Building a multicultural peer-consultation team: Planning, implementing, and early sustainment evaluation.

This article represents an implementation-focused evaluation of a multicultural peer-consultation team situated within a psychiatry department in a large academic medical center in the Southern United States. The evaluation comprised anonymous self-report questionnaires (n = 14) as well as individual (n = 3) or group interviews (n = 10) conducted by outside independent evaluators. Participants were current and former team members (i.e., graduate trainees, mental health care providers, clinical and research staff members) who voluntarily participated in this multimethod implementation evaluation. Results indicated that attendance on the team had several important impacts on members, and most notably an increased ability to provide multiculturally competent care, that is treatment that carefully and routinely considers the influence of culture and context on patients and therefore their clinical presentation. Further, no negative impacts from participating on the team were noted. A primary strength of the team's sustainability is that participation on the team was deemed to be relevant and useful by current and former team members. A major barrier to participation on the team is competing demands, such as high clinical loads. We conclude that this model for multicultural peer-consultation holds promise as an effective and implementable educational method for mental health care professionals. We discuss strengths, limitations, and future directions for research.

Adapting Caring Contacts for Veterans in a Department of Veterans Affairs Emergency Department: Results From a Type 2 Hybrid Effectiveness-Implementation Pilot Study.

Transitions in care, such as discharge from an emergency department (ED), are periods of increased risk for suicide and effective interventions that target these periods are needed. Caring Contacts is an evidence-based suicide prevention intervention that targets transitions, yet it has not been widely implemented. This pilot study adapted Caring Contacts for a Department of Veterans Affairs (VA) ED setting and population, created an implementation toolkit, and piloted implementation and evaluation of effectiveness. To inform adaptation, qualitative interviews were conducted with stakeholders. Data were used by an advisory board comprised of stakeholders, experts, and veterans to make adaptations and develop an implementation planning guide to delineate steps needed to implement. Key decisions about how to adapt Caring Contacts included recipients, author, content, and the schedule for sending. Pilot implementation occurred at one VA ED. Caring Contacts involved sending patients at risk of suicide brief, non-demanding expressions of care. Program evaluation of the pilot used a type 2 hybrid effectiveness-implementation design to both pilot an implementation strategy and evaluate effectiveness of Caring Contacts. Evaluation included qualitative interviews with veteran patients during implementation. VA electronic health records were used to evaluate VA service utilization in the 6-month periods immediately before and after veterans were delivered their first Caring Contact. Hundred and seventy-five veterans were mailed Caring Contacts and the facility continued adoption after the pilot. Participants were positive about the intervention and reported feeling cared about and connected to VA as a result of receiving Caring Contacts. This project developed an implementation planning process that successfully implemented Caring Contacts at one site. This can be used to further implement Caring Contacts at additional VA or community EDs.

Measurement of Intersectional Microaggressions: Conceptual Barriers and Recommendations.

Since Crenshaw coined the term "intersectionality" in 1989, researchers of bias have struggled with how to capture the complexity and intricacies of intersectional identities and microaggressions experienced by individuals holding these identities within the quantitative framework that dominates psychology. Although scholarship has grown in the exploration of experiences such as racialized sexual harassment, or sexual racism within queer and trans communities, there is no strong consensus on how this might be measured systematically in ways that allow for inferences regarding the experiences of populations of interest. With an emphasis on the experiences of queer and trans people of color, this article explores intersectional identities through three main points: First, we define what is meant by intersectionality and the real-world experiences that are important for advancing an understanding of microaggressions; second, we review the existing measures and their ability to capture the breadth and depth of the lived experience of those with intersectional identities; and third, we propose a framework for the development of a more accurate and comprehensive measure of microaggressions.

Psychometric evaluation of the Functional Analytic Psychotherapy Intimacy Scale in obsessive-compulsive and related disorders.

Functional Analytic Psychotherapy (FAP) is a contextual behavioral therapy that targets specific ideographic behaviors related to interpersonal functioning and intimacy. There is a scarcity of measures specifically focused on behavioral measurement of intimacy as well as limited studies that examine intimacy in obsessive-compulsive and related disorders (OCRDs). Leonard and colleagues (2014) created the Functional Analytic Psychotherapy Intimacy Scale (FAPIS). The purpose of this study was to investigate the validity of the FAPIS in evaluating those with OCRDs. The FAPIS and other measures of intimacy were administered to 549 nonreferred adults endorsing OCRD symptoms. Several confirmatory factor analyses were conducted to assess the best fitting factor structure, and convergent validity and divergent validity were also assessed. Given the psychometric properties of the FAPIS in this sample, future research may be helpful in assessing if the FAPIS would be beneficial in measuring change related to intimacy when working with people with OCRDs.

Hair pulling antecedents in trichotillomania: Their relationship with experiential avoidance.

In this study, 285 adults who met criteria for trichotillomania (TTM) via self-report completed an online, cross-sectional survey examining antecedent phenomenological experiences pertaining to hair pulling along with measures of TTM severity and experiential avoidance (i.e., avoidance of or escape from unwanted thoughts or feelings). Results showed a heterogeneous depiction of antecedent experiences. Subsequent analyses revealed that certain antecedents were not significantly related to TTM severity but were significantly correlated with higher levels of experiential avoidance. In particular, four of five classes of antecedents (i.e., bodily sensations, physical symptoms, mental anxiety, and general uncomfortableness) were significantly related to greater experiential avoidance. The authors conclude that treatments may need to be designed to address specific private antecedents, and that this may be done through targeting experiential avoidance.

The relationship between physical work hazards and employee withdrawal: The moderating role of safety compliance.

We examined the relationship between physical work hazards and employee withdrawal among a sample of health care employees wherein safety compliance was hypothesized to moderate the relationship between physical work hazards and withdrawal. Health care workers (N = 162) completed an online questionnaire assessing physical work hazards, withdrawal, and indicators of workplace safety. Safety compliance moderated the relationship between patient aggression and withdrawal. Interaction plots revealed that for all significant moderations, the relationship between physical work hazards and withdrawal was weaker for those who reported high levels of compliance. Results shed initial light on the benefits of fostering safety compliance in health care contexts, which can contain exposure to physical work hazards.