A Model for Adapting Evidence-Based Interventions to Be LGBQ-Affirmative: Putting Minority Stress Principles and Case Conceptualization Into Clinical Research and Practice

The mental health field now possesses clinical trials attesting to the efficacy of affirmative practice with sexual minority individuals. With the goal of efficiently moving the results of these clinical trials into real-world clinical practice, this paper offers a model for adapting existing evidence-based practices originally developed for the general population to be lesbian, gay, bisexual, and queer (LGBQ)-affirmative. The adaptation model presented here guides clinicians to incorporate six LGBQ-affirmative transtheoretical principles of change into practice. These principles facilitate raising awareness of the impact of minority stress on sexual minority clients’ mental health and on client self-evaluation while drawing upon sexual minority resilience and intersectional experiences to build empowering coping skills and validating relationships. The adaptation model also provides a transtheoretical approach to case conceptualization that directs clinicians to consider the role of early and ongoing minority stress on sexual minority clients’ cognitive, affective, motivational, behavioral, and self-evaluative experiences that maintain current distress. This case conceptualization approach highlights common associations among these experiences, suggesting clear routes of interventions for many sexual minority client presentations. Case examples from recent clinical trials of LGBQ-affirmative cognitive-behavioral therapy illustrate how these principles and this case conceptualization can be effectively utilized in practice. While the principles and case conceptualization are meant to be transtheoretical and therefore applicable across therapeutic techniques, to date they have been tested only in clinical trials for cognitive-behavioral treatments. Therefore, this paper concludes with a call for future research to determine the effectiveness of implementing this adaptation model across diverse therapeutic modalities and client presentations.     

Race in the Space: Clinical Considerations for Addressing Race in Treatment

During a period of intense racial unrest in the nation, we were working as clinicians delivering a manualized protocol to LGBTQ adults of varying racial and ethnic backgrounds. Intrigued by the differences in our modes of engagement with clients, we, a Black, cis female therapist and White, cis male therapist, set out to further explore how our positionalities informed our communications with, and expectations of, White and non-White clients during this time. In this paper, we reflect on these differences when delivering therapy in cross-racial and same-race dyads. We highlight where our experiences overlap as clinicians trained in the same program and where they diverge due to our respective worldviews. We conclude with considerations for practitioners to engage with race in psychotherapeutic treatment.     

Personality traits,coping strategies and quality of life in patients of hepatitis C

IntroductionIn recent decades, hepatitis has become a community health issue. A severe, asymptomatic and unobserved acute disease could be resulted by HCV and it could be treated completely in few cases or could result in chronic hepatitis.ObjectiveThe current research investigated the relationship among personality traits, coping strategies and quality of life in patients of hepatitis C in Pakistan.MethodTotal 102 patients of HCV were selected from government, semi-government and private hospitals. Mental Health Screening Questionnaire (Mirza & Kausar, 2008) was used to screen the patients. The Urdu versions of Big Five Inventory (John & Srivastava, 1999), Coping Strategies Questionnaire (Kausar & Munir, 2004) and Quality of Life-BREF (1997) were used to measure the study variables.ResultsThe results showed that extraversion had positive relationship with the subscales of quality of life except physical health. Conscientiousness had positive relationship with physical and psychological health. Neuroticism had negative relationship with all the domains of quality of life. Openness to experience had positive relationship with psychological health and environment. religious coping and conscientiousness positively predicted physical health, whereas, agreeableness was the negative predictor of physical health. Psychological health and social relationships were positively predicted by active focused coping, whereas, neuroticism negatively predicted psychological health.ConclusionThe results of present research indicated significant contribution of personality traits and coping strategies in maintaining quality of life of HCV patients. The clinical implications to improve quality of life of HCV patients are discussed in light of results.     

On the longevity of behavioral interventions for challenging behavior

The capacity for a treatment to maintain its effects over time may be the most critical component of behavioral interventions for challenging behavior as treatments that fail to persist are likely to be of little value to society. We reviewed the quality and quantity of different types of post-intervention data for the treatment of challenging behavior in studies published over the last 7 years. We found that for the majority of participants at least one measure of maintenance, fading, or follow-up was reported but with limited information regarding the quality of those measures. Reports of secondary variables related to post-intervention data (e.g., latency to measurement) were also uncommon. We discuss possible explanations for the paucity of post-intervention data, barriers to obtaining post-intervention data, strategies for obtaining these data, and implications for the external validity of behavioral interventions for challenging behavior. We provide recommendations for increasing the probability that post-intervention data are included in applied research on challenging behavior.     

Ordinance influences individuals' perceptions towards prospects of social circumstance but not the status quo: An experimental field study on sexual minorities issues in Japan

Scientific evidence shows that institutional decisions can change individuals' private attitudes towards relevant issues. However, little is known about their effect on individuals' perceptions of social norms. This intriguing question has gained the attention of scholars. Nonetheless, the findings are primarily observed only in samples of the Western, Educated, Industrialised, Rich, and Democratic countries, leading to doubts about their generalisability. This study experimentally tested residents' (N = 411) reactions to the new Tokyo ordinance prohibiting discrimination against sexual minorities enacted on October 5, 2018, and tested whether it dispelled self–other discrepancies regarding tolerance towards sexual minorities (i.e., pluralistic ignorance). The results showed that exposure to information about enactment increased future perceptions of support and understanding of sexual minorities. By contrast, private attitudes, perceptions of current social norms, and willingness to speak out did not change. Willingness to speak out was indirectly enhanced through increased perceptions of gaining future support. Furthermore, Tokyo residents overestimated other residents' negative attitudes towards sexual minorities. However, even when informed of the new ordinance, this self–other discrepancy in intolerance towards sexual minorities was not corrected. These findings suggest that institutional decisions can shape the perception of social norm change in the future beyond Western countries.     

Using tenets from the Bhagavad Gita in counselling diaspora Hindu older adults: Impact on stress mitigation and improving quality of life

This article reports a study on the impact of a Bhagavad Gita (BG) text-based counselling programme for long-term immigrant diaspora Hindu older adults in the US and UK. Compared with the journal writing sessions, participants of the BG lessons reported lower stress and better quality of life post-test (p ≤ 0.025; Hedges' g = −0.65–0.36). Results of the latent class analyses highlighted complex behaviour patterns in the post-test dataset and foregrounded six classes/subgroups of participants likely to gain most from the BG programme: older adult females, diaspora Hindu older adults with postgraduate-professional qualifications, widowed older adults, those living alone or with other kith-kin, those with above threshold programme compliance (defined as those who attended 13–24 (>50%) BG lessons, and completed 13–24 (>50%) BG homework lessons). Overall, the results of the study endorse the connection between age and religiosity and support a BG text-based counselling programme as a workable strategy for long-term immigrant diaspora Hindu older adults. The BG text provides a firm ethnoculturally grounded counselling approach to work with diaspora Hindu older adult clients, taking cognisance of their intersectional realities. It may help them cope with the dynamics of the modern, traditional, and continuously shifting realities in a foreign milieu.     

Treating Young Adult Depression With Text-Delivered Cognitive Behavioral Therapy: A Pilot Randomized Clinical Trial

Young adults (ages 18 to 25) in the U.S. suffer from the highest rates of past-year major depressive episode and are the least likely to receive treatment compared to other age groups. As such, we examined the feasibility, acceptability, and efficacy of a text-message delivered cognitive behavioral therapy: CBT-txt with young adults. The study was a 2-month pilot RCT to test a 4-week intervention for depression that contained 197 text messages (average 12 texts every other day). The sample, recruited via Facebook and Instagram, was 102 U.S. young adults who presented with at least moderate depressive symptomatology. Assessments occurred at baseline prior to randomization and at 1 and 2 months post enrollment. The primary outcome, severity of depressive symptoms, was assessed using the Beck Depression Inventory II. Feasibility benchmarks were met and participants reported high levels of engagement with and acceptability of the intervention. Logistic regression indicated that treatment participants were three times as likely to have minimal or mild depression symptoms at 2 months compared to waitlist control participants. Latent change score modeling found that the strongest significant treatment effect appeared at the 1-month follow-up period, particularly for participants who began with severe depressive symptoms. Mediation analysis revealed significant indirect treatment effects of increases in behavioral activation on reducing depressive symptoms, suggesting a mechanism of change. Limitations were that the sample was relatively small and consisted of primarily women. These results provide initial evidence for the feasibility, acceptability, and efficacy of a text-delivered treatment for young adult depression.     

“均”与“寡”阶段性变动下中国居民公平感的变迁

利用中国综合社会调查和中国社会状况综合调查重复截面数据,通过年龄-时期-队列模型对居民公平感的时代变化进行分析。研究发现公平感在年龄上呈“J”型趋势;从时期效应看, 2008年公平感较高, 2010～2013年在低谷徘徊,2015年以后又开始回升;从队列视角看,建国前出生队列公平感偏低,建国后初期的队列相对较高,“50”后有所下滑,从“60”后开始公平感持续走低,到“80”后跌入低谷,但“90”后又开始升高。从1949年前后“寡且不均”到建国初期阶段的“寡且均”,再到改革开放40年快速经济增长下“不寡但不均”的社会变迁过程影响了居民的公平感。     

“‘WE' AND ‘THEY'”: WHY MUST WE ENGAGE IN CROSS-CULTURAL CONVERSATION?

This article contains the principal ideas that I presented in four different sessions at the IRAS 2022 conference, on the theme “‘We' and ‘They’: Cross-Cultural Conversation on Identity.” Focusing on the central topic, the article begins with (i) the contents of my opening lecture; followed by (ii) a broad outline of the concerns discussed in my book, Cross-Cultural Conversation: A New Way of Learning, intertwined with glimpses of the intellectual journey that led me to CCC, delivered in the Book-discussion session; (iii) a summary of the main ideas about the importance of meeting of religions today, which formed the background for the CCC Panel discussion on religion, where I was in conversation with spokespersons of five world religions; and (iv) my comments on how science–religion dialogue can help promote a sense for human solidarity by combining knowledge with wisdom, in the concluding session.     

Psychological underpinnings of akrasia: A new integrative framework based on self-regulation vulnerabilities and failures

Akrasia is intentional behavior against one's better judgment. This concept has a rich history in Western philosophy, but it does not feature prominently in the psychological literature. After a brief conceptual review, I propose here a new integrative theoretical framework that draws on motivation science to explicate its psychological underpinnings. Leveraging cybernetic big five and regulatory mode theories, I argue that the self-regulation processes underlying key personality structures can explain why regulatory vulnerabilities can lead to various kinds of akratic failures. For example, I elucidate how maladjusted extraversion associated with a chronic malfunctioning of the assessment and locomotion modes could lead to hedonic dysregulations typical of a specific form of akratic behavior characterized by excessive self-indulgence. This new framework marries multiple disciplines and recomposes the fragmentation of the philosophical speculation on akrasia, suggesting pathways towards potential psychological interventions to mitigate its maladaptive consequences.