Clinical supervision is a foundational mechanism through which the mental health field reproduces its values, practices, and professional norms. Current models of supervision fail to interrogate how white supremacy is embedded in the history, training structures, and epistemologies of the field. As a result, supervision often functions as a site of unexamined power, reinforcing racialized hierarchies, silencing marginalized knowledge, and perpetuating inequities for supervisors, supervisees, and clients. The authors propose a model of supervision titled "Culturally Responsive Supervision (CRS)," rooted in Relational-Cultural Theory, Helms's Racial Identity Theory, and Helms's Social Interaction Model. These theories serve as a theoretical basis for our CRS model, which accounts for the role of race(s), culture(s), and power in supervisory relationships. The CRS model has five components: (1) Name Race(s), Culture(s), and Power; (2) Establish mutual trust; (3) Engage in self-reflection; (4) Integrate race(s) & culture(s), and; (5) Engage in ongoing learning. The purpose of this paper is to offer supervisors across clinical fields a supervision model that supports the development of cultural competence as a lifelong process. This model is intended to foster cultural humility, curiosity, and responsiveness, while also facilitating a growth-fostering supervisory relationship that enhances both clinical supervision and the trainee experience.
Maladaptive daydreaming (MD) is a dissociative absorption state triggered by excessive daydreaming, characterized by extensive fantasy activity that diminishes human interaction and/or impairs academic, interpersonal, or vocational functioning. The Maladaptive Daydreaming Scale-16 (MDS-16) is one of the most widely used measures to assess MD. However, its psychometric properties in the Vietnamese version are less documented. This study aims to investigate the psychometric properties of the MDS-16 in a Vietnamese student sample. A cross-sectional study was conducted on a sample of 302 older teens and young adults in Vietnam, comprising 32 high school students and 270 university students (Mage = 20.25, SDage = 1.62). Factor analysis revealed a two-factor structure: immersive daydreaming, which encapsulates excessive immersion in daydreaming, and interference with life, which encapsulates the impacts of excessive daydreaming on life. The MDS-16 scores exhibited positive correlations with anxiety, depression, and loneliness and a negative correlation with social support. This insight enables therapists to develop personalized interventions targeting the core psychological factors underlying MD. In conclusion, the Vietnamese version of the MDS-16 is a valid and reliable measure.
Sociopolitical conflict can place minority-positioned counsellors under forms of professional strain not fully captured by conventional models of professional identity. This study examined how wartime conditions, minority positioning, gender, and collectivist belonging shaped the professional identity of Arab women educational counsellors in Israel during the Gaza war. Using a qualitative interview design with phenomenological sensitivity, semi-structured interviews were conducted in Arabic with 23 Arab women educational counsellors in northern Israel, including 13 Muslim, 2 Bedouin Muslim, 4 Christian, and 4 Druze counsellors. Interviews were transcribed, translated, and analysed thematically. Three interrelated themes were generated. First, participants described a destabilising split between professional mission and personal life, marked by emotional overload, role conflict, and psychological and physical exhaustion. Second, professional identity was strained by silence, self-monitoring, and fractured belonging, with pressures differing across subgroups. Third, counsellors drew on unevenly distributed family, communal, spiritual, and professional resources to sustain practice and preserve meaning. Findings suggest that professional identity in conflict settings is shaped by occupational demands, minority positioning, gendered expectations, and collectivist obligations. An integrative model is proposed, showing how professional identity is strained and reworked under such conditions, with implications for culturally responsive training, supervision, and institutional support in counselling psychology.
Counselors' self-awareness has been linked to effective counseling and psychotherapy. Counselors' self-awareness encompasses unresolved conflicts, family dynamics, cultural biases, worldviews, beliefs, and self-perception. Clinical supervision as part of continuing professional development is one area of training where counselors' self-awareness typically receives more explicit attention. Conducted in T & uuml;rkiye, this study examined the role of supervision in novice counselors' self-awareness. For this purpose, 11 novice supervisees participated in semi-structured interviews as part of this phenomenological study. The results indicated that novice supervisees gained greater awareness of their counseling competencies, emotional responses toward clients, and their present circumstances. Supervisor behaviors, supervision techniques, and supervision methods were identified as key factors facilitating this awareness. The supervisor played a catalytic role in helping counselors uncover inner processes. The findings provided a framework for understanding how supervisors support the developmental progression of novice supervisees to the next developmental level.
The dissolution of a romantic relationship is a psychologically significant event that often engenders long-lasting emotional responses. In an effort to gain a better understanding of this experience, we inbestigated how individuals reflect on what they were "left with" following the breakup of a significant romantic relationship and how these relate to their sense of closure. A thematic analysis of responses (N = 859) yield six themes: General Personal Growth, Development in the Realm of Intimate Relationships, Growth in Relational Competence, Positive experiences, Mixed Experiences, Negative experiences with Lessons Learned, and Negative Experiences Without Growth. Being in a new relationship, having initiated the breakup, length of time since termination of the relationship, and being female were all positively associated with closure whereas attachment anxiety, continued contact-seeking, younger age at relationship start, and being single at the time of the survey were associated with reduced closure. FInally we discuss the clinical implications for heling individuals process unresolved aspects of breakups.
Technology-based psychological interventions gained increasing prominence during the COVID-19 pandemic. Qualitative methods and interpretative phenomenological analysis (IPA) were employed to investigate the online counseling experiences of twelve Vietnamese university students. Participants completed a semi-structured questionnaire about their online counseling experience during the outbreak. The findings illustrated students' efforts to overcome psychological and mental health problems, as well as the importance of online counseling in the context of the pandemic. The participants expected and highly valued the counselors' attentive listening and emotional support, which helped them better understand themselves and their difficulties, as well as enhance their problem-solving skills. The limitations of online counseling and solutions to improve service quality were also proposed by the research participants. In conclusion, this study provides a new perspective on university students' coping with mental health issues and the importance of online counseling in the context of a public health crisis.
Breast cancer is a potentially traumatic experience for women. Although adjustment to the disease has been conceptualized through several theoretical models as critical for improving women's psychological well-being and quality of life, the intrapsychic processes underlying this adjustment remain underexplored. The Assimilation Model provides a framework for understanding how problematic experiences, such as breast cancer, are integrated into the self. The current case-study, based on two patients contrasting in terms of psychological well-being and quality of life, explored the levels of assimilation of breast cancer experience. We conducted semi-structured interviews with the two participants and analyzed the level of assimilation of breast cancer using the Assimilation of Problematic Experiences Scale. Psychological well-being was assessed with the Clinical Outcome Routine Evaluation - Outcome Measure, and quality of life with the Functional Assessment of Cancer Therapy - General. We observed differences in the assimilation patterns of the breast cancer experience between participants, supporting an association between higher assimilation and better psychological well-being and quality of life. The Assimilation Model offers a novel framework for understanding and measuring the adjustment to breast cancer. Furthermore, our findings provide hints for tailoring psychological interventions according to the women's assimilation of the disease.
11 young adults were interviewed about their experiences of using photographs of their deceased parent in group therapy for parental bereavement. A reflexive thematic analysis was conducted. Five themes were identified. The first theme concerned finding photographs at home. Many clients were already accessing photographs prior to the psychotherapy, while a few had actively avoided them. The second theme concerned photograph selection. A range of justifications for selecting photographs were identified; that the parent looked healthy; that the photograph represented how the client wanted to remember their parent; that the parent would approve of the picture; that there were visible similarities to the parent; and that the picture did not emotionally unsettle the client too much. The three further themes addressed: how the clients used photographs to reconnect with the parent after a need for distance after the death or a period of estrangement; how the photographs reminded the clients about the dual fact that their parent was now dead, and that they had a significant shared life to remember, and finally how sharing photographs in the group helped clients accept the reality of their loss by seeing the other clients' photographs of their deceased parents.
Despite increasing evidence of the risks associated with hate speech, the factors influencing emerging adults' responses to online hate remain underexplored, particularly their decision-making processes and strategies for upstanding against cyberhate. This study addresses this gap by focusing on emerging adults, a demographic frequently exposed to online hate. Through three focus groups involving 14 participants living in the European Union, we investigated the motivations behind bystanding or upstanding. Our findings reveal that recognizing hate speech does not necessarily lead to upstanding. Cognitive, emotional, and behavioral barriers - especially an undue focus on perpetrators and insufficient attention to targets and bystanders - appear to hinder upstanding behavior. Additionally, many participants perceived upstanding as an overwhelming task due to excessively high self-imposed expectations. These insights underscore the need for targeted initiatives to empower emerging adults and inform future research on fostering supportive online communities.
In light of the health disparities affecting racially marginalized populations, which include somatic distress, there is a need for research that effectively clarifies how various factors are interconnected and contribute to their somatic distress. This study analyzed the link between the experience of invisibility and somatic issues among college students from historically marginalized racial and ethnic backgrounds. Adopting a biopsychosocial model of racism, the relationship between invisibility and somatic distress was tested, specifically by the following mediators in sequence: Imposter phenomenon and depressive symptoms. A total of 333 racially diverse college students (186 women, 144 men; Mage = 23.1). Findings corresponded to the hypothesized serial mediation. The invisibility experiences related to imposter experiences, which related to depressive symptoms and, in turn, related to somatic distress. A sensitivity analysis confirmed the findings. Results highlight the need for early intervention to support racially diverse students from internalizing the invisibility experiences (such as externalization of invisibility experiences) and ultimately prevent the detrimental effects of invisibility on somatic distress.
Despite dialectical coping being a Chinese indigenous, positive psychological construct, there is limited research about its associations with mental health in Hong Kong. Guided by the Conservation of Resources Theory, this study employed structural equation modeling to examine the relations among dialectical coping, perceived stress, and mental health (i.e. peace of mind, meaning in life, and somatization) in a sample of Hong Kong Chinese college students (N = 476). Results indicated that dialectical coping was positively associated with peace of mind and meaning in life as well as negatively correlated with somatization. Also, dialectical coping was significantly and indirectly related to the three mental health variables, namely, peace of mind, meaning in life, and somatization. That is, increased dialectical coping was associated with lower perceived stress, which in turn was associated with fewer somatic symptoms and greater peace of mind and meaning in life. Based on our findings, limitations and implications for future research, practice, education and training, and advocacy are discussed.Public significance statementStudy findings demonstrated that a sample of Hong Kong Chinese college students who adopted dialectical coping reported diminished perceived stress, which was associated with greater peace of mind and meaning in life as well as reduced somatization. Findings provide implications for future research, practice, education and training, and advocacy.
Research in psychotherapy often highlights the value of observing and evaluating therapist performance, as differences in treatment delivery can occur, and assessing treatment integrity may provide useful insights. Practical challenges, including time constraints, high costs, and limited resources, can make such evaluation difficult. This study investigated if 10-minute segments could be generalized to whole-session ratings of treatment integrity and whether the results differed according to the observation format (video vs. audio). Twenty-two sessions (66 segments) of emotion-focused therapy (EFT) from 11 cases were coded, including 13 (59.1%) videos and 9 (40.9%) audio recordings. A mixed-design analysis of variance examined differences across three within-session segments and between observation formats (video or audio) and session timings (session 5 or session 10). Overall interrater reliability was good (ICC=.90). Mid-session and late-session segments demonstrated higher shared variance with global ratings than early-session segments. Video segments received significantly higher ratings than audio segments did. These preliminary findings suggest that one or two 10-minute segments may provide a reasonable approximation of whole-session treatment integrity ratings in EFT. Video recordings, which capture both verbal and nonverbal cues, may offer greater value than audio alone, but their use should be weighed against practical considerations.
Racial socialization has been demonstrably linked to shaping the racial identity, and positive and negative indicators of psychological health of minoritized groups. The unique racial and ethnic identities of African immigrants warrant an investigation of their racial socialization processes and the influence it may have on psychological adaptation. Therefore, this study investigated the mediating role of racial private regard in the relationship between racial socialization and acculturative stress among a sample of 172 black African immigrants in the U.S. The results revealed that racial socialization directly contributes to increased acculturative stress. Yet, mediation analysis revealed that increased racial socialization contributed to an increase in positive feelings about race, which then decreased experiences of acculturative stress. The results present significant implications for promoting racial socialization practices that foster internalization of positive feelings about one's racial group while addressing the factors that exacerbate acculturative stress.
This study describes the results of a qualitative analysis of psychotherapy clients who deteriorated on the Outcome Questionnaire-45 (OQ-45) but retrospectively reported improvement, one version of a phenomenon called paradoxical outcomes. We screened 106 students from a college counseling center who reported increased symptoms during therapy, assessed clients' retrospective self-reported progress, and interviewed participants who reported improvements. In this sample, 58.5% reported they had gotten better, 31.1% reported they had neither worsened nor improved, and 9.4% reported they had gotten worse. Interviews with 13 participants who reported improvement revealed clinically relevant findings. Of the 13 domains identified through a qualitative analysis of interview transcripts, two domains are presented: (1) perceived outcomes of therapy and (2) clients' explanations of the discrepancy. Participants reported increased insight and self-awareness, coping strategies, interpersonal improvements, symptom reduction, increased resilience, remoralization (i.e. renewed hope and motivation), and improved self-concept. Participants explained the discrepancy by citing extratherapeutic factors, changes in how they interacted with the questionnaire, elements of progress not detected by the questionnaire (e.g. increased capacity for adversity), and memory recall bias and consistency bias. These findings suggest that current notions of deterioration and psychotherapy outcomes may be limited.
International students tend to underutilize and benefit less from traditional mental health services compared to their domestic counterparts. This conceptual and theoretical paper aims to articulate the significance of digital mental health interventions (DMHIs) to expand mental health service access for international students, propose approaches for designing culturally sensitive DMHIs for international students, and inspire more rigorous research on these interventions. We explore the definition, types, and efficacy of DMHIs. We outline the unique promise of these interventions in reducing barriers to health service access encountered by international students. Most importantly, a five-stage model is proposed to guide the design and testing of equitable and culturally adapted DMHIs for international students. To illustrate these points, we discuss and critically evaluate existing studies of DMHIs for international students. Recent studies supported the potential benefits of DMHIs for improving international students’ psychological distress and well-being. However, the evidence base remains limited in scope and rigor. Future studies can apply the proposed five-stage cultural adaptation framework to guide the development and evaluation of DMHIs for international students. Researchers may conduct well-powered randomized controlled trials, examine correlates of intervention use, co-develop DMHIs with international students, and integrate DMHIs within the larger system.
Childhood maltreatment (CM) has been associated with mental health problems and less favorable treatment outcomes in adulthood. The working alliance is a key component of psychotherapy, yet evidence on CM's effect on the working alliance is inconclusive and contradictory. While personality functioning has been identified as a significant mediator between CM and adult mental health, this mechanism remains unexplored in the context of the working alliance. This naturalistic cross-sectional study examined the mediating role of personality functioning in the relation between CM and early working alliance in a clinical adult sample. A total of 215 adults starting individual psychotherapy completed intake self-report questionnaires assessing CM experiences, personality functioning, and mental health problems. Early working alliance was measured after the first five sessions. Bootstrap mediation analyses tested the mediating role of personality functioning in the association between CM and early working alliance. Personality functioning significantly mediated this association. Among CM types, only mediation models involving emotional neglect and emotional abuse were significant. Findings support partial mediation, highlighting personality functioning as a central mechanism linking CM and emotional maltreatment to difficulties in early working alliance. These results emphasize the importance of targeting personality functioning impairments in adults with CM to improve alliance.
Psychology's troubled past perpetuates systemic racism, reinforcing racial trauma and marginalization through mental health disparities, structural barriers, and culturally discordant clinical practices. This legacy affects racialized communities in Canada and the United Kingdom. This article explores psychology's intersection with racism and cultural identity, drawing on our experiences as Black and racialized individuals. We examine the historical context of psychology, disclosing how early theories and figures promoted pseudoscientific claims that justified segregation and pathologization. Understanding this historical context is crucial for addressing ongoing racism and mental health disparities. We identify barriers to mental health services and emphasize the need for decolonized, and culturally informed practices. To promote healing, we draw on the Africentric framework, recommending healing-centered care strategies that spotlight culturally responsive assessments and systemic change. In conclusion, this paper charts a transformative path forward for counseling psychology. It advocates for an inclusive discipline that embraces diverse epistemologies and fosters healing for Black and racialized communities.
