Search

Emerging research shows that Acceptance and Commitment Therapy (ACT) may improve mental health for caregivers. Parents of autistic children, adolescents, and adults (N = 54) were randomly assigned to either complete a brief group-based ACT intervention or remain on the waitlist. Participants completed surveys immediately prior to randomization, and 3-, 7-, and 17-weeks post-randomization. The primary outcome was depression symptoms and secondary outcomes included stress, goal attainment, positive affect, ACT psychological processes, child mental health, and family functioning. Mixed effects linear models testing Group × Time interaction indicated the Treatment group (n = 27) demonstrated greater post-intervention improvements than the Waitlist group (n = 27) in parent depression (p =.03, d = −0.64) and family distress (p =.04, d = −0.57). Treatment group parents also reported greater short-term gains in positive affect (p =<.001, d = 0.77) and personal goal attainment (p =.007, d = 0.80), compared to the Waitlist group. Although there was no significant Group × Time interaction for other outcomes, stress (b = −2.58, p =.01), defusion (b = −3.78, p =.001), and experiential avoidance (b = −4.22, p =.01) showed improvement for the Treatment group, but not the Waitlist group, at post-intervention. All Treatment group improvements were maintained at follow-up. Results suggest that a brief ACT group intervention is efficacious for improving some aspects of mental health for parents of autistic children. Parents of autistic children commonly experience difficulties with their own mental health. This study looked at the effects of a brief group-based Acceptance and Commitment Therapy program, developed for parents of autistic children, youth, and adults. ACT focuses on increasing psychological flexibility, which is the ability to be mindful and accepting of difficult thoughts and experiences, shown to be important for mental wellness. Participants included 54 parents of autistic people, ages 3–34. Parents were randomly divided into two groups: a Treatment group that received the intervention right away, and a Waitlist group that completed the program after the Treatment group completed the trial. All parents filled out questionnaires right before the program began, and at 3, 7, and 17 weeks after randomization. Compared to the group that was waiting to participate in the program, parents in the Treatment group reported greater improvements in depression and family distress, and these improvements were still present 4 months later. Parents in the Treatment group also reported short-term improvements in their positive feelings and personal goals, compared to those waiting. Results showed that ACT may help improve some aspects of mental health for parents of autistic children, but further research is recommended. [ABSTRACT FROM AUTHOR]

The knowledge and experience of diverse psychiatrists is crucial to improving care for racialized patients and working toward broader change in health-care institutions and systems.[106],[163],[183] In the meantime, health-care institutions and professional organizations must stop current "colourblind" approaches that are common and continue to perpetuate discrimination against people of colour.[184] One important step would be for each academic department of psychiatry in Canada to identify an equity, diversity and inclusion (EDI) leader. In Canada, where Indigenous Peoples[116] and many other groups are under-represented in the health professions, funding and hiring strategies that lead to recruitment of minority medical students and residents can contribute to a long range shift within psychiatry toward greater diversity and inclusiveness in the mental health workforce and equitable representation of racialized groups.[181],[182] More than mere numerical representation, racialized psychiatrists and trainees need the mental health system to change to become actively anti-racist and welcoming of diversity. Bridging cultural psychiatry and global mental health: a resident-led initiative. Bridging cultural psychiatry and global mental health: a resident-led initiative. [Extracted from the article]

Objective: Although there is evidence of effective stigma reduction by various psychological and educational interventions, the mechanisms of change remain unclear. In this article, we examine hypothesized processes that might have mediated reductions in stigma observed among Asian men who had received in mental health promotion interventions in Greater Toronto Area, Canada. Method: Our sample consisted of 495 Asian men, who received either acceptance and commitment therapy (ACT; n = 133), contact-based empowerment education (CEE; n = 149), combination of ACT and CEE (n = 152), or psychoeducation (n = 61). Group differences on intervention outcomes, including stigmatizing attitudes (Community Attitudes toward the Mentally Ill), internalized stigma (Internalized Stigma of Mental Illness), valued living (Valued Living Questionnaire), and attitudes to engage in social change (Social Justice Scale) were hypothesized to be due to the impact of the different interventions and mediated by changes in specific underlying psychological processes. These process-related changes were modelled using measures of mindfulness (Freiburg Mindfulness Inventory), psychological flexibility (Acceptance and Action Questionnaire version II), and empowerment (Empowerment Scale [ES]). Their pre- and post changes were analyzed with repeated measures analysis of variance, and mediational analyses were performed. Results: Findings from mediational analyses suggest that empowerment (ES) mediated a significant portion of the effects observed in reduction in stigmatizing attitudes and internalized stigma across intervention groups (t = 3.67 to 3.78 for CEE groups, and t = 4.32 to 4.56 for ACT groups). For the ACT groups, reduction in internalized stigma might also have been partly mediated by psychological flexibility, an intervention-specific psychological process. Conclusions: Results from the current study suggest that different stigma reduction interventions may be mediated by increased empowerment as a common mechanism of change, while intervention-specific mechanism of change, improved psychological flexibility through ACT, may also contribute to improvement in internalized stigma. [ABSTRACT FROM AUTHOR]

A position statement developed by the Canadian Psychiatric Association (CPA) on racism and social justice in mental health is presented. It calls for social change to address violence and inequities of systemic racism and discrimination around the world. It also calls for diversity in mental health professional training, the creation of inclusive and safe educational and clinical environment, and challenging biases and assumptions built into mental health theory and practice.

This position paper has been substantially revised by the Canadian Psychiatric Association (CPA)'s Section on Transcultural Psychiatry and the Standing Committee on Education and approved for republication by the CPA's Board of Directors on February 8, 2019. The original position paper1 was first approved by the CPA Board on September 28, 2011. [ABSTRACT FROM AUTHOR]

A position paper developed by the Canadian Psychiatric Association's Education Committee and approved by the CPA's Board of Directors on August 15, 2016. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We appreciate the response to the CPA Position Paper on Training in Cultural Psychiatry from Drs. Persad and Oyewumi.[1] We completely concur with their comments underscoring the importance of religion and spirituality in cultural psychiatry. [Extracted from the article]

The article offers guidelines for training in cultural psychiatry. Based on a review of literature and existing training programs, it addresses issues relevant to general psychiatry and specific populations including refugees and immigrants. A knowledge exchange centre is developed by the Section on Transcultural Psychiatry of the Canadian Psychiatric Association to share curriculum materials, interactional learning and self assessment tools of clinical practice and organizational change.

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Many cultures around the world observe specific postpartum rituals to avoid ill health in later years. This qualitative systematic review examined the literature describing traditional postpartum practices from 51 studies in over 20 different countries. Commonalities were identified in practices across cultures. Specifically, the themes included organized support for the mother, periods of rest, prescribed food to be eaten or prohibited, hygiene practices and those related to infant care and breastfeeding, among others. These rituals allow the mother to be 'mothered' for a period of time after the birth. They may have beneficial health effects as well as facilitate the transition to motherhood. In today's society, with modernization, migration and globalization, individuals may be unable to carry out the rituals or, conversely, feel pressured to carry out activities in which they no longer believe. The understanding of traditional postpartum practices can inform the provision of culturally competent perinatal services. [ABSTRACT FROM AUTHOR]

Background and aims: It has been recognized that Asian immigrants in North America have lower rates of mental health service utilization. From the perspective of cross-cultural psychiatry, one of the most important cultural factors may be differences in the explanatory model of illness. This article examines the relationship of causal beliefs, perceived service accessibility and attitudes towards seeking mental health care. Method: The sample consisted of 1000 immigrant and refugee women from five ethnic minority communities in Toronto, including three Chinese Canadian communities (Hong Kong, mainland China and Taiwan), Korean Canadians and Vietnamese Canadians. Data were acquired by a self-administered structured questionnaire. Quantitative data were analysed using MANOVA, ANOVA and stepwise multiple regression. Results: The five ethnic minority groups of women differed in their explanatory models about mental illness and distress. In the full model where other variables were controlled for, the most significant factor predicting attitudes towards seeking professional help was perceived access for all groups except the Hong Kong Chinese. In the last group, those subscribing more to a Western stress model of illness had a more positive attitude towards seeking professional help, while those subscribing more to supernatural beliefs had a more negative attitude. Age and education were not significant predictors. Conclusion: Perceived access is one of the main factors that influence attitudes toward seeking professional help. Explanatory models may predict help-seeking behaviours if perceived access to such services is available. [ABSTRACT FROM AUTHOR]

To provide effective psychotherapy for culturally different patients, therapists need to attain cultural competence, which can be divided broadly into the 2 intersecting dimensions of generic and specific cultural competencies. Generic cultural competence includes the knowledge and skill set necessary to work effectively in any cross-cultural therapeutic encounter. For each phase of psychotherapy--preengagement, engagement, assessment and feedback, treatment, and termination--we discuss clinically relevant generic cultural issues under the following headings: therapist, patient, family or group, and technique. Specific cultural competence enables therapists to work effectively with a specific ethnocultural community and also affects each phase of psychotherapy. A comprehensive assessment and treatment approach is required to consider the specific effects of culture on the patient. Cultural analysis (CA) elaborates the DSM-IV cultural formulation, tailoring it for psychotherapy; it is a clinical tool developed to help therapists systematically review and generate hypotheses regarding cultural influences on the patient's psychological world. CA examines issues under 3 domains: self, relations, and treatment. We present a case to illustrate the influence of culture on patient presentation, diagnosis, CA, and psychotherapeutic treatment. Successful therapy requires therapists to employ culturally appropriate treatment goals, process, and content. The case also demonstrates various techniques with reference to culture, including countercultural, cultural reinforcing, or culturally congruent strategies and the use of contradictory cultural beliefs. In summary, developing both generic and specific cultural competencies will enhance clinician effectiveness in psychotherapy, as well as in other cross-cultural therapeutic encounters. [ABSTRACT FROM AUTHOR]