ADDRESSING diversity, equity, inclusion and belonging (DEIB) in mentorship relationships

The growing racial, ethnic, and cultural diversity within the United States underscores the importance of neuropsychologists developing cultural competence to improve patient care and support increased practitioner diversity. APA has recognized the importance of expanding the field's diversity, equity, inclusion, and belonging (DEIB) efforts to promote the retention of historically underrepresented practitioners and culturally competent practices. Supervisors and mentors are particularly well suited and ethically required to support DEIB-related professional development in their trainees. However, current literature suggests that a lack of time and perceived lack of competence in initiating and facilitating these conversations remain barriers to DEIB efforts. This paper aims to increase a supervisor's/mentor's self-efficacy in facilitating these efforts. We offer adapted theoretical models of cultural competence and provide a "tool kit" of experiential activities adapted for neuropsychologists that can be utilized to support the initiation, maintenance, and quality of DEIB-focused discussions within these relationships.

Fostering Teachers' Multicultural Competence for Chinese Ethnic Minority Education: An Analysis of Teacher Education Programmes, Syllabuses and Teacher Educator Perceptions

The multicultural characteristics of students belonging to ethnic minorities in China pose challenges for teachers. Teacher competence in dealing with culturally diverse students has been extensively discussed in international scholarship and referenced by Chinese researchers, but there is limited empirical research on how teacher education programmes in China respond to this challenge and theoretical discussions. Based on content analysis on teacher education programmes and syllabuses, as well as expert interviews with four teacher educators at two teacher education institutions, this study investigates how the cultivation of multicultural competence is incorporated into teacher education programmes, and the external forces that shape it. Drawing on international scholarship on teachers' multicultural competence and Cochran-Smith's framework on external forces influencing multicultural teacher education practices, I argue that the cultivation of teachers' multicultural competence for their future work in ethnic minority education is, to a great extent, missing from teacher education programmes. Furthermore, what pre-service teachers' competence covers, and the external forces that influence how teacher education plays out in practice, are influenced and somewhat determined by the large social, economic and political context as well as the agenda for educational reform in China.

Race in Supervision: Let's Talk About It

Addressing race and racial trauma within psychotherapy supervision is increasingly important in psychiatry training. A therapist's ability to discuss race and racial trauma in psychotherapy supervision increases the likelihood that these topics will be explored as they arise in the therapeutic setting. The authors discuss the contextual and sociocultural dynamics that contributed to their own avoidance of race and racial trauma within the supervisory relationship. The authors examine the features that eventually led to a robust discussion of race and culture within the supervisory setting and identify salient themes that occurred during three phases of the conversation about race: pre-dialogue, the conversation, and after the conversation. These themes include building an alliance, supercompetence, avoidance, shared vulnerability, "if I speak on this, I own it," closeness versus distance, and speaking up. This article reviews the key literature in the field of psychiatry and psychology that has shaped how we understand race and racial trauma and concludes with guidelines for supervisors on how to facilitate talking about race in supervision.

Behavioral indices in medical care outcome: the working alliance, adherence, and related factors

BACKGROUND

The working alliance has been shown to be a consistent predictor of patient outcome and satisfaction in psychotherapy. This study examines the role of the working alliance and related behavioral indices in predicting medical outcome.

OBJECTIVE

Cognitive and emotional dimensions of the physician-patient relationship were examined in relation to patients' ratings of physician empathy, physician multicultural competence, perceived utility of treatment, and patients' adherence self-efficacy. These factors were then examined as part of a theoretical framework using path analyses to explain patient self-reported adherence to and satisfaction with treatment.

DESIGN

The study was based on an ex-post facto field correlation design.

PARTICIPANTS

One hundred fifty-two adult outpatients from a neurology clinic at Bellevue Hospital, a large municipal hospital in New York City, participated in the study.

INTERVENTIONS

Surveys given to participants.

MEASUREMENTS

We used the following measurements: Physician-Patient Working Alliance Scale, Perceived Utility Scale, Treatment Adherence Self-Efficacy Scale, Medical Outcome Study Adherence Scale, Physician Empathy Questionnaire, Physician Multicultural Competence Questionnaire, Medical Patient Satisfaction Questionnaire.

MAIN RESULTS

The effect sizes for adherence are between 0.07 and 0.21 and for satisfaction between 0.10 to >0.50. Regression and path analyses showed that ratings of physician multicultural competence and patient adherence self-efficacy beliefs predicted patient adherence (SB = 0.34) and (SB = 0.30) and satisfaction (SB = 0.18) and (SB = 0.12), respectively. Working alliance ratings also predicted patient satisfaction (SB = 0.49).

CONCLUSIONS

Psychological and interpersonal dimensions of medical care are related to patient adherence and satisfaction. Medical care providers may be able to use these dimensions to target and improve health care outcomes.