An Acceptance-Based Behavioral Therapy for Individuals With Generalized Anxiety Disorder

In response to clinical observations and research findings that individuals with generalized anxiety disorder are reactive to their internal experiences, avoid and suppress painful emotions, thoughts, and sensations, and limit their involvement in meaningful activities, an Acceptance Based Behavioral Therapy (ABBT) was developed to specifically target these responses. ABBT incorporates acceptance and mindfulness strategies with more traditional behavior therapy techniques. Specifically, ABBT uses mindfulness and acceptance approaches as an alternate response to the rigid, avoidant responses characteristic of GAD. Likewise, therapy focuses on identifying and enacting behaviors that are congruent with what is personally meaningful to the client rather than engaging in actions that are motivated by avoidance of anxiety. This article provides a case conceptualization from an ABBT perspective for “William,” the composite client presented in Robichaud (2013a--this issue). The article goes on to demonstrate how an ABBT approach to treatment may unfold session-by-session for “William.”     

Changes in proposed mechanisms of action during an acceptance-based behavior therapy for generalized anxiety disorder

Based on the theory that generalized anxiety disorder (GAD) is maintained through a reactive and fused relationship with one's internal experiences and a tendency towards experiential avoidance and behavioral restriction, an acceptance-based behavior therapy (ABBT) was developed to specifically target these elements. Since ABBT has been shown to be an efficacious treatment in previous studies, the current study focuses on proposed mechanisms of change over the course of therapy. Specifically, the current study focuses on session-by-session changes in two proposed mechanisms of change: acceptance of internal experiences and engagement in meaningful activities. Overall, clients receiving ABBT reported an increase in the amount of time spent accepting internal experiences and engaging in valued activities. Change in both acceptance and engagement in meaningful activities was related to responder status at post-treatment and change in these two proposed mechanisms predicted outcome above and beyond change in worry. In addition, change in acceptance was related to reported quality of life at post-treatment.     

A Mixed Methodological Analysis of the Role of Culture in the Clinical Decision‐Making Process

Even though literature indicates that particular cultural groups receive more severe diagnoses at disproportionate rates, there has been minimal research that addresses how culture interfaces specifically with clinical decision making. This mixed methodological study of 41 counselors indicated that cultural characteristics of both counselors and clients—including the degree of match between these characteristics—affect attention to cultural issues in clinical decision making. In addition, there was a significant relationship between participant cultural bias and perceived level of client functioning.     

Applying a Process-Oriented Model of Cultural Competence to Behavioral Activation for Depression

Efforts to integrate cultural competence and evidence-based treatments (EBTs) typically take the form of cultural adaptations of EBTs, characterized by modifications to the existing treatment based on presumed cultural notions of a given race or ethnic group. Much less attention has been given to ways EBTs can integrate a process model of cultural competence, which focuses on what clinicians do in-session to identify and integrate key cultural factors for a given individual in the treatment. Our objective is to consider how a process model of cultural competence (Shifting Cultural Lenses) can be integrated with an EBT (Behavioral Activation). We present a theoretical rationale for integrating the SCL model with BA and illustrate this integration, which provides an additional approach to bringing culture to treatments and shows promise for identifying clinicians’ in-session behaviors that reflect cultural competence.     

LISTENING AND SPEAKING PSYCHOANALYTICALLY ‐ WITHWHAT IN MIND?*

In this paper, the proposition is developed that multi‐model thinking with respect both to theories of mind and to theories of technique has always been implicitly present in psychoanalytic practice as a response to the demands of the clinical moment. But this has gone unnoticed and untheorised, in part because it is hidden in general considerations regarding tact, timing and (less discussed) variations in voice tone and also because our psychoanalytic practices, without our awareness but as adaptations to the clinical moment, do not always match our theories. The author offers reasons from the broad culture of psychoanalysis why this is so. He also offers a conceptualisation and a strategy for raising the implicit and untheorised to heightened levels of awareness; he does this by highlighting the place of patient characteristics as the underpinning of theory variation and the place of a vast array of clinical possibilities as the backdrop of analytic listening. Clinical examples are used throughout.     

A systematic review of cultural adaptations in the global application of ABA-based telehealth services

With telehealth gaining acceptance as a service delivery method, behavior analysts are now providing services to individuals worldwide. This review highlights the cultural adaptations used in ABA-based telehealth treatments for individuals with ASD outside of the United States. Nine studies met our inclusion criteria and the data were synthesized narratively. All studies reported some type of cultural adaptation, with most studies reporting changes made to the service delivery method. This included using translated materials; training in the language of the client; and matching the trainer in birthplace, ethnicity, or gender with the participants. The adaptations described in published research can serve as a resource for behavior analysts who have interest in global telehealth services. However, given the emerging nature of this area of research, it is challenging to know which adaptations are necessary to achieve optimal outcomes. The review concludes with ideas for research development in this area.     

Training of interventionists and cultural adaptation procedures: A systematic review of culturally adapted evidence-based parenting programs in Africa

There has been an increase in the implementation of evidence-based parenting programs from high-income countries to several African countries. In this review, we systematically evaluated intervention studies of culturally adapted parenting programs in nine African countries with the objective of examining the quality of training for interventionists and cultural adaptation procedures. A total of 18 studies, obtained from an electronic search of 6 databases, met the inclusion criteria and were evaluated following PRISMA guidelines. The Ecological Validity Model was adopted to organize data on cultural adaptation procedures. Sixteen of the 18 studies reported information regarding the clinical training of interventionists and the cultural adaptations undertaken. Live and interactive workshops were the most common format used to train interventionists in the focal intervention. Overall, cultural adaptations in most studies included translation of intervention protocols into the local language. However, studies varied in the way cultural adaptation procedures were reported with some studies failing to report on cultural adaptation procedures. Concurring with previous literature, attending to issues of culture, power, privilege, access, sustainability, and other relevant concepts to increase the cultural relevance is highly encouraged in parent intervention studies in Africa. This review provides a baseline upon which future training and adaptation procedures can be built.     

CULTURAL ADAPTATIONS AND DIFFUSION FOR MANAGERIAL STRATEGIES AND RESPONSES IN HONG KONG

This paper addresses the issue of cultural adaptations and diffusion for managerial strategies in host societies to which work enterprises are not indigenous in terms of their capital and management or either. With illustrations drawn from a series of case-studies of work organisations in Hong Kong managed respectively by Chinese, British and Japanese capital, there was an appearance of support for the thesis of ‘cultural’ determinism and its implications for strategical adaptations in work organisations. The implication was drawn that the Oriental nexus of altruism, trust and subtlety could be rooted in the more laudible and perhaps global influence of Confucianism. Some subsequent issues are raised. First, the problem of cultural adaptation is not specific to multinationals or foreign firms visiting from outside but also applies where the management and their ethic background are not indigenous. The other issue is the extent of cultural adaptation within work organisations, as determined by the degree of affinity with a common mother culture. The paper suggests that a common denominating mother culture can serve a strategical starting point to bring about intra-organisational and organisation-society link and harmony.     

Traits and Adaptations: A Theoretical Examination and New Empirical Evidence

We investigated the distinction between traits (also labelled basic tendencies or dispositions) and (characteristic) adaptations, two related features of the personality system postulated to influence how personality manifests throughout the lifespan. Traits are alleged to be universal, causal, and enduring entities that exist across cultures and through evolutionary time, whereas learned adaptations are acquired through sustained interaction with cultural, physical, and social environments. Although this distinction is central to several personality theories, they provide few measurable criteria to distinguish between traits and adaptations. Moreover, little research has endeavoured to operationalize it, let alone test it empirically. Drawing on insights from four frameworks—the Five-Factor Theory, Cybernetic Big Five Theory, Disposition–Adaptation–Environment Model, and New Big Five—we attempted to investigate the distinction both theoretically and empirically. Using various experimental rating conditions, we first scored 240 questionnaire items in their degrees of definitionally reflecting traits and/or adaptations. Next, we correlated these definitional ratings with the items' estimates of rank-order stability, consensual validity, and heritability—criteria often associated with personality traits. We found some evidence that items rated as more trait-like and less adaptation-like correspond to higher cross-rater agreement and stability but not heritability. These associations survived controlling for items' retest reliability, social desirability, and variance. The theoretical and empirical implications of these findings are discussed. © 2020 European Association of Personality Psychology     

Sociocultural studies of families of children with intellectual disabilities

This article reviews recent sociocultural studies of families of children with intellectual disabilities to introduce the range of research conducted from this perspective and to highlight the methodological, conceptual, and theoretical contributions of this approach to the study of mental retardation. Sociocultural studies examine families within their cultural, historical, and sociopolitical contexts. This type of research is comparative across different cultural groups, but is not limited to such comparisons. Sociocultural studies use varied theories and methods, but they share a focus on families' coproduction of meanings and practices related to intellectual disability; families' responses and adaptations to disability; and how their understandings and experiences are shaped within larger social institutions and inequities. Sociocultural approaches take into account community contexts that matter to families with members with mental retardation or developmental delay, and they examine the broader systems that define and position individuals with disabilities and their families. As a whole, these studies provide a more experiential and holistic view of families' beliefs and adaptations within sociopolitical worlds, and offer new tools by which to study the families of children with developmental delays within and across different cultural groups.     

Adaptive Flexibility,Cooperation, and Prosocial Motivations: The Emotional Foundations of Becoming Human

ABSTRACT

Humans are highly motivated to cooperate, share, and help others. The evidence for this claim comes from examining prosocial behaviors as they show up very early in development, and by systematic comparisons between young children and mankind’s closest great ape relatives. Highly cooperative and social species that care for kin and nonkin members of their group are rare in nature and call for an evolutionary explanation. Based on the work of Michael Tomasello and others, I offer a possible explanation based on a two-phase model. The first phase of the evolution of cooperation and sociability is induced by climate change taking place during a critical period of human evolution. Climate variability produced shifts from wet, monsoon landscapes to dry and arid landscapes in East Africa, the home of many of humanity’s ancestors. Shifting environmental conditions produced selective pressures favoring adaptive flexibility and forced cooperation and interdependence among our hominin ancestors, who had to search for food (cooperative foraging) and protect each other from predators. Forced interdependence came together with two biosocial adaptations: a cooperative form of raising young children (cooperative breeding) and long-term mating patterns (pair bonding). These biosocial adaptations help explain how the species might have begun to develop emotionally modern intersubjective mind-reading capacities. During a second phase of the evolution of cooperation, the emergence of shared social norms, social reputations, the cumulative effects of cultural knowledge passed on over many generations, and cultural differences produced a new form of evolution: cultural evolution. In turn, cultural evolution produced a new cycle of innovations consisting of symbolic capacities and language. When it comes to psychotherapy, the same conditions that made one human—adaptive flexibility, cooperation, helping others and mutual enjoyment in sharing—are the same conditions that make for a strong therapeutic alliance.     

Followup of psychoanalysis five to ten years after termination: III. The relation between the resolution of the transference and the patient-analyst match

As part of a long-term followup study of the outcome of psychoanalysis, we examined the relation between the extent of resolution of the transference at termination and the characteristics of the patient-analyst match. For twelve of the seventeen patients interviewed five to ten years after termination of psychoanalysis, the researchers found that the patient-analyst match played a role in the outcome of the analysis. Illustrations of the influence of the match in cases where the transference was resolved and those where it was not are presented.     

A Multi-Cultural Study of Salespeople's Behavior In Individual Pay-For-Performance Compensation Systems: When Managers Are More Equal And Less Fair Than Others

In this research, we examine salespeople's behavior in individual pay-for-performance compensation systems and show how perceived management fairness seems to energize sales employees in some environments but not in others. We use a large multicountry database of individual-level remuneration for more than 2,500 salespeople across four B2B industry sectors to demonstrate cultural adaptations of the effect of perceived management fairness. The results indicate that top management should be concerned with employees' perceptions of fairness in addition to the more typical concerns of control and motivation widely acknowledged in the microeconomics-based sales-force compensation literature. In particular, we show that perceptions of management fairness are key to salespeople's proportion of total pay generated by pay-for-performance formulas.     

Stability of the factor structure of Barrat's Impulsivity Scales for children across cultures: a comparison of Spain and Colombia

Despite the great importance of impulsivity in many childhood and adolescence disorders, there are few self-reports on child impulsivity. Recently, a modified version of Barratt's BIS-11 questionnaire adapted for children has been developed, which may be useful in assessing this personality dimension. The present study reports an adaptation of this questionnaire in a different culture (Colombia) and assesses the degree of convergence between the factor structures of both adaptations using consensus oblimin rotation. The results indicate not only that the factor structure of the test remains stable across both adaptations, and that two of the three scales in the Colombian version show acceptable reliabilities, but also that cultural and linguistic issues are important in test adaptation even when the same language is used.     

Parental Perceptions of Child Development Among Low-Income Mexican American Families

Parents' perceptions of child development are influenced by complex interactions among cultural, social, and economic factors. Insights into how parents from culturally diverse societies perceive the development of their children might explain why different cultural groups foster or value the development of different skills in their children. In this study, we explored the perceptions of child development among low income Mexican American parents. A series of ethnographic interviews were conducted with eight Mexican American families who had preschool children. Qualitative data analyses yielded three main themes that were important to these parents: family attitudes and values, changes, and adaptations. For these parents, the development of social attributes in children, that will enable them to function within their own cultural group, was as important as the development of cognitive or motor skills. Service providers, such as school and mental health personnel, should take into account cultural differences in parents' perceptions of the importance of various developmental milestones for their children when suggesting interventions typically used by parents in the dominant culture.     

Diversity and Community Can Coexist

We examine the (in)compatibility of diversity and sense of community by means of agent‐based models based on the well‐known Schelling model of residential segregation and Axelrod model of cultural dissemination. We find that diversity and highly clustered social networks, on the assumptions of social tie formation based on spatial proximity and homophily, are incompatible when agent features are immutable, and this holds even for multiple independent features. We include both mutable and immutable features into a model that integrates Schelling and Axelrod models, and we find that even for multiple independent features, diversity and highly clustered social networks can be incompatible on the assumptions of social tie formation based on spatial proximity and homophily. However, this incompatibility breaks down when cultural diversity can be sufficiently large, at which point diversity and clustering need not be negatively correlated. This implies that segregation based on immutable characteristics such as race can possibly be overcome by sufficient similarity on mutable characteristics based on culture, which are subject to a process of social influence, provided a sufficiently large “scope of cultural possibilities” exists.