Practice-based evidence for spiritually integrated psychotherapies: Examining trajectories of psychological and spiritual distress.

The aims of this practice-based evidence study were to (a) examine clients' trajectories of psychological and spiritual distress over the course of spiritually integrated psychotherapies (SIPs) and (b) explore the role of varying types of spiritual interventions in these outcomes. In total, 164 practitioners of SIPs from 37 settings in a practice-research network administered the Clinically Adaptive Multidimensional Outcome Survey (Sanders et al., 2018) at each session with 1,227 clients and reported their use of theoretical orientations and spiritual interventions on an after-session summary checklist. Focusing on sessions over an initial 12-week period, latent growth curve modeling analyses revealed that clients, on average, experienced significant reduction of psychological distress during their engagement in SIPs with improvements occurring most sharply in the first month. Further, other findings revealed a salient reciprocal interplay with spiritual distress throughout treatment, such that clients who were struggling with their religious faith and/or spirituality were more psychologically distressed and displayed a more attenuated and gradual pattern of symptom reduction. In such cases, clinicians frequently utilized spiritual interventions involving basic skills (e.g., spiritual assessment), virtues (e.g., discuss self-control), and religious attachment (e.g., encourage acceptance of divine love) that were uniquely associated with clients' rate and duration of decline in psychological and spiritual distress. The present findings affirm the routine effectiveness of SIPs along with highlighting the potential value of certain spiritual interventions in supporting holistic recovery among clients who want clinicians to be culturally responsive to their spiritual and/or religious identities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Cultural humility and racial microaggressions in cross-racial clinical supervision: A moderated mediation model.

Cultural humility is important in supervision; however, studies have primarily sampled White supervisees. Racially and ethnically minoritized trainees experience microaggressions during their training, yet cross-racial supervision is less often studied. We examined a moderated mediation model to test whether the supervisory working alliance mediated the relationship between frequency of racial microaggressions and satisfaction with supervision, and whether the impact of racial microaggressions on the supervisee and supervisor cultural humility moderated the relationship between racial microaggression frequency and the supervisory working alliance. In a sample of supervisees of color (N = 102; majority cisgender women, 86.2%, and heterosexual, 59.8%; 35.3% Black/African American, 28.4% Asian/Pacific Islander, 18.6% Hispanic/Latine) receiving clinical supervision from White supervisors, we found that racial microaggression frequency was negatively associated with satisfaction with supervision, and this relationship was fully accounted for by the supervisory working alliance. Racial microaggressions in supervision were found to be detrimental to the supervisory working alliance, which was then related to lower satisfaction with supervision. Further, racial microaggression impact and cultural humility moderated the relationship between racial microaggression frequency and the supervisory working alliance; this relationship was strongest when racial microaggression impact was high and cultural humility was average or high. The social bond hypothesis suggests we are more likely to allow ourselves to be vulnerable when we assess cultural humility to be high. We posit that the observed moderation effect may be due to supervisees experiencing greater shock when experiencing racial microaggressions from supervisors whom they perceived to be culturally humble. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Session Reactions Scale-3: Initial psychometric evidence.

Objective: This study aimed to develop an updated brief self-report post-session measure, suitable for collecting systematic feedback on clients' session reactions in the context of measurement-based care (MBC). Method: The Session Reactions Scale-3 (SRS-3; 33 items) was developed by extending and adjusting the Revised Session Reactions Scale. In Study 1, the psychometric properties of the SRS-3 were tested on N = 242 clients. In Study 2, a brief version of the SRS-3 (SRS-3-B; 15 items) was developed using a combination of conceptual, empirical, and pragmatic criteria. In Study 3, the psychometric properties of the SRS-3-B were tested on a new sample of N = 265 clients. Results: Exploratory factor analysis supported the use of the SRS-3-B as a two-factor (helpful reactions, hindering reactions) or unidimensional (overall session evaluation) instrument. The SRS-3-B was meaningfully related to another process measure (Individual Therapy Process Questionnaire) both on the item and factor levels. Conclusions: The SRS-3-B is a reliable process measure to elicit rich and clinically meaningful feedback from clients within the MBC context and as a research instrument to assess the helpful and hindering aspects of therapy sessions.

A Latent Class Analysis of Predictors for Engaging in Sex: A Study with Ethnically Diverse High School Students.

Sexual activity occurs among a large portion of young adults and adolescents, including high school students. While about 40% of high school students nationwide have engaged in sexual intercourse, more information is needed about how individual characteristics may relate to larger patterns of adolescent sexual behavior. This exploratory study utilized a latent class analysis (LCA) to identify clusters of high school students (N = 801) based on demographic characteristics, sexual refusal skills, healthy relationship skills, sociosexuality, internalizing symptoms, alcohol use, various forms of social support (i.e., parents, friends, teachers), and sexual activity at baseline to predict their sexual behavior at a 6-month follow-up. Four unique latent classes were identified based on these baseline predictors. Distinctions in the profiles of high schoolers varied significantly by internalizing symptoms, race/ethnicity, sexually conservative attitudes, and social support in the prediction of adolescent sexual activity at 6-months. This study contributes to the investigation of demographic, social, psychological, attitudinal, and behavioral factors that may distinguish high school students from one another in terms of their longitudinal rates of sexual activity.

Longitudinal Associations Among Adolescents' Sexual Attitudes, Beliefs, and Behaviors.

Youth sex and relationship education programs aim to improve adolescent well-being by changing their knowledge, beliefs, and attitudes regarding sex and their health. However, there is a gap in existing research linking these cognitive targets to relevant behaviors, and a particular dearth of data on links with sexual behaviors. The current study tested longitudinal links between cognitive factors related to sex (attitudes about sex, normative beliefs, risk-avoidant intentions, and confidence in refusal skills) and outcomes of sexual behaviors (recent sexual encounters, number of sexual partners, and frequency of condom use). Data were drawn from three waves of data from a panel study of US high-school students and were analyzed using cross-lagged structural equation modeling. We hypothesized direct, reciprocal links between intentions and behaviors, but this hypothesis was not supported. Instead, more conservative attitudes about sex emerged as the most consistent prospective predictor of fewer sexual encounters and sexual partners, though with small effect sizes (ßs = - .08 to - .131, ps < .05). Further, bidirectional interrelationships were observed among several of the cognitive and behavioral variables over time. These results highlight attitudes about sex as a potentially useful intervention target, but also suggest that sex and relationship education curricula and evaluations should consider multiple pathways of links between cognition and behavior. Continued research is needed on causal links between adolescents' sexual attitudes, knowledge, intentions, and behavior.

Meta-analysis of couple therapy in non-randomized clinical trial studies: Individual and couple level outcomes.

Couple therapy has outperformed control conditions in randomized clinical trials (RCTs). However, there have been some questions whether couple treatment in naturalistic settings is as effective as those with more rigorous controls. The current meta-analysis examined 48 studies of couple therapy in non-randomized clinical trials. The pre-post effect size was Hedge's g = 0.522 for relational outcomes and Hedge's g = 0.587 for individual outcomes. However, there was significant heterogeneity in the results. Several moderators explained some of the variance in these estimates. For relationship outcomes, studies who had older couples and longer length of relationship had better outcomes. Studies with a higher percentage of racial/ethnic minority (REM) couples and studies in Veteran Affairs Medical Centers (VAMC) had lower relational outcomes. For individual outcomes, studies that had more sessions, older couples, and VAMC had better outcomes. Studies with a higher percentage of REM couples also had worse individual outcomes. Trainee status was not consistently related to relational or individual outcomes. Implications for research and practice are provided.

Sudden gains and deteriorations: Modeling the impact across outcomes with university counseling center clients.

OBJECTIVE: This study examines the longitudinal impact of sudden gains/deteriorations across the outcomes associated with the phase model. METHOD: In a sample of 16,657 clients who completed the Behavioral Health Measure-20, we identified sudden gains/deteriorations and employed multilevel piecewise analyses to assess their impact on subsequent treatment phases. RESULTS: We found that: (1) Following a sudden gain in the well-being outcome, the mean-level for the symptom outcome increased (meaning symptoms improved), and the rate of change decreased, (2) Following a sudden gain in the symptom outcome, the mean-level for the life functioning outcome increased, (3) Following a sudden deterioration in the well-being outcome, the mean-level and rate of change for the symptom outcome decreased, and (4) Following a sudden deterioration in the symptom outcome, the mean-level for the life functioning outcome decreased. CONCLUSIONS: These findings reveal that sudden gains/deteriorations function and occur at different rates across phases of change in psychotherapy.

Therapist engagement in measurement-based care: The association between client outcomes and therapist viewing frequency.

Engagement in measurement-based care (MBC) has been shown to be an effective practice for optimizing psychotherapy outcomes. Best practices for MBC suggest that it is crucial for therapists to consistently review scores. However, the exact impact of this practice on MBC's effectiveness has yet to be fully elucidated. The current study examined the association between the frequency of therapists reviewing clients' depression scores and client psychotherapy outcomes. The sample consisted of 6182 clients diagnosed with depression who sought treatment from 2248 therapists through a practice research group. Patient Health Questionnaire-9 (PHQ-9) was administered prior to sessions, and therapists could access the scores via their therapist portal. The results based on multilevel modelling revealed that how often therapists view their clients' PHQ-9 results was not a significant predictor of therapy outcomes. However, therapists who, across their caseloads, viewed client PHQ-9 scores more frequently facilitated better treatment outcomes. These results suggest that therapists who routinely engage in MBC facilitate better therapy outcomes. Implications for practice and research are provided.

Longitudinal measurement invariance of the Behavioral Health Measure in a clinical sample.

The practice of routine outcome monitoring (ROM) has grown in popularity and become a fixture in feedback-supported clinical practice and research. However, if the interpretation of an ROM measure changes over time, treatment outcome scores may be inaccurate and produce erroneous or misguided interpretations of client progress and therapist efficacy. The current study examined whether factorial invariance held when using the Behavioral Health Measure (BHM-20) longitudinally in a clinical sample (n = 12,467). Using multidimensional item response theory-based models for the investigation of the BHM-20 factor structure, at a single time point and then longitudinally. Based on the original factor structure of the BHM-20 a unidimensional model, a three-factor orthogonal model, and a three-factor correlated model were fit to the data, indicating poor model fit with the proposed three-factor or unidimensional models. Next, using exploratory factor analysis and subsequent multidimensional item response theory procedures, a new 4-factor (General Distress, Life Functioning, Anxiety, and Alcohol/Drug Use) model was proposed with improved model-fit statistics. Finally, when testing the longitudinal invariance of the BHM-17 over 10 sessions of treatment, it was found to be fully consistent. The current study proposes the use of a 17-item, 4-factor model for a new understanding of the BHM-17. Implications for use in ROM and limitations are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Impact and implementation findings from a cluster randomized trial of a youth relationship education curriculum.

The current study presents implementation and impact data from a cluster randomized trial of a youth relationship education curriculum. High school students (n = 1,135) were randomized at the school level to receive curricula-as-usual or a healthy relationships program delivered by facilitators who were not employed by the high schools. Program evaluators reported high engagement and students indicated high satisfaction with the program, but multilevel models showed no statistically significant impacts on healthy relationship skills, attitudes, and behaviors at three and nine months post-intervention. Strengths and limitations of the research design and program implementation, as well as implications for evaluating youth relationship education more broadly, are discussed.

El estudio actual presenta datos de implementación e impacto de una prueba controlada aleatoriade una intervención de educación sobre relaciones para juveniles. Los estudiantes de secundaria (n= 1,135) fueron asignados al azar a nivel escolar para recibir un plan de estudios como decostumbre o un programa de relaciones saludables entregado por facilitadores que no eranempleados de las escuelas secundarias. Evaluadores de programas informaron un alto compromisoy los estudiantes indicaron una alta satisfacción con el programa, pero los modelos multinivel nomostraron impactos estadísticamente significativos en las habilidades de relación saludable,actitudes, y comportamientos a los tres y seis meses después de la intervención. Se discutefortalezas y limitaciones del diseño de la investigación y la implementación del programa, asícomo las implicaciones para la evaluación de los jóvenes.

Attending to the intersectionality and saliency of clients' identities: A further investigation of therapists' multicultural orientation.

Psychotherapy clients often hold multiple and varied cultural identities, and it is important for therapists to attend to the intersectionality of clients' cultural identities, as well as the saliency of these identities. However, to date, few studies have considered the saliency of clients' multiple identities and how this may impact clients' perceptions of cultural processes in therapy. Therefore, this study utilized polynomial regression and response surface analysis to operationalize and examine congruent and discrepant effects between the saliency of clients' multiple identities and their perceptions of their therapists' cultural humility and cultural missed opportunities. Data for this study consisted of 87 clients who received individual counseling services at either a university counseling center or training clinic at two large universities in the United States. As hypothesized, results indicated significant discrepant effects between the saliency of clients' first and second most important cultural identities and perceptions of their therapists' cultural humility and cultural missed opportunities. Specifically, clients' ratings of their therapist's cultural missed opportunities were lowest when they reported either a) high saliency of cultural identity one and low saliency of cultural identity two, or b) low saliency of cultural identity one and high saliency of cultural identity two. Similarly, clients' ratings of their therapist's cultural humility were highest when they reported either a) high saliency of cultural identity one and low saliency of cultural identity two, or b) low saliency of cultural identity one and high saliency of cultural identity two. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Psychotherapy racial/ethnic disparities in treatment outcomes: The role of university racial/ethnic composition.

OBJECTIVE: Mental health disparities between racial/ethnic minorities (REM) and White individuals are well documented. These disparities extend into psychotherapy and have been observed among clients receiving care at university/college counseling centers. However, less is known about if campus RE composition affects outcomes from psychotherapy for REM and White clients. METHOD: This study examined psychotherapy outcomes from 16,011 clients who engaged in services at 33 university/college counseling centers. Each of these clients completed the Behavioral Health Measure as a of part routine practice. Campus RE composition was coded from publicly available data. RESULTS: The results demonstrated that White clients had better therapy outcomes than REM clients when they were at campuses where there were more White students. For universities 1 SD below the mean percentage of White students, the average difference in therapy outcomes for White and REM clients was Cohen's d = .21 (with White students experiencing more improvement); however, for universities 1 SD above the mean, the between group outcome disparity was greater (Cohen's d = .38). CONCLUSION: Therapists and higher education professionals should consider environmental impacts on counseling services. Implications for higher education, counseling centers, and mental health disparities are provided. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Determining the therapist's contribution in therapist multicultural competence process and outcome.

Efforts to help therapists improve their multicultural competence (MCC) rely on measures that can distinguish between different levels of competence. MCC is often assessed by asking clients to rate their experiences with their therapists. However, differences in client ratings of therapist MCC do not necessarily provide information about the relative performance of therapists and can be influenced by other factors including the client's own characteristics. In this study, we used a repeated measures design of 8,497 observations from 1,458 clients across 35 therapists to clarify the proportion of variability in MCC ratings attributed to the therapist versus the client and better understand the extent that an MCC measure detects therapist differences. Overall, we found that a small amount of variability in MCC ratings was attributed to the therapist (2%) and substantial amount attributed to the client (70%). These findings suggest that our measure of MCC primarily detected differences at the client level versus therapist level, indicating that therapist MCC scores were largely dependent on the client. Clinical implications and recommendations for future MCC research and measurement are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Alliance-Outcome Association in Couple Therapy: A Common Fate Model.

The working alliance has been shown to be a robust predictor of couple therapy outcomes. However, there are still questions regarding the best way to conceptualize and analyze the association between the alliance and outcomes in the couple therapy context. This study presents results from a relatively novel analytic approach for evaluating the alliance and therapy outcomes via the shared influence model (i.e., common fate statistical methodology) with 93 couples who had at least three sessions. Examining the alliance in couple therapy this way allows for nuance in conceptualizing the process of the alliance among partners and the therapist in couple therapy. Empirically, the question that remains is whether the shared experience of the alliance between partners is a stronger predictor of therapy outcome as compared to the unique individual experiences of the alliance. This approach has not yet been utilized to model the couple alliance-outcome association. Results revealed that the shared influence model demonstrated a significant association between the alliance and therapy outcome. Specifically, the couple-level alliance construct was adequately represented from the partners' alliance ratings with the therapist, and couples that report higher shared alliance experiences were also likely to have better therapy outcomes. These findings suggest that conceptualizing and analyzing the alliance at the couple level may be strongly advantageous. Implications for research and practice are provided.

Se ha demostrado que la alianza terapéutica es un predictor fiable de los resultados de la terapia de pareja. Sin embargo, aún quedan preguntas con respecto a la mejor manera de conceptualizar y analizar la asociación entre la alianza y los resultados en el contexto de la terapia de pareja. Este estudio presenta resultados de un enfoque analítico relativamente innovador para evaluar la alianza y los resultados de la terapia mediante el modelo de influencia compartida (p. ej.: metodología estadística del destino común) con 93 parejas que tuvieron al menos tres sesiones. Analizar la alianza en la terapia de pareja de esta manera permite matices a la hora de conceptualizar el proceso de la alianza entre los integrantes de la pareja y el terapeuta en la terapia de pareja. Empíricamente, la pregunta que queda pendiente es si la experiencia compartida de la alianza entre los integrantes de la pareja es un predictor más fiable de los resultados de la terapia en comparación con las experiencias individuales únicas de la alianza. Este enfoque aún no se ha utilizado para interpretar la asociación entre la alianza de la pareja y los resultados. Los resultados revelaron que el modelo de influencia compartida demostró una asociación significativa entre la alianza y los resultados de la terapia. Específicamente, el constructo de la alianza a nivel de la pareja se representó adecuadamente a partir de las valoraciones de la alianza de los integrantes de la pareja con el terapeuta, y las parejas que informan más experiencias de alianza compartida también fueron propensas a tener mejores resultados en la terapia. Estos datos sugieren que puede ser enormemente ventajoso conceptualizar y analizar la alianza a nivel de la pareja. Se explican las consecuencias para la investigación y la práctica.

Trajectories of changes in distress in counseling center clients: a replication study.

Objective: Latent growth mixture modeling (LGMM) and latent class growth analysis (LCGA) are methods of identifying subgroups of individuals with similar trajectories during the course of psychotherapy. Due to inconsistent methodology, previous LGMM/LCGA psychotherapy research has led to inconsistent findings. The purpose of this study was to contribute to our understanding of individual differences in change trajectories during psychotherapy using LGMM/LCGA by attempting to replicate a previous study by Owen et al. (2015. Trajectories of change in psychotherapy. Journal of Clinical Psychology, 71(9), 817-827). Method: This study used LGMM/LCGA to model trajectories of change in a sample of 2538 psychotherapy clients at a university student counseling center. This was a secondary analysis of naturalistically-collected outcome data using The Behavioral Health Measure. Results: LGMM models did not converge. A 2-class LCGA model was selected based on fit statistics and parsimony. One class was labeled as Slow and Steady Change Before Plateau, whereas the other was labeled as Early Rapid Change Before Plateau. We also extended these findings by considering variables associated with class membership. Conclusions: These classes followed similar trajectories to two of the classes identified by Owen et al. These results indicate that latent trajectory modeling may lead to replicable findings. Furthermore, these results have implications for managing expectations about change in psychotherapy.

A group positive psychology intervention for cancer survivors and caregivers: A pilot study of Activating Happiness©.

The purpose of this study was to examine the feasibility and potential concept of a 4-week positive psychology group intervention (Activating Happiness©) for cancer survivors and caregivers that emphasized mindfulness, self-compassion, and gratitude. Nine facilitators led 6 intervention groups for 49 participants (35 cancer survivors, 14 caregivers). Of eligible participants, 63% enrolled and of those, 89% completed all study activities. Participants completed self-report measures at baseline, after the second and final sessions, and 3-month post-intervention, and provided qualitative feedback after the final session. Qualitative data demonstrated that participants found the intervention acceptable. The intervention's potential proof-of-concept was supported by benchmarking outcomes against those reported in randomized controlled trials, with effect sizes for mindfulness, self-compassion, anxiety, and depression for caregivers and survivors, and for pain for survivors comparable to size estimates for efficacy in clinical trials.

Benchmarking Community-Based Couple Therapy: Considering Measurement Reactivity.

Couple therapy has been shown to be effective in randomized clinical trials; however, results from naturalistic couple therapy have been less consistent. This study utilized a benchmarking approach to compare the effectiveness of couple therapy in a community-based setting with findings from efficacy treatments, such as treatment within randomized clinical trials. The current study is the largest couple therapy sample published to date (N = 3,347 couples). Clients in couple therapy were asked to provide initial and weekly ratings of symptomology on the Outcome Questionnaire (OQ-45.2). We found that treatment effect sizes found at community clinics were smaller than efficacy studies (i.e., the benchmark). However, when taking into account measurement reactivity, the effect sizes were comparable. This is the first benchmarking study for community-based couple therapy, allowing for meaningful comparisons and understanding of outcomes in real-world couple therapy. Implications for the field are offered in terms of evaluating community-based psychotherapy studies with benchmarking for couple therapy. Results of this study provide clinicians and researchers a way to meaningfully compare couple therapy outcomes, accounting for differences in community-based practices and randomized clinical trials. This benchmark also underscores the impact of measurement sensitivity, an issue commonly overlooked in psychotherapy research and practice.

Se ha demostrado que la terapia de pareja es eficaz en los ensayos clínicos aleatorizados, sin embargo, los resultados de la terapia de pareja naturalista han sido menos consecuentes. Este estudio utilizó un enfoque comparativo para comparar la eficacia de la terapia de pareja en un entorno basado en la comunidad con hallazgos de los tratamientos de eficacia, como los tratamientos dentro de los ensayos clínicos aleatorizados El presente estudio es la muestra más grande de terapia de pareja publicado hasta la fecha (N = 3347 parejas). Se pidió a los pacientes en terapia de pareja que proporcionen calificaciones iniciales y semanales de la sintomatología en el cuestionario para evaluación de resultados (OQ-45.2).Descubrimos que los tamaños del efecto de los tratamientos hallados en las clínicas comunitarias fueron más pequeños que los de los estudios de eficacia (p. ej.: el estudio comparativo). Sin embargo, cuando se tomó en cuenta la reactividad a la medición, los tamaños del efecto fueron comparables. Este es el primer estudio comparativo para la terapia de pareja basada en la comunidad, el cual permite comparaciones significativas y comprensión de los resultados en la terapia de pareja en el mundo real. Se ofrecen las implicancias para el área en cuanto a la evaluación de los estudios de la psicoterapia basada en la comunidad con evaluación comparativa de la terapia de pareja. Los resultados de este estudio proporcionan a los clínicos y a los investigadores una manera de comparar significativamente los resultados de la terapia de pareja, así como de explicar las diferencias en las prácticas basadas en la comunidad y en los ensayos clínicos aleatorizados. Esta evaluación comparativa también subraya el efecto de la sensibilidad a la medición, una cuestión comúnmente pasada por alto en la investigación y la práctica de la psicoterapia.

Understanding Relations Among Drinking and Hookup Motives, Consequences, and Depressive Symptoms in College Students.

In this longitudinal study (N = 98), we examined whether drinking for suppression reasons moderated the relation between depressive symptoms and hooking up for self-affirmation reasons and negative hookup consequences. No moderation was found for hooking up for self-affirmation reasons, but the effect for negative hookup consequences approached significance. When drinking for suppression reasons is low, participants with fewer depressive symptoms reported more negative consequences, and participants with more depressive symptoms reported fewer negative consequences 2 months later. Results are discussed within the context of sex education and mental health programming for young adults.

A Short-Term Longitudinal Investigation of Hookups and Holistic Outcomes Among College Students.

Majority of college students hook up at least once during their time in school. The literature on casual sex encounters among college students is growing, though most studies are cross-sectional and individual studies focus on few outcomes at a time, leaving piecemeal and mixed results. The current longitudinal study clarifies prior work by analyzing how post-event process (PEP), an understudied construct within the hookup literature, and emotional (i.e., positive or negative) hookup reactions interact to predict a breadth of outcomes, representing holistic student well-being. The inclusion of PEP reframes the current literature to consider PEP as a predictor variable of hookup outcomes, as moderated by emotional hookup reactions. This is consistent with literature indicating emotional experiences affect PEP across a variety of incidents. Participants (N = 377, 87.6% female) completed self-report measures at 2-month intervals. We tested relationships between the main and interaction effects of PEP and emotional hookup reactions as a moderation regression analyses on anxiety, academic engagement, religious coping, and psychological flourishing. The main effect of PEP predicted more anxiety and less negative religious coping, negative hookup reactions predicted more anxiety, and positive hookup reactions predicted more flourishing. Regarding interaction effects, high levels of positive hookup reactions and PEP were associated with less anxiety, less academic engagement, more negative religious coping, and less psychological flourishing; high levels of negative hookup reactions and PEP were associated with less anxiety and more negative religious coping and were unrelated to academic engagement or flourishing over two months.

Construction and validation of the Multicultural Orientation Inventory-Group Version.

Given the continued racial/ethnic diversification of the United States, it is not uncommon for therapy groups to consist of members with diverse racial/ethnic backgrounds and various cultural identities. Scholars have underscored how this cultural diversity can directly impact many processes and outcomes of group-based interventions (Chen, Kakkad, & Balzano, 2008). However, there is presently a paucity of empirical research testing the relationship between cultural processes of therapy groups and members' outcomes. Moreover, no psychometrically sound measure of the cultural process that unfolds in group therapy currently exists. As such, this study sought to adapt the Multicultural Orientation Inventory to develop and validate the Multicultural Orientation Inventory-Group Version (MCO-G), a measure assessing the cultural humility, cultural comfort, and cultural missed opportunities in therapy groups. Data for this validation study consisted of 208 members of 49 therapy groups across 10 university counseling centers. Confirmatory factor analyses supported a 3-factor structure of the MCO-G Inventory, wherein the 3 factors corresponded with the underlying constructs of cultural humility, cultural comfort, and cultural missed opportunities. This study provides initial evidence for the estimated internal and convergent validity of the MCO-G, as measured by clients' perceptions of a higher-order group therapeutic factor and improvement in therapy. Results provide initial support for the psychometric properties of the MCO-G. Moreover, groups' cultural humility and cultural missed opportunities were related to members' improvement in therapy. Clinical implications and future research are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).