Open Pages: Relational-Cultural Therapy

APA Books Open Pages is an ongoing series in which we share interesting tidbits from current & upcoming books. Find the full list by browsing the Open Pages tag. APA Books will publish Relational-Cultural Therapy, Second Edition by Judith V. Jordan, in October 2017. The following excerpt is from Chapter 7, “Summary.”

The neurobiological data strongly support the notion that we need connections to grow and thrive. In fact, new data indicate that we need connection to survive throughout our lives; we never outgrow our need for connection (Banks, 2016; Lieberman, 2013). We come into the world primed to seek mutual connection; our brains grow, and there is balance between sympathetic and parasympathetic functioning when there is sufficient early mutuality between infant and caregiver and an absence of chronic stress. However, our social conditioning with its overvaluing of separation, autonomy, and independence is at odds with our underlying biological predispositions. Herein lies a profound dilemma, as these competing tendencies produce enormous stress in all of us. Our individualistic social conditioning erodes the very community that our biology suggests we need. We are neurologically wired to connect (to thrive in relationship) but taught to stand strong alone (to be independent and autonomous). Stress is created at a chronic and undermining level when standards for maturity that cannot actually be attained with any predictability are placed on people. Thus, we are told to be strong through autonomy and separation. But in fact, “going it alone,” or being on the outside, creates pain and a sense of inadequacy. We are told not to be vulnerable, particularly if we are male; and yet every day we encounter the inevitability of our vulnerability. We see loved ones get sick or die; we watch our children suffer with illnesses that we cannot always cure. We watch parents and loved ones succumb to the indignities of older age. We hear of random acts of violence felling adolescent boys in the inner city, of children starving in Africa, of people tortured in prisons. Yet, in our effort to deny our vulnerability, we tend to locate vulnerability in chosen target groups who are then seen as “lesser than.” We marginalize and denigrate those who are seen as “weak.” We minimize the real pain of exclusion and marginalization.

RCT therapy offers a responsive relationship based on respect and dedication to facilitating movement out of isolation. In this context, people heal from chronic disconnections and begin to rework maladaptive, negative relational images, which are keeping them locked in shame and isolation. Energy is generated, feelings of worth increase, creative activity resumes, and people demonstrate enhanced clarity about their experience and about relationships. Most important, they engage in relationships that contribute to the growth of others and community is supported.

References

Banks, A. (2016). Wired to connect. New York, NY: Tarcher/Penguin.

Jordan, J. V. (2017, in press). Relational-Cultural Therapy, Second Edition. Washington, DC: American Psychological Association.

Lieberman, M. (2013). Social: Why our brains are wired to connect. New York, NY: Crown.

Open Pages: Ethics in LGBTQ Psychology

APA Books Open Pages is an ongoing series in which we share interesting tidbits from current & upcoming books. Find the full list by browsing the Open Pages tag. APA Books recently published Teaching LGBTQ Psychology: Queering Innovative Pedagogy and Practice, edited by Theodore R. Burnes and Jeanne L. Stanley. The excerpt below comes from Chapter 4: Teaching Ethics in Relation to LGBTQ Issues in Psychology.

Conflict between students’ personal beliefs and actions or inactions in their training and client care within their educational institutions have escalated into legal disputes. Educators can use examples as teaching tools in class for discussing and working through such conundrums. Students may also learn about and discuss recent court cases in which students sued their educational institutions after they were dismissed from their programs for not meeting the program’s requirements for becoming multiculturally-competent providers where LGBTQ individuals are involved (Hancock, 2014). Three such cases, all involving MHPs [mental health professionals]-in-training, involve key areas of these debates: Ward v. Wilbanks, 2010; Ward v. Polite, 2012; and Keeton v. Anderson-Wiley, 2010. These court cases are relevant for teaching MHPs and should be included in coursework because they give a view of how legal and ethical concerns can collide in regard to the competency of MHPs when working with LGBTQ individuals.

In the two Ward cases, Ms. Ward was a graduate student in the counseling master’s program at Eastern Michigan State University. After being assigned a gay male client who had previously received counseling regarding his same-sex relationship, Ward asked her supervisor whether she could refer the client because she could not support his same-sex behavior. Ward argued that she followed the ethical guidelines by referring a client she felt she could not support. The program countered that Ward chose to follow her personal beliefs that were discriminatory in practice and, therefore, inconsistent with the requirements of the program and the profession (Haldeman & Rasbury, 2014). The program offered her the following choices: to take part in a remedial program, voluntarily leave the program, or request a formal hearing. Ward chose the formal hearing and was dismissed from the program. After suing the university and after two court cases, an out-of-court settlement agreement was reached between and the student and the university.

The Keeton case involved a graduate student in counseling from Augusta State University. In her courses, Ms. Keeton asserted that if she were to work with LGBTQ clients, she would express her views of the immoralities of their same-sex behavior and then either use SOCE or refer the client to a practitioner who practiced SOCE to rectify the clients’ behavior. The program faculty expressed their concern to the student and asked her to complete a remediation program because of the deficits in her multicultural competency in working with LGBTQ clients. She refused remediation and then sued, claiming that the remediation plan violated her First Amendment rights. The court rejected Keeton’s claim on the grounds that the program did not ask her to alter her personal religious beliefs but to not use her beliefs to discriminate against clients. Keeton’s proposed actions were in direct conflict with the ACA Ethics Code because she planned to not only impose her values on clients but also to discriminate against them on the basis of their sexual orientation.

. . .

The court in the Keeton case cited the 1988 U.S. Supreme Court decision in Hazelwood School District v. Kuhlmeier, finding in favor of the educational institution, citing “if there is a legitimate educational concern involved, free speech can be regulated by the educational institution” (Hancock, 2014, p. 6). Students’ personal values as counselors may not outweigh their ethical obligations to the client, and the program, therefore, has to intervene to prevent harm to the client (Hancock, 2014). Bieschke and Mintz (2012) aptly argued that the core issue in these cases is one of the competences of the trainee in following the ethical requirements of their profession. Although such cases have not yet specifically involved psychologists or psychologists-in-training, similar cases are likely to follow.

 

References cited in this passage

Bieschke, K. J., & Mintz, L. B. (2012). Counseling psychology model training values statement addressing diversity: History, current use, and future directions. Training and Education in Professional Psychology, 6, 196<en>203. http://dx.doi.org/10.1037/a0030810

Haldeman, D. C., & Rasbury, R. L. (2014). Multicultural training and student beliefs in cultural context. Psychology of Sexual Orientation and Gender Diversity, 1, 289<en>292. http://dx.doi.org/10.1037/sgd0000076

Hancock, K. (2014). Student beliefs, multiculturalism, and client welfare. Psychology of Sexual Orientation and Gender Diversity, 1, 4<en>9. http://dx.doi.org/10.1037/sgd0000021

Hazelwood School District v. Kuhlmeier, 484 U.S. 260 (1988).

Keeton v. Anderson-Wiley, 733 F. Supp. 2d 1368 (S.D. Ga. 2010).

Ward v. Polite, 667 F.3d 727 (6th Cir. 2012).

Ward v. Wilbanks, No. 09-11237 (E.D. Mich. 2010).

 

Open Pages: Clinical Handbook of Psychology

The American Psychological Association recently released the 20th publication in the APA Handbooks in Psychology® series. The five volumes of the APA Handbook of Clinical Psychology actively reflect the state of the art in clinical psychology—science, practice, research, theory, and training—and comprehensively cover our multifaceted and vibrant discipline. Each volume surveys different areas of the largest subfield of psychology:

handbook clinical psych

  1. Clinical Psychology: Roots and Branches;
  1. Clinical Psychology: Theory and Research;
  1. Clinical Psychology: Applications and Methods;
  1. Clinical Psychology: Psychopathology and Health; and
  1. Clinical Psychology: Education and Profession. (Norcross, VandenBos, & Freedheim, 2016).

In this excerpt from the Introduction to the Handbook, the Editors-in-Chief describe their guiding principles:

Throughout the five volumes, authors were asked to infuse their chapters with three themes:

diversity, evidence-based practice, and international contributions. Contributors were asked to mind this tripartite commitment as they considered potential coauthors and drafted their chapters. These superordinate themes are evidenced in content, contributors, and citations throughout the handbook.

Diversity has become a cardinal feature of contemporary clinical psychology. It has been incorporated in word, if not always deed, into the teaching curriculum, into practice guidelines, into theoretical revisions, into research conventions, and into professional ethics. For the purposes of this handbook, we have adapted the APA ethics definition of diversity as referring to age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, socioeconomic status, and other facets of personal identity and their intersections (APA, 2010).

Evidence-based practice (EBP) in psychology refers to the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences (APA Presidential Task Force on Evidence-Based Practice, 2006). EBP is a global juggernaut requiring solid research evidence to guide practice and training. Properly conceptualized, however, EBP does not end with the research results; it begins with research findings integrated with the psychologist’s expertise and then tailored to the unique patient. EBP requires all three legs. Clinical psychologists have largely embraced the properly conceptualized version of EBP because it collaboratively integrates the researcher, the psychologist, and the client.

International or global aptly characterizes the state of clinical psychology. Whereas in the 1960s there were probably more psychologists in the United States than in all other nations combined, this is assuredly not the case today. No more than a quarter of all psychologists are now located within the borders of the United States (APA Office of International Affairs, 2015). Contributors were asked to incorporate research, theory, and practice from throughout the world into their respective chapters. In several instances, we commissioned entire chapters to address the international scene; Volume 5, for example, has a chapter devoted to educational paths around the world and another to professional ethics around the world.

—from “Introduction to the Handbook,” pp. xxiii–xxiv, in APA Handbook of Clinical Psychology (Vol 1) by John C. Norcross, Gary R. VandenBos, and Donald K. Freedheim (Editors-in-Chief). Copyright © 2016 by the American Psychological Association. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, including, but not limited to, the process of scanning and digitization, or stored in a database or retrieval system, without the prior written permission of the publisher.

Open Pages: Womanist and Mujerista Psychology

APA Books Open Pages is an ongoing series in which we share interesting tidbits from current & upcoming books. Find the full list by browsing the Open Pages tag. Here, we check out the introduction of Womanist and Mujerista Psychologies: Voices of Fire, Acts of Courage to find out what, briefly, these lesser-known terms mean:

“The term womanist was coined by Walker (1983): ‘a Black feminist or feminist of color committed to the survival and wholeness of entire people, male and female. Not a separatist, except periodically for health’ (p. xi). In other words, in addition to centralizing survival and wholeness of women and men, a womanist does not create a hierarchy between the rights against racism and sexism but sees both of these fights as necessary and central. Womanism is a sociopolitical framework that centralizes race, gender, class, and sexuality as central markers of women’s lived experiences (Brown-Douglas, 1993). It moves beyond the compartmentalizing of Black women’s experience as is often seen in feminism and multiculturalism and moves toward an integrated perspective and analysis.” (pp. 5-6).

“As a construct, mujerismo (from the Spanish word mujer, meaning woman) emerged when Latina feminist theologians baptized themselves as mujeristas (Isasi-Diaz, 1994). Mujerismo is Latina womanism (Comas-Diaz, 2008; Meija et al., 2013; Ojeda, 2014). Indeed, the conceptual and political translation of womanist into Spanish is mujerista…like womanists, mujeristas embrace an interdisciplinary perspective. They endorse inclusion as an essential ingredient for the movement’s continual development. In this way, diverse voices are not only welcomed but also sought after.” (pp. 7-8).

 

Bryant-Davis, T., & Comas-Diaz, L. (2016). Womanist and Mujerista Psychologies: Voices of Fire, Acts of Courage. Washington, DC: American Psychological Association.

Open Pages: Mindfulness in Dialectical Behavior Therapy

APA Books Open Pages is an ongoing series in which we share interesting tidbits from upcoming & recent books. Find the full list by browsing the Open Pages tag.

What does this mindfulness practice look like? Contemplative mindfulness practices can be found across Eastern and Western religious and spiritual traditions, and there is no single, specific, or “right way” to practice mindfulness as a dialectical behavior therapist. However, because DBT incorporates many concepts from Zen Buddhism, it is common for dialectical behavior therapists to have experience with mindfulness practices from this tradition. Dialectical behavior therapists practice what they teach, and as a result, the same skills we ask our clients to practice are the skills we practice ourselves. For mindfulness, this means that therapists using DBT practice observing and describing their experiences without judgment or evaluation, intentionally choose to one-mindfully do things with full attention each moment at a time, and aim to be effective with their actions by being sensitive to the context of each moment. In addition, dialectical behavior therapists work toward having moments of their life in which they can let go of the need to observe and describe experiences and instead fully participate without conscious awareness of each moment by fluidly responding effectively, as if they are in “the zone” that athletes find themselves in when at peak performance. Learning these DBT skills is hard for clients, and it can be equally hard for us as therapists.

From Chapter 12, “When the Therapist Gets in the Way,” in Managing Therapy-Interfering Behavior: Strategies From Dialectical Behavior Therapy by Alexander L. Chapman and M. Zachary Rosenthal. Copyright © 2016 by the American Psychological Association. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, including, but not limited to, the process of scanning and digitization, or stored in a database or retrieval system, without the prior written permission of the publisher.