to “do all [you] can do to change this pernicious status quo,” he said

“Instead of despair, I offer you the opportunity to learn as much as you can, develop a strategy and intervention, and move forward confidently with the assurance that whatever you do will, in concert with what others do, be sufficient to alter the course of history.”

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.”

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.

Social Justice and MOOCs

As part of the amazing diversity that APA convention offers, I had a chance yesterday to make some comparisons across topics that I might not always think about in the same day. I went to a fantastic and thought-provoking session on Martin Luther King’s 1967 speech to APA, and later I went to a talk by James Pennebaker on his experience with MOOCs [massive open online courses]. That I experienced them so close together, as well as some of Pennebaker’s points, led me to consider the social justice implications of MOOCs.

I will start with the positives, as Pennebaker’s talk was mostly positive, and I thought he made some excellent points in favor of his version of a MOOC — the SMOC, or synchronized massive open course.

University of Texas Tower and Littlefield FountainFirst, Pennebaker has always struck me as a curious, insightful and humane researcher, and his approach to his class was no exception. He professed to love teaching intro psychology (he mentioned it as being part of his contract when he came to UTexas). He applied his scientific curiosity and experimental openness to his own class, experimenting with different technologies and approaches to student learning. When approached by Stanford professors to try a MOOC, he was open to the research opportunities it presented.

Second, Pennebaker noted the benefits of collaboration with teaching, finding the back and forth interactions with his co-teacher Sam Gosling incredibly rewarding. He described both Gosling and himself clearing their fall travel schedules so that they could be present for these classes, in a way that they had not done previously. The collaboration clearly freshened up the experience of teaching intro psych for both of them.

176722241Third, Pennebaker paid particular attention to how different social classes did in his SMOC, first noting that differential academic performance by socioeconomic status is a huge problem in intro classes (what he called Big Old Classes, or BOC) and then being optimistic that his SMOC approach seems to particularly help this group of students. I think Pennebaker should be commended for this attention to “telling it like it is,” at least on the baseline of how students performed in previous iterations of intro psych. He also noted the different academic performance of lower SES students as a social scientific puzzle. These students often enter the University of Texas looking great on paper (top 5 percent of their class, etc.) but flail early on in classes. One of the big positives (although tentative) of this class was that Pennebaker noted that lower SES students actually did better in their other classes,both during and after taking this class. Pennebaker speculated that this was likely due to the daily quizzes, instilling good habits (and providing frequent feedback) among students who had likely gotten by without deeper conceptual understanding in (what Pennebaker guessed) lower quality high schools.

Now, the negatives (in terms of social justice). I think the best illustration was an interaction during the question period. There were two, in my mind related, questions. Pennebaker answered one question, “Should I do this with my 30 person class?” with, no, this is a replacement for BOCs. And another question, “Are you able to provide real writing feedback?” with “no, not really, but we weren’t able to do that in the past with 500-person lectures either.” In regard to the writing, he was hopeful that algorithmic approaches like his LIWC [linguistic inquiry and word count] program might in the future be able to offer some rudimentary feedback. So, Pennebaker seems cautious in whether this SMOC should replace courses which are not BOC, big lecture courses. But yet, a few moments later, he expressed excitement about expanding the course, and “moving into the AP market.” This is a huge problem with MOOCs, piloting on high-achieving University of Texas students (even lower SES ones) and then seeking to scale well beyond, in the hope of saving money. I am sure Pennebaker’s and Gosling’s course is a wonderful experience, but I am equally sure that all the online community building and fancy analytics won’t replace the expertise and humanity of a skilled high school Psychology teacher like Steve Jones or Maria Vita.

Related to this negative, I often find that excitement about MOOCs or flipped classrooms is often as much a testament to what they are comparing them to: often poor-quality lectures and inattention to teaching. Pennebaker himself noted how important the daily quizzes are, as well as the interaction between himself and Gosling. Each of these is not a feature of a MOOC, but a discovery of old pedagogical techniques.

In closing, I am still a MOOC skeptic, but I was impressed by some of Pennebaker’s findings, if a little disturbed by his vision of a future of higher education dominated by celebrity superprofessors. I hope that going forward, Pennebaker and his fellow MOOC teachers will recognize that these courses that they are building are not merely fun pedagogical experiments, but are being “weaponized” in a way, in a massive paradigm shift in academic labor (and K-12, too, as his AP comment notes). Pennebaker’s and Gosling’s course might be a wonderful experience, but I don’t think psychology as a whole is improved by an increased reliance on big star celebrities as we further diminish high school psychology teachers, or even teaching of psychology in smaller places like where I teach. Dr. King noted that social scientists have escaped the guilt of the physicists in designing the atomic bomb, but I worry that perhaps in 20 years, we may look back in regret at some of these bold experiments in pedagogy, not seeing the damage that they could do to the profession of teaching psychology.

The True Convention Experience

DSC02104APA convention is fun all around. It’s more than just men in suits and ties, or women in pants, dresses or fancy attire. APA convention is an experience like no other. You can go from a day of scholarly presentations to fun at social hours; and connecting with old and new colleagues.

Today was truly a rewarding experience, which solidified why I love psychology.This convention experience was full of high moments and anxiety about presenting my first solo symposium. My day started bright and early with attending the Minority Fellowship Program breakfast, which allowed me the opportunity to meet other fellows and mentors. This was followed by a busy day of seDSC02098ssions to gain valuable psychological knowledge, stopping by the APA art project in the convention hall, and then having my stomach in a knot while feeling anxious about presenting my symposium on parent-child interaction therapy (PCIT).

Convention attendee doing art.

Convention attendee doing art.

Overall, my day was busy yet rewarding. I used my own cognitive-behavioral techniques that I often use with my therapy clients to calm myself before giving my talk, which must have worked really well. I was very pleased that I was able to give my talk to a packed room waiting to hear me present on treating disruptive behaviors in children. The highlight was after my presentation getting a comment from Karen Budd, PhD (professor at DePaul University who does research on PCIT), who complimented me on doing a great job presenting and encouraged me to continue my work. Who knows, this could open doors for future collaboration. That’s what I love about APA convention. There are so many opportunities to network.

DSC02114

The celebration continued, and ended with attending social hours sponsored by the
Committee on Early Career Psychologist (CECP), as well as, the Division 42 S/ECP social hour. I am truly excited to be in this profession and look forward to continued involvement in APA. I hope your convention experience is full of fun.

APA members at ECP social

APA members at the ECP social

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.”