Divided into three sections, this edited volume offers a comprehensive view of the foundational issues, cultural communities, and practical approaches involved in working with a diverse clientele. Contributions to this book include a wide overview of the issues that arise when working with a culturally diverse clientele and a consideration of a broad range of issues with diversity, including vulnerable populations. Chapters address issues of cultural identity development and specific populations, discussing relevant historical contexts as well as practical points that inform best practices. This book is both informative and practical, serving as both a primer and as a succinct source of information. The specific focus on cross-cultural competency versus the more commonly used term of cultural competency highlights the importance of continued development of competency for practitioners.
Given the divide between research and practice, there has been an increased focus on evidence-based practice (EBP) in psychology. EBP has been defined as the integration of three main components during clinical decision-making: (a) best available research evidence, (b) clinical expertise, and (c) client characteristics, cultures, and treatment preferences. However, little is known about the self-ratings of implementing EBP or its components among psychotherapy providers. Secondary data analyses of a survey of Canadian psychotherapy providers (Middleton et al., 2020) investigated differences in providers’ self-ratings of implementing EBP according to five psychotherapist variables. These psychotherapist variables included the primary therapeutic approach, the number of years of professional experience, the primary setting of practice, the level of education, and the professional capacity of practice. Results indicated significant results for many psychotherapist variables. Among other findings, while psychotherapy providers who were oriented primarily toward cognitive and/or behavioural approaches had significantly higher self-ratings of implementing EBP than did those with a psychoanalytic/psychodynamic approach, providers with a master’s degree had significantly lower self-ratings than did those with a Ph.D. or with postdoctoral training. Findings are discussed in relation to educational, research, and training initiatives in EBP.
The inherent ambiguity of therapy is a significant source of stress for novice counsellors-in-training. As such, the development of their ability to tolerate ambiguity is an important task within their clinical development. The authors sought to examine the effects of a novel 6-week mindfulness and compassion program on ambiguity tolerance and well-being measures in counsellors-in-training working with clients for the first time. Twenty-three counsellors-in-training from across Canada completed measures of ambiguity tolerance, mindfulness, self-compassion, psychological distress, and life and work satisfaction at baseline, post-training, and 3-month follow-up. Participants also provided brief written feedback on the program to assess its feasibility and acceptability. Non-parametric analyses revealed significant increases in the epistemic dimension of ambiguity tolerance, overall meditative mindfulness, self-warmth, and life satisfaction at post-training and follow-up. All participants recommended this training to other students and reported increased knowledge of mindfulness, compassion, and ambiguity tolerance. Future studies should assess this program using a controlled design.
In this paper, the authors explore the challenges and the opportunities for therapists to help their clients bridge the divide between their religious and spiritual beliefs and their sexual practices and identities. The therapeutic work experiences of both authors are primarily with clients who identify with some expression of the Christian faith, hence the focus of this article. The article emphasizes the importance of therapists collaborating holistically with clients who identify as spiritual/religious, and while therapists having prior knowledge of spirituality/religion is helpful, it is not necessary. The article concludes that, in order to work effectively with clients who identify as spiritual or religious, therapists must include spirituality/religion in the healing process.
A great deal of concern exists over the impact of COVID-19 on people’s mental health, with many employees experiencing anxiety over their health and safety and that of their loved ones. The viability of short-term counselling to treat mental health cases related to COVID-19 was explored. Two hypotheses were tested: 1) the short-term counselling component of employee and family assistance programs is equally effective in the treatment of cases related to COVID-19 as it is in the treatment of cases unrelated to COVID-19; 2) after a certain number of counselling sessions, the improvement in outcomes greatly diminishes for short-term counselling cases. Results showed positive outcomes for both case types, related or not to COVID-19. In addition, a diminishing return was found as the number of treatment sessions increased. From a clinical perspective, the results supported the viability of short-term counselling as a treatment option for cases related to COVID-19, thus suggesting short-term counselling is an effective approach for mental health issues stemming from mass traumatic events.
Minoritized children and their families living in Canada face a number of barriers to accessing mental health care. This article explores some common barriers related to location, race and ethnicity, language, and financial considerations that minoritized children and their families face when they seek or receive psychosocial interventions within a Canadian context. Practical accommodations and strategies used to address these barriers are discussed and illustrated by an example of work with a Latin American youth and her parents. Implications for the psychosocial treatment of minoritized children and their families are outlined, and calls to action for individual counsellors and for the field of counselling psychology to address barriers are discussed.
Rachel Aviv, a staff writer at The New Yorker, explores the roles and inadequacies of stories in accounting for and shaping the lives of people “unsettled” by crisis and mental distress. Through six evocative case examples, including her own experience of being diagnosed with anorexia at age 6, she highlights the complexities and centrality of narrative meaning making by clients and professionals when they address mental health concerns. Such stories made out of distress not only implicate the identities of clients and professionals but also change with different medical and cultural developments. This is a book that will interest and perhaps perplex counsellors who have embraced narrative ideas and practices.
The Canadian Red Cross approved funding for the Psychologists’ Association of Alberta through its Alberta Wildfires 2016 Community Organization Partnership Program. Funding was used to directly resource psychological trauma assessment and treatment until June 2020. Outcome-informed practices were employed to empirically validate treatment employing the Outcome Rating Scale (ORS). Sixteen approved psychologists provided trauma-informed services to 349 clients over 3 years, with the ORS being completed at five-session intervals. Results indicated very low levels of functioning and well-being at intake. For adults, overall average functioning and well-being increased over the treatment period. By the 5th, 10th, and 15th sessions, there was an average reported increase in perceived well-being of 65%, 57%, and 100%, respectively. Treatment made a significant difference for clients. The resulting five primary recommendations are 1) to provide timely access to qualified assessment and treatment, 2) to conduct trauma-informed screening of referrals, 3) to identify and provide additional resources for vulnerable populations, 4) to tailor services to gender considerations, and 5) to take steps to reduce barriers to accessing assessment and treatment.
The aim of this program evaluation was to assess the impact of an 8-week art therapy intervention for adults in a hospital-based outpatient mood disorders clinic on depressive symptoms and overall quality of life and to examine how these symptoms may change over time by primary psychiatric diagnosis. Following a convergent mixed-methods approach, data collection included quantitative and qualitative patient feedback regarding program implementation to improve delivery. Pre- and post-treatment results from this evaluation are presented (n = 88), including patient feedback on the program (n = 34). Independent of primary diagnosis, patients experienced improvements in depressive symptoms (p < .001, ηp2 = .33), anxiety symptoms (p < .001, ηp2 = .16), and stress symptoms (p < 0.01, ηp2 = 15), as measured by the Depression Anxiety Stress Scales-21. In addition, patients experienced improvement in scores on the Quality of Life Enjoyment and Satisfaction Questionnaire—Short Form (p < .001, ηp2 = .37). Findings suggest that structured group art therapy can reduce symptoms of depression, anxiety, and stress and can improve quality of life in a Canadian outpatient psychiatric setting. Participants were generally satisfied with the quality of this service delivery and provided constructive qualitative feedback to help improve the service.
Bien que les émotions soient omniprésentes dans la vie des gens et interviennent dans la prise de décision, on leur porte très peu d’attention lors du choix de carrière à la fin des études secondaires. Pourtant, les adolescents vivent une période où les émotions sont ressenties intensément alors qu’ils doivent faire un choix de carrière qui influencera leur avenir. Cette étude indique les émotions ressenties par les élèves lors de leur dernière année d’études secondaires et la présence de relations de dépendance entre certaines variables. Les données quantitatives recueillies par une enquête en ligne, auprès de 674 élèves, indiquent une forte présence des émotions ressenties lors du choix de carrière. Elles indiquent également que l’écoute et la compréhension des émotions sont en relation avec le degré de certitude et l’expérience du choix de carrière. Cet article offre des pistes d’intervention en counseling de carrière pour les conseillers d’orientation.
This book review looks at a clinical tool kit that provides a solid conceptual foundation in trauma care. The editors have drawn on the expertise of psychotherapists, psychological associates, psychiatrists, social workers, and a medical illustrator. The unique approach offers a resource to paraprofessionals, professionals, and anyone working in settings where trauma is a necessary consideration. The tool kit provides practice information for psychoeducation and guidance on how to develop strategies to manage the effects of complex trauma. The primary goal is to build community capacity in an already overburdened mental health system.
This article presents the narrative of the first author witnessing the process of sharing intergenerational trauma (IGT) stories between a parent-offspring dyad. The narrative described in this paper is part of a study that involved the construction of IGT narratives in Chinese Canadian families (Chou et al., 2023). Arvay’s (2003) Collaborative Narrative Method was utilized to develop participant narratives, while autoethnographic data was used to construct the researcher’s narrative. The paper introduces an intergenerational family dyad (father-daughter) engaging in a facilitated process that involved sharing their IGT stories with one another and presented from the researcher’s perspective. The study has implications for researchers and practitioners working with IGT in the Chinese diasporic community as well as other ethnocultural groups. It provides insight into a scarcely studied phenomenon and illustrates how IGT narratives can be shared in a facilitated and supportive manner and has implications for research and clinical practice.
As counselling practitioners navigate through the 21st century, holding and integrating multiple views in counselling practice with Indigenous people is more crucial than ever. Indigenous people face unimaginable health, social, and political inequalities; therefore, there is a call to action that would create ripple effect change from practitioners and as a collective. In this article, the author explores how a two-eyed lens, a term coined by Elders Albert and Murdena Marshall (Iwama et al., 2009), answers this call by honouring Western and Indigenous world views and healing. What this article adds to the literature is how practitioners can implement two-eyed seeing, which starts with exploring the self, self-in-relation, and felt sense (Gendlin et al., 1968). This article describes this reflexive process in which counselling practitioners can develop a many-eyed lens in practice that honours Western and Indigenous therapeutic lenses and our own, in walking alongside Indigenous people. A many-eyed lens illustration with an Indigenous family is presented as a way to demonstrate and foster reconciliation, healing, and hope.
The following professionals deserve special recognition for the time and effort they have recently contributed by serving as reviewers for the Canadian Journal of Counselling and Psychotherapy.
911 dispatchers are considered the first of the first responders. Despite existing literature concluding 911 dispatchers experience rates of traumatic exposure similarly to other emergency service personnel, there is limited research regarding this population’s specific experiences. The purpose of this study was to explore the lived experiences of 911 dispatchers to determine the consistency of their experiences with the limited existing literature regarding trauma-related disorders among dispatchers. In this international study, a transcendental phenomenological research approach was utilized to describe the lived experiences and commonalities of the participants. Participants were primarily recruited through social media groups specifically for 911 dispatchers. Based on the findings from this study, six prominent themes emerged: (a) health issues, (b) juxtaposed positive and negative work environment, (c) passion and pride about work, (d) cumulative stress, (e) vicarious traumatization, and (f) strained interpersonal relationships. Limitations, recommendations for future research, and implications are discussed. Keywords: 911 dispatchers, traumatic calls, posttraumatic symptoms, lived experiences
The practice of therapy is continuously evolving, but the global pandemic especially caused drastic and sudden shifts in our service delivery. Although therapists were generally able to adapt quickly, guidelines and suggestions for novel practices are lagging. This book was written to provide foundational knowledge on emergent practices as result of the pandemic and other influences. This essential read covers topics such as teletherapy, innovative approaches (such as concierge therapy) race/power, legal/ethical issues, and self-care. By reading this book, therapists will be able to strengthen their understanding on how we (should) practice therapy now.
This article, the third transcribed interview (edited for readability) in a concurrent series highlighting leaders who have been instrumental in shaping the profession in Canada, is an interview with William A. Borgen, a prominent leader in the Canadian counselling profession. This article will focus on Bill’s achievements during his career and recommendations for the future of the profession in Canada. In particular, the interview provides insight, guidance, and wisdom for influencing future leaders in counselling.
In Canada, statutory regulation for the mental health professions is a provincial or territorial matter. In 2007, the Ontario government introduced the Psychotherapy Act (PA), which details the scope of practice as well as the authorized act of psychotherapy. The PA established the College of Registered Psychotherapists of Ontario (CRPO) to regulate its members in the service of protecting the public. Given the long history of contestation and ambiguity surrounding the definition of psychotherapy, the PA represents an important historic moment for practitioners in Ontario. However, little research has been conducted on psychotherapy practitioners’ experiences and perspectives on professional regulation. This study qualitatively explored perspectives on, and experiences with, the PA among regulated mental health practitioners who have access to the act of psychotherapy in Ontario, including psychotherapists, nurses, physicians, occupational therapists, psychologists, and social workers. The study provides insights into the ways that these professional groups are impacted by the regulation of psychotherapy and has implications for the future implementation of statutory regulation.
This study qualitatively examined the evolving experience and change process occurred when 14 clinical psychology doctoral trainees worked directly with refugee clients as part of their multicultural counselling training (MCT). The trainees’ post-session critical incident journals were collected and analyzed based on the Grounded Theory Method. A superordinate theme emerged from the data analysis in response to the research questions of this study - Increased Awareness and Responses to Make Cultural Adaptations to Therapy. This superordinate theme, with its 8 subthemes, suggest that in learning how to respond to and build relationship with refugee clients, trainees experienced a dynamic developmental progression, involving elements of cultural awareness, knowledge, and skill. A three-progned ‘Cognitive-Affective-Behavioural’ model was also identified and hypothesized to help conceptualize the effects/impacts on trainees’ overall development of multicultural competence through building relationship and offering culturally-informed therapy to refugees. Implications for MCT theory-building, research and practice are discussed.
Given that an increasing number of newcomer youth enter high schools in Canada each year, educational settings are faced with the challenge of creating programming and policies that promote a positive integration process. As part of a larger study that examined the integration experiences of newcomer youth, four participants were asked to offer advice for other newcomer students and for professionals working with this group and suggestions of ways to improve the current educational system. Analysis of these suggestions revealed four themes: (a) forming connections, (b) support from professionals, (c) appropriate placement, and (d) provision of additional resources and information. These themes highlight areas in which newcomer youth are lacking support and provide practical solutions to ensure that newcomer youth feel more connected to their schools and communities and supported through the process of school integration.
