The Clinical Psychologist, 2026, Vol 79, No. 3

Volume 79 / Issue 3 Summer 2026

May 15, 2026

Lynn Collins headshot

APA is Right Around the Corner

by Lynn H. Collins, PhD

Professor, Department of Psychology, La Salle University

Read the President's Update

As Western psychological science is disseminated around the world, it is important to remember that there are things it may have missed due to its Western lens. In 2008, Arnett reported that 96% of subjects in psychological research were from Western industrialized countries, and 99% of first authors were at universities in Western countries. In other words, 96% of psychological samples come from countries with only 12% of the world’s population. Although that study should be updated, it is still clear that we need to pay more attention to the Majority World where most of the world’s population lives. It will be important to structure research as partnerships between the researchers and the community such that the needs and interests of all parties are served. It will be important to engage in cultural immersion before beginning the work in hopes of opening our minds up to new perspectives and ways of being. We will need to get back to basics – Western psychology had humble beginnings, starting with observations of self and others, introspection, measurement, and case studies. So will the study of other communities around the globe. There will need to be dialogue and collaboration with an awareness of power differentials.

APA is right around the corner. This year we have an invited speaker whose talk will cover considerations when engaging in research in the Majority World – the parts of the world inadequately studied by psychological science. Dr. Rachel Sing-Kiat Ting is a clinical psychologist, researcher, and professor at Fuller Seminary whose accomplishments center on cultural psychology, indigenous healing traditions, and clinical training across Asia and the U.S. Her contributions to transnational psychology follow naturally from the transnational nature of her career itself, spanning Indigenous communities across Southeast Asia and relying on decolonizing research approaches to understand the psychology of communities within Southeast Asia. She has published in international journals, secured international grants as principal investigator, led multidisciplinary teams of international researchers, and established the Culture and Health Lab at Monash University to mentor early-career researchers and students. She is also founder and director of the Southeast Indigenous Psychology Network, founded to empower psychological researchers in this region to conduct culturally relevant studies.

Though recent events have further reduced trust in our country in addition to funds available for research, I hope that at some point universities and NGOs can offer similar immersion experiences coupled with research partnerships around the globe. Before we can have a complete clinical psychology, we need a better foundation of basic psychological research from communities around the globe. I’ve called it “pointillistic” because our knowledge is likely to accumulate as a collection of independent studies across the world. It would be helpful to introduce Western psychology students to Majority World contexts and engage them in the process.

One of the challenging aspects of a Transnational Psychology (some in the Majority World object to the term “Global” because they associate it with the exploitation that has accompanied globalization) will be the many disparate research findings and dynamic intersections of identity in distant places. If AI ever becomes sufficiently well-designed and informed, it may be able to help integrate the huge number of disparate sources of information more quickly and look for patterns to be investigated further. It may be able to present possible framings and scenarios with the caveat that they are just a few of the possible scenarios and do not necessarily apply to the individual. At this point, the most it may be able to do is instantaneously provide clinicians with information about the basic characteristics of the communities and regions in which a client has lived and possible experiences based on their demographics. This information would need to be verified, but it is a start. For good or bad, Wikipedia serves as one source of AI’s information. The good thing about using Wikipedia is that it is multi-lingual and people in communities all over the world can contribute knowledge to it. If the clinician has very little information about the places someone has lived, it may be useful in providing basic information about those places, their culture, notable events, and even local “chatter” about community issues gleaned from local social media very, very quickly, providing links to sources. If you don’t think AI could ever help inform a case conceptualization, type in your own demographic characteristics, the places you have lived at different ages over your lifespan, the types of schools you have attended, where you have vacationed, and any other notable experiences you have had… AI still needs a lot of work, to become accurate, environmentally-friendly, to compensate the content creators, protect privacy, etc., before it is truly ready and safe to use. Europe already finds ways to use the heated water produced, so with planning and further technical advancement, who knows? Think about the history of technology, especially computing itself…monumental progress is still possible.

Laptop computer sitting on a table

Where Your Week Actually Goes (It’s Not the Clients)

Most allied health practitioners didn’t get into clinical work for the paperwork. But somewhere between client notes, intake forms, billing, reminders, and chasing payments, the admin starts running the day.

Zanda’s practical guide breaks down the eight operational areas where allied health practices most often lose time and the workflow changes that consistently win those hours back. A few of the big ones:

  • Clinical notes take the largest single block of admin time. AI-assisted notes can compress a 15-minute write-up into 2 to 3 minutes without losing clinical accuracy.
  • Intake and onboarding is a hidden cost. Practices using customizable digital forms cut new client setup from 20+ minutes down to under 5.
  • No-shows quietly drain revenue and time. Automated SMS reminders reduce no-show rates by an average of 30 percent.
  • Billing and invoicing pile up at the end of the day. Built-in claiming and invoicing can save 3 to 5 hours a week for a busy solo practitioner.

None of this requires a new system overnight. Even one workflow change can free up a clinical hour a day! Zanda combines everything allied health practices need into one secure platform. Start your free trial today.

Whitney Ringwald

How the HiTOP Field Trials Can Enhance Your Clinical Practice and Advance Psychological Science

by Whitney Ringwald, PhD

Assistant Professor, Department of Psychology, University of Minneso

wringwal@umn.edu

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As a clinical psychologist, I imagine you’ve experienced frustration and challenge at some point applying the Diagnostic and Statistical Manual for Mental Disorders (DSM) to complex cases in your training or practice. These issues are widely recognized. One shortcoming of the DSM system is that people with the same diagnosis can have very different problems; for example, someone can meet criteria for major depressive disorder with symptoms of low mood, insomnia, and agitation or with symptoms of anhedonia, hypersomnia, and fatigue. Paradoxically, another issue is that people often meet criteria for multiple diagnoses, which complicates treatment planning. Despite that, clients often end up in the “other specified” categories; for instance, they present with a few symptoms of depression that cause distress and impairment, but don’t meet full diagnostic criteria.

To address some of these limitations of the DSM, researchers have been developing an alternative classification system based on decades of quantitative evidence: the Hierarchical Taxonomy of Psychopathology (HiTOP) (for a clinician-oriented overview see Ruggero et al., 2019). In HiTOP, psychopathology is defined by continuous dimensions rather than discrete categories. These dimensions are organized into varying levels of specificity from narrow symptoms (e.g., low mood, distractibility) to broad, transdiagnostic domains (e.g., internalizing, disinhibition). Instead of giving a diagnostic label like depression that can look very different from one person to another, the lower levels of HiTOP allow for a more precise, detailed profile of presenting problems. The issue of frequent “comorbidity” is addressed in HiTOP by broad domains; for example, instead of describing a client as suffering from major depression, generalized anxiety, and panic disorder they would be characterized as having prominent internalizing problems. Finally, because dimensions capture the full range of symptom severity, “subthreshold” cases are fully represented. HiTOP is quite comprehensive, and the majority of client’s mental health problems can be described by HiTOP profile.

When most people learn about HiTOP, they tell me it makes intuitive sense. And you may find yourself thinking that it aligns with how you conceptualize cases and psychological disorder already. But one of the most common questions people ask next is, “So, how does HiTOP work in clinical practice?” Unfortunately, the answer to that question has been mostly hypothetical to date, because there have been few efforts to bring HiTOP to the clinic and study its clinical utility.

That brings me to my main message: We’re working to close this research-practice gap with the HiTOP Field Trials, and we need your help to do it.

The Field Trials has two main goals: 1) equip clinics with a standardized, validated assessment tool supported by the latest scientific research on HiTOP, and 2) produce research on how HiTOP works in the real world, with real clients. Several university clinics and private practices across the nation are already participating. To help decide if your clinic might want to join, here are some FAQs:

What are the HiTOP Field Trials?

We are providing clinics with a no-cost assessment battery to use with their clients called the HiTOP Digital Assessment and Tracker (HiTOP-DAT) that includes questionnaires covering symptoms and maladaptive traits in the HiTOP model. Clinicians and clients can benefit from the reports, and researchers will learn directly from clinicians about what works, what does not, and what needs to change.

What does participation involve?

Participating clinics use the HiTOP-DAT in routine clinical assessments and eventually provide feedback on what works and what doesn’t via a short, anonymous survey.

How would my clinic benefit from participating?

1) Assessment and case conceptualization benefits. Scales capturing the full range of symptom severity provide more detailed information about a client’s problems. Broad coverage of symptoms and maladaptive traits can help clinicians better identify concerns that need attention in treatment planning.

2) Clinic workflow benefits. The remote, fully automated administration maximizes flexibility and efficiency, all while generating broad and complex insight about client symptom presentation.

3) Training benefits. For university clinics, HiTOP-DAT helps fulfill the mission of a scientist-practitioner or clinical scientist model by more closely aligning research and practice.

How do I get started?

Email me (Field Trials director) with any questions about participation or the process. If you decide to join the Field Trials, I will work with you and your team to get the HiTOP-DAT assessment up and running in your clinic.There is also a comprehensive instructional manual and free virtual workshop to aid implementation of HiTOP-DAT.

To conclude, adding the HiTOP-DAT to routine clinical assessments offers a potential solution to improve how we assess, diagnose, and treat the unique set of symptoms each of our client’s experience. Your participation in the Field Trials is also a unique opportunity to be involved with the latest scientific research. Together, we can improve clinical care at your clinic now and contribute to research that can have a lasting impact on clinical psychological science.

References

Ruggero, C. J., Kotov, R., Hopwood, C. J., First, M., Clark, L. A., Skodol, A. E., Mullins-Sweatt, S. N., Patrick, C. J., Bach, B., Cicero, D. C., Docherty, A., Simms, L. J., Bagby, R. M., Krueger, R. F., Callahan, J. L., Chmielewski, M., Conway, C. C., De Clercq, B., Dornbach-Bender, A., Eaton, N. R., … Zimmermann, J. (2019). Integrating the Hierarchical Taxonomy of Psychopathology (HiTOP) into clinical practice. Journal of Consulting and Clinical Psychology, 87(12), 1069–1084. https://doi.org/10.1037/ccp0000452

News & Updates

US Capitol Building, Washington DC

APA Convention 2026

August 6-8, 2026 | Washington, DC + Virtual

Registration now open!

SCP’s APA programming is outstanding – we hope to see you at Convention this year!

Visit our Convention page for more information

 

Society of Clinical Psychology Division 12 of APA

Join a Society of Clinical Psychology Section

The Society of Clinical Psychology (Division 12) has six sections.

J Kim Penberthy

At the Table, Not on the Sidelines: Clinical Psychology and the Psychedelic Renaissance

by J. Kim Penberthy, PhD, ABPP

Chester F. Carlson Professor of Psychiatry & Neurobehavioral Sciences, University of Virginia School of Medicine & Health System

Contact via email

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As clinical psychologists, we are trained to sit with suffering in its complexity. We know that healing is rarely reducible to symptom reduction alone. It involves meaning, relationship, memory, identity, culture, safety, and the therapeutic encounter itself. For that reason, I believe clinical psychologists must be centrally involved in the rapidly evolving conversation about psychedelics and psychedelic-assisted psychotherapy.

Psychedelic-assisted psychotherapy is no longer a distant or fringe topic. It is an active area of research, public interest, clinical curiosity, commercial investment, and policy development. Patients are asking about it. Clinicians are seeking training. Researchers are conducting randomized trials and expanding usage to multiple disorders. Legislators, regulators, health systems, and private companies are beginning to shape access and standards of care. If clinical psychologists are not at the table, decisions about these interventions will be made without the profession most deeply trained in psychological assessment, psychotherapy, ethics, therapeutic relationship, trauma-informed care, states of consciousness, and the science of behavior change.

This matters because psychedelic-assisted psychotherapy is not simply a medication intervention. The psychological components are central: careful screening, preparation, support during the psychedelic experience, integration afterward, attention to risk, and respect for the patient’s meaning-making process. These are core competencies of clinical psychology. Research with psilocybin-assisted therapy has demonstrated promising outcomes for depression, cancer-related anxiety and depression, and existential distress, with subjective experiences such as meaning, connectedness, emotional breakthrough, and mystical-type experience often playing an important role in reported benefit (Davis et al., 2021; Griffiths et al., 2016; Ross et al., 2016). Similarly, MDMA-assisted therapy studies for PTSD have highlighted the importance of a therapeutic container in which trauma, trust, safety, and relational support are central to treatment (Mitchell et al., 2021, 2023).

My own recent work has focused on use of psilocybin for Prolonged Grief Disorder, an area in which symptom reduction alone is an insufficient lens. Grief involves love, attachment, longing, memory, identity, spirituality, and the ongoing relationship to the deceased. In our open-label feasibility study protocol, we are examining whether psilocybin-assisted therapy may help people with Prolonged Grief Disorder engage more flexibly with painful memories, disrupted meaning, emotional avoidance, and existential suffering (Penberthy et al., 2026). This work is closely connected to my broader research interests in consciousness, spirituality, bereavement, and after-death communications; experiences that many grieving individuals describe as meaningful, comforting, and sometimes transformative. Whether we are studying psychedelic experiences, after-death communications, mystical experiences, or other profound experiences reported in grief, clinical psychologists have a responsibility to approach them with scientific curiosity, humility, and clinical care rather than reflexive dismissal or uncritical acceptance.

The Society of Clinical Psychology and the American Psychological Association have important roles to play. Our involvement should not be understood as uncritical endorsement or premature expansion of practice. Rather, it should reflect our responsibility to provide leadership grounded in science, ethics, equity, and public protection. APA and SCP can help clarify competencies, training needs, informed consent practices, safeguards for vulnerable patients, appropriate boundaries, cultural humility, integration practices, adverse event monitoring, and the distinctions among research, legally authorized clinical care, harm reduction, and unregulated use.

This is also an access and equity issue. If psychedelic-assisted psychotherapy continues to develop, we must ask who will benefit, who will be excluded, and who may be harmed. We need to ensure that emerging models of care do not become available only to those with wealth, geographic privilege, or access to elite treatment centers. We must also attend to communities historically harmed by criminalization, medical exploitation, and inequitable access to mental health care. Psychologists have an ethical obligation to bring these questions forward early and often.

For these reasons, I am especially encouraged that APA will feature the Main Stage presentation, “Psychedelics in Practice: Lessons from APA CODAPAR Initiative,” at the August convention in Washington, DC. This session will bring psychedelic-assisted therapy into a central APA forum and invite psychologists to consider the science, clinical applications, ethics, equity, training needs, and practice guidance needed for this field. Division 12, the Society of Clinical Psychology, is represented in this conversation through its leadership and participation in the CODAPAR-supported interdivisional work on psychedelic-assisted therapy. SCP’s presence matters because clinical psychologists must help ensure that psychotherapy, psychological science, and patient protection remain central to any responsible model of psychedelic-assisted care.

The question is not whether psychedelics will continue to shape public and professional conversations about mental health treatment. They already are. The question is whether clinical psychologists will help guide that development wisely. I believe SCP and APA should be active leaders in this space—not to chase a trend, but to protect patients, support clinicians, advance psychological science, and ensure that the human work of psychotherapy remains at the heart of psychedelic-assisted treatment.

References

Davis, A. K., Barrett, F. S., May, D. G., Cosimano, M. P., Sepeda, N. D., Johnson, M. W., Finan, P. H., & Griffiths, R. R. (2021). Effects of psilocybin-assisted therapy on major depressive disorder: A randomized clinical trial. JAMA Psychiatry, 78(5), 481–489. https://doi.org/10.1001/jamapsychiatry.2020.3285

Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., Cosimano, M. P., & Klinedinst, M. A. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of Psychopharmacology, 30(12), 1181–1197. https://doi.org/10.1177/0269881116675513

Mitchell, J. M., Bogenschutz, M., Lilienstein, A., Harrison, C., Kleiman, S., Parker-Guilbert, K., Ot’alora G., M., Garas, W., Paleos, C., Gorman, I., Nicholas, C. R., Mithoefer, M., Carlin, S., Poulter, B., Mithoefer, A., Quevedo, S., Wells, G., Klaire, S. S., van der Kolk, B., … Doblin, R. (2021). MDMA-assisted therapy for severe PTSD: A randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine, 27, 1025–1033. https://doi.org/10.1038/s41591-021-01336-3

Mitchell, J. M., Ot’alora G., M., van der Kolk, B., Shannon, S., Bogenschutz, M., Gelfand, Y., Paleos, C., Nicholas, C. R., Quevedo, S., Balliett, B., Hamilton, S., Mithoefer, M., Kleiman, S., Parker-Guilbert, K., Tzarfaty, K., Harrison, C., de Boer, A., Doblin, R., & Yazar-Klosinski, B. (2023). MDMA-assisted therapy for moderate to severe PTSD: A randomized, placebo-controlled phase 3 trial. Nature Medicine, 29, 2473–2480. https://doi.org/10.1038/s41591-023-02565-4

Penberthy, J. K., Wise, F. A., Cherup, N. P., Penberthy, J. M., Mitchell, E., Burns, M., Akinlade, O., Chung, D., Parmar, H., & Singer, J. (2026). Psilocybin for treatment of prolonged grief disorder: An open-label feasibility study protocol. Psychoactives, 5(2), Article 12. https://doi.org/10.3390/psychoactives5020012

Ross, S., Bossis, A., Guss, J., Agin-Liebes, G., Malone, T., Cohen, B., Mennenga, S. E., Belser, A., Kalliontzi, K., Babb, J., Su, Z., Corby, P., & Schmidt, B. L. (2016). Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: A randomized controlled trial. Journal of Psychopharmacology, 30(12), 1165–1180. https://doi.org/10.1177/0269881116675512

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Jenna Wesely

Recognizing and Reducing Bias in Psychological Diagnosis

Jenna Wesely, MA

Doctoral Student, Clinical Psychology PhD Program, Alliant University, San Diego

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Evidence suggests that racial, gender, and age bias can affect the validity of some psychological diagnoses. Potential sources of bias include (but are not limited to) diagnostic criteria or assessment tools that function differently across groups, initial impressions of a patient’s identity may shape subsequent diagnostic questioning, and racial, cultural, or gender differences in symptom presentations (Garb, 2021).

 One of the best-replicated findings on racial diagnostic bias involves differentiating schizophrenia from psychotic mood disorders in Black patients (Garb, 2021). Evidence from studies comparing clinical diagnoses with structured assessments or ethnicity-blinded expert diagnoses indicates that Black individuals with bipolar disorder are more likely than White individuals with bipolar disorder to be misdiagnosed with schizophrenia or another nonaffective psychotic disorder (Akinhanmi et al., 2018). This pattern may reflect clinicians placing disproportionate weight on psychotic symptoms relative to mood symptoms when evaluating Black patients (Akinhanmi et al., 2018; Gara et al., 2019).

 Racial bias may also contribute to Attention-Deficit/Hyperactivity Disorder (ADHD) being overlooked and to disruptive behavior disorders being overdiagnosed in some children. Among pediatric inpatients diagnosed with either ADHD or a disruptive behavior disorder, Native American, Asian, Black, and Hispanic youth had higher adjusted odds than White youth of receiving a disruptive behavior disorder diagnosis rather than an ADHD diagnosis (Savage et al., 2024). Research also demonstrated Black children (particularly boys) were less likely than observationally similar White children to receive an ADHD diagnosis even after researchers accounted for differences in ADHD related behavior and functioning (Morgan & Hu, 2023). In addition, a study conducted in community mental health clinics found that conduct disorder was overdiagnosed among African American adolescents when routine clinical diagnoses were compared with comprehensive research assessments (Tapia et al., 2024).

 Symptoms may also be miscategorized when they do not conform to gendered expectations. ADHD may be overlooked in girls and women because they more often show predominant inattention and associated internalizing difficulties, fewer disruptive behaviors, and compensatory strategies that can mask ADHD related impairment (Hinshaw et al., 2022). Autism may likewise be recognized later in women, with social camouflaging identified as a possible contributor to this delayed recognition (Kentrou et al., 2024). In a 2024 study, 31.7% of autistic women, compared with 16.7% of autistic men, reported a previous psychiatric diagnosis they perceived as inaccurate. Across participants, the most frequently perceived misdiagnoses were personality, anxiety, and mood disorders (Kentrou et al., 2024). Meanwhile, eating disorders may be missed or misdiagnosed in boys and men. Eating disorder diagnostic frameworks and assessment tools developed largely from female samples that tend to emphasize thinness. As a result, these may overlook dietary restriction aimed at muscularity or leanness, compulsive exercise, and dissatisfaction centered on muscle size or definition (Murray et al., 2017).

 Older adults may be particularly vulnerable to diagnostic error because depression and neurocognitive disorders can produce overlapping cognitive, emotional, and functional changes. Late-life depression may go unrecognized when prominent sadness is absent or its symptoms are attributed to normal aging (Adriani et al., 2024; Tetsuka, 2021). In a Norwegian primary-care study, nearly one-third of patients aged 65 or older who screened positive for moderate depressive symptoms were neither previously recognized nor currently suspected by their general practitioners as having depression (Kvalbein-Olsen et al., 2023). Depression can also impair memory, attention, processing speed, and executive functioning, such that it can be mistaken for a neurocognitive disorder in older populations (Adriani et al., 2024; Tetsuka, 2021). Conversely, depressive symptoms may accompany dementia, which allows for an emerging neurocognitive disorder to be mistaken for a primary depressive disorder (Adriani et al., 2024; Tetsuka, 2021).

 Clinicians can reduce these diagnostic errors by using a systematic and revisable assessment process rather than relying primarily on unstructured first impressions. Routine symptom screening, structured or semistructured interviews, and psychological measures can prompt consideration of symptoms and competing diagnoses that might otherwise be overlooked; however, these tools do not eliminate bias and should have appropriate norms and validity evidence for the populations in which they are used (Garb, 2021). Clinicians should also examine how culture, gender socialization, and age may shape symptom expression. Moreover, clinicians can use culturally informed approaches, such as the Cultural Formulation Interview, to elicit patients’ own understandings of their difficulties and relevant cultural and social contexts, although evidence supporting its routine use with all patients remains preliminary (Kayrouz et al., 2024; Wallin et al., 2022). Lastly, cultural-diversity and cognitive-debiasing training may further improve clinical judgment, but these efforts should be accompanied by continued development and validation of diagnostic criteria and assessment tools across diverse populations (Garb, 2021).

References

 Adriani, B., Arena, J. F., Fioretti, A., Mancino, S., Sarno, F., Ferracuti, S., & Del Casale, A. (2024). Current Diagnostic Challenges in Late-Life Depression and Neurocognitive Disorders. Psychiatry International, 5(4), 904-916. https://doi.org/10.3390/psychiatryint5040061

Akinhanmi, M. O., Biernacka, J. M., Strakowski, S. M., McElroy, S. L., Balls Berry, J. E., Merikangas, K. R., Assari, S., McInnis, M. G., Schulze, T. G., LeBoyer, M., Tamminga, C., Patten, C., & Frye, M. A. (2018). Racial disparities in bipolar disorder treatment and research: a call to action. Bipolar disorders, 20(6), 506–514. https://doi.org/10.1111/bdi.12638

Gara, M. A., Minsky, S., Silverstein, S. M., Miskimen, T., & Strakowski, S. M. (2019). A Naturalistic Study of Racial Disparities in Diagnoses at an Outpatient Behavioral Health Clinic. Psychiatric services (Washington, D.C.), 70(2), 130–134. https://doi.org/10.1176/appi.ps.201800223

Garb H. N. (2021). Race bias and gender bias in the diagnosis of psychological disorders. Clinical psychology review, 90, 102087. https://doi.org/10.1016/j.cpr.2021.102087

Hinshaw, S. P., Nguyen, P. T., O’Grady, S. M., & Rosenthal, E. A. (2022). Annual Research Review: Attention-deficit/hyperactivity disorder in girls and women: underrepresentation, longitudinal processes, and key directions. Journal of child psychology and psychiatry, and allied disciplines, 63(4), 484–496. https://doi.org/10.1111/jcpp.13480

Kayrouz, R., Karin, E., Staples, L., Nielssen, O., Cross, S., Dear, B. F., & Titov, N. (2024). A quantitative systematic review to evaluate the favorability of the DSM-5 cultural formulation interview (CFI) on the acceptability, feasibility, and clinical utility for clinicians, patients, and relatives. Journal of Cross-Cultural Psychology, 55(8), 835-864.

Kentrou, V., Livingston, L. A., Grove, R., Hoekstra, R. A., & Begeer, S. (2024). Perceived misdiagnosis of psychiatric conditions in autistic adults. EClinicalMedicine, 71, 102586. https://doi.org/10.1016/j.eclinm.2024.102586

Kvalbein-Olsen, L. C., Aakhus, E., Haavet, O. R., & Werner, E. L. (2023). Unrecognised depression among older people: a cross-sectional study from Norwegian general practice. BJGP open, 7(1), BJGPO.2022.0135. https://doi.org/10.3399/BJGPO.2022.0135

Morgan, P. L., & Hu, E. H. (2023). Sociodemographic disparities in ADHD diagnosis and treatment among U.S. elementary schoolchildren. Psychiatry research, 327, 115393. https://doi.org/10.1016/j.psychres.2023.115393

Murray, S. B., Nagata, J. M., Griffiths, S., Calzo, J. P., Brown, T. A., Mitchison, D., Blashill, A. J., & Mond, J. M. (2017). The enigma of male eating disorders: A critical review and synthesis. Clinical psychology review, 57, 1–11. https://doi.org/10.1016/j.cpr.2017.08.001

Savage, W. M., Saint-Hilaire, S. A., Shah, M., & Lugo-Candelas, C. (2024). Racial disparities in the diagnosis of disruptive behavior disorders: a U.S. national inpatient sample analysis. Frontiers in psychiatry, 15, 1425559. https://doi.org/10.3389/fpsyt.2024.1425559

Shi, Y., Hunter Guevara, L. R., Dykhoff, H. J., Sangaralingham, L. R., Phelan, S., Zaccariello, M. J., & Warner, D. O. (2021). Racial Disparities in Diagnosis of Attention-Deficit/Hyperactivity Disorder in a US National Birth Cohort. JAMA network open, 4(3), e210321. https://doi.org/10.1001/jamanetworkopen.2021.0321

Tapia, J. D., Sparber, A., Lopez, O., Martin, P., Graziano, P. A., Basu, H., Beaulieu, M. A., & Sibley, M. H. (2024). Racial and Gender Disparities in Community Mental Health Center Diagnoses of Adolescent ADHD and Comorbidities: A Mixed Methods Investigation. Journal of Child and Family Studies, 33(11), 3472-3485.

Tetsuka S. (2021). Depression and Dementia in Older Adults: A Neuropsychological Review. Aging and disease, 12(8), 1920–1934. https://doi.org/10.14336/AD.2021.0526

Wallin, M. I., Galanti, M. R., Nevonen, L., Lewis-Fernández, R., & Bäärnhielm, S. (2022). Impact on routine psychiatric diagnostic practice from implementing the DSM-5 cultural formulation interview: a pragmatic RCT in Sweden. BMC psychiatry, 22(1), 149. https://doi.org/10.1186/s12888-022-03791-9

J Morgan Penberthy

Regulation and Intentional Self-Compassion for Empowerment (RISE): Assessing the Feasibility and Acceptability of a Mindfulness-Based Intervention for Survivors of Sexual Coercion

J. Morgan Penberthy, MA; Clinical Psychology PhD Candidate, Pacific University, Oregon

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Nearly 40% of American women and 13.3% of American men have experienced at least one incident of sexual coercion (i.e., unwanted sexual contact) in their lifetime.1 Underreporting of sexual coercion is prevalent due to stigma associated with victimization2,3, suggesting that instances of sexual coercion are likely higher than current data suggests. Sexual coercion can be enacted through a range of means, including verbal pressure or physical force,4 with the fundamental principle being that survivors lack choice and face a range of consequences if they do not consent.5,6 Survivors of sexual coercion report heightened emotional reactivity, difficulty managing emotions, and challenges with regulating mood.7,8 These emotional difficulties resulting from sexual coercion victimization can hinder the development of self-compassion and increase the risk of harmful behaviors, including disordered eating.11,12

 Mindfulness-based interventions (MBIs) may improve emotion regulation within this population, potentially by increasing awareness of emotional responses to triggering stimuli.13 Such emotion regulation strategies or skills may promote improvement after trauma, also known as posttraumatic growth (PTG), in sexual coercion survivors.14 Additionally, resilience, or the capacity to recover after trauma, mediates the relationship between trauma symptoms and disordered eating in female sexual coercion survivors15, highlighting the importance of exploring how changes in resilience and related constructs may shape behavioral outcomes after sexual coercion. However, few studies have investigated how confidence in one’s abilities to regulate negative mood, or negative mood regulation expectancies (NMREs) may contribute to improvement after sexual coercion. While limited research suggests that NMREs may predict PTG among survivors of sexual coercion, this work has not examined whether emotion-focused MBIs can enhance PTG or resilience in this population.16 Existing MBI studies demonstrate preliminary efficacy in promoting PTG among survivors of sexual coercion, yet often involve small, predominantly collegiate female samples, adapt MBIs for non-victimized populations, and overlook NMREs and other emotion-related mechanisms as potential contributors to PTG.13

 Additionally, survivors of sexual coercion often face barriers to engaging in mindfulness-based interventions (MBIs), including internalized stigma, fear of judgment, and diminished self-worth, which are reinforced by self-blame, heightened emotional reactivity, and low confidence in regulating negative mood states.11,13

 Given that NMREs contribute to PTG among sexual coercion survivors, MBIs tailored to bolster confidence in emotion regulation abilities must be explored within this population. Some MBIs have demonstrated efficacy in reducing trauma-related cognitions and improving positive emotionality among survivors of interpersonal violence.17 However, such MBIs have not yet incorporated NMREs nor been explored within a population of sexual coercion survivors. Because NMREs predict PTG in sexual coercion survivors, integrating them within an MBI has the potential to (a) further bolster PTG and resilience and alleviate negative outcomes, such as disordered eating, while (b) specifically addressing the feasibility for use among survivors of sexual coercion.

 Regulation and Intentional Self-Compassion for Empowerment (RISE) is a trauma-informed, emotion-focused mindfulness-based intervention (MBI). The protocol is adapted from several developed practices, manuals, and protocols, including Mindfulness-Based Stress Reduction23,24, Trauma-Adapted Mindfulness and Loving-Kindness Intervention25, Integrative Restoration-Yoga Nidra Meditation (iRest)26, as well as practices from loving-kindness meditation27, compassion-focused therapy as an intervention for sexual trauma survivors28, and self-compassion yoga for survivors of sexual violence.29

 RISE will be provided to participants virtually over a course of eight weeks, with participants engaging in a 2-hour intervention workshop, 7 subsequent Zoom-based weekly 1-hour intervention sessions, and finally a focus group occurring 8 weeks after the final intervention session. Each session will include didactic psychoeducation, experiential learning (e.g., mindful meditation and emotion regulation practices), and group discussion. Participants will be asked to practice skills between sessions on their own time. Participants will also be provided with a workbook including weekly agendas, psychoeducation, review of take-home assignments/practices, and reflection questions.

 The long-term goal of my dissertation is to develop, examine, and disseminate an adapted MBI which addresses the role of emotion among sexual coercion survivors. The primary objectives of this dissertation are (a) to evaluate the feasibility and acceptability of Regulation and Intentional Self-Compassion for Empowerment (RISE), which incorporates NMRE-boosting strategies for survivors of sexual coercion; and (b) to examine the efficacy of RISE in reducing disordered eating behavior, and increasing levels of PTG and resilience.

 A target sample size of 20 adult sexual coercion survivors will be recruited to assess feasibility outcomes. Given the exploratory nature of the study to assess the feasibility and acceptability of an intervention adapted by the researcher, less weight is given to sample sizes based on a priori power analyses and a formal power analysis will not be conducted.18 Recommended sample sizes of 12–25 participants per arm optimize the estimation of group means and variability while avoiding oversampling.19,20,21 Additionally, this range provides reasonably precise confidence intervals for retention rates. Therefore, the aim of this study is to recruit 20 participants to account for potential attrition, which tends to be higher in this population.22 As noted previously, given that sexual coercion survivors face several potential barriers to engagement in mental health interventions, funding through a Varela Grant offered by the Mind & Life Institute has been secured to provide participant incentives, including payment for participation and transportation coverage, to combat these barriers. More information about this grant and project can be found on the Mind & Life Institute website. I am deeply grateful for the opportunity to carry this work forward and to contribute to research that supports resilience, restores agency, and honors the possibility of healing after sexual coercion.

 

References

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Melanie Morse

Member Spotlight: Interview with Dr. Melanie Morse, PhD

Assistant Professor of Pediatrics at the University of Virginia School of Medicine

 

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Where did you complete your training (graduate school and area of emphasis, internship, post doc, etc.)?

I completed my doctoral training in clinical-community psychology at the University of South Carolina, with a focus on child clinical/adolescent and pediatric psychology. I completed several practicum experiences within our local children’s hospital system during that time. For internship, I trained at the Virginia Treatment Center for Children (part of VCU Health System), where I gained experience in inpatient residential behavioral healthcare for children and teens, along with additional pediatric psychology rotations. I then completed a combined research and clinical postdoctoral fellowship in pediatric psychology at St. Jude Children’s Research Hospital.

Please provide an overview of your work (e.g., clinical specialty and interests, research program, etc.).

I get to use everything I gained throughout training, which I love! I see outpatients across three multidisciplinary pediatric specialty clinics — nephrology, allergy and immunology, and developmental pediatrics — and I run UVA’s pediatric behavioral health inpatient consultation-liaison program. I also lead quality improvement initiatives for our pediatric psychology team and have a small research program focused on using VR for anxiety reduction.

What is your current position/occupation?

I’m an Assistant Professor of Pediatrics at the University of Virginia School of Medicine.

Can you describe the ways that your career has taken shape over time? How did you get to where you are today?

I had the good fortune of completing a psychology practicum as an undergraduate at Hendrix College, where I volunteered with child life specialists at Arkansas Children’s Hospital. I really appreciated the emphasis on patient and family strengths and resilience in what can often be a very challenging setting. That experience showed me there was a place for me in pediatric care, and I’m grateful to now do this work as a licensed psychologist.

How long have you been a member of SCP? Please indicate any past or present roles in SCP (e.g., leadership, committees, task forces, etc.)?

I have been a member since 2014 when I began my doctoral training. In addition to my role as programming co-chair for APA, I serve as treasurer for Section 10.

What do you see as an important direction for the field of Psychology?

I’d like to see continued progress toward equitable access to evidence-based mental health care — making sure that quality psychological services reach all children and families, regardless of background or geography.

Please describe any roles you have with APA or other national, state, or local organizations.

None at this time, although I hope to pursue some in the future!

What’s something nobody would know about you? 

I was a Girl Scout for years and I never miss cookie season! I hated Samoas as a kid, but they’re my favorite now.

What are your hobbies?

I have a scruffy dog named Theo, and I love taking him on walks and the occasional short hike around Charlottesville. I’ve also gotten really into gardening — recently branching into hydroponics so I can grow my favorite veggies year-round. And, of course, I love to travel!