The impact of historical loss on Native American college students' mental health: The protective role of ethnic identity.

Culturally relevant stressors and protective factors are vital to understanding and effectively supporting Native American/Alaska Native (NA/AN) college students' mental health and well-being. This study examined the theorized pathways among historical loss, well-being, psychological distress, and the proposed cultural buffer of ethnic identity in the indigenist stress-coping model (ISCM). Cross-sectional data were collected via online survey and analyzed using structural equation modeling. Participants were a national sample of 242 NA/AN college students. Participants were predominantly women (n = 185; 76%) and median age was 21 years. Partial support was found for the ISCM. Participants reported frequent thoughts of historical loss, which were associated with lower well-being and higher levels of psychological distress. Ethnic identity moderated the relationship between historical loss and well-being such that those with stronger ethnic identities reported a weaker relationship between historical loss and lower well-being. Results underscore the importance of culturally specific risk and protective factors in NA/AN college students' resiliency and inform needed interventions and systemic change in higher education. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Guidelines for psychological practice for people with low-income and economic marginalization: Executive summary.

This is a summary of the guidelines for working with low-income and economically marginalized (LIEM) people developed by the American Psychological Association (APA) task force and approved by the APA Council of Representatives. The task force, consisting of psychologists from a range of psychological specialties and both practice and educational settings, created guidelines in four main categories: Education and Training, Health Disparities, Treatment Considerations, and Career Concerns and Unemployment. Each category includes specific guidelines and recommended interventions. Further, the task force identified two major assumptions that cut across all of the recommendations: (1) The intersection of economic status and other identities is critical to psychological and other aspects of health, and (2) biases and stigma exacerbate the negative experiences of living with LIEM, and must be acknowledged and confronted by psychologists and trainees. Many of the guidelines and corollary interventions reinforce the need for psychologists and trainees to engage in activities that increase their own self-awareness and knowledge of issues and concerns that are exacerbated by economic marginalization, as well as challenge their own implicit and explicit biases related to social class and poverty. The impact of economic marginalization on education, health, and career attainment are addressed, and adaptations to psychological interventions are recommended. The task force concludes with a call to engage psychologists in action that seeks and promotes economic justice. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Employment and poverty: Why work matters in understanding poverty.

This article synthesizes the work-related dynamics that contribute to economic inequality and identifies ways for psychologists to offer their expertise to mitigate poverty through employment and re-employment. We summarize scholarship from subspecialties under the umbrella of work psychology to explore concepts germane to understanding unemployment, underemployment, and reemployment. The review and synthesis is organized around 4 primary themes that concern the relationships between work, economic inequality, and poverty. First, unemployment has devastating financial and psychological consequences for individuals, families, and communities. Second, reemployment is challenging to acquire but crucial to recovering from unemployment and escaping poverty. Third, systemic and societal factors, such as employment bias and gaps in employment law, shape and constrain employment processes for individuals and organizations. Fourth, the nature of employment is changing because of technological advances, growth in the contingent labor force, and globalized business relationships that introduce new concerns for underemployment, unemployment, and reemployment processes for individuals. We conclude by charting important directions for future research, describing promising interventions for practitioners, and summarizing opportunities for psychologists to apply their knowledge and expertise to support policies that can alleviate poverty. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Examining mental health practitioners' perceptions of clients based on social class and sexual orientation.

There is negligible research exploring mental health clinicians' perceptions of clients based upon client social class and sexual orientation (McGarrity, 2014; Whitcomb & Walinsky, 2013). The purpose of this study was to examine how licensed mental health clinicians' perceptions of clients were influenced by a hypothetical client's social class and sexual orientation using a 2 (lower social class vs. higher social class) × 2 (lesbian vs. straight) quasi-experimental vignette-based design. Results from 257 practitioners demonstrated that the hypothetical client portrayed in the video was rated differently on levels of depression, anxiety, and flourishing, as well as job satisfaction and meaningful work. Participants who viewed the client portrayed as having a lower social class rated her as having more symptoms of depression and anxiety, as being less satisfied at work, as having lower levels of meaningful work, and as having lower levels of flourishing as compared with the participants who viewed the client portrayed as having a higher social class. Participants did not rate the hypothetical clients differently on symptoms of depression, anxiety, meaningful work, or job satisfaction based upon client sexual orientation. The lesbian client was rated as being significantly more attractive to work with and as having significantly higher levels of flourishing as compared to the straight clients. No interaction effects were demonstrated. Implications of these findings and directions for future research are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Patient financial distress and treatment outcomes in naturalistic psychotherapy.

Although psychotherapy is on the whole an effective health care practice, treatment efficacy for patients with varying levels of reported financial distress is less clear. The purpose of this study was to examine the impact of patient self-reported financial distress on psychotherapy outcomes using a large, naturalistic psychotherapy dataset of college students who sought psychotherapy services (n = 5,078 patients, n = 238 therapists). Multilevel models accounted for the nesting of patients within therapists and treatment outcome was assessed using the Outcome Questionnaire-45. Patients on the whole showed treatment effects in the moderate to large range (d = 0.73). However, patients with higher financial distress at baseline were more likely to drop out of treatment after 1 session and, when controlling for baseline severity, had worse outcomes at the end of treatment. Though the effects were small, these findings held when controlling for age, gender, and treatment length. Further, the relationship between baseline financial distress and treatment retention (but not treatment outcome) varied between therapists, though the effects were also small. Patients' financial distress specifically and social class more generally may be patient contributors to psychotherapy outcome (and therapist effects) that warrant further attention. (PsycINFO Database Record

Clinical Experiences With Clients Who Are Low-Income: Mental Health Practitioners' Perspectives.

The experiences of nine licensed mental health practitioners regarding their work with clients from low-income backgrounds were examined utilizing grounded theory methodology. Themes that emerged from the semi-structured interviews highlighted a rich narrative that portrayed the work as both deeply satisfying and inherently complex. Participants described the personal nature of this work, including countertransference elicited because of their own personal economic contexts and emotional reactions experienced within and outside the therapy room. Their stories acknowledged systematic challenges that act as barriers to treatment. Some participants noted that this has contributed to feelings of disillusionment toward the field as well as fears about the future of the mental health care. Based on these findings, we discuss implications for training, future research, and clinical practice.

A grounded theory exploration of undergraduate experiences of vicarious unemployment.

The experiences of vicarious unemployment (VU) among 17 undergraduate student participants who had a primary caregiver who was involuntarily unemployed were explored using grounded theory (Charmaz, 2006; Glaser & Strauss, 1967). Data from semistructured interviews with 15 women and 2 men revealed the nuanced nature of experiences with unemployment among those who experience it vicariously. Struggles related to increased family stress and experiences with stigma were common across participants. As participants reflected upon these challenges, they both lamented the costs associated with the struggles and expressed appreciation for the lessons that they have learned. They emerged from their VU experiences with increased financial and job market awareness, which informed their hope for a life that is free from the struggles endured in their families. Participants expressed confidence in their ability to cultivate financial security for their own families, stable employment, and opportunities to pursue work that will allow them to give back to others. Implications for counseling and directions for future research are discussed.

Native American undergraduate students' persistence intentions: a psychosociocultural perspective.

Attending to persistence intentions among Native American students enrolled in institutions of higher education is critical, given low retention rates. The purpose of the study was twofold: (a) we developed and examined the psychometric properties of a new measure, the Native American Collective Pursuits of Education (NACOPE), and (b) we explored persistence attitudes among 156 Native American students using Gloria and Rodriguez's (2000) psychosociocultural framework. Pilot data and exploratory analysis supported the psychometric properties of the NACOPE and its use to understand educational experiences for Native American students. Results also supported the prediction of culturally relevant noncognitive variables to persistence intentions. Limitations, directions for future research, and implications for higher education are discussed.

Financial strain and regional unemployment as barriers to job search self-efficacy: a test of social cognitive career theory.

Social cognitive career theory (SCCT) emphasizes the potential impact of contextual barriers on vocational self-efficacy, interests, and goals. However, most tests of SCCT to date have focused exclusively on person-level, perceptual barriers rather than objective, macroeconomic barriers that may influence large groups of people. In this study, we examine how the effects of personal experiences with financial strain among a sample of adults who are unemployed are qualified by regional unemployment rates. Results indicated that financial strain has a direct, negative relation with job search self-efficacy, and indirect, negative relations with job search outcome expectations and search goals. These direct and indirect relations are moderated by unemployment rates and are only significant for participants residing in U.S. counties with high unemployment. These findings highlight the importance of taking into account broader contextual influences when studying vocational outcomes and demonstrate the applicability of incorporating macroeconomic barriers and supports into SCCT in future research.

Recognizing social class in the psychotherapy relationship: a grounded theory exploration of low-income clients.

The process of psychotherapy among 16 low-income clients was explored using grounded theory (Charmaz, 2006; Glaser & Strauss, 1967) in order to understand and identify their unique experiences and needs. Semistructured interviews were conducted with 12 women and 4 men who had attended at least 6 sessions of psychotherapy within 6 months of the interview. Our grounded theory that evolved depicted a tapestry of the dynamic process by which low-income clients experience social class within psychotherapy. Specific therapist behaviors that contribute to more and less positive experiences emerged from the data and pointed to the importance of acknowledging social class within the therapy room. The significance of therapists enhancing the 50-min hour via advocacy and meaningful moments within and outside of the therapy room was highlighted among all participants. Implications for practice with low-income clients and directions for future research are provided.