Identifying and enhancing the necessary ingredients for cultural humility in supervisory relationships.

Cultural humility is an oft-studied construct in psychotherapy and supervision and, as such, has multiple definitions and frameworks and is frequently contextualized as the organizing pillar of the multicultural orientation framework (MCO; alongside cultural comfort and cultural opportunities; Davis et al., 2018; Owen, 2013). Many definitions of cultural humility emphasize a high level of self-awareness, openness to feedback, empathy, and curiosity toward others' cultural experiences (Davis et al.

Social support and psychotherapy outcomes for international students in university/college counseling centers.

: To explore the relationship between international students' social support at intake and international student distress at end of treatment. : Data was collected from participants ( = 40,085) from 90 United States universities using the Center for Collegiate Mental Health (CCMH) database. : Participants completed measures of psychological distress and perceived social support.

Psychosociocultural correlates of mental health among Mexican American students in a Hispanic-serving institution: A conditional process analysis.

In this study, we used a psychosociocultural framework to examine whether cultural congruity was related to mental health indirectly via a sense of university belonging in a sample of 322 Mexican American undergraduates attending a Hispanic-serving institution (HSI). In line with literature on biculturalism and cultural values, we also examined whether Mexican American HSI students' adherence to the ethnic value of familismo and to White ethnoracial values jointly moderated this indirect association. Results of conditional process modeling indicated that greater cultural congruity was partially indirectly associated with greater university belonging, which, in turn, was associated with better mental health.

Psychotherapy outcomes with Latinx clients attending Hispanic-serving institutions and predominantly White institutions.

In the present study, we used a large, national data set to examine psychotherapy outcomes from 9,515 Latinx clients seeking treatment in 71 college or university counseling centers in the United States, 13 of which were in Hispanic-serving institutions (HSIs) and 58 in predominantly White institutions (PWIs). We examined the hypothesis that Latinx clients in HSIs, compared to Latinx clients in PWIs, would experience greater relief in symptoms of depression, generalized anxiety, and academic distress over the course of psychotherapy. Results of multilevel modeling offered partial support for our hypothesis.

Introduction to special section: Addressing racism, anti-blackness, and racial trauma in psychotherapy.

This article introduces the special section on "Addressing Racism, Anti-Blackness, and Racial Trauma in Psychotherapy." The special section was organized to highlight research and clinical practices on addressing racism, anti-Blackness, and racial trauma in psychotherapy. We provide an overview of the special section with attention to future research to continue to advance practice and scholarship on addressing racism, anti-Blackness, and racial trauma in psychotherapy.

Measurement invariance and psychometric properties of the CCAPS-62 and -34 for international student clients.

Objectives: International students attending universities in the United States may encounter psychological distress related to their adjustment and experiences studying in a new context and seek services from university counseling centers. Many centers use the Counseling Center Assessment of Psychological Symptoms (CCAPS) to measure psychological distress in college counseling centers. However, this scale has not been tested for measurement invariance with international students.

"Where have you been in this world?" a qualitative study of clients' curiosity about their psychotherapists.

Curiosity is widely seen as a basic human drive, important to the development of relationships as well as to the process of change in psychotherapy. Less attention, however, has been directed toward examining curiosity in the client-therapist relationship. In particular, we lack a comprehensive understanding of what occurs for clients when they become curious about their therapists.

"How could I not bring it up?": A multiple case study of therapists' comfort when Black clients discuss anti-Black racism in sessions.

Anti-Black racism is often overlooked in predominantly White spaces such as psychotherapy. This pervasive disregard and dehumanization reflects the perpetuation of ongoing racial trauma that can influence the psychological health of Black people seeking psychotherapy. Therapists, therefore, ought to be equipped and comfortable to have conversations about anti-Blackness and anti-Black racism in sessions, though evidence suggests they are often uncomfortable discussing race and racism in practice.

Center effects, therapist effects, and international student clients' drop out from psychotherapy.

In 2019-2020, 1,075,496 international students pursued higher education in the United States. Many of these students endure unique experiences of psychological distress that accompanies their shared experience of studying abroad in the United States. Researchers have explored clinical experiences within this diverse group, with some suggesting that international students are at greater risk than students from the United States for dropping out of psychotherapy.

Therapist and counseling center effects on international students' counseling outcome: A mixed methods study.

We employed a convergent mixed methods design to examine therapist and counseling center effects on international student clients' (ISCs) counseling outcomes. Using the Center for Collegiate Mental Health (CCMH) data set (2015-2017), we conducted a three-level hierarchical linear model with clients ( = 85,110) nested in therapists (N = 1,267), and therapists nested in counseling centers ( = 111), with clients' international status predicting distress (DI) in their last sessions while controlling for initial DI. Compared to domestic students, the average last session DI was significantly higher among ISCs.

Do birds of a feather flock together? Clients' perceived personality similarity, real relationship, and treatment progress.

In the present study, we examined whether clients' perceptions of similarity to their therapists in terms of the Big Five personality traits were associated with the real relationship and, indirectly through the real relationship, to treatment progress. Data collected through an online crowdsource platform from 212 adult clients in individual psychotherapy were analyzed using polynomial regression and response surface analysis. Results indicated that clients who perceived greater similarity to their therapists at higher (vs.

Therapists' cultural comfort and clients' distress: An initial exploration.

The extent to which therapists are comfortable discussing clients' cultural identities in psychotherapy has been considered a valuable component of how therapists integrate clients' cultures into treatment. Cultural comfort specifically reflects a therapist's way of being at ease, relaxed, and open when discussing clients' cultural identities in treatment. Some initial research has demonstrated the relationships between cultural comfort and clinical outcomes, yet this work has relied largely on cross-sectional designs.

Development and initial validation of the Therapist Cultural Comfort Scale.

The development and initial validation of a client-rated measure of therapist cultural comfort (the Therapist Cultural Comfort Scale [TCCS]) is reported. The first phase of the study involved content validation of the initial pool of items via consultation with (a) focus groups of doctoral student therapists and (b) experts in the field of multicultural counseling and psychotherapy. A 56-item pool generated during this phase, together with instruments used to gauge convergent and incremental validity, were administered to a community adult sample of current psychotherapy clients ( = 889).

"Alguien abrió la puerta:" The phenomenology of bilingual Latinx clients' use of Spanish and English in psychotherapy.

There has been a growing recognition of the role that various aspects of culture play in the theory and practice of psychotherapy. One aspect of culture that has received little attention, however, is language. Specifically, we lack comprehensive understanding of the value bilingual clients find in expressing thoughts, feelings, and experiences in two languages.

Pretreatment counseling experiences, stressors, and support differences between transgender and cisgender university students seeking mental healthcare.

Objectives: Our aim was to explore rates of prior counseling experiences as well as pretreatment stressors and supports among transgender university students seeking psychotherapy services in university counseling centers.

Methods: We used regression models to explore relationships between gender identity and prior mental health experiences, risk-related experiences, traumatic experiences, and support among clients (cisgender: n = 162,305; transgender: n = 545) seeking treatment at 136 university counseling centers.

Results: Results demonstrate more previous mental health service utilization and greater frequency of some prior stressors transgender clients.

The development and initial validation of the Countertransference Management Scale.

Countertransference is an important aspect of the therapeutic relationship that exists in therapies of all theoretical orientations, and depending on how it is managed, it can either help or hinder treatment. Management of countertransference has been measured almost exclusively with the Countertransference Factors Inventory (Van Wagoner, Gelso, Hayes, & Diemer, 1991) and its variations, all of which focus on 5 therapist qualities theorized to facilitate management: self-insight, conceptualizing ability, empathy, self-integration, and anxiety management. Existing versions of the Countertransference Factors Inventory, however, possess certain psychometric limitations that appear to constrain how well they assess actual management of countertransference during a therapy session.

Is training effective? A study of counseling psychology doctoral trainees in a psychodynamic/interpersonal training clinic.

We investigated changes over 12 to 42 months in 23 predoctoral trainees during their externship training in a psychodynamic/interpersonal psychotherapy clinic. Over time, trainees increased in client-rated working alliance and real relationship, therapist-rated working alliance, client-rated interpersonal functioning, ability to use helping skills (e.g.

Love and sexuality in the therapeutic relationship.

We examine sexual and loving feelings, on the part of both the therapist and patient, as they relate to their real relationship, patient transference, and therapist countertransference. Loving feelings (agape) often are part of a strong real relationship and they tend to have a positive effect. Sexual feelings, too, may be part of the real relationship, but they are also often more conflict-based, residing in the transference and countertransference experience.