College students' barriers to seeking mental health counseling: Scale development and psychometric evaluation.

This article reports the development and psychometric properties of the 27-item Barriers to Seeking Mental Health Counseling (BMHC) scale, which assesses perceived help-seeking barriers among college-aged students. Across 2 studies involving ethnically diverse samples (e.g., Latinx majority students), the authors provided evidence for this new measure's validity and reliability. Exploratory and confirmatory factor analyses (including a bifactor analysis) provided support for the BMHC scale's multidimensionality reflecting 6 barriers: Negative Perceived Value, Discomfort with Emotions, Ingroup Stigma, Lack of Knowledge, Lack of Access, and Cultural Barriers. Evidence for criterion-related validity was shown through significant but differential correlations with self-stigma, emotional control, and the 4 components of Ajzen's (1991) Theory of Planned Behavior model-attitude, subjective norm of social stigma, perceived behavioral control, and mental health help-seeking intention. Discriminant evidence of validity was established through nonsignificant or small correlations between BMHC subscales and 2 measures of socially desirable responding. The authors also found evidence for incremental validity and measurement invariance across race, and evidence for internal reliability and temporal stability of the BMHC subscales. Findings are discussed in light of the conceptual, methodological, and clinical contributions of the BMHC scale. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Encouragement Character Strength Scale: Scale development and psychometric properties.

This article reports the development and psychometric properties of the 12-item Encouragement Character Strength Scale (ECSS), a measure of the character strength of encouragement using diverse samples (e.g., noncollege adults, Latinx-majority college students, and psychotherapists). The encouragement character strength is the enjoyment and perceived ability to express affirmations to motivate others. This character strength is relevant to counseling psychology because of the latter's historical embrace of human strengths and encouragement's importance in many counseling psychology applications, such as psychotherapy and supervision. Bifactor modeling provided evidence for a general factor and for measurement invariance across race and gender. Ancillary bifactor indices suggest that ECSS should be treated as a unidimensional measure. Criterion-related evidence of validity for ECSS was demonstrated through positive correlations with secure attachment, generativity, empathy, kindness, optimism, social connectedness, the personality traits of agreeableness and extraversion, psychological well-being, and a strength-based focus in psychotherapy (for therapists). Discriminant evidence of validity revealed small correlations with impression management and self-deception enhancement. Incremental evidence of validity showed unique, positive correlations with psychological well-being and generativity, after controlling for other variables. Moreover, self-reported ECSS scores were correlated with positive features of written encouragement messages and with other-reported ECSS scores, providing support for heteromethod convergent validity. The authors also found evidence for ECSS's internal consistency and temporal stability. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Mexican American women's perspectives on a culturally adapted cognitive-behavioral therapy guided self-help program for binge eating.

The prevalence of bulimia nervosa (BN) and binge eating disorder (BED) among Latinas is comparable to those of the general population; however, few interventions and treatment trial research have focused on this group. Cognitive-behavioral therapy (CBT) is the treatment of choice for binge eating related disorders. CBT-based guided self-help (CBTgsh)-a low-cost minimal intervention-has also been shown effective in improving binge eating related symptom, but the effectiveness of the CBTgsh among ethnic minority women is not well understood. Cultural adaptation of evidence-based treatments can be an important step for promoting treatment accessibility and engagement among underserved groups. This qualitative study was part of a larger investigation that examined the feasibility and efficacy of a culturally adapted CBTgsh program among Mexican American women with binge eating disorders. Posttreatment focus groups were conducted with 12 Mexican American women with BN or BED who participated in the intervention. Data were analyzed with the grounded theory methodology (Corbin & Strauss, 2008). Three themes emerged from the data: (a) eating behavior and body ideals are socially and culturally constructed, (b) multifaceted support system is crucial to Mexican American women's treatment engagement and success, and (c) the culturally adapted CBTgsh program is feasible and relevant to Mexican American women's experience, but it can be strengthened with increased family and peer involvement. The findings provide suggestions for further adaptation and refinement of the CBTgsh, and implications for future research as well as early intervention for disordered eating in organized care settings.

Culturally adapted cognitive behavioral guided self-help for binge eating: a feasibility study with Mexican Americans.

Objective was to test feasibility and preliminary efficacy of a culturally adapted cognitive-behavioral self-help program to treat binge eating and related problems in Mexican Americans. Participants were 31 women recruited from the Los Angeles area and diagnosed with binge eating disorder, recurrent binge eating, or bulimia nervosa. Participants completed a culturally adapted version of a CBT-based self-help program with 8 guidance sessions over a 3-month period. Treatment efficacy was evaluated in terms of binge eating, psychological functioning, and weight loss. Intent-to-treat analyses revealed 35.5% abstinence from binge eating at posttreatment and 38.7% diagnostic remission. Results indicated significant pretreatment to posttreatment improvement on distress level, BMI, eating disorder psychopathology, and self-esteem. Satisfaction with the program was high. Findings demonstrate that the program is acceptable, feasible, and efficacious in reducing binge eating and associated symptoms for Mexican American women. Study provides "proof of concept" for implementation of culturally adapted forms of evidence-based programs.

How many therapists? Practical guidance on investigating therapist effects in randomized controlled trials for eating disorders.

OBJECTIVE: An important question in implementation/dissemination research is whether the efficacy of a given treatment varies in part based on the therapist delivering the treatment. This study sought to provide practical guidance to researchers in the field of eating disorders for building measurement of therapist effects into the design of a typical, relatively small randomized controlled trial (RCT). METHOD: Using assumptions based on past trials of eating disorder treatments, Monte Carlo simulations were used to examine 12 different scenarios based on crossing the number of therapists (between two and five) and the estimated therapist effect size (small, medium, and large). Patient sample size and study design were held constant. RESULTS: There was reasonable power (≥70%) to detect the therapist effect with three or four therapists and a large effect size. DISCUSSION: Several practical implications for testing therapist effects in RCT are discussed.

A latent class regression analysis of men's conformity to masculine norms and psychological distress.

How are specific dimensions of masculinity related to psychological distress in specific groups of men? To address this question, the authors used latent class regression to assess the optimal number of latent classes that explained differential relationships between conformity to masculine norms and psychological distress in a racially diverse sample of 223 men. The authors identified a 2-class solution. Both latent classes demonstrated very different associations between conformity to masculine norms and psychological distress. In Class 1 (labeled risk avoiders; n = 133), conformity to the masculine norm of risk-taking was negatively related to psychological distress. In Class 2 (labeled detached risk-takers; n = 90), conformity to the masculine norms of playboy, self-reliance, and risk-taking was positively related to psychological distress, whereas conformity to the masculine norm of violence was negatively related to psychological distress. A post hoc analysis revealed that younger men and Asian American men (compared with Latino and White American men) had significantly greater odds of being in Class 2 versus Class 1. The implications of these findings for future research and clinical practice are examined.

Cultural Adaptation of a Cognitive Behavior Therapy Guided Self-Help Program for Mexican American Women With Binge Eating Disorders.

Data on the compatibility of evidence-based treatment in ethnic minority groups are limited. This study utilized focus group interviews to elicit Mexican American women's (N = 12) feedback on a cognitive behavior therapy guided self-help program for binge eating disorders. Findings revealed 6 themes to be considered during the cultural adaptation process and highlighted the importance of balancing the fidelity and cultural relevance of evidence-based treatment when disseminating it across diverse racial/ethnic groups.

Loss, Psychosis, and Chronic Suicidality in a Korean American Immigrant Man: Integration of Cultural Formulation Model and Multicultural Case Conceptualization.

Culture shapes the nature, experience, and expression of psychopathology and help-seeking behavior across ethnically diverse groups. Although the study of psychopathology among Asian Americans has advanced, clinicians remain in need of culturally appropriate tools for the assessment and diagnosis of severe mental disorders including psychotic symptoms among Asian Americans. In this article, we present a brief overview of two culturally relevant conceptual tools: a) the Cultural Formulation Model, and b) the Multicultural Case Conceptualization approach. We use a case scenario to illustrate the integration of these two approaches in providing culturally responsive clinical conceptualization, assessment and treatment of a Korean American immigrant suffering from prominent psychiatric symptoms. We intend this discussion to engender further empirical work to advance our knowledge of the manifestation and experience of severe mental illness including psychotic disorders among Asian Americans, and contribute to culturally competent prevention and intervention of chronic and persistent mental illness within this group.

Chinese immigrant high school students' cultural interactions, acculturation, family obligations, language use, and social support.

When immigrant youth come to the United States, they must learn to interact with dominant and cultural groups as part of the adjustment process. The current study investigated whether the association between Chinese immigrant high school students' (N = 286) English fluency, academic and career/ college help-seeking, multidimensional acculturation, family responsibilities, and social support, predicted their intercultural competence concerns (their interactions across dominant and cultural groups). Results indicate that this was the case. Implications for research and practice with immigrant youth in a high school context are discussed.