Tag Archives: mental health

What Does Our Past Tell Us About Our Future? The Essential Role of Psychologists in Fighting HIV

aidsblogphoto

(L-R) Dr. Rich Wolitski (HHS/OHAIDP); Dr. Fayth Parks (Georgia Southern University) APA Ad Hoc Committee on Psychology & AIDS (COPA) chair and symposium co-chair; Dr. Sherry Wang (Santa Clara University) COPA symposium co-chair; Ms. Cherie Mitchell (APA); Dr. Karen Ingersoll (University of Virginia); Dr. Richard Jenkins (NIH/NIDA); and Dr. Ramani Durvasula (California State University, Los Angeles)

This article is cross-posted from the HIV.gov blog with their permission.

 

By Richard Wolitski, PhD (Director, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human Services)

 

Since the early days of the HIV/AIDS epidemic, psychologists have been essential in the response to HIV:

  • They offered mental health support for people living with, or at risk for, HIV—as well as for their families and communities, and those who provide HIV medical care and social services.
  • Psychologists developed programs to educate people about HIV and motivate behavior change to reduce risk.
  • They counseled and supported those who were diagnosed, and also played important roles in working to eliminate the stigma that attaches to HIV/AIDS, sexual minority status, gender identity, substance use, and other characteristics associated with HIV infection.
  • They conducted research that gave us an understanding of cognitive, behavioral, and social determinants of health that create health disparities.

 

They continue to do all of these things, and they play a vital role as the response to HIV/AIDS continues to evolve.

This year, the professional organization for psychologists, the American Psychological Association (APA), celebrated its 125th anniversary. The APA has been deeply involved in the response to HIV/AIDS in the United States:

  • From 1996-2014, the Centers for Disease Control and Prevention (CDC) funded APA’s Behavioral and Social Science Volunteer (BSSV) Program. The program established a national network of more than 300 psychologists, sociologists, anthropologists, and public health experts who provided capacity-building technical assistance to improve the delivery and effectiveness of HIV prevention services to more than 700 organizations.
  • And from 1991-2014, the Substance Abuse and Mental Health Services Administration (SAMHSA) funded APA’s HIV Office for Psychology Education (HOPE) Program, which trained more than 36,500 psychologists and allied mental health providers about HIV, substance use, and mental health.

 

Today, the organization continues its mission to address the ongoing toll of HIV on the mental and physical health of people living with HIV. You can view information about activities, events, and resources on the APA’s HIV webpage.

 

Dr. Arthur C. Evans, Jr. , PhD, APA’s Chief Executive Officer, expressed his support for APA’s role in this work. He shared with me that he sees psychology’s role in this way:  

Psychology plays a critical role in HIV prevention and treatment by promoting behaviors aimed at helping to improve overall health, mental health and well-being and providing a better understanding of social and cultural factors, such as stigma and culturally appropriate counseling and treatment interventions. We know that access to quality behavioral health services facilitate better outcomes across the HIV care continuum, including viral suppression.

Dr. Arthur C. Evans, Jr., PhD

 

Given the organization’s commitment and long track record of service to the HIV community, I was honored when APA asked me to be a discussant as part of the 125th Anniversary Talk, Past, Present and Future of HIV/AIDS Science and Practice in Psychology. Under the skillful direction of co-chairs Dr. Fayth Parks and Dr. Sherry Wang, the panelists addressed a number of important topics:

  • Eugene Farber, PhD, ABPP, Emory University School of Medicine, The Future of Psychology as a Health Service Discipline: Clinical Lessons from the HIV Epidemic
  • Ramani Durvasula, PhD, California State University, Los Angeles: A History of HIV/AIDS in Women: Shifting Narrative and a Structural Call to Arms
  • Karen Ingersoll, PhD, Professor of Psychiatry and Neurobehavioral Sciences at the Center for Behavioral Health & Technology, University of Virginia: Internet Intervention for HIV+ Substance Users to Improve ART Adherence and Addictive Behaviors
  • Richard Jenkins, PhD, Health Scientist Administrator, Prevention Research Branch, National Institute on Drug Abuse: Roles for Psychologists in a World of Changing Epidemics and Policies

Each of the presentations drew attention to the ways that psychologists have contributed to the fight against HIV. A key point made by all the participants is that behavioral approaches to HIV prevention, care, and treatment optimize biomedical approaches—and that the two are inextricably linked.

Dr. Eugene Barber speaking
Dr. Eugene Farber, Emory University

Dr. Gene Farber set the frame for the session by reflecting on the essential role of behavioral health service providers in supporting a humanistic, culturally responsive, and patient-centered care experience for people living with HIV. He stressed that behavioral health services must encompass not only assessment and treatment of behavioral disorders but also interventions to prevent the onset of other health conditions and to optimize biopsychosocial well-being. He also noted that psychologists can make substantial contributions to patient care and evaluation in medical settings.

Dr. Karen Ingersoll took his points a step further to show how psychologists can help individuals even when in-person contact is impossible. She is working on finding better ways to support substance users who are living with HIV—particularly those in rural areas, where HIV and other types of care are not always available and may require time away from work. These individuals are at significantly higher risk for nonadherence to their HIV medications and disengaging from care—so Dr. Ingersoll and her colleagues have developed an interactive online video intervention  that features peer role models offering advice and support to viewers. (Much like our own Positive Spin series, which takes a similar approach to supporting people living with HIV to achieve viral suppression.) This behavioral intervention is currently being tested to see if it can support substance users to take full advantage of biomedical treatment for their HIV disease.

Dr. Ramani Durvasula spoke about the need for holistic approaches to psychological care for women living with HIV. Her presentation focused on “the story of HIV in women,” which includes the multiple challenges women have faced in attempting to:

  • Get information on HIV risk;
  • Obtain an HIV diagnosis, care and treatment; and
  • Participate in HIV clinical trials.

For many women, neither biomedical or behavioral interventions were available.

Dr. Durvasula then discussed the current need for psychologists to be aware of the multiple psychosocial stressors women with HIV face (e.g., economic and caregiving burdens, relational issues, stigma, intersectional discrimination) and how they affect women’s physical health. She also emphasized the need to focus on women’s resiliencies, strengths, and growth rather than just their HIV disease. She ended with the observation that, for the future, psychology training programs should be looking at social justice and advocacy training as key to producing psychologists with the skill sets necessary for the future.

Finally, Dr. Richard Jenkins took the audience through a history of the role of psychologists in the U.S. epidemic, including a look at the ways in which the advent of antiretroviral therapy (ART) and other biomedical approaches have pushed many behavioral interventions to the margins. However, he noted that many of issues that affected people living with HIV in the early days of the epidemic persist and have not been eliminated by effective biomedical treatment, including stigma, access to care, and racial/ethnic disparities. He ended his presentation with a series of questions about how to connect psychologists to opportunities in HIV work, and raise the value of psychology for workforce development related to HIV.

As I listened to these passionate, committed professionals, I thought about the long history of the HIV/AIDS epidemic in the United States. I thought about how our early efforts, which were based on the best information we had at the time, created systems and approaches that have sometimes hampered our efforts to respond to the realities of today’s epidemic.

For example, when the first HIV test became available, we created a standalone system for HIV testing that was supported with siloed funding (meaning the funds could only be used for HIV testing—not any follow-up care or treatment). This was necessary because of the large number of people who needed to be tested and the fact that many people were unwilling to be tested by their usual healthcare providers. They didn’t want their providers to know they were at risk for infection or did not want information about their risk and their HIV test results to be recorded.

So, we set up stand-alone systems for anonymous testing—meaning your name was never attached to your HIV test. You were given a number that matched the one on the vial of blood the worker at the testing site took from you, and you had to have that number to get your results. This approach was intended to alleviate the stigma of testing—but it also meant that we were not able to set up linkages to care and treatment for newly diagnosed people.

The lack of connection with health care was further reinforced—first, by the absence of effective treatment, and, then, for almost three decades, by guidelines indicating that ART was not needed until later in the course of the infection, when damage to the immune system became clear. This history—and the fact that funding streams were established for HIV testing separately from health care—have required substantial changes to facilitate immediate linkage to care, and establishing late in the epidemic coordinated prevention, care, and treatment plans.

Another way that our past response affects our future is in the way that surveillance systems were established. Initially we were focused on AIDS. We did not know what caused it, and we focused on documenting the cases when and where they were identified and when and where the person died. We did not need to gather data to support engagement in HIV care over a lifetime. We were focused on keeping people alive for the next year (or month) and preventing new cases. This changed as we learned what caused HIV, its effects on the body and how to treat it effectively. As changes occurred, we had to start playing catch-up on the surveillance front, and we continue to wrestle with how to collect data in ways that will help us end the epidemic.

We know now that being diagnosed and beginning HIV treatment as soon as possible are essential to the health of people living with HIV. We also know that good physical health and good mental health are closely connected, and that people who feel a sense of well-being are also more likely to feel motivated to care for their bodies. That’s particularly important for people living with HIV.

Our goal is to support every person to engage in care, remain on treatment, and achieve viral suppression—and that goal can only be reached if people feel empowered to take charge of their healthcare. That is where the contributions of my colleagues at APA come in.

Even though biomedical tools are clearly the way we will ultimately win this battle against the HIV epidemic, they will not work if people do not engage in the behaviors that are needed to use them effectively. Psychologists have the training and the skills to help them do just that.


Filed under: AIDS, Health Disparities, Human Rights and Social Justice Tagged: aids, AIDS research, behavioral health, discrimination, HIV, hiv prevention, HIV treatment, mental health, stigma

Kickstart a Lifelong Healthy Habit this Summer! 4 Reasons Gardening Benefits Your Health as You Age

Group of people planting vegetable in greenhouse

By Layla Dang, Brianna Wenande, Bethany Westphal, and Jessica R. Petok (Department of Psychology, Saint Olaf College, Northfield, MN)

 

Gardening is a popular summer activity for a reason! Research shows that it can have positive effects on our physical, mental, and social well-being as we age. Gardening can range from caring for a single plant to mowing the lawn or planting an entire vegetable garden. Don’t be intimidated. Given the versatility of gardening options, anyone can do it. It’s not too late to dig into gardening this summer! Here are four reasons to kickstart this healthy habit:

 

1. Gardening is great for your physical health:

Gardening is an enjoyable way to keep active and physically healthy1,2. Gardeners report increased levels of physical activity through planting seeds, positioning plants, watering, or simply walking through the garden2. Such physical activity has the following benefits3:

 

  • Increased hand and body strength
  • Improved flexibility
  • Reduced bodily pain

 

Regular gardening can also reduce your risk of4:

  • Some cancers
  • Type 2 diabetes
  • Heart disease
  • Osteoporosis

 

Beyond exercise-driven benefits, gardening can also improve nutrition, as well as sleeping and eating patterns. Planting a kitchen garden has nutritional benefits because it can encourage you to eat fruits and vegetables1. Spending time in an outdoor garden can help regulate your sleeping and eating patterns because sunlight controls your circadian rhythms4.

 

2. Gardening also benefits your mental and emotional wellbeing:

Gardening can keep you mentally active and alert, providing opportunities to cultivate new knowledge4. In addition to learning about new plants and gardening techniques, many gardeners enjoy the creativity of planning their gardens, which can include choosing what to plant or designing their garden’s layout4. Additionally, research shows that gardening and spending time in nature can even improve one’s attention span through exposure to a variety of sensory stimuli 5.

 

Among its emotional benefits, gardening can reduce depression and stress, and gardeners report feelings of anticipation, hope, and achievement4,5. If you are older, gardening can provide you with an opportunity to nurture and care for plants, giving you a sense of purpose and improving your self-esteem through a meaningful activity4. Many gardeners report simply gardening “for the love of it,” being attached to their gardens and finding them aesthetically pleasing4.

 

 

3. Gardening is an excellent way to improve your social life:

Gardening is a good strategy for expanding your social circle6. For instance, Participants in an organized horticultural program enjoyed sharing their gardening experiences and personal knowledge with others; it helped them form supportive relationships and become more socially active6. Additionally, gardeners have the opportunity to connect with others who share their passion through community gardens, gardening clubs, or social media groups4.

 

In addition to promoting social interaction and meaningful conversation with others, gardening can also increase your sense of companionship and combat loneliness. Many gardeners even form special bonds with their plants. For example, one participant in a gardening study reflected, “I say hello and talk to my plants everyday . . . It seems that the little plants can understand what I say to them . . . They respond to my encouragement and make me feel that I am not alone”6.

 

4. You can adapt your gardening habits as you age:

It is important to create optimistic goals as you age, and in order to promote optimum physical and emotional health, you should choose a gardening activity appropriate for your physical capabilities. You can continue your passion for gardening as you age, because luckily, gardening is easily adapted to meet changing needs. You can vary the duration and intensity of your gardening activities; ergonomic tools and low-maintenance plants such as succulents help make gardening more comfortable and achievable. Even just being in nature is cognitively and emotionally beneficial for you7,8.

 

Overall, gardening is a fulfilling, holistic way to improve your well-being as you get older. Even if you’ve never tended to plants before, gardening is within reach at any age. So, pot a plant today, and maybe it will blossom into a lifelong passion for gardening you never thought you had!

 

If you’re a gardener:

  • What is your favorite thing about gardening?
  • What do you like to grow in your garden?
  • Do you have any tips and tricks for new gardeners?

 

Let us know in the comments below! If you would like to learn more about the benefits of gardening, this information may be of interest to you:

 

1Wang, D., & MacMillan, T. (2013). The benefits of gardening for older adults: A systematic review of the literature. Activities, Adaptation & Aging, 37, 153-181. doi: http://dx.doi.org/10.1080/01924788.2013.784942

2Tse, M. M. Y. (2010). Therapeutic effects of an indoor gardening programme for older people living in nursing homes. Journal of Clinical Nursing, 19, 949-958. doi: http://dx.doi.org/10.1111/j.1365-2702.2009.02803.x

3Park, S., & Shoemaker, C. A. (2009). Observing body position of older adults while gardening for health benefits and risks. Activities, Adaptation & Aging, 33, 31-38. doi: http://dx.doi.org/10.1080/01924780902718582

4Scott, T. L., Masser, B. M., & Pachana, N. A. (2015). Exploring the health and wellbeing benefits of gardening for older adults. Ageing and Society, 35, 2176-2200. doi: http://dx.doi.org/10.1017/S0144686X14000865

5Detweiler, M. B., Sharma, T., Detweiler, J. G., Murphy, P. F., Lane, S., Carman, J., . . . Kim, K. Y. (2012). What is the evidence to support the use of therapeutic gardens for the elderly? Psychiatry Investigation, 9, 100-110. doi: http://dx.doi.org/10.4306/pi.2012.9.2.100

6Chen, Y. & Ji, J. (2014). Effects of horticultural therapy on psychosocial health in older nursing home residents: A preliminary study. The Journal of Nursing Research : JNR., 23, 167-171. doi: http://dx.doi.org/10.1097/jnr.0000000000000063

7Ulrich, R. S. (1984). View through a window may influence recovery from surgery. Science, 224, 420-421. doi: http://dx.doi.org/10.1126/science.6143402

8Berman, M. G., Jonides, J., & Kaplan, S. (2008). The cognitive benefits of interacting with nature. Psychological Science, 19, 1207-1212. doi: http://dx.doi.org/10.1111/j.1467-9280.2008.02225.x

 

Biographies:

 

Layla Dang is a senior at St. Olaf College, pursuing a bachelor’s degree in Psychology with concentrations in Management Studies and Women’s and Gender Studies. She is currently doing research focused on healthy age-related changes in various types of learning and memory, in the Petok Aging Lab. In the future, she hopes to pursue graduate studies in industrial/organizational psychology.

Brianna Wenande is a senior undergraduate student at St. Olaf College, pursuing a bachelor’s degree in Psychology, Neuroscience, and Statistics. She is currently doing research in the Petok Aging Lab on how healthy aging and genetics influence learning and memory, and in the future, she hopes to pursue a career in child clinical psychology or pediatrics.

Beth Westphal is a junior at St. Olaf College, and she is studying Chemistry and Neuroscience. She is currently researching healthy aging, learning, and genetics alongside Brianna and Layla. Although undecided about her future career goals, she plans to spend time this summer working in her mother’s garden.

Jessica Petok, PhD, is an Assistant Professor at St. Olaf College. Her research is aimed at understanding the cognitive and neural mechanisms of learning, memory and decision-making in healthy adults of all ages. Her current work examines how genetic polymorphisms contribute to variability in learning and memory across the adult lifespan. She received her BA in Psychology from Skidmore College and her PhD in Lifespan Cognitive Neuroscience from Georgetown University.

 

Image source: iStockPhoto.com

 

 


Filed under: Aging, Health and Wellness Tagged: emotional health, gardening, healthy aging, mental health, physical activity, physical health

4 Reasons to Add Dancing to Your Valentine’s Day Plans

Romantic Mature Urban Couple

 

By Kimberlee Bethany Bonura, PhD

 

Whether your Valentine’s Day plans include a romantic partner, dear friends, or a solo activity, why not trip the light fantastic? In other words: make like Fred and Ginger and go dancing!

 

Dancing, research increasingly shows, is good for both your physical and your psychological health.

 

1. In terms of physical health, dancing is good exercise.

One scholarly review found that dancing improved a range of physical strengths and abilities, including cardiovascular endurance, muscle strength and flexibility, and balance. Balance, in particular, is important for maintaining health and independence in older adults, since improved balance reduces a risk of falls. Research has found that while falls are common among older adults, they can be devastating and the risk of mortality increases drastically after a serious fall.

 

2. Dancing may even improve physical strength and balance among older adults with Parkinson’s disease-related balance issues.

One research study found improved balance, walking distance, and backward stride among participants in a 13-week dance class. Both tango and foxtrot participants improved compared to a control group who took no dance classes, and tango participants improved the most. The researchers proposed that the rhythm of dancing activated brain areas necessary to improve balance and functioning.

 

3. Dancing is also great for your mind and psychological health.

One longitudinal study published in the New England Journal of Medicine reported that dancing was associated with a lower risk of dementia. A 12-week dance intervention found that dance participation reduced the experience of bodily pain. Other research with older adults in care homes and facilities has found that a variety of dance interventions (line dancing, social dancing, and aerobic dancing) all improve wellbeing and enjoyment by the individuals in the home. And a study with older adults with depression found that dance lessons improved self-efficacy and reduced hopelessness.

 

4. Dance melds health and fun in one.

When you put on your dancing shoes and hit the floor, you get physical exercise, maintain your memory, improve your mental health, and have fun in the process. Plus, there is the magic of dressing up, remembering the dances of your youth, and enjoying the beat of the music. Can you think of a better way to spend an afternoon or evening?

 

Ready to go dancing?

 

In your local area, check the calendars and schedules of these organizations, which often host regular dances.

At most dance venues, a free introductory lesson is usually included at the start of the evening. Dances are often hosted on a regular basis at: Community Centers, Senior Citizen Centers, VFW halls, and American Legion halls. Many college extension programs and community continuing education program host dance classes as part of their courses. Dance studios often have introductory packages to get you started at a low cost, and once you meet dancers in your area, you’ll learn of other opportunities in the area.

 

Ballroom dance:

USA Dance has chapters throughout the US. Most chapters host regular social dances at a minimal fee, and include an introductory dance lesson before the start of each social dance. You can make friends with local dancers and have a fun evening on the town. Find your local chapter here.Click here

 

Line dancing:

Line dancing instructor Bill Bader offers a list of line dancing venues by country and state. Click here to look in your area. The United Country Western Dance Council promotes both line dancing and country partner dancing around the US and the world, through dance festivals and competitions. Local events in your area will include lessons and opportunities to dance. Click here to learn more about UCWDC.

 

Aerobic dance:

Zumba (a Latin-based dance exercise program) and Jazzercise both offer the benefits of dance in group exercise format. Many gyms, fitness centers, community centers, and YMCAs offer Zumba and Jazzercise classes, and classes are often included in your membership. You can also look for Zumba dance classes by clicking here (on the main page, click on “Find a Class). For Jazzercise, click here to find a class in your area.

 

Biography:

Kimberlee Bethany Bonura, PhD, is the Division 47 (Sport and Exercise Psychology) liaison to APA’s Committee on Aging. As an exercise scientist, Dr. Bonura focuses on promoting health and wellness through fun activities and self-care. Dr. Bonura has been an amateur ballroom dancer for more than two decades, and plans to keep her balance and maintain her memory by twinkling her toes. Learn more about her work at www.drkimberleebonura.com or contact her directly at [email protected].

Image source: iStockPhoto.com


Filed under: Health and Wellness Tagged: dancing, emotional health, exercise, health, mental health, older adults, physical activity

The Inside Scoop: Straight from the Older Adults in Your Life

elderly african american man enjoying coffee with his granddaughter

By Sheri R. Levy, PhD, Rachel Smith, and MaryBeth Apriceno (Stony Brook University)

Who doesn’t enjoy a good story? This holiday season take a few minutes to listen to a story from an older person in your life. You may learn a thing or two and even find some inspiration. Sure, there are lots of self-help and motivational books out there, but a wealth of helpful inside information about how to find happiness and fulfillment is likely waiting for you a lot closer than you think – at your own dinner table or your neighbor’s doorstep.

Long before the Internet and Wikipedia, older adults were a key source of information about how the world works and how to successfully maneuver our way through life’s endless twists and turns. Unfortunately, our jam-packed, fast-paced schedules often don’t leave time for us to take even a few minutes to learn from the older adults we know.

Spending those few minutes together can be mutually beneficial. When older adults share about their lives, there are psychological benefits for both the older individuals doing the talking and for the younger people doing the listening. Since at least the 1960s, healthcare providers have been successfully dabbling in this kind of informal interviewing in which they encourage unstructured storytelling among older adults. Studies with healthcare providers as well as studies with children in schools show that older individuals doing the talking report reduced depressive symptoms and increased positive well-being, while the individuals listening report receiving valuable life advice and more positive attitudes toward aging and older adults. That’s a win-win.

This activity is simple to do and doesn’t have to be time-consuming. Just ask an older adult you know to share something about her/his life. Be sure to ask for details – lots and lots of them. The positive effects of storytelling are magnified when the story is detailed and comes to life. You’ll get a clearer window into their lives, and they will appreciate and enjoy an engaged listener.

So, go ahead and be a nosy relative, neighbor, and friend, and get to know more about the older adults in your life. You are likely to learn something new, while helping make an older adult feel more valued. You might just make a new friend, strengthen a bond, and discover a role model. Bring on the holiday cheer!

 

If you would like to learn more about this topic, the following articles might be of interest to you:

 

Butler, R. N. (1963). The life review: an interpretation of reminiscence in the aged. Psychiatry, 26, 65-76.

Clarke, A., Hanson, E. J., & Ross, H. (2003). Seeing the person behind the patient: enhancing the care of older people using a biographical approach. Journal of Clinical Nursing, 12, 697-706.

Gaggioli, A., Morganti, L., Bonfiglio, S., Scaratti, C., Cipresso, P., Serino, S., & Riva, G. (2014). Intergenerational group reminiscence: A potentially effective intervention to enhance elderly psychosocial wellbeing and to improve children’s perception of aging. Educational Gerontology, 40(7), 486-498. doi:10.1080/03601277.2013.844042

Levy, S.R. (2016). Toward reducing ageism: PEACE (Positive Education about Aging and Contact Experiences) Model. The Gerontologist. 10 AUG 2016, doi: 10.1093/geront/gnw116

Levy, S.R., & Macdonald, J.L. (2016). Progress on Understanding Ageism. Journal of Social Issues, 72(1), 5-25. doi: 10.1111/josi.12153

McKeown, J., Clarke, A., & Repper, J. (2006). Life story work in health and social care: systematic literature review. Journal of Advanced Nursing, 55(2), 237-247. doi: 10.1111/j.1365-2648.2006.03897.x

Pinquart, M., & Forstmeier, S. (2012). Effects of reminiscence interventions on psychosocial outcomes: A meta-analysis. Aging and Mental Health, 16(5), 541-558. doi:10.1080/13607863.2011.651434

 

Biographies: 

Sheri R. Levy is an Associate Professor in the Department of Psychology at Stony Brook University, USA. She earned her PhD at Columbia University in New York City, USA. Levy studies factors that cause and maintain prejudice, stigmatization, and negative intergroup relations and that can be harnessed to reduce bias, marginalization, and discrimination. Her research focuses on bias based on age, ethnicity, gender, nationality, race, sexual orientation, and social class.  With Jamie L. Macdonald and Todd D. Nelson, Levy co-Edited a special issue of Journal of Social Issues on “Ageism: Health and Employment Contexts” (Levy, Macdonald, & Nelson, 2016). Levy’s research has been funded by the National Science Foundation, and Levy publishes her research in journals such as Basic and Applied Social Psychology, Child Development, Cultural Diversity and Ethnic Minority Psychology, Group Processes and Intergroup Relations, Journal of Personality and Social Psychology, Personality and Social Psychology Bulletin, and Social Issues and Policy Review. Levy was Editor-in-Chief of Journal of Social Issues from 2010-2013 and is a Fellow of the Society for the Psychological Study of Social Issues (Division 9 of American Psychological Association).

Rachel Smith is currently a graduate student and teaching assistant at Stony Brook University. Rachel received her BA in Psychology from Eugene Lang College in New York City, NY. Her research investigates the role of construal level in the narrative effects on social mindsets, and seeks to elucidate the link between concrete detail and beliefs shown to underlie different styles of person perception.

MaryBeth Apriceno is a graduate student and teaching assistant at Stony Brook University. She received her BA in Forensic Psychology from John Jay College of Criminal Justice in NYC. Her research investigates the impact of cultural messages and representations of aging in popular forms of media on ageist attitudes, anti-aging behavior intentions, and aging anxiety.


Filed under: Aging Tagged: healthy aging, mental health, older adults, psychological benefits, social bonding, social relationships

Getting Better or Getting Well? How Culture Can Improve Your Health

man head silhouette with jigsaw

By Gordon Nagayama Hall, PhD (Professor of Psychology, University of Oregon)

If you had a cold, with a stuffy nose, sore throat, and headache, would you want a medicine that treated all the symptoms or just the stuffy nose? Most people would want the medicine that treated all the symptoms. A decongestant can make you feel better but a medicine that treats all three symptoms can get you well. Yet, when it comes to mental health problems, such as depression and anxiety, standard mental health treatments do not necessarily address all the issues involved, particularly cultural issues. Standard mental health treatments make many people better and even well, but does everyone get well?

Jennifer was a successful 29-year-old Chinese American computer engineer in the Silicon Valley with one apparent weakness; she was indecisive (Should I bake cookies for my co-workers? Should I take on this project at work?) and needed repeated reassurance from her family that her decisions were correct. After experiencing heart palpitations, she went to a doctor who could not find a medical reason for the heart palpitations and sent her to psychologist. The psychologist told her that her heart palpitations were caused by anxiety associated with her dependence on her family and diagnosed her with obsessive-compulsive disorder and dependent personality disorder. The goals of treatment prescribed by the psychologist were for Jennifer to become more independent: (a) set personal boundaries with her family; (b) stop seeking their assurance and advice; and (c) stop second-guessing her own decisions. Jennifer tried not to contact her family for two weeks and she felt relieved and less anxious but began to miss her family and the heart palpitations resumed occasionally. She was better but not completely well.

A Chinese American coworker of Jennifer’s noticed that she seemed preoccupied and asked what was going on. Jennifer told her about seeing a psychologist and having mixed feelings on the attempts to set boundaries with her family. The coworker told Jennifer about a Japanese American psychologist who seemed to understand Asian American cultures. Jennifer decided to leave the first psychologist and try the Japanese American psychologist. The treatment began with controlled breathing exercises and Jennifer noticed that her heart palpitations became less frequent. The psychologist observed that seeking her family’s advice kept Jennifer connected with her family, who were concerned about “losing her” as she became more involved in her career. Similar to the first psychologist, this psychologist encouraged Jennifer to stop second-guessing her own decisions. But rather than stopping contact with her family, the psychologist had Jennifer meet once a week, not for unnecessary advice but to go grocery shopping together. Her heart palpitations stopped, she became more confident in her decisions, and she felt good about her relationship with her family. In other words, she got well.

The first psychologist offered the standard treatment – be your own person, make your own decisions, don’t rely on others. Jennifer began to feel better but this treatment didn’t help her relationships with her family or her heart palpitations. Wellness for Jennifer meant: (a) reduced heart palpitations; (b) making her own decisions; and (c) staying in touch with her family. The second psychologist offered a culturally-adapted treatment that promoted wellness by:

  • addressing physical health complaints which are an important component of distress for many Asian Americans and other cultural groups (Hunter & Schmidt, 2010; Ryder et al., 2008)
  • combining independence and interdependence, which are both important for many Asian Americans and other cultural groups (Nguyen & Benet-Martínez, 2007; Oyserman, Coon, & Kemmelmeier, 2002)

Science tells us that paying attention to culture can improve the effectiveness of mental health treatments. In a recent meta-analysis of 78 studies of nearly 14,000 people worldwide that will be published in the 50th Anniversary Issue of Behavior Therapy, culturally-adapted mental health treatments were more effective in reducing mental health problems than standard treatments that did not incorporate the client’s culture (Hall et al., 2016). A meta-analysis is a statistical analysis that combines the results of multiple studies to determine the overall effectiveness of a treatment. People with African, Arab, Asian, Latino/a, and Native American ancestries in these 78 studies all benefitted from attention to their cultures.

Nearly 40% of the people in the United States are not White and the majority of children under age 5 are not White (U.S. Census Bureau, 2014). These are people who stand to benefit from culturally-adapted treatments. Yet, critics of cultural adaptations argue that they are more costly and complicated than standard treatments. Such criticisms have impeded research and development of culturally-adapted treatments. But the costs in not developing culturally-adapted treatments include unaddressed suffering for a large number of people and in some cases suicide. Standard mental health treatments help people get better, but incorporating culture into mental health treatments can help many people get well.

 

References:

Hall, G. C. N., Ibaraki, A. Y., Huang, E. R., Marti, C. N., & Stice, E. (2016). A meta-analysis of cultural adaptations of psychological interventions. Behavior Therapy. (Online version available here: http://www.sciencedirect.com/science/article/pii/S0005789416300806)

Hunter, L. R., & Schmidt, N. B. (2010). Anxiety psychopathology in African American adults: Literature review and development of an empirically informed sociocultural model. Psychological Bulletin, 136, 211-235. doi: 10.1037/a0018133

Nguyen, A. D., & Benet-Martínez, V. (2007). Biculturalism unpacked: Components, measurement, individual differences, and outcomes. Social and Personality Psychology Compass, 1, 101-114. doi: 10.1111/j.1751-9004.2007.00029.x

Oyserman, D., Coon, H., & Kemmelmeier, M. (2002). Rethinking individualism and collectivism: Evaluation of theoretical assumptions and meta-analyses. Psychological Bulletin, 128, 3–73. doi: 10.1037/0033-2909.128.1.3

Ryder, A. G., Yang, J., Zhu, X., Yao, S., Yi, J., Heine, S. J., & Bagby, R. M. (2008). The cultural shaping of depression: Somatic symptoms in China, psychological symptoms in North America? Journal of Abnormal Psychology, 117, 300-313. doi: 10.1037/0021-843X.117.2.300

U.S. Census Bureau (2014). A more diverse nation. Retrieved 9/20/16 from https://www.census.gov/content/dam/Census/newsroom/releases/2015/cb15-113_graphic.pdf

 

Biography:

Gordon C. Nagayama Hall, PhD, is a Professor of Psychology at the University of Oregon. He has authored over 100 publications on topics including Asian Americans and mental health. Dr. Hall is Past President of the Asian American Psychological Association and of the Society for the Study of Culture, Ethnicity, and Race.


Filed under: Culture, Ethnicity and Race, Health and Wellness Tagged: cultural adaptation, cultural competence, culturally adapted treatment, mental health, mental health care

Getting Better or Getting Well? How Culture Can Improve Your Health

man head silhouette with jigsaw

By Gordon Nagayama Hall, PhD (Professor of Psychology, University of Oregon)

If you had a cold, with a stuffy nose, sore throat, and headache, would you want a medicine that treated all the symptoms or just the stuffy nose? Most people would want the medicine that treated all the symptoms. A decongestant can make you feel better but a medicine that treats all three symptoms can get you well. Yet, when it comes to mental health problems, such as depression and anxiety, standard mental health treatments do not necessarily address all the issues involved, particularly cultural issues. Standard mental health treatments make many people better and even well, but does everyone get well?

Jennifer was a successful 29-year-old Chinese American computer engineer in the Silicon Valley with one apparent weakness; she was indecisive (Should I bake cookies for my co-workers? Should I take on this project at work?) and needed repeated reassurance from her family that her decisions were correct. After experiencing heart palpitations, she went to a doctor who could not find a medical reason for the heart palpitations and sent her to psychologist. The psychologist told her that her heart palpitations were caused by anxiety associated with her dependence on her family and diagnosed her with obsessive-compulsive disorder and dependent personality disorder. The goals of treatment prescribed by the psychologist were for Jennifer to become more independent: (a) set personal boundaries with her family; (b) stop seeking their assurance and advice; and (c) stop second-guessing her own decisions. Jennifer tried not to contact her family for two weeks and she felt relieved and less anxious but began to miss her family and the heart palpitations resumed occasionally. She was better but not completely well.

A Chinese American coworker of Jennifer’s noticed that she seemed preoccupied and asked what was going on. Jennifer told her about seeing a psychologist and having mixed feelings on the attempts to set boundaries with her family. The coworker told Jennifer about a Japanese American psychologist who seemed to understand Asian American cultures. Jennifer decided to leave the first psychologist and try the Japanese American psychologist. The treatment began with controlled breathing exercises and Jennifer noticed that her heart palpitations became less frequent. The psychologist observed that seeking her family’s advice kept Jennifer connected with her family, who were concerned about “losing her” as she became more involved in her career. Similar to the first psychologist, this psychologist encouraged Jennifer to stop second-guessing her own decisions. But rather than stopping contact with her family, the psychologist had Jennifer meet once a week, not for unnecessary advice but to go grocery shopping together. Her heart palpitations stopped, she became more confident in her decisions, and she felt good about her relationship with her family. In other words, she got well.

The first psychologist offered the standard treatment – be your own person, make your own decisions, don’t rely on others. Jennifer began to feel better but this treatment didn’t help her relationships with her family or her heart palpitations. Wellness for Jennifer meant: (a) reduced heart palpitations; (b) making her own decisions; and (c) staying in touch with her family. The second psychologist offered a culturally-adapted treatment that promoted wellness by:

  • addressing physical health complaints which are an important component of distress for many Asian Americans and other cultural groups (Hunter & Schmidt, 2010; Ryder et al., 2008)
  • combining independence and interdependence, which are both important for many Asian Americans and other cultural groups (Nguyen & Benet-Martínez, 2007; Oyserman, Coon, & Kemmelmeier, 2002)

Science tells us that paying attention to culture can improve the effectiveness of mental health treatments. In a recent meta-analysis of 78 studies of nearly 14,000 people worldwide that will be published in the 50th Anniversary Issue of Behavior Therapy, culturally-adapted mental health treatments were more effective in reducing mental health problems than standard treatments that did not incorporate the client’s culture (Hall et al., 2016). A meta-analysis is a statistical analysis that combines the results of multiple studies to determine the overall effectiveness of a treatment. People with African, Arab, Asian, Latino/a, and Native American ancestries in these 78 studies all benefitted from attention to their cultures.

Nearly 40% of the people in the United States are not White and the majority of children under age 5 are not White (U.S. Census Bureau, 2014). These are people who stand to benefit from culturally-adapted treatments. Yet, critics of cultural adaptations argue that they are more costly and complicated than standard treatments. Such criticisms have impeded research and development of culturally-adapted treatments. But the costs in not developing culturally-adapted treatments include unaddressed suffering for a large number of people and in some cases suicide. Standard mental health treatments help people get better, but incorporating culture into mental health treatments can help many people get well.

 

References:

Hall, G. C. N., Ibaraki, A. Y., Huang, E. R., Marti, C. N., & Stice, E. (in press). A meta-analysis of cultural adaptations of psychological interventions. Behavior Therapy. (Online version available here: http://www.sciencedirect.com/science/article/pii/S0005789416300806)

Hunter, L. R., & Schmidt, N. B. (2010). Anxiety psychopathology in African American adults: Literature review and development of an empirically informed sociocultural model. Psychological Bulletin, 136, 211-235. doi: 10.1037/a0018133

Nguyen, A. D., & Benet-Martínez, V. (2007). Biculturalism unpacked: Components, measurement, individual differences, and outcomes. Social and Personality Psychology Compass, 1, 101-114. doi: 10.1111/j.1751-9004.2007.00029.x

Oyserman, D., Coon, H., & Kemmelmeier, M. (2002). Rethinking individualism and collectivism: Evaluation of theoretical assumptions and meta-analyses. Psychological Bulletin, 128, 3–73. doi: 10.1037/0033-2909.128.1.3

Ryder, A. G., Yang, J., Zhu, X., Yao, S., Yi, J., Heine, S. J., & Bagby, R. M. (2008). The cultural shaping of depression: Somatic symptoms in China, psychological symptoms in North America? Journal of Abnormal Psychology, 117, 300-313. doi: 10.1037/0021-843X.117.2.300

U.S. Census Bureau (2014). A more diverse nation. Retrieved 9/20/16 from https://www.census.gov/content/dam/Census/newsroom/releases/2015/cb15-113_graphic.pdf

 

Biography:

Gordon C. Nagayama Hall, PhD, is a Professor of Psychology at the University of Oregon. He has authored over 100 publications on topics including Asian Americans and mental health. Dr. Hall is Past President of the Asian American Psychological Association and of the Society for the Study of Culture, Ethnicity, and Race.


Filed under: Culture, Ethnicity and Race, Health and Wellness Tagged: cultural adaptation, cultural competence, culturally adapted treatment, mental health, mental health care

Suffering from Depression is Pointless

blog-depression-screening-day4

By David Palmiter, PhD (Psychology Professor, Marywood University)

Monsters are real, and ghosts are real too. They live inside us and sometimes they win.

Stephen King

October 6th is National Depression Screening Day. This day affords the opportunity to receive a free, anonymous and confidential screen for a mood disorder. Some statistics to keep in mind:

  • About 15.7 million American adults suffered from depression in 2014.
  • Suicide is the 3rdleading cause of death among young people ages 10-24.
  • Depression has a higher mortality rate than cardiac disease.
  • Depression causes more days off from work than any other medical disease.
  • The large majority of people suffering from depression do not get effective care, even though evidence-based treatments yield impressive results.

What would we conclude about our culture if the same statistics were true regarding our dental health? It’s sort of hard to imagine, isn’t it: dental health problems are common, destructive and usually treatable but only a small percentage of people receive said healing treatment. Images of us walking around with our knuckles dragging on the ground would come to mind. Yet, this is the reality regarding our collective mental health. Let’s vow to combat this state of affairs. Let’s agree that such a reality is stupid and beneath us. October 6th affords an opportunity to walk the talk that our mental health matters and that we deserve to live lives filled with joy and meaning.

Those attending a screening event can typically count on being greeted by a gracious person and asked to complete a form. No identifying information is requested and no fee is charged. Participants fill out the form, wait a little (so the form can be reviewed), and then meet with a mental health professional in a confidential space. The primary goal is to figure out whether further evaluation might be worthwhile but there is usually time to discuss other matters as well. Screening sites also typically provide referral information and education materials.

Referring back to the Stephen King quote, depression is a lying, liar that lives within its victim’s mind. It sings dirges such as,

“Everything is terrible. It’s all your fault and none of it can be changed.”

“You’ll never feel better again.”

“You suck and have no purpose.”

Depression’s end game is the death of its victim. But, on 10/6/16, an army of lean-mean-healing-machines will be available to help all those who may be so afflicted to begin the process of understanding and healing.

Please do yourself a favor if you are struggling with your mood, and take the brave and wise step to get screened. And, if you have a friend or a loved one who might benefit, ask that person to keep you company as you get screened. Such an act of kindness portends to open a door to transformative change. To find a screening site in your location, click here. For additional resources on fighting depression, visit the APA Help Center.

Biography:

Dr. David Palmiter is a psychology professor at Marywood University and a private practitioner. He is a fellow of APA, The American Academy of Clinical Psychology and the Pennsylvania Psychological Association (PPA). He is also a past president of PPA, a frequent consultant to the media and a blogger. An author of multiple scholarly papers, his two books are Working parents, thriving families: 10 Strategies that make a difference and Practicing cognitive behavioral therapy with children and adolescents: A Guide for students and early career professionals. His website is at http://www.helpingparents.com/; his blog can be found at http://www.hecticparents.com/ and his Twitter moniker is @HelpingParents.

Image source: Graţiela Dumitrică via Flickr Creative Commons


Filed under: Health and Wellness Tagged: depression, depression prevention, depression screening, mental health, National Depression Screening Day, screening, suicide prevention

How to Help People with Mental Health Conditions Quit Smoking for Good

blog-cdc-tips-smokers-mhconditions

By Corinne M. Graffunder, DrPH, MPH (Director of the Office on Smoking and Health,  Centers for Disease Control and Prevention)

Rebecca’s Story                                                                                                                                         

Rebecca, a former smoker featured in CDC’s Tips From Former Smokers campaign, started smoking cigarettes at age 16. Everyone in her family smoked, and once she started smoking, she quickly became addicted. She kept smoking into adulthood. While she tried to stop, she had difficulty quitting. “I probably tried to quit smoking at least half a dozen times, but the addiction was so strong.”

Rebecca was also diagnosed with depression at age 33, and she is not alone. Smoking is more common among people with mental health conditions than among people in the general population. In fact, people with mental health conditions smoke about 4 out of every 10 cigarettes smoked by adults in the United States.

Rebecca recalls the shame she felt when she tried to quit smoking and couldn’t. “All this time, I didn’t even realize that smoking and my depression went hand in hand. I was smoking to try to help my depression, but it only made things worse.” Struggling to quit made her feel even more depressed.

Smoking didn’t just affect Rebecca’s mental health. She also had gum disease and started losing her teeth. The additional toll smoking had on her health motivated her more than ever before to lead a healthy lifestyle. “I finally realized I had to look to myself for my own happiness and health. I had to quit,” she said. She finally quit smoking and received treatment for her depression.

Today Rebecca feels better than ever, both mentally and physically. “Today, I take care of myself. I eat right. I went back into therapy to self-check and to have a professional to talk to about the trials and tribulations that I go through as a single grandmother, and as someone who wants to stay healthy.”

After she quit smoking, Rebecca began running while taking her grandson along for a ride in his stroller. This activity helped her manage stress and depression and to stay smokefree. Six months after starting to run, Rebecca ran her first 5K. “I actually placed third in my age group. That gave me the confidence to keep going,” she said. Learn more about Rebecca’s story, and the wake-up call that  helped her quit smoking for good.

Smoking and Adults with Mental Health Conditions

The percentage of adults with mental health conditions who smoke is at least twice that of the general population, compared with fewer than one in five (17%) adults in the general population.

Smoking-related diseases such as heart disease, lung disease, and cancer are among the most common causes of death among adults. Smoking is not a treatment for depression or anxiety.

Quitting smoking is not easy, but it is possible! Like other smokers, adults with mental health conditions who smoke want to quit, can quit, and can benefit from using proven stop-smoking treatments. By including cessation as part of your treatment plan, you can improve more than just your patients’ physical health – you can improve their overall mental and emotional well-being.

Resources to Help Smokers Quit for Good

Primary care and mental health care providers should routinely screen patients for tobacco use and offer evidence-based smoking cessation treatments. You can help by asking patients about their tobacco use and providing support and education about cessation to those who smoke.

Mental health care professionals and primary care providers can:

  • Ask their patients if they use tobacco; if they do, help them quit.
  • Offer proven quitting treatments, including tailored quit assistance, to patients who use tobacco.
  • Refer patients interested in quitting to 1-800-QUIT-NOW, Smokefree.gov, or other resources.
  • Provide counseling, support, and stop-smoking medicines, as appropriate.
  • Make quitting tobacco part of an overall approach to treatment and wellness.
  • Monitor and adjust mental health medicines as needed in people trying to quit using tobacco.

Free resources to support smokers in their quit journey are at CDC.gov/quit.  These tools can help smokers:

  • Choose a quit date. A new month as a start date is a great idea.
  • Let loved ones know about their quit journey, so they can be supportive.
  • List the reasons for quit smoking.
  • Find out what triggers cause them to smoke, especially during the early days.
  • Have places to turn to for help right away.

Just like Rebecca, smokers can end the cycle of nicotine addiction. If you are a mental health professional who works with patients who smoke, please take a look at CDC’s Resources for Mental Health Care Professionals.

No matter what your specialty is, you know the damaging effects that smoking can have on your patients’ health. Most smokers want to quit. Getting started often takes support and motivation from trusted sources, like you. With CDC’s Resources for Health Care Professionals, you can help your patients quit smoking for good and begin a healthy, smokefree life.

For more information, check out APA’s Smoking and Health Disparities resource page.

 

References:

Centers for Disease Control and Prevention. (2013). Vital Signs: Current Cigarette Smoking Among Adults Aged ≥ 18 Years with Mental Illness—United States, 2009–2011. Morbidity and Mortality Weekly Report 2013;62 (05):81–7 [accessed 2016 July 28].

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (2013). The NSDUH Report: Adults With Mental Illness or Substance Use Disorder Account for 40 Percent of All Cigarettes Smoked [PDF–563 KB]. March 20, 2013. Rockville, MD [accessed 2016 May 18 ].

Biography:

blog-graffunder

Dr. Corinne Graffunder is Director of the Office on Smoking and Health within the National Center for Chronic Disease Prevention and Health Promotion. She is responsible for providing broad leadership and direction for all scientific, policy, and programmatic issues related to tobacco control and prevention.

Prior to her current position she served as the Deputy Associate Director for Policy in CDC’s Office of the Director, working to strengthen collaboration between public health, health care, and other sectors to advance CDC’s population health priorities. She has more than 25 years of experience with national, state, and local prevention efforts and working with the US Surgeon General and National Prevention Council, led the development of the first ever National Prevention Strategy: America’s Plan for Better Health and Wellness.

Since joining CDC in 1987, she has held leadership positions in the National Center for Chronic Disease Prevention and Health Promotion and in the National Center for Injury Prevention and Control, working on a range of health issues including tobacco control, cancer prevention and control, and violence prevention.  She received her doctorate from the University of North Carolina and her Masters of Public Health and Bachelors of Science from the University of South Carolina.

 


Filed under: Health and Wellness, Health Disparities Tagged: CDC, CDC Tips from Former Smokers Campaign, depression, health disparities, mental health, mental illness, smoking, smoking and mental health, smoking cessation, tobacco

How to Help People with Mental Health Conditions Quit Smoking for Good

blog-cdc-tips-smokers-mhconditions

By Corinne M. Graffunder, DrPH, MPH (Director of the Office on Smoking and Health,  Centers for Disease Control and Prevention)

Rebecca’s Story                                                                                                                                         

Rebecca, a former smoker featured in CDC’s Tips From Former Smokers campaign, started smoking cigarettes at age 16. Everyone in her family smoked, and once she started smoking, she quickly became addicted. She kept smoking into adulthood. While she tried to stop, she had difficulty quitting. “I probably tried to quit smoking at least half a dozen times, but the addiction was so strong.”

Rebecca was also diagnosed with depression at age 33, and she is not alone. Smoking is more common among people with mental health conditions than among people in the general population. In fact, people with mental health conditions smoke about 4 out of every 10 cigarettes smoked by adults in the United States.

Rebecca recalls the shame she felt when she tried to quit smoking and couldn’t. “All this time, I didn’t even realize that smoking and my depression went hand in hand. I was smoking to try to help my depression, but it only made things worse.” Struggling to quit made her feel even more depressed.

Smoking didn’t just affect Rebecca’s mental health. She also had gum disease and started losing her teeth. The additional toll smoking had on her health motivated her more than ever before to lead a healthy lifestyle. “I finally realized I had to look to myself for my own happiness and health. I had to quit,” she said. She finally quit smoking and received treatment for her depression.

Today Rebecca feels better than ever, both mentally and physically. “Today, I take care of myself. I eat right. I went back into therapy to self-check and to have a professional to talk to about the trials and tribulations that I go through as a single grandmother, and as someone who wants to stay healthy.”

After she quit smoking, Rebecca began running while taking her grandson along for a ride in his stroller. This activity helped her manage stress and depression and to stay smokefree. Six months after starting to run, Rebecca ran her first 5K. “I actually placed third in my age group. That gave me the confidence to keep going,” she said. Learn more about Rebecca’s story, and the wake-up call that  helped her quit smoking for good.

Smoking and Adults with Mental Health Conditions

The percentage of adults with mental health conditions who smoke is at least twice that of the general population, compared with fewer than one in five (17%) adults in the general population.

Smoking-related diseases such as heart disease, lung disease, and cancer are among the most common causes of death among adults. Smoking is not a treatment for depression or anxiety.

Quitting smoking is not easy, but it is possible! Like other smokers, adults with mental health conditions who smoke want to quit, can quit, and can benefit from using proven stop-smoking treatments. By including cessation as part of your treatment plan, you can improve more than just your patients’ physical health – you can improve their overall mental and emotional well-being.

Resources to Help Smokers Quit for Good

Primary care and mental health care providers should routinely screen patients for tobacco use and offer evidence-based smoking cessation treatments. You can help by asking patients about their tobacco use and providing support and education about cessation to those who smoke.

Mental health care professionals and primary care providers can:

  • Ask their patients if they use tobacco; if they do, help them quit.
  • Offer proven quitting treatments, including tailored quit assistance, to patients who use tobacco.
  • Refer patients interested in quitting to 1-800-QUIT-NOW, Smokefree.gov, or other resources.
  • Provide counseling, support, and stop-smoking medicines, as appropriate.
  • Make quitting tobacco part of an overall approach to treatment and wellness.
  • Monitor and adjust mental health medicines as needed in people trying to quit using tobacco.

Free resources to support smokers in their quit journey are at CDC.gov/quit.  These tools can help smokers:

  • Choose a quit date. A new month as a start date is a great idea.
  • Let loved ones know about their quit journey, so they can be supportive.
  • List the reasons for quit smoking.
  • Find out what triggers cause them to smoke, especially during the early days.
  • Have places to turn to for help right away.

Just like Rebecca, smokers can end the cycle of nicotine addiction. If you are a mental health professional who works with patients who smoke, please take a look at CDC’s Resources for Mental Health Care Professionals.

No matter what your specialty is, you know the damaging effects that smoking can have on your patients’ health. Most smokers want to quit. Getting started often takes support and motivation from trusted sources, like you. With CDC’s Resources for Health Care Professionals, you can help your patients quit smoking for good and begin a healthy, smokefree life.

For more information, check out APA’s Smoking and Health Disparities resource page.

 

References:

Centers for Disease Control and Prevention. (2013). Vital Signs: Current Cigarette Smoking Among Adults Aged ≥ 18 Years with Mental Illness—United States, 2009–2011. Morbidity and Mortality Weekly Report 2013;62 (05):81–7 [accessed 2016 July 28].

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (2013). The NSDUH Report: Adults With Mental Illness or Substance Use Disorder Account for 40 Percent of All Cigarettes Smoked [PDF–563 KB]. March 20, 2013. Rockville, MD [accessed 2016 May 18 ].

Biography:

blog-graffunder

Dr. Corinne Graffunder is Director of the Office on Smoking and Health within the National Center for Chronic Disease Prevention and Health Promotion. She is responsible for providing broad leadership and direction for all scientific, policy, and programmatic issues related to tobacco control and prevention.

Prior to her current position she served as the Deputy Associate Director for Policy in CDC’s Office of the Director, working to strengthen collaboration between public health, health care, and other sectors to advance CDC’s population health priorities. She has more than 25 years of experience with national, state, and local prevention efforts and working with the US Surgeon General and National Prevention Council, led the development of the first ever National Prevention Strategy: America’s Plan for Better Health and Wellness.

Since joining CDC in 1987, she has held leadership positions in the National Center for Chronic Disease Prevention and Health Promotion and in the National Center for Injury Prevention and Control, working on a range of health issues including tobacco control, cancer prevention and control, and violence prevention.  She received her doctorate from the University of North Carolina and her Masters of Public Health and Bachelors of Science from the University of South Carolina.

 


Filed under: Health and Wellness, Health Disparities Tagged: CDC, CDC Tips from Former Smokers Campaign, depression, health disparities, mental health, mental illness, smoking, smoking and mental health, smoking cessation, tobacco

Racial Trauma is Real: The Impact of Police Shootings on African Americans

blog-racial-trauma

By Erlanger A. Turner, PhD (Assistant Professor of Psychology, University of Houston-Downtown) & Jasmine Richardson

There have been many changes within the criminal justice system as a means to deter crime and to keep citizens safe. However, research demonstrates that often times men of color are treated harshly which leads to negative perceptions of police officers. The recent shootings in Baton Rouge, Falcon Heights, and Dallas have exposed many individuals and their families to incidents of police brutality that reminds us that as a society work needs to be done to improve police and community relations.

In light of these recent events, many people have witnessed these traumatic incidents through social media or participation in marches in their cities. The violence witnessed towards people of color from police continues to damage perceptions of law enforcement and further stereotype people of color negatively. In a study published in the American Journal of Public Health (Geller, Fagan, Tyler, & Link, 2014), the authors reported that 85% of the participants reported being stopped at least once in their lifetime and 78% had no history of criminal activity. What is more concerning is that the study also found that those who reported more intrusive police contact experienced increased trauma and anxiety symptoms. Furthermore, those who reported fair treatment during encounters with law enforcement had fewer symptoms of PTSD and anxiety.

 

What is Racial Trauma?

In addition to the mental health symptoms of individuals who have encounters with law enforcement, those who witness these events directly or indirectly may also be impacted negatively. In an attempt to capture how racism and discrimination negatively impacts the physical and mental health of people of color, many scholars have coined the term “racial trauma” or race-based traumatic stress. Racial trauma may result from racial harassment, witnessing racial violence, or experiencing institutional racism (Bryant-Davis, & Ocampo, 2006; Comas-Díaz, 2016). The trauma may result in experiencing symptoms of depression, anxiety, low self-esteem, feelings of humiliation, poor concentration, or irritability.

 

Effects of Racial Trauma on Communities of Color

Decades of research have noted the impact of discrimination and racism on the psychological health of communities of color (e.g., Bryant-Davis & Ocampo, 2006; Carter & Forsyth, 2009; Comas-Díaz, 2016). Although not everyone who experiences racism and discrimination will develop symptoms of race-based trauma, repeated exposure may lead to the following. According to a report on The Impact of Racial Trauma on African Americans, Dr. Walter Smith notes the following effects of racial trauma:

Increased vigilance and suspicion – Suspicion of social institutions (schools, agencies, government), avoiding eye contact, only trusting persons within our social and family relationship networks

Increased sensitivity to threat – Defensive postures, avoiding new situations, heightened sensitivity to being disrespected and shamed, and avoid taking risks

Increased psychological and physiological symptoms – Unresolved traumas increase chronic stress and decrease immune system functioning, shift brains to limbic system dominance, increase risks for depression and anxiety disorders, and disrupt child development and quality of emotional attachment in family and social relationships

Increased alcohol and drug usage – Drugs and alcohol are initially useful (real and perceived) in managing the pain and danger of unresolved traumas but become their own disease processes when dependency occurs

Increased aggression – Street gangs, domestic violence, defiant behavior, and appearing tough and impenetrable are ways of coping with danger by attempting to control our physical and social environment

Narrowing sense of time – Persons living in a chronic state of danger do not develop a sense of future; do not have long-term goals, and frequently view dying as an expected outcome

 

Coping with Racial Trauma

Racial trauma or race-based trauma often goes unnoticed. These hidden wounds that adults and youth of color experience are worn like invisible weights. Hardy (2013) provides the following eight steps to heal after experiencing racial injustices in our community.

  1. Affirmation and Acknowledgement: This involves professionals helping the individual to develop a sense of understanding acceptance of racial issues. This step is important because it opens the door for us to dialogue about issues related to race.
  2. Create Space for Race: Creating space allows an open dialogue with our communities about race. Hardy notes that we must take a proactive role to identify race as a significant variable and talk openly about experiences related to race.
  3. Racial Storytelling: Gives individuals an outlet to share personal experiences and think critically about events in their lives. This provides an opportunity to hear others voice how they have been treated differently due to their race and it helps expose hidden wounds through storytelling.
  4. Validation: Can be seen as a personalized tool used to counter devaluation. This provides confirmation of the individuals’ worth and their redeemable qualities.
  5. The Process of Naming: With the scarcity of research on the effects of racial trauma on mental health, there is of course no name as of yet making it a nameless condition. This in turn increases the doubt and uncertainty. By naming these experiences we give individuals a voice to speak on them and also recognize how they impact them. If we apply a mental health condition, individuals may experience symptoms similar to post-traumatic stress disorder (PTSD).
  6. Externalize Devaluation: The aim for this step is to have people focus on increasing respect and recognizing that racial events do not lower their self-worth.
  7. Counteract Devaluation: This step uses a combination of psychological, emotional, and behavioral resources to build self-esteem and counter racial attacks. This helps prevent future kiss if dignity and sense of self.
  8. Rechanneling Rage: By rechanneling rage, individuals can learn to gain control of their emotions and not let emotions consume them. This is an important step because it empowers people to keep pushing forward after adversity. This may include taking steps to engage in activism or self-care strategies such as spending time with family.

 

Biographies:

Erlanger A. Turner, PhD, is a Clinical Psychologist and an Assistant Professor of Psychology at the University of Houston-Downtown (UHD) in the College of Humanities and Social Sciences. Dr. Turner’s research focuses on access to child mental health services, health inequity, help-seeking attitudes and behaviors, and cultural competency in clinical practice. He teaches courses at UHD in clinical psychology, multicultural psychology, and child psychopathology. Dr. Turner is also a blogger for The Race to Good Health. Dr. Turner is a member of the American Psychological Association and the Association of Black Psychologists. He has served in numerous leadership positions throughout APA and APA Divisions. He earned his B.S. in psychology from Louisiana State University and an M.S. and Ph.D. in clinical psychology from Texas A&M University. Dr. Turner is currently Chair-Elect for the APA Board for the Advancement of Psychology in the Public Interest and he was recently appointment to the Behavioral Health National Project Advisory Committee for the U.S. Department of Health and Human Services, Office of Minority Health.

Jasmine Richardson, BS earned her psychology degree from the University of Houston- Downtown (UHD) and is a former research assistant at the UHD Race, Culture, and Mental Health Research Lab under the supervision of Dr. Turner.

Note: An earlier version of this blog was published on BlackDoctor.org

 

References:

Bryant-Davis, T., & Ocampo, C. (2006). A therapeutic approach to the treatment of racist-incident-based trauma. Journal of Emotional Abuse6(4), 1-22.

Carter, R. T., & Forsyth, J. M. (2009). A guide to the forensic assessment of race-based traumatic stress reactions. Journal of the American Academy of Psychiatry and the Law Online37(1), 28-40.

Comas-Díaz, L. (2016). Racial trauma recovery: A race-informed therapeutic approach to racial wounds. In Alvarez, A.N. (Ed); Liang, C. T. H. (Ed); Neville, H. A. (Ed), The cost of racism for people of color: Contextualizing experiences of discrimination. Cultural, racial, and ethnic psychology book series (pp. 249-272). Washington, DC, US: American Psychological Association.

Geller, A., Fagan, J., Tyler, T., & Link, B. G. (2014). Aggressive policing and the mental health of young urban men. American Journal Of Public Health, 104(12), 2321-2327

Hardy, K. V. (2013). Healing the Hidden Wounds of Racial Trauma. Reclaiming Children And Youth, 22(1), 24-28.

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Filed under: Criminal and Juvenile Justice, Culture, Ethnicity and Race, Human Rights and Social Justice, Violence Tagged: coping, discrimination, mental health, policing, racial bias, racial discrimination, racial profiling, racial trauma, racism, stress, trauma