Promoting Mental Health Equity: The Role of Integrated Care

People suffering from mental illness experience poor physical health outcomes, including an average life expectancy of 25 years less than the rest of the population. Stigma is a frequent barrier to accessing behavioral health services. Health equity refers to the opportunity for all people to experience optimal health; the social determinants of health can enable or impede health equity. Recommendations from the U.S. government and the World Health Organization support mental health promotion while recognizing barriers that preclude health equity. The United States Preventive Services Task Force recently recommended screening all adults for depression. The Satcher Health Leadership Institute at the Morehouse School of Medicine (SHLI/MSM) is committed to developing leaders who will help to reduce health disparities as the nation moves toward health equity. The SHLI/MSM Integrated Care Leadership Program (ICLP) provides clinical and administrative healthcare professionals with knowledge and training to develop culturally-sensitive integrated care practices. Integrating behavioral health and primary care improves quality of life and lowers health system costs.     

Long-Term Guilt and Hostility Underlying Posttraumatic Stress Symptoms in War Combatants and Ex-Prisoners of War

The link between posttraumatic guilt and posttraumatic stress disorder has gained recognition over the past decades and was recently expressed in the modifications made to the diagnostic criteria for the disorder under the DSM-V. Yet, the psychological dynamics underlying this relation are still not fully understood. The present study introduces a model whereby different dynamics between guilt and hostility are related to posttraumatic stress disorder symptoms (PTSS), following different traumatic war experiences. One hundred and forty-four former prisoners of war (ex-POWs) and 143 comparable combatants participated in the study, 30 years after the war, reporting on their PTSS, guilt, and hostility. Moderation analyses revealed a three-way interaction, where high hostility buffered the effect of guilt on PTSS only among ex-POWs. This finding suggests a distinctive dynamic among guilt, hostility, and PTSS following diverse traumatic events. Specifically, it appears that hostility can have a mitigating effect on the negative outcomes of guilt for ex-POWs following trauma, but not for non-POW veterans. The theoretical reasoning and the clinical implications of these findings are discussed.     

Actors in the Classroom: The Dramatic Pedagogy Model of Counselor Education

Role playing is a fundamental component in the training of counselors to use counseling skills. However, role play activities commonly involve counseling students as clients or actors and hence have notable limitations. One training method widely practiced in the medical profession is the use of professional actors as patients. Although there are some examples in the literature of studies that have used actors for counselor training, most address only a specific topic or skill set. In this article, the authors propose the dramatic pedagogy model (DPM) as a comprehensive model for implementing client actors into the education of counselors. The DPM includes a set of pedagogical techniques and a structure for preparing actors and curriculum.     

Experiences of Healing Touch and Counseling on a Bereaved Population: A Grounded Theory

Grounded theory was selected as a way to develop a theory about the potential adjunctive use of energy healing in the form of healing touch (HT) along with counseling on a bereaved population. Semi-structured interviews were conducted twice with clients and once with the counselors and HT practitioners. Results indicated that the participants agreed that both counseling and HT operated well together to provide bereavement support. The themes of trust, openness, intention, and spirituality within the holistic context seemed to make this model possible. Potential ethical concerns are discussed, as well as areas for future research and clinical applications.     

The Narrative Arc of TATs: Introduction to the JPA Special Section on Thematic Apperceptive Techniques

The past decade has seen important developments in thematic apperceptive techniques (TATs), with the creation of new card sets having alternate pictures representing different cultures, new scoring systems becoming available, and increasing international communication of these achievements. However, continuing impediments to the development of a validational literature include lingering mistaken assumptions about the nature of story data, ongoing debates about appropriate psychometric evaluation, and continuing questions about how stimuli and scoring systems should be conceptualized and interpreted. Negotiating the publication system can impede some potential authors. Excellent work on TATs with children is not well known in the adult-focused journals. The labor burden of meeting increasingly sophisticated publication standards might be a barrier to assessors focused on clinical practice. Accumulating a focused evidence base is challenging given the diversity of criterion variables for which TATs have been used. Research on TATs by clinicians can span the science–practice gap, but the narrative arc can be a dramatic one. The articles in this special section on TATs represent important conceptual, methodological, and substantive innovations.     

Adorno: Cultural Education and Resistance

In recent years, culture has become significantly politicized, or conspicuously de-politicized, in different parts of the UK, making its appearance in education policy of pivotal interest and ripe for critical attention. From the vantage point of Theodor Adorno’s work on the culture industry and his writings on the work of the teacher, I argue that cultural education is a site where something crucial and distinctive takes place. Within the Enlightenment tradition, critical self-reflection and resistance to heteronymous ways of thinking are core aims of education. Adorno’s contribution to an understanding of these aims leads us to consider the importance of ‘live contact with the warmth of things’ as essential to ethical and intellectual life. The kindly tolerance of the pluralist ideal is now being teased and goaded by acts of terror and widespread concern about personal and social security. At such an unstable juncture, an understanding of cultural education as an experience of ‘incorrigible plurality’ enriches and informs the beleaguered ideal of pluralism and points a way forward in troubled times.     

Strategy and Misdirection in Forced Choice Memory Performance Testing in Deception Detection

We examined forced choice memory performance testing in deception detection from a theoretical perspective. Evidence suggests that participants form different strategies to defeat this test. We attempted to describe these strategies within the framework of Cognitive Hierarchy Theory, a theory that distinguishes strategies based on their degree of anticipation of opponents' strategies. Additionally, we explored whether the strategy selection process is malleable. Truth tellers and liars were subjected to a forced choice memory test about a mock crime. Additionally, half of the sample was subjected to a misdirection changing the appearance of the test to that of a polygraph examination. We found detection accuracies and strategies similar to previous experiments and our misdirection manipulation elicited new strategies and behaviour. Theoretical and practical applications are discussed.Copyright © 2017 John Wiley & Sons, Ltd.     

The Differential Impact of Video-Stimulated Recall and Concurrent Questioning Methods on Beginning Readers' Verbalization About Self-Monitoring During Oral Reading

This pilot study explored two methods of eliciting beginning readers' verbalizations of their thinking when self-monitoring oral reading: video-stimulated recall and concurrent questioning. First and second graders (N = 11) were asked to explain their thinking about repetitions, attempts to self-correct, and successful self-corrects, in order to determine affordances and constraints of these two methods. Data analysis revealed the concurrent questioning method enabled students to recall their thinking and did not hinder comprehension. Video-stimulated recall method elicited fewer explanations due to a higher cognitive load from successive questioning and from an extended time interval between the oral reading and discussion.