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.     

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.     

“‘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.     

IS THERE A DISTINCTIVE QUANTUM THEOLOGY?

Quantum mechanics (QM) is a favorite area of physics to feature in “science and religion” discussions. We argue that this is at least partly because the arcane results of QM can be deployed to make big theological claims by the linguistic sleight of hand of “register switching”—sliding imperceptibly from technical into everyday language using the same vocabulary. We clarify the discussion by deploying the formal mapping of QM into classical statistical mechanics (CSM) via the mathematical device of “Wick rotation.” This equivalence between QM and CSM suggests caution in claiming distinctiveness for quantum theologizing. After outlining two areas in which quantum insights nevertheless resonate with longstanding themes in theological reflection (hiddenness and visualizability), we suggest that both QM and CSM point to a theology of science in which scientists participate in the divine gaze on creation as imago Dei.     

Reflexivity in quantitative research: A rationale and beginner's guide

Reflexivity is the act of examining one's own assumption, belief, and judgement systems, and thinking carefully and critically about how these influence the research process. The practice of reflexivity confronts and questions who we are as researchers and how this guides our work. It is central in debates on objectivity, subjectivity, and the very foundations of social science research and generated knowledge. Incorporating reflexivity in the research process is traditionally recognized as one of the most notable differences between qualitative and quantitative methodologies. Qualitative research centres and celebrates the participants' personal and unique lived experience. Therefore, qualitative researchers are readily encouraged to consider how their own unique positionalities inform the research process and this forms an important part of training within this paradigm. Quantitative methodologies in social and personality psychology, and more generally, on the other hand, have remained seemingly detached from this level of reflexivity and general reflective practice. In this commentary, we, three quantitative researchers who have grappled with the compatibility of reflexivity within our own research, argue that reflexivity has much to offer quantitative methodologists. The act of reflexivity prompts researchers to acknowledge and centre their own positionalities, encourages a more thoughtful engagement with every step of the research process, and thus, as we argue, contributes to the ongoing reappraisal of openness and transparency in psychology. In this paper, we make the case for integrating reflexivity across all research approaches, before providing a ‘beginner's guide’ for quantitative researchers wishing to engage reflexively with their own work, providing concrete recommendations, worked examples, and reflexive prompts.     

THEOLOGY AS THE QUEEN (BEE) OF THE DISCIPLINES?

Abstract. Once Queen of the Medieval court of sciences, dethroned theology may be able in our time to play a strategic servant role in rightly humiliating, elevating, and ordering the disciplines, in gadflying like a mutant honeybee, generating surprise and serendipity through the intermediacy of social science, and in offering ethical homing direction to the disciplines in their applied endeavors.     

SCIENCE AND GOD THE CREATOR

Abstract. Variable judgments, both negative and positive, have been made by scientists (mainly physicists and astronomers) on the theological implications of their Findings. It is urged that science and theology are most appropriately related through a critical realist approach. On this basis some implications for our conceptions of God and our scientific perspectives on the created world are explored with respect to both divine Being and divine Becoming. A positive assessment of nature as created concludes the article.     

Medical education: The training of ethical physicians

This paper suggests that medical education be revised to assist in diffusing potential ethical dilemmas that arise during health care provision. A revised medical education would emphasize the role of the humanities in the training of physicians, especially in light of recent critiques of the canonical scientific model in general, and more specifically in the use of that model for medical training and practice.I wish to thank Dr. Mary Ann Cutter and Melissa M. Amaro for their critical suggestions.     

The myth of science education

It is argued that the manner in which we teach science in the high schools represents an outdated positivistic conception of science. The standard presentation of a year of each of chemistry, biology and physics should be replaced by an integrated science plus history, philosophy, and sociology of science which would take a total of three years to complete. A proper appreciation for the true nature of science is essential to the continued health of the scientific enterprise.