Grief research among American Indian (AI) and Alaska Native (AN) people has been limited to studies on historical trauma and elevated mortality rates among AI/ANs. A lack of validated measures is one barrier to grief research with AI/ANs. Therefore, we conducted three studies to develop and validate a culturally congruent measure of grief. In Study 1, interviews were conducted with 12 AI reservation-based community members to understand perspectives on grief. In Study 2, AI/AN community members ( = 10) and professionals ( = 7) provided feedback on measure items adapted or developed in Study 1. In Study 3, exploratory and confirmatory factor analyses using separate randomly selected samples from a web-based survey of 600 AI/ANs were conducted to identify the factor structure of the Complicated and Adaptive Grief Inventory for Native Americans (CAGI-NA). Findings suggest that the resulting 30-item CAGI-NA is valid, reliable, and suitable for use in research with AI/AN people.

This study examined the extent to which the Negative Context of Reception Scale generates valid and reliable scores with Puerto Rican Hurricane Maria survivors. A sample of 319 adult Hurricane Maria survivors completed measures of the negative context of reception, discrimination, language stress, depressive and anxiety symptoms, optimism, and life satisfaction. Confirmatory factor analyses (CFAs) indicated that the previously validated one-factor solution fit the data adequately, and multigroup invariance tests indicated that this solution fit largely equivalently across gender, age groups, year of arrival in the United States, and self-reported English proficiency. Negative context of reception was correlated positively with discrimination and language stress, positively with symptoms of depression and anxiety, and negatively with optimism and life satisfaction. It may be important to adjust item order to reduce intercorrelations among some item responses. This study offers an instrument that counselors can use with Hurricane Maria survivor clients.

Using structural equation modeling in a national, nonprobabilistic sample of 292 transgender women and men, this project extends the pantheoretical dehumanization framework by testing direct and indirect relations between dehumanization (i.e., a higher-order construct from experiences of transgender microaggressions and sexual objectification), internalization processes (i.e., internalized transnegativity, self-objectification), shame, and general mental health. The model explained 55% of the variance in general mental health. Direct relations between dehumanization and all internalization processes were positive and significant. Internalized transnegativity and shame were significant, negative, direct predictors of mental health, but neither dehumanization nor self-objectification was a significant direct predictor of transgender mental health. Both self-objectification and internalized transnegativity directly predicted more feelings of shame. However, only shame yielded a significant indirect pathway from dehumanization to mental health. The indirect relations from self-objectification and internalized transnegativity to mental health through shame were significant. Research, advocacy, and clinical implications are discussed.

Given that half or more of supervisees (therapist trainees) never have their clinical work monitored or observed, supervisees who withhold salient information in clinical supervision compromise supervisors' ability to monitor client welfare and promote supervisees' professional development. Attempting to further understand the factors explaining supervisee nondisclosure, we tested the supervisory working alliance as a mediator of the hypothesized inverse relations of cultural humility and collaborative supervision with supervisee nondisclosure (supervision-related and clinically-related nondisclosure) among a diverse sample of 214 supervisees in applied psychology and allied mental health programs. Results supported the hypotheses that (1) descriptively, supervision-related nondisclosure was more prominent than clinically-related nondisclosure, (2) cultural humility substantially inversely predicted supervisee nondisclosure, and (3) the supervisory working alliance fully mediated the inverse relations of cultural humility and collaborative supervision with supervisee nondisclosure. Understanding the mechanisms underlying supervisee nondisclosure have broad implications for clinicians and researchers alike.

This study uses Lent et al.'s (1994) social cognitive career theory (SCCT) as a framework for understanding the career barriers and coping efficacy experienced by international master's of counseling psychology students. Grounded in SCCT, we described coping efficacy as international students' perceived capability to navigate career barriers. Using Braun and Clarke's (2006) thematic analysis, we explored the career barriers and coping efficacy of 12 international master's of counseling psychology students. The first focus area, International Journey with Multiple Barriers, included five themes: Interpersonal Stress, Language Barriers, Financial Pressures, Advising Concerns, and Visa and Immigration-Related Stress. The second focus area, Agents of Change in the Midst of Barriers, included five themes: Self-Regulating, Stepping into Discomfort, Cognitive Reappraising, Becoming a Change Agent, and Social Support Seeking. Findings demonstrated participants' coping efficacy and perceptions of themselves as agents of change. This study deepens the field's understanding of career development among international master's of counseling psychology students.

This study evaluated rates of psychiatric symptoms and mental health treatment utilization among National Guard service members during the post-deployment period. National Guard service members (=311) completed surveys assessing demographics, beliefs about mental health treatment, emotion regulation strategies, and psychiatric symptoms. Mental health treatment utilization was assessed at 6-month follow-up. Post-deployment, 41.2% of the sample had psychiatric symptoms above the clinical cut-off for at least one symptom measure. This proportion increased at follow-up (53.5%). Alcohol use disorder (AUD) symptoms showed the largest increase (=0.66), although symptoms of depression and posttraumatic stress disorder (PTSD) also showed small magnitude increases. Among those with elevated symptoms post-deployment (=128), only 27.8% received mental health treatment at follow-up. Severity of depression, anxiety, and PTSD were higher among those who utilized treatment. The post-deployment period is a vulnerable one. Continued efforts to understand and address barriers to treatment for this population are warranted.

The COVID-19 pandemic has upended life like few other events in modern history, with differential impacts on varying population groups. This study examined trauma-related distress among 6,882 adults ages 18 to 94 years old in 59 countries during April to May 2020. More than two-thirds of participants reported clinically significant trauma-related distress. Increased distress was associated with unemployment; identifying as transgender, nonbinary, or a cisgender woman; being from a higher income country; current symptoms and positive diagnosis of COVID-19; death of a loved one; restrictive government-imposed isolation; financial difficulties; and food insecurity. Other factors associated with distress included working with potentially infected individuals, care needs at home, a difficult transition to working from home, conflict in the home, separation from loved ones, and event restrictions. Latin American and Caribbean participants reported more trauma-related distress than participants from Europe and Central Asia. Findings inform treatment efforts and highlight the need to address trauma-related distress to avoid long-term mental health consequences.

Are higher levels of work-family enrichment a consequence or manifestation of certain personality traits and individuals' psychological functioning? Using random intercept cross-lagged panel models, this study examined the hypothesized stability of work-to-family enrichment (WFE) and family-to-work enrichment (FWE) over two 10-year intervals, the extent to which the within-person changes of WFE and FWE are associated with personality traits and psychological well-being (PWB), and possible gender differences. In this 20-year, longitudinal data analysis of employed adults (=535), results indicated the robust nature of the stability of WFE/FWE. Our results suggest that personality traits were not associated with within-person change for either WFE or FWE, but PWB was associated with within-person change. Theoretically and conceptually, our findings provide strong evidence that work-family enrichment is not simply an "optimistic worldview" created by personality and well-being. The within-person results lend strong evidence that interventions that improve psychological well-being will also enhance work-family enrichment.

Medically unexplained symptoms (MUS) are common among veterans and are difficult to treat. Optimal treatment entails continued care from providers, including primary care and counseling psychologists. Non-concordance between veterans' and providers' views of MUS may contribute to poor veteran satisfaction with care and possibly disengagement with care (e.g., non-adherence to treatment recommendations, including counseling and graded exercise). The current study surveyed 243 veterans with MUS post-deployment and evaluated the degree of non-concordance perceived by veterans with their primary care providers regarding their MUS and the effect of perceived non-concordance on treatment behaviors and outcomes. Many veterans in the current sample perceived non-concordance with their provider regarding their MUS (19% reporting quite a bit or complete disagreement). Perceived non-concordance (regarding MUS overall and specific causal perceptions) predicted important outcomes of interest, particularly veterans' satisfaction with their provider. Perceived concordance with primary care doctors may be required for sufficient adherence to MUS treatment recommendations, such as seeking and maintaining psychological counseling. Research should evaluate the effect of perceived concordance with the counseling psychologist on adherence to and outcomes from counseling for MUS.

Medically unexplained symptoms and syndromes (MUS) affect the health of 20%-30% of patients seen in primary care. Optimally, treatment for these patients requires an interdisciplinary team consisting of both primary care and mental health providers. By developing an expertise in MUS, counseling psychologists can improve the care of patients with MUS who are already in their practice, expand the number of patients they help, and enhance the integration of counseling psychology into the broader medical community. Additionally, counseling psychologists' expertise in culture, attunement to therapeutic processes, and our focus on prioritizing patients' perspectives and quality of life can fill the gap in research on MUS and bringing increased attention to counseling psychologists' unique contributions to health service delivery.

Police brutality and widespread systemic racism represent historical and current sources of trauma in Black communities. Both the Black Lives Matter movement and counseling psychology propose to confront these realities at multiple levels. Black Lives Matter seeks to increase awareness about systemic racism and promote resilience among Black people. Counseling psychology states values of multiculturalism, social justice, and advocacy. Executive leadership in counseling psychology may seek to promote racial justice, yet struggle with how to participate in Black Lives Matter movements and address racial discrimination within larger systems spontaneously and consistently. However, counseling psychology trainees and professionals are actively involved in the Black Lives Matter movement, leading the way forward. Through the framework of spontaneity in social movements, this manuscript highlights what counseling psychologists are currently contributing to Black Lives Matter and makes recommendations that build on the opportunity counseling psychologists have for further involvement in the movement.

Using a sex positive framework, the authors conducted a 61-year (1954-2015) content analysis of sexuality research in the flagship counseling psychology journals, the and . Given counseling psychology's core strengths- and multiculturalism-related values, this study aimed to uncover which human sexuality topics were published most, whether publications aligned with a sex positive, neutral, or negative discourse, what methodologies were used, and differences in how populations were investigated across race. Researchers used an integrative approach to content analysis and human coding (Neuendorf, 2011). Results highlighted that out of 188 articles meeting criteria, a slight majority (38.05%) focused on sexual orientation, identity, and minorities topics. Only 4.78% utilized a sex-positive perspective. Quantitative and conceptual pieces were most published, and publications disproportionately focused on primarily White populations. When people of color were included, the discourse was sex negative. Implications for research and practice are discussed.

Religion is a source of strength in Latina/o culture during challenging life transitions, such as the immigration process. Guided by a sociological stress-process model, this study examines relations between dimensions of religious coping, acculturative stress, and psychological distress among 530 young Latina women (ages 18-23 years) who recently immigrated to the United States (i.e., approximately 12 months prior to assessment). Higher levels of acculturative stress were associated with higher levels of psychological distress. Negative religious coping (i.e., the tendency to struggle with faith) moderated the relation between acculturative stress and psychological distress. Participants experiencing higher levels of acculturative stress reported greater psychological distress when they indicated more negative religious coping. Positive religious coping (i.e., the tendency to relate to faith with comfort and certainty) was not linked with acculturative stress or psychological distress. Implications for culturally tailored counseling interventions for this underserved and understudied population are discussed.

In this study, we examined data from 200 families to investigate whether family functioning and adolescent psychiatric symptomatology were associated with differential attendance in a family-based or individually focused intervention for Latino adolescents. Latent profile analysis was used to identify families, and regression models were used to examine whether profiles exhibited differential attendance. Overall, three latent profiles were observed. The first described families where parents and adolescents reported discrepancies on psychiatric symptoms and family conflict. The second profile described families with elevated adolescent psychiatric symptoms but no family conflict. The third profile described families with low family cohesion and high levels of adolescent psychiatric symptoms. For this third profile, attendance in family-based treatment was significantly higher than in individual treatment. Results indicate that a family-based intervention may be better able to address issues of poor family cohesion.

We present a narrative case study of an urban American Indian male college student who integrated Indigenous and professional therapies during an acute period of stress, loss, and depression. The first published case of an American Indian in an urban context, this article expands on previous clinical cases by focusing on the perspective of the client relative to his own conceptions of help-seeking behaviors. Based on qualitative analysis of five audio-recorded interviews, this case utilizes an innovative methodology to portray four approaches to healing (medication, counseling, bonding, and spirituality), which contribute to holistic well-being. Implications for counseling psychologists include being aware of how some American Indian clients may (a) view professional treatment dynamics through a Native cultural lens (e.g., seeing ideal communication as a "rhythm"); (b) utilize an expanded range of therapeutic agents;

In recent years psychologists have been increasingly concerned about potentially harmful therapy, yet this recent discourse has not addressed issues that have long been voiced by the multicultural counseling and psychotherapy movement. We aim to begin to bring these seemingly disparate discourses of harm into greater conversation with one another, in the service of placing the discipline on a firmer foothold in its considerations of potentially harmful therapy. After reviewing the two discourses and exploring reasons for their divergence, we argue that they operate according to differing assumptions pertaining to the sources, objects, and scope of harm. We then argue that these differences reveal the discipline's need to better appreciate that harm is a social construct, that psychotherapy may be inherently ethnocentric, and that strategies for collecting evidence of harm should be integrated with a social justice agenda.

This collaborative, community-engaged project developed and tested a Culturally-Tailored Treatment (CTT) for American Indian/Alaska Native (AI/AN) smokers in the Menominee tribal community. One hundred three adult AI/AN smokers were randomized to receive either Standard Treatment (= 53) or CTT ( = 50) for smoking cessation. Both treatment conditions included 12 weeks of varenicline and four individual counseling sessions but differed in terms of cultural tailoring of the counseling. The primary outcome was 7-day biochemically-confirmed point-prevalence abstinence (PPA) at the 6-month end-of-study visit. Both intention-to-treat (ITT) and responder-only analyses were conducted. There were no statistically significant group differences in 7-day PPA. The overall ITT abstinence rate at 6 months was 20%; the responder-only rate was 42%. The current study represents the first randomized smoking cessation clinical trial testing a culturally-tailored smoking cessation intervention designed for a specific AI/AN tribal community that combined FDA-approved cessation medication (varenicline) and innovative cultural intervention components.

The current study examined how parental ethnic socialization informed adolescents' ethnic identity development and, in turn, youths' psychosocial functioning (i.e., mental health, social competence, academic efficacy, externalizing behaviors) among 749 Mexican-origin families. In addition, school ethnic composition was examined as a moderator of these associations. Findings indicated that mothers' and fathers' ethnic socialization were significant longitudinal predictors of adolescents' ethnic identity, although fathers' ethnic socialization interacted significantly with youths' school ethnic composition in 5 grade to influence ethnic identity in 7 grade. Furthermore, adolescents' ethnic identity was significantly associated with increased academic self-efficacy and social competence, and decreased depressive symptoms and externalizing behaviors. Findings support theoretical predictions regarding the central role parents play in Mexican-origin adolescents' normative developmental processes and adjustment and, importantly, underscore the need to consider variability that is introduced into these processes by features of the social context such as school ethnic composition.

Previous scholars have explored various challenges facing children of gay and lesbian individuals, and some have explored the impact of a parent's sexual orientation on the parent-child relationship. However, the impact of religion on the parent-child relationships of adult children with a gay or lesbian parent has been overlooked. In this study, 10 adult children with both a gay or lesbian parent and a heterosexual parent were interviewed and asked to retrospectively explore how religion impacted their parent-child relationships. The following themes emerged from phenomenological analysis of the interviews: (a) family break-up more difficult than the parents' coming out; (b) discovery that parent was gay or lesbian; (c) initial shame over having gay or lesbian parent; (d) positive aspects of having a gay or lesbian parent; (e) redefined relationship with religion; and (f) impact of culture on how gay and lesbian individuals are viewed.

This article builds on assertions in Richardson's (2012, this issue) Major Contribution on counseling for work and relationship. In this reaction, I expand on the relevance and potential of the counseling for work and relationship perspective to enrich the field of counseling psychology. My comments focus on three considerations to further extend the cultural relevance of Richardson's work and relationship perspective: (1) broadening sources of dignity, (2) centering knowledge of marginalized communities, and (3) promoting psychologists' critical consciousness. Richardson's perspective holds great promise for being a guiding heuristic to inform counseling psychology research, theory, and practice.