Aboriginal Practitioners Offer Culturally Safe and Responsive CBT: Response to Commentaries

We appreciate the valuable commentaries that have been provided for our paper “Can CBT be effective for Aboriginal Australians? Perspectives of Aboriginal practitioners trained in CBT.” The international authors identify how CBT, with adaptations by culturally responsive practitioners can be of value for non‐Western and Indigenous peoples. The commentary by Australian psychologists Dudgeon and Kelly questions the value of CBT for Indigenous Australians, terming it a “Western therapy” that is “culturally unresponsive” and “culturally blind.” They also critique the methodology of the study. We argue that CBT can be adapted by culturally competent practitioners to be culturally safe in Australia, as elsewhere. Cultural safety is mostly a function of the therapist, not the therapy. In the Bennett‐Levy et al. (2014) study, CBT was delivered in a culturally responsive way by Aboriginal counsellors within their own communities. CBT is a particularly adaptable and versatile therapy, and embodies principles of empowerment and self‐determination that are central to Indigenous social and emotional well‐being. We are concerned that CBT, which has strong empirical support and has been adapted elsewhere for a range of cultures, including Indigenous cultures, may be being denied to Indigenous Australian clients. There is considerable opportunity to evaluate the effectiveness and versatility of CBT, and variations of its mode of delivery, for all Australians.     

Neuroscientific evidence for defensive avoidance of fear appeals

Previous studies indicate that people respond defensively to threatening health information, especially when the information challenges self‐relevant goals. The authors investigated whether reduced acceptance of self‐relevant health risk information is already visible in early attention allocation processes. In two experimental studies, participants were watching high‐ and low‐threat health commercials, and at the same time had to pay attention to specific odd auditory stimuli in a sequence of frequent auditory stimuli (odd ball paradigm). The amount of attention allocation was measured by recording event‐related brain potentials (i.e., P300 ERPs) and reaction times. Smokers showed larger P300 amplitudes in response to the auditory targets while watching high‐threat instead of low‐threat anti‐smoking commercials. In contrast, non‐smokers showed smaller P300 amplitudes during watching high as opposed to low threat anti‐smoking commercials. In conclusion, the findings provide further neuroscientific support for the hypothesis that threatening health information causes more avoidance responses among those for whom the health threat is self‐relevant.     

Pathways to adulthood and their precursors and outcomes

Norway has an extensive welfare system which may provide adolescents with many options and high levels of flexibility in terms of pathways to adulthood. This study aimed to describe Norwegian developmental pathways to adulthood, including changes in role statuses (such as living situations, education, work, marriage/cohabitation and parenthood) from 16 to 30 years of age, and their precursors and outcomes. Repeated measures latent class analysis of longitudinal data from 998 Norwegian individuals indicated three main pathways to adulthood among women and men. In both sexes, most individuals undertook a long period of education and postponed family formation. However, some individuals started working early, a group of women established families with partners and children early, and a group of men remained primarily single between 16 and 30 years of age. Furthermore, the results show that pathways to adulthood in Norway are surprisingly similar to pathways in other countries such as the US, UK and Finland. The results indicate that pathways to adulthood are influenced by social reproduction factors in a country with high levels of welfare benefits as well. In addition, the results suggest that pathways involving living with a partner and either higher education or work are associated with high life satisfaction at age 30.     

The mental health of unaccompanied refugee minors on arrival in the host country

Despite increasing numbers of unaccompanied refugee minors (UM) in Europe and heightened concerns for this group, research on their mental health has seldom included the factor “time since arrival.” As a result, our knowledge of the mental health statuses of UM at specific points in time and over periods in their resettlement trajectories in European host countries is limited. This study therefore examined the mental health of UM shortly after their arrival in Norway (n = 204) and Belgium (n = 103) through the use of self‐report questionnaires (HSCL‐37A, SLE, RATS, HTQ). High prevalence scores of anxiety, depression and posttraumatic stress disorder (PTSD) symptoms were found. In addition, particular associations were found with the number of traumatic events the UM reported. The results indicate that all UM have high support needs on arrival in the host country. Longitudinal studies following up patterns of continuity and change in their mental health during their trajectories in the host country are necessary.     

Behavioral Health Competence: An Exploration of Army Reserve Occupational Therapists

In this study the behavioral health competence of Army Reserve occupational therapists (OTs) was examined by the authors through electronic survey to determine current levels of competence and highlight pre-deployment training needs. Results indicated that while Army Reserve OTs report high levels of behavioral health competence, many questions regarding diagnosis, assessment, evaluation, treatment planning, intervention, and progress arose throughout deployment. OTs often relied on skills from Level II fieldwork education and entry-level didactic education for competency. Perceived competencies may be compromised by curriculum changes in entry-level education, available fieldwork settings, and a lack of adequate training currently available prior to deployment.     

The Application of Community Psychology Practice Competencies to Reduce Health Disparities

This article demonstrates the application of community psychology practice competencies to health disparities reduction. It begins with a discussion of changes and evolution of the maternal child health field over nearly three decades, then describes implications for community psychology practice and the application of practice competencies.     

American Indian Historical Trauma: Community Perspectives from Two Great Plains Medicine Men

The field of community psychology has long been interested in the relations between how community problems are defined, what interventions are developed in response, and to what degree power is distributed as a result. Tensions around these issues have come to the fore in debates over the influence of historical trauma (HT) in American Indian (AI) communities. After interviewing the two most influential medicine men on a Great Plains reservation to investigate how these tensions were being resolved, we found that both respondents were engaging with their own unique elaboration of HT theory. The first, George, engaged in a therapeutic discourse that reconfigured HT as a recognizable but malleable term that could help to communicate his “spiritual perspective” on distress and the need for healing in the reservation community. The second, Henry, engaged in a nation-building discourse that shifted attention away from past colonial military violence toward ongoing systemic oppression and the need for sociostructural change. These two interviews located HT at the heart of important tensions between globalization and indigeneity while opening the door for constructive but critical reflection within AI communities, as well as dialogue with allied social scientists, to consider how emerging discourses surrounding behavioral health disparities might be helpful for promoting healing and/or sociostructural change.     

Societal Threat to Safety,Compensatory Control,and Right‐Wing Authoritarianism

We analyzed directly and indirectly the relationships between societal threat to safety, perceived control, and the increase in right‐wing authoritarianism (RWA) in two studies. In Study 1 (national sample of the Italian population, N = 1,169), we performed a longitudinal analysis structured into three waves (January 2003, September 2004, and January 2005). A moderated regression analysis showed that RWA increased from 2003 to 2005 as a function of perceived societal threat to safety more among low‐ than among high RWA scorers. In experimental Study 2 (Italian university students, N = 131) a moderated mediation model showed loss of perceived control to mediate the relation between societal threat to safety and the increase in RWA, but among low authoritarians only. Limitations, implications, and possible developments of this research are discussed.