The association between patient-provider racial/ethnic concordance, working alliance, and length of treatment in behavioral health settings.

Racial/ethnic concordance between patients and providers concerning the quality of care has received interest over past decades yielding mixed results. Patients seem to prefer clinicians of their own race/ethnicity, but empirical studies have found small or inconsistent effects on the quality of care. Research on the impact of racial/ethnic concordance and treatment duration appears to suggest that racial/ethnic concordance is associated with retention and completion; however, exactly why racial/ethnic concordance improves treatment length remains unexplored. On the other side, the quality of working alliance is a well-established common factor underlying effective treatments. In this study, we examined the interaction between patient-provider racial/ethnic concordance, length of treatment in the therapeutic dyad, and working alliance as evaluated by both patients themselves and objective raters. The study included 312 patients and 74 providers from 13 community and hospital-based outpatient mental health clinics in Massachusetts. Results indicated that among racial/ethnic concordant therapeutic dyads, longer length of treatment was associated with better quality of working alliance as evaluated by objective raters. Implications for clinical practice and future research on racial/ethnic concordance studies linked to the length of treatment are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Model minority stereotype and the diagnosis of alcohol use disorders: Implications for practitioners working with Asian Americans.

This study investigated the priming effects of the model minority stereotype on 122 clinicians in training regarding their diagnostic accuracy on Asian Americans compared to Whites. It was hypothesized that clinicians in training would be less likely to diagnose Asian Americans with alcohol use disorder and would perceive them to have fewer clinical symptoms than Whites due to the model minority stereotype. Consistent with the hypotheses, clinicians in training were less likely to assign alcohol use disorder to Asian Americans compared to Whites, as well as to the unprimed condition versus the condition primed with the stereotype. Implications regarding cultural competence and future research are discussed.

College counseling services: Meeting today's demands.

This article is an introduction to the special issue of Psychological Services highlighting college counseling services as integral agents in public service delivery. The editors hope that readers across varied environments will enjoy learning of samples of the creative work being implemented across counseling centers to the benefit of all those who are served in public service settings. (PsycINFO Database Record

Model Minority Stereotype: Influence on Perceived Mental Health Needs of Asian Americans.

This study examined the influence of the model minority stereotype on the perceived mental health functioning of Asian Americans. It was hypothesized that college students would perceive Asian Americans as having fewer mental health problems and clinical symptoms than Whites due to the model minority stereotype. Four hundred and twenty-five undergraduate students from a predominately White college campus in the American northeast were randomly exposed to one of four conditions: (1) a clinical vignette describing a White college student suffering from adjustment disorder; (2) the same vignette describing an Asian American college student; (3) a newspaper article describing a success story of Whites and the White clinical vignette; (4) the same newspaper article and clinical vignette describing an Asian American. Following exposure to one of the conditions, participants completed a memory recall task and measures of colorblindness, attitudes towards Asian Americans, attitudes towards out-group members, and perceived mental health functioning. Participants exposed to the vignettes primed with the positive/model minority stereotype perceived the target regardless of race/ethnicity as having better mental health functioning and less clinical symptoms than the condition without the stereotype. Additionally, the stereotype primer was found to be a modest predictor for the perception of mental health functioning in Asian American vignettes. Results shed light on the impact of the model minority stereotype on the misperception of Asian Americans' mental health status, contributing to the invisibility or neglect of this minority group's mental health needs.

Asian American and White College Students' Heavy Episodic Drinking Behaviors and Alcohol-Related Problems.

BACKGROUND: Heavy episodic drinking (HED) and alcohol-related problems appears to be a growing problem among young adult Asian Americans. One promising factor that helps explain within-group differences among Asian American includes nativity. Nativity refers to whether an individual was born in (i.e., second generation or higher) or outside (i.e., first generation) of the United States. Despite this theoretically promising variable, there has been a paucity of literature examining comparing drinking patterns between first and second generation Asians Americans and White college men. OBJECTIVES: The current study examined the relationship between HED and alcohol-related problems among first- and second-generation Asian American, and White college male students. Interaction between race and the variables in HED and alcohol-related problems models were also investigated. METHOD: A total of 630 men were recruited of which 489 were Asian American men (407 second generation and 82 first generation) and 148 White students attending a public university in southern California (USA) were recruited. RESULTS: Results revealed no differences in HED rates between second-generation Asian American and White male college students; however, White students reported higher rates of HED compared to first-generation Asian Americans. No differences in alcohol-related problems were found between all three groups. There were no significant interactions between racial groups, drinking to cope, Greek/fraternity status, and descriptive norms on the alcohol outcomes. Conclusion/importance: Second-generation Asian American young adult men reported similar HED and rates of alcohol-related problems as White men. The present findings suggest that alcohol-related problems among Asian American men are a larger public health concern than previously believed.

The effects of race and other socioeconomic factors on health service use among American military veterans.

This study examined the extent to which racial disparities in service utilization exist in veterans (VA) and non-VA health care systems. An observational study design was used with a nationally representative sample of veterans. Logistic regression models were constructed using sociodemographic characteristics, health insurance and benefits, and health status as predictors of health service use in both VA and non-VA health care systems. A population weighted sample of 19,270 veterans from the 2001 National Survey of Veterans was used, which included 17,004 (88.24%) White, 1,864 (9.15%) African American, 414 (2.15%) Native American/Alaskan Native, and 87 (0.45%) Asian American/Pacific Islander veterans. Results showed that use of the VA health care system was not associated with race, but was associated with VA disability compensation, lack of private health insurance, and greater health care need. Contrarily, in non-VA healthcare systems, veterans who were racial minorities, less educated, and without private health insurance were less likely to use services. Together, these findings demonstrate the socioeconomic context in which health disparities exist and suggest the influence of health insurance on racial disparities in service utilization.

Heavy Drinking, Poor Mental Health, and Substance Use Among Asian Americans in the NLAAS: A Gender-Based Comparison.

The severity of heavy drinking among Asian Americans has often been dismissed because of relatively low rates compared to other racial/ethnic groups. However, higher depression and suicide rates among Asian Americans and their association to alcohol use suggest serious detrimental effects of heavy alcohol use among Asian Americans. Gender differences in heavy drinking have been documented among other immigrant based ethnic minorities, little is known of this pattern for Asian Americans. The purpose of the present study was to examine gender differences in heavy drinking, poor mental health, and substance use among a national sample of Asian Americans (N = 581) in the National Latino and Asian American Study (NLAAS). Using National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines, heavy drinkers were categorized as those who exceeded the recommended weekly number of drinks (≥14 drinks/week for male and ≥7 drinks/week for female). Accordingly, six comparison groups were created (male non, light, and heavy drinkers, and female non, light, and heavy drinkers). Pearson's chi-square test was conducted to examine percentage distribution for the six groups for mental health disorders (i.e., suicidality, DSM-IV mental health endorsement for past 12-month and lifetime). Logistic regression was followed to determined predictors for heavy drinking behavior for men and for women. Female heavy drinkers reported significantly poorer mental health than non drinkers, light drinkers and male heavy drinkers, as indicated by higher rates of lifetime generalized anxiety, and depressive disorders. In contrast, male heavy drinkers were more likely to have lifetime substance use disorders. Findings suggest the need to develop gender-specific drinking interventions for Asian Americans that focus on improving mental health among women and substance treatment among men.