Succeeding in Rural Mental Health Practice: Being Sensitive to Culture by Fitting in and Collaborating

Sustainable solutions to the access to mental health care problems are complex and must address both the availability of mental health care resources and the acceptability of those resources to consumers. The purpose of this study was to determine how to address the acceptability problem by learning from medical and mental health care providers what mental health therapists need to know to be successful in providing care in rural communities. Using a qualitative design, focus groups were conducted in three rural communities (<2,500) with medical and mental health care providers practicing in these communities. Data were analyzed using inductive qualitative methods. Results indicate that in addition to sound clinical skill, mental health therapists should (A) be sensitive to the culture of the rural community in which they are working and (B) practice in a way that accommodates to the care culture of the community. The latter includes spending time with patients commensurate with what is expected by other providers, engaging in generalist practice, and collaborating with local providers in patient care. An important implication of these results is that mental health care must be acceptable to both the residents of the community and the gatekeepers to health care.     

A Narrative Analysis of Sibling Grief

Sibling grief is linked to serious physical and mental health outcomes, yet remains the least researched of all family bereavement. This exploratory study created a shared sibling grief narrative. Open-ended interviews were conducted with 27 participants who lost a sibling. Primary themes included Shared Life: Identity Within the Sibling Arrangement; Sibling Death: Pivotal Moments in Time; Life After Sibling Loss: Emotional Suffering, Life After Sibling Loss: Missing Roles & Changing Relationships; and The Sibling Lives On. The following study findings clarify the overlooked impact that sibling death has on the surviving sibling and demonstrate the crucial need for more sibling loss research.     

Different sides of the same conversation: Black and White partners differ in perceptions of interaction content

A positive interracial interaction can create a foundation for friendships, improved intergroup attitudes and reduced prejudice. Recent research has demonstrated that what people talk about in important. Here, two studies expand the interaction content model of interracial interactions to reveal that Black and White Americans perceive interaction content in similar and different ways. As expected, Black and White participants evaluated conversation topics along the same three dimensions, but differed in their perceptions of specific conversation topics. These convergences and differences emerged for pre‐generated (Study 1) and self‐generated (Study 2) topics. Factor analyses revealed that conversation attributes similarly distilled to the predicted underlying content dimensions of intimacy, valence, and controversy for Black and White Americans. However, Black individuals found interaction content, in general, to be more controversial, race‐related, enjoyable, and predictable than White individuals. Although both groups found race‐related content more controversial, Black individuals were less bothered by discussing race and found race‐related topics to be more predictable and enjoyable to discuss. These findings supported the interaction content model which may provide a framework for future research on interracial interactions. We conclude with the importance of considering differences in perceptions of interaction content, as well as suggestions for how intergroup interaction research could benefit from systematically incorporating such content.     

An Auto‐Ethnographic Study of “Open Dialogue”: The Illumination of Snow

This auto‐ethnographic study describes the changes in the author's thinking and clinical work connected to her first‐hand experience of Open Dialogue, which is an innovative, psychosocial approach to severe psychiatric crises developed in Tornio, Finland. In charting this trajectory, there is an emphasis on three interrelated themes: the micropolitics of U.S. managed mental health care; the practice of “dialogicality” in Open Dialogue; and the historical, cultural, and scientific shifts that are encouraging the adaptation of Open Dialogue in the United States. The work of Gregory Bateson provides a conceptual framework that makes sense of the author's experience and the larger trends. The study portrays and underscores how family and network practices are essential to responding to psychiatric crises and should not be abandoned in favor of a reductionist, biomedical model.     

Reducing automatically activated racial prejudice through implicit evaluative conditioning

The authors report a set of experiments that use an implicit evaluative conditioning procedure to reduce automatically activated racial prejudice in White participants in a short period and with relatively few trials. Experiment 1 demonstrated that participants were unaware of the repeated conditioned stimulus-unconditioned stimulus (CS-US) pairings of Black-good and White-bad. In Experiment 2, the procedure was found to be effective in reducing prejudice as indicated by an evaluative priming measure of automatically activated racial attitudes. In Experiment 3, this reduction in prejudice was found to persist throughout a 2-day separation between the conditioning procedure and the administration of the dependent measure. The implications of the present findings for the persistence of automatically activated racial prejudice are discussed.     

Processing Speed Deficits in Attention Deficit/Hyperactivity Disorder and Reading Disability

The goal of the current study was to test whether deficits in processing speed (PS) may be a shared cognitive risk factor in reading disability (RD) and Attention Deficit/Hyperactivity Disorder (ADHD), which are known to be comorbid. Literature on ADHD and RD suggests that deficits on tasks with a speeded component are seen in both of these disorders individually. The current study examined a wide range of speeded tasks in RD, ADHD, comorbid RD+ADHD, and a control group to test whether RD and ADHD have similar profiles of PS deficits, and whether these deficits are shared by the two disorders. The results suggest that a general PS deficit exists in both clinical groups compared to controls, although children with RD demonstrate greater PS deficits than children with ADHD. Two tests (underadditivity and partial correlations) were conducted to test whether these PS deficits are shared. Since we found that PS deficits were underadditive in the comorbid group and that partialling PS reduced the correlation between RD and ADHD, it appears that PS is a shared cognitive risk factor that may help explain the comorbidity of these two disorders.     

The Hemispheric Lateralization for Processing Geometric Word/Shape Combinations: The Stroop-Shape Effect

The authors conducted 4 experiments to test whether hemispheric lateralization occurs for the processing of geometric word–shape combinations. In 3 experiments, participants responded to geometric shapes combined with geometric words (square, circle, triangle). In the 4th experiment, stimuli were combinations of geometric shapes and nongeometric words. The authors predicted that it would take longer to respond in incongruent conditions (e.g., the word “square” combined with the shape of a circle) than in congruent conditions. The authors found the strongest incongruency effects for the dominant hemisphere—that is, the left hemisphere for responding to words and the right hemisphere for responding to shapes. A Shape Interfering Properties hypothesis (SIP) is a possible explanation for these results.