Centering culture in the treatment of opioid use disorder with American Indian and Alaska Native Communities: Contributions from a National Collaborative Board

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program-level implementation intervention using a strength-based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.     

Examining awareness of privilege among midwestern college students: An analysis of race/ethnicity,gender, and religion

Dominant group members often are not aware of the privileges they benefit from due to their dominant group membership. Yet individuals are members of multiple groups and may simultaneously occupy multiple categories of dominance and marginality, raising the question of how different group memberships work in concert to facilitate or inhibit awareness of multiple forms of privilege. Examining awareness of privilege is important as awareness may be linked to action to dismantle systems of privilege that maintain oppression and inequality. Grounded in intersectional scholarship, in this study we examined how occupying intersecting categories of race/ethnicity, gender, and religion corresponded to an awareness of White, male, and Christian privilege. In a sample of 2321 Midwestern college students, we demonstrated that students from marginalized groups broadly reported greater awareness of all forms of privilege than students from dominant groups, and the difference between marginalized and dominant groups was most pronounced when the specific group category (e.g., gender) aligned with the type of privilege (e.g., male privilege). We also tested interactions among race/ethnicity, gender, and religion, only finding an interaction between race/ethnicity and religion for awareness of White and male privilege. These findings helped to clarify that multiple group memberships tended to contribute to awareness as multiple main effects rather than as multiplicative. Finally, we examined mean differences among the eight intersected groups to explore similarities and differences among groups in awareness of all types of privilege. Taken together, these findings quantitatively demonstrate the ways in which group memberships work together to contribute to awareness of multiple forms of privilege. We discuss study limitations and implications for community psychology research and practice.     

The Intergenerational Transmission of Party Preferences in Multiparty Contexts: Examining Parental Socialization Processes in the Netherlands

Research shows that parents have a strong influence on the party preferences of their children. Yet little is known about how such preferences are transmitted in multiparty systems with weak party identification and high electoral volatility. We propose a model of intergenerational transmission that includes both direct effects of parents' party preferences on those of their children, as well as indirect effects through left–right and issue positions. We test this model with original survey data of Dutch adolescents (14–20 years old) and their parents (N = 751 adolescent-parent pairs). We find two paths through which parents exert influence on the party preferences of their adolescent children. On the first path, parental party preferences function as a direct predictor of adolescent party preferences. On the second path, adolescent left–right and issue positions function as a mediator between parental left–right and issue positions and adolescent party preferences, with the effect of left–right positions being stronger than that of issue positions. The frequency with which adolescents discuss political topics with their parents moderates these effects.     

听觉刺激对虚拟环境中空间压缩的影响

人们往往会低估虚拟环境中空间的距离(空间压缩)。早期研究发现视听刺激的不一致会改善空间压缩,但听觉刺激在其中的作用及其影响效果需进一步研究。本研究首先探究了听觉刺激的有无对空间压缩的影响,接着操控视听刺激之间的物物距离进一步探究其对空间压缩的影响和改善。研究发现听觉刺激以两种方式影响空间压缩：听觉刺激的存在可以改善空间压缩;空间压缩与视听刺激的物物距离负相关。研究建议为了改善空间压缩,视听刺激应当同时呈现且物物距离至少为1 m。     

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.     

Year of Zoom in a Year of Doom: Lessons Learned Delivering ERP Remotely During the COVID-19 Pandemic

In response to the COVID-19 pandemic and consequential shutdown measures, many mental health professionals started providing therapy to patients exclusively via telehealth. Our research center, which specializes in studying and treating obsessive-compulsive disorder (OCD), historically has provided in-person exposure and response prevention (ERP) to adults with OCD, but shifted to telehealth during the pandemic. Unlike in other modes of talk therapy, ERP’s emphasis on therapist-supervised exposures presented unique opportunities and challenges to delivering treatment entirely via a virtual platform. This paper provides case examples to illustrate lessons we learned delivering ERP exclusively via telehealth in New York from March 2020 through June 2021 and offers recommendations for future study and practice. Though we observed a number of drawbacks to fully remote ERP, we also discovered advantages to delivering ERP this way, meriting additional research attention.     

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.     

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.     

Systematic review of interruption and redirection procedures for autistic individuals

Interruption and redirection (IR) procedures involve systematically disrupting an undesirable behavior and prompting an individual to engage in an alternative behavior. These procedures have been frequently assessed for reducing repetitive behaviors for autistic individuals. The primary purpose of this review was to assess IR interventions to determine whether outcomes vary according to intervention characteristics, dependent variable types, design quality, or publication status. A secondary purpose was to assess the extent to which generalization and maintenance outcomes were measured and whether characteristics of these conditions were related to outcomes. IR interventions were moderately successful for reducing repetitive behaviors but less effective for improving corollary variables such as appropriate vocalizations and functional engagement. Generalization and maintenance outcomes, when measured, were poor. Results indicate the need for alternative or augmentative procedures that focus on engagement in meaningful interactions and activities.