Playing to their strengths: Can focusing on typical in-group strengths be detrimental to people of colour?

With increasing awareness about racism, portrayals of communities of colour are shifting away from negative representations. Emphasizing their strengths could counter negative stereotypes about who they are and low expectations for who they can be, but could also backfire. In two experiments centring adolescents (n = 198) and adults of colour (n = 321), the effect of reflecting on a typical strength was moderated by perceived misalignments between racial/ethnic and ideal future selves (i.e., ethnic–ideal self-discrepancy). For participants perceiving them as aligned, reflecting on a typical in-group strength reduced actual–ideal self-discrepancy. However, for participants perceiving them as misaligned, reflecting on a typical in-group strength increased actual–ideal self-discrepancy. Reflecting on a typical strength also indirectly influenced engagement, through actual–ideal self-discrepancy. Reflecting on an atypical in-group strength did not yield significant effects. Thus, emphasizing typical aspects of stigmatized communities, even when positive, sometimes impede identity and motivation.     

Examining civic engagement in ethnic minority youth populations: A literature review and concept analysis

Racial reckoning is defined as the subjugation of Black, Indigenous, and people of Color (BIPOC) to racial hierarchies and subordinate groups that influence multiple well-being outcomes throughout the developmental lifespan and across generations. With the two pandemics of racial reckoning and COVID-19 amidst a growing controversial political landscape, topics around civic engagement have been brought to the forefront of community conversation. Discussions surrounding civic engagement must go beyond addressing issues of public concern and examine the vehicle in which civic engagement may be delivered. This is becoming increasingly important as civic engagement is one of the main avenues of social change through individual and collective action, particularly regarding racial reckoning and healthcare disparities highlighted by COVID-19. The paper focuses on civic engagement among ethnic minority youth and young adults. An integrated model of civic engagement was created based off what was learned through this review. This proposed model of civic engagement is meant to be the first step to addressing the gap in civic engagement literature for ethnic minority youth. Weaknesses and future considerations regarding the model will also be discussed, as well as any implications for ethnic minority youth and young adults.     

Intensive specialised multi-family therapy for multi-stressed families: Therapeutic alliance as predictor for effectiveness

The effectiveness of intense specialised multi-family therapy (ISMFT) for 111 multi-stressed families, and the therapeutic alliance as a possible predictor of outcome, were examined. A repeated measures design was used, where changes in all ISMFT phases (preparation, multi-family therapy and follow-up) were assessed and compared for both mothers and fathers. Evidence was found for improved family functioning after the therapy period, which was maintained at 3 months follow-up, although the multi-stressed families still functioned in the problematic range. The therapy did however not decrease parenting stress, or did so only temporarily. Observations of the therapeutic alliance with the System for Observing Family Therapy Alliances (SOFTA) scales indicated that high therapist engagement was related to positive therapy outcomes, both at the start of therapy and later. High family engagement also predicted therapy effectiveness, but only at the start of therapy. The present study shows that solution-focused multi-family therapy at least seems to provide the first step in alleviating problems in multi-stressed families.     

Conceptualising,designing and drafting a monthly multi-family therapy programme and manual for adolescents with anorexia nervosa

The written transmission of therapists' expertise in manuals is an important issue which is highlighted in the literature. Manuals are essential for research, training and therapeutic guidance. However, the conceptualisation, design and drafting of therapy manuals have received little attention. Our team conceptualised and designed a 10-monthly session multi-family therapy programme for adolescents suffering from anorexia nervosa. This paper presents the methodology used to evolve from training and theoretical models to designing a programme and drafting the accompanying manual. We then describe how our team reached a consensus regarding the role to be attributed to food-related symptoms in the programme. These arduous tasks were rewarded by fruitful discussions among team members, which led to a shared theory of treatment. The methodology presented here is drawn from both the experience of specialised teams and from that of families in providing care to adolescents with anorexia nervosa.     

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.     

Cognitive Behavioral Therapy for Postamputation Chronic Pain: A Case Report

Limb amputation has a significant impact on an individual, not only physically but emotionally. Consequences of both traumatic and atraumatic amputations are vast and can result in functional disability, impaired emotional functioning, and changes in overall quality of life. These consequences may be further complicated by the development of chronic pain. Traditional management of postamputation chronic pain often involves invasive procedures and pharmacotherapy. While research notes behavioral interventions, such as cognitive-behavioral therapy (CBT) as a viable treatment alternative for chronic pain, there is no literature supporting CBT for postamputation chronic pain. In this case report, we present a 63-year-old male lower limb amputee complicated with chronic pain who experienced pain reduction and improved quality of life following manualized treatment with CBT for chronic pain. Treatment took place over 12 sessions with fidelity (93%) being measured throughout to ensure accurate utilization of the treatment manual. As part of the treatment manual, self-report measures (Pain Rating Scale, Pain Catastrophizing Scale, Pain Outcomes Questionnaire, and subjective units of distress) were used throughout to track patient progress. All measures showed improvement with the biggest gains being seen in pain ratings and pain catastrophizing.     

Post-Admission Cognitive Therapy for a Transgender Service Member With a Recent Suicidal Crisis: A Case Study of Gender-Affirming Care

While elevated suicide risk in the American military and veteran population has led to the development of targeted interventions, the increased risk of suicidal ideation and behavior among transgender and gender diverse (TGD) Service members requires that interventions address suicide risk within the context of minority stressors and gender-affirming care. This case study presents Jordan (an alias), a transgender Service member who received inpatient psychiatric treatment following a suicide attempt precipitated by distress relating to gender dysphoria, minority status, and associated stressors. Jordan completed Post-Admission Cognitive Therapy (PACT; Ghahramanlou-Holloway, Cox, & Greene, 2012), a cognitive-behavioral intervention targeting suicide risk among military personnel and dependents psychiatrically hospitalized following a suicidal crisis. Within the context of PACT, Jordan’s treatment included identifying and addressing distress related to minority stressors (externalized stigma, internalized transphobia, anticipated rejection, gender concealment) using gender-affirming best practices. Marked changes in Jordan's self-report measures from baseline to follow-up, as well as qualitative changes reported by Jordan, demonstrate that she felt comfortable, safe, and ready to be discharged from the inpatient unit after completing PACT treatment and gaining exposure to the skills necessary to help prevent and/or manage future suicidal crises. Treatment implications and recommendations for addressing suicide risk within the context of gender-affirming care and prevalent minority stressors are discussed.     

Critical action among Asian and Hispanic/Latinx youth: Identifying a multidimensional measure and exploring within-group differences

Critical action—behaviours aimed at dismantling systems of oppression—must be examined within youths' racialized experiences and should incorporate cultural and sociohistorical factors. We considered an expansive list of items capturing youth behaviours to create a novel four-factor (service, community change, expression, and care) measure of critical action for Asian and Hispanic/Latinx youth. Multiple distinct profiles of critical action were identified within both racial-ethnic groups, and associations between the profiles and sociodemographic and contextual support variables were explored. Gender differences in the type of critical action were found in both racial-ethnic groups, pointing to the potential influence of gender roles on critical action among these populations. Differences in critical action patterns were also found between those born in the U.S. versus those born outside the U.S.; access to critical action may differ within racial-ethnic groups depending on birthplace and associated nuances in familial and cultural contexts. This paper demonstrated a need for attending to variation between and within groups in the study of critical action in order to effectively support racialized youth's coping within and resistance against systems of oppression.     

Why do young people engage in some civic actions and not others? Exploring the roles of individual and collective civic efficacy

Civic actions are behaviours intended to improve conditions for others or help shape a community's future. Such actions vary widely from voting to voluntary helping, from canvassing to community organizing, and attempts have been made to categorize the array of civic actions. However, the question of why young adults engage in some types of civic actions versus others is not well understood. Using data from 598 White, cisgender, heterosexual young adults in the United States, we examined the relations between individual civic efficacy, collective civic efficacy, and seven actions: writing social media posts, voting, buycotting, volunteering, participating in an organization, supporting political candidates, and protesting. We hypothesized that individual efficacy would be positively related to all seven actions, but collective efficacy would be more strongly related to collective or political actions, compared to the individual or civil ones. Logistic regression analyses showed that individual efficacy positively predicted engagement in all seven civic actions. Individual and collective efficacy had a complex curvilinear relation with buycotting and supporting political candidates. Implications for future research and applications aimed at promoting civic engagement amongst young adults are discussed. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement .     

“It's wrong to relax,you have to be on the go,go, go,all the time”: Emotional transformation in a case of emotion-focused therapy for generalised anxiety disorder

Generalised anxiety disorder (GAD) is a highly prevalent, chronic and impairing disorder. The aim of this study was to qualitatively describe the transformation in emotional processing across 16 sessions of a successful emotion-focused therapy (EFT) treatment for GAD. A theoretical framework derived from the EFT model of in-session emotional transformation proposed by Pascual-Leone and Greenberg was used as the basis for qualitative analysis. Additionally, the Classification of Affective Meaning States, the Client-Expressed Arousal Scale-III and the Client Emotional Productivity Scale-Revised were utilised by observer–raters to classify moment-by-moment shifts in client affective-meaning states, emotional arousal and emotional productivity. Results supported the emotion transformation model. The client presented in a state of poorly differentiated but highly aroused distress provoked by identifiable interpersonal and intrapersonal triggers. Emotional and behavioural avoidance provoked by fear of pain was evident. Accessing core pain and responding to attendant needs with compassion and protective anger was shown to facilitate the higher order emotional processing states of grief, relief and agency. Implications are proposed, including that addressing core emotional vulnerability may be a critical intervention in the successful treatment of GAD.