Challenges in Developing a Cultural Evidence‐Based Psychotherapy in the USA: Suggestions for International Studies

In this article, we underscore some of the cultural challenges and limitations of the evidence‐based psychotherapy (EBP) utilised within the USA with the hope that these problems will be avoided or ameliorated in Australia and other countries. Although the EBP research is very diverse and complex, we categorise this fast‐growing literature using a threefold classification system that underscores culture. This classification system is proposed to examine the influence of culture on EBPs. The three categories used are (a) universal evidence‐based psychotherapies or universal psychotherapies, (b) race and ethnic minority evidence‐based psychotherapies or racial/ethnic psychotherapies, and (c) cultural evidence‐based psychotherapies or cultural psychotherapies. After each category is described, its benefits and limitations are discussed, emphasising implications for culturally diverse and international studies. We conclude with suggestions to promote the advancement of a more effective and inclusive cultural EBP in which researchers from different countries can collaborate and learn from each other.     

The Self‐Care of Psychologists and Mental Health Professionals: A Review and Practitioner Guide

It has been documented in the professional literature that psychologists and mental health professionals in general tend to neglect their own mental health, despite serving in a field that promotes the health and well‐being of others. Numerous empirical studies support the need for psychologists and mental health professionals to be more conscientious of the effect that stress and the nature of their work has on them. This article reviews some of the recent literature and discusses the pertinent issues at hand. A number of interventions are suggested along with tips for professionals to consider in order to function in a more productive and ethical fashion.     

Mothers' attitudes toward fat, weight, and dieting in themselves and their children

We examined how a mother's view of her body, and fatness in general, affects her attitude toward her child's weight and eating. Mothers (N = 118) of 3–5-year-old children filled out a questionnaire designed to assess weight satisfaction, anti-fat attitudes, and how concerned and restrictive they are with regards to their child's weight and eating. We found mothers who were more fearful of being or becoming overweight themselves worried more for their children, although fearful attitudes did not predict restricting a child's eating. These results suggest that maternal attitudes toward their own weight affect their beliefs about their children's weight.     

The environment influences whether high-fat foods are associated with palatable or with unhealthy

This study investigated whether relatively automatic evaluations of food differ between situations and between obese people and lean controls. These evaluations were assessed in the affective priming paradigm (APP) -- a response latency based measure for associations. In Experiment 1, we either focused participants (33 obese and 26 lean controls) on the palatability (restaurant condition) or on the healthiness (health condition) of food, prior to the APP. Independent of weight-status, relatively automatic evaluations of food were based on palatability in the restaurant condition, and on health in the health condition. So, the current focus of attention can shape the way foods are evaluated relatively automatically. In Experiment 2, craving was induced in participants (27 obese and 29 lean controls). Unexpectedly, the craving induction did not achieve its goal of focusing on the palatability of food in general, but just for low-fat foods, possibly because of the health-emphasizing environment -- a hospital. Interestingly, obese people showed a stronger palatability priming effect with increasing levels of initial craving. For normal weight controls the effect was in the same direction, but missed significance. In our environment, palatability of food may be too salient, and health may not be salient enough, influencing automatic food-evaluations.     

The effect of contingent reinforcement on target variables in outpatient psychotherapy for depression: a successful and unsuccessful case using functional analytic psychotherapy

The current study investigated a behavior-analytic treatment, functional analytic psychotherapy (FAP), for outpatient depression utilizing two single-subject A/A+B designs. The baseline condition was cognitive behavioral therapy. Results demonstrated treatment success in 1 client after the addition of FAP and treatment failure in the 2nd. This study highlights the challenges in measuring treatment progress and outcome idiographically in this population.     

Who's afraid of the Wolfe couple: the interlocking traumatic scene

Fulfilling intimate relationships require a constant emotional and psychological struggle to disentangle strangleholds created by the interpenetration of unresolved complexes stemming from previous disappointing relational experiences. These complexes may manifest as an encrypted pattern of engagement that each partner brings to the marriage, like a 'malignant dowry'. The dowry box, once opened, releases its nefarious contents to create an extremely complex and entangled drama I call the 'interlocking traumatic scene'. Partners unconsciously entrap each other to play a part in such a scene with double (sometimes multiple) roles for each antagonist. The imaginal space between the two characters can be seen as a projection screen, upon which are superimposed two separate shadow plays, one on each side of the screen. A third play, which is a co-created product of these two individual traumatic scenes, can also be observed. Three plays are performed simultaneously. The defensive systems that the two individuals bring to the equation dovetail together, but the actual interlocking mechanism itself deadlocks in such a way that it seems to have its own malignant presence, a 'malevolent third' (after Ogden 1994). I outline therapeutic interventions using the metaphor of the therapist as 'anti-director' and I introduce my concept of the conjoint selected fact (after Bion 1963 after Poincaré 1952).     

Sexual Attitudes and Instructional Set Affect Estimates of Risk and Response Effectiveness

Two hundred and eleven undergraduate men and women were assigned to different instructional set conditions and asked to rate (1) the sexual risk depicted in a set of written items describing problem situations undergraduate women might face when dating or interacting socially with men, and (2) the effectiveness of responses to these situations, described by a set of response codes. Results revealed that sexual attitudes and instructional set were the strongest predictors of both ratings. Gender did, however, predict risk ratings for stranger and authority figure situations, with women rating these situations as more risky than men. In addition, women assigned to the risk instructional set condition rated refusal responses as more effective in decreasing risk than did men in the same condition. In contrast, women assigned to the popularity instructional set condition rated the same refusal responses as less effective in increasing popularity than did men in that condition.

Decreased approach motivation in depression

The present study examined relations between choice preference and reaction time to emotionally valenced words, dysphoric symptoms (BDI), and dysfunctional attitudes (DAS) in clinically depressed (CD; n= 61), previously depressed (PD; n= 42), and never depressed controls (ND; n= 46). The results showed: (1) NDs and PDs exhibited a choice preference for the relatively more positive words and differed significantly from CDs; (2) PDs and CDs exhibited longer reaction time and differed significantly from NDs; and (3) BDI and DAS were positively associated with reaction time to positively valenced words, whereas no associations were found for reaction time to negatively valenced words. The increased reaction time, in PDs and CDs, is discussed as a possible vulnerability factor to depression, which may be related to decreased approach motivation.     

HISTORICAL ASPECTS OF MINDFULNESS AND SELF-ACCEPTANCE IN PSYCHOTHERAPY

We describe some of the historical conditions that made possible Kabat-Zinn’s [(1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delacorte] very successful use of mindfulness in his stress management program. The ground had been prepared by the nonjudgmental acceptance of people and symptoms by Humanistic psychotherapists, and by the increasing assimilation of Buddhist ideas into Western psychology and psychotherapy. In addition the word “mindfulness,” as the translation of the Pali sati, came to refer to both the manualized practice that provides the evidence for its efficacy in the hands of Kabat-Zinn and others, and the more complex process of clear comprehension and recollection that is described in his more discursive writings, and is similar to Ellen Langer’s use of “mindfulness” in her book of that name.