Exploring service user and family perspectives of a Culturally adapted Family Intervention (CaFI) for African-Caribbean people with psychosis: A qualitative study.

OBJECTIVES: In the UK, people of African-Caribbean background have the highest rates of psychosis and greatest inequity in mental health services of all ethnicities. National policies have highlighted the lack of evidence-based psychological interventions for this group. The aim of this study was to examine the acceptability of a novel Culturally adapted Family Intervention (CaFI) for African-Caribbean individuals diagnosed with non-affective psychosis and their relatives. DESIGN: A qualitative design. METHODS: Semi-structured interviews conducted with 22 service users and 12 family members following participation in CaFI. The interview topic guide included perceptions of the needs and benefits of CaFI; usefulness, cultural specificity and accessibility of CaFI therapy and supporting materials; content and delivering of CaFI sessions; views and experiences of working with CaFI therapists; and perceived barriers and facilitators to implementation. RESULTS: Deductive framework analysis identified three main themes for service users: perceived benefits, barriers and limitations, and delivery of the therapy. Four themes were identified for family members: perceived benefits, perceptions of therapists, delivery of therapy, and accessibility of therapy content, supporting materials, and cultural appropriateness. CONCLUSIONS: CaFI was found to be an acceptable intervention for African-Caribbean service users with psychosis and their relatives. Family interventions considering the needs of ethnic and cultural groups have the potential to improve the mental health care and experiences of service users and their families. PRACTITIONER POINTS: The Culturally adapted Family Intervention (CaFI) was viewed as acceptable to African-Caribbean service users with psychosis and their families. Through adapting interventions to be more culturally sensitive, it is possible to enhance the care of those who typically have poor engagement with mental health services. In-keeping with their ethos of individualized care delivery, mental health services should place more emphasis on being able to offer appropriate, culturally adapted interventions to their service users.

The effect of context on responses to racially ambiguous faces: changes in perception and evaluation.

Reactions to individuals who possess features associated with multiple racial groups may be particularly susceptible to external contextual influences, leading to meaningfully different racial perceptions and judgments in different situations. In the present study, we found that an extrinsic race-label cue not only changed evaluative associations activated by a racially ambiguous face, but also changed quickly occurring neural responses sensitive to racial perception. Behaviorally, prototypical Black faces and racially ambiguous faces labeled as Black activated more negative implicit associations than prototypical White faces and racially ambiguous faces labeled as White. Neurally, prototypical faces and racially ambiguous faces cued with the same race elicited similar responses. Specifically, prototypical Black and racially ambiguous faces labeled as Black elicited larger P200s but smaller N200s than prototypical White and racially ambiguous faces labeled as White. These results show that racial perception can be changed by an external cue and this, in turn, influences subsequent evaluative reactions.

Contextual Variation in Automatic Evaluative Bias to Racially-Ambiguous Faces.

Three studies examined the implicit evaluative associations activated by racially-ambiguous Black-White faces. In the context of both Black and White faces, Study 1 revealed a graded pattern of bias against racially-ambiguous faces that was weaker than the bias to Black faces but stronger than that to White faces. Study 2 showed that significant bias was present when racially-ambiguous faces appeared in the context of only White faces, but not in the context of only Black faces. Study 3 demonstrated that context produces perceptual contrast effects on racial-prototypicality judgments. Racially-ambiguous faces were perceived as more prototypically Black in a White-only than mixed-race context, and less prototypically Black in a Black-only context. Conversely, they were seen as more prototypically White in a Black-only than mixed context, and less prototypically White in a White-only context. The studies suggest that both race-related featural properties within a face (i.e., racial ambiguity) and external contextual factors affect automatic evaluative associations.