Objective This study evaluates whether a web-based educational program for patients who read their mental health notes online improves patient-clinician communication and increases patient activation. Methods The web-based educational program, developed with end-user input, was designed to educate patients on the content of mental health notes, provide guidance on communicating with clinicians about notes, and facilitate patients’ safe and purposeful use of their health information. Eligible patients were engaged in mental health treatment (≥1 visit in the prior 6 months) and had logged into the Veterans Health Administration (VHA) patient portal at least twice. Participants completed measures of patient activation, perceived efficacy in healthcare interactions, patient trust in their clinicians, and patient assessment of the therapeutic relationship before and after participating in the program. A total of 247 participants had complete data and engaged with the program for 5 minutes or more, comprising the analytic sample. Multivariate analysis using mixed effects models were used to examine pre-post changes in outcomes. Results In bivariate analyses, patient activation, perceived efficacy in healthcare interactions, and trust in clinicians increased significantly between pre- and post-training assessments. In fully adjusted models, changes in patient activation [b = 2.71 (1.41, 4.00), P < 0.01] and perceived efficacy in healthcare interactions [b = 1.27 (0.54, 2.01), P < 0.01)] remained significant. Conclusions Findings suggest that this educational program may help empower mental health patients who read their notes online to be active participants in their care, while also providing information and tools that may facilitate better relationships with their clinicians.
The purpose of the present study was to examine application materials for assistant professor positions in 3 academic disciplines. Applicants were asked to write a diversity statement describing how they would advance diversity through their research, teaching, and service. The sample included application materials submitted by 191 candidates for tenure-track faculty positions at a public research university in computer science, political science, and psychology. Application letters and diversity statements were coded for 9 diversity dimensions. For example, My research in the Latino community . . ., and I volunteer at a middle school to encourage more girls to pursue computer science . . ., would be coded as reflecting the diversity dimensions of ethnicity/race and gender, respectively. Applicant self-disclosures of diversity were uncommon, occurring in fewer than 1 quarter of the letters. Nonspecific forms of diversity were most frequently mentioned in application materials, followed by references to ethnicity/race, disability, age, and gender. Comparisons between the searches revealed that psychologist applicants had significantly higher density of references to diversity in their letters than the 2 other disciplines, and also were most likely to cite specific, rather than nonspecific, dimensions of diversity. These results add to our understanding of how faculty applicants approach the diversity statement component of applications and reveal potential differences between disciplines in the diversity construct. The results are discussed in terms of suggestions to faculty applicants and directions for further research.
A cultural opportunity is 1 of 3 pillars within multicultural orientation framework; it is defined as a moment in therapy when aspects of a client's background emerge, which can be deeply explored to better understand the salient aspects of a client's cultural identities. Research on cultural opportunities provides evidence that clients desire cultural conversations. However, no study to date has examined what cultural opportunities sound like in therapy and how therapists and clients utilize these opportunities. Accordingly, the purpose of this study was to examine the ways in which cultural conversations emerge during the first psychotherapy session and how clients and therapists engage in these cultural conversations. Psychotherapy sessions from diverse therapist-client pairings at a university counseling center (n = 22) were analyzed using (reflexive) thematic analysis. Qualitative findings revealed 4 themes around how cultural opportunities emerge (e.g., windowpane of feeling) and 3 themes in how they are responded to (e.g., look out the same window: using client's language to explore culture). Implications for therapist training and supervision are discussed. Clinical Impact StatementQuestion: How do clients and therapists engage in cultural conversations? Findings: We found four ways that cultural opportunities emerge in sessions and three ways they are engaged with. Meaning: Therapists and clients can explore and better understand clients' cultural backgrounds in a variety of ways. Next Steps: Future research should examine the effects of using different approaches to utilize cultural opportunities for cultural deepening as well as how therapists' selfreported multicultural orientation ratings are reflected in session.
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