This conceptual paper considers the role of culture in shaping family, professional, and community understanding of developmental disabilities and their treatments. The meanings of health, illness, and disability vary greatly across cultures and across time. We use Bronfenbrenner's ecological model to provide a theoretical framework for examining disability, with special attention to autism spectrum disorders. Cultural beliefs about the cause of a disorder influence families' decision-making about what treatments to use and what outcomes to expect. Autism provides an example that is especially challenging, as there is no agreed-upon cause. Also, an overwhelming array of treatments is available in the West for autism, including behavioral, cognitive, pharmaceutical, sensory, relational, vitamin, and diet therapies. Other cultures contribute additional views on cause (e.g., Karma, Allah's will) and treatments (e.g., acupuncture, herbal medicines, Ayurveda). We suggest how a broad cultural view can help us understand treatments and the treatment delivery system of a nation and a culture. For the best course of care, professionals need to understand and respect families' views of autism and work toward mutually agreeable treatments that may involve a combination of biomedical and cultural practices. Although a family-focused, open teamwork model that aims to acknowledge the context of the child, take into consideration the strengths and limitations of the child and the family, and introduce appropriate, sustainable, and sensitive interventions is regarded as best practice in the United States, it will take sensitive work to find out whether it will suit other cultural groups across the world.
Beliefs and practices regarding autism were explored in Indian families living outside India. Parents (N = 24) of children (3 to 15 years) with an autism spectrum disorder wrote open-ended answers in an online questionnaire regarding their beliefs about causes, treatments and services received, use of and preference for Indian medicine and practices, and acculturation. Although two participants did not provide enough answers to be categorized, three groups of parents emerged: Those who were primarily Western (n = 4) in their beliefs and practices concerning autism, those who were primarily Indian (n = 4), and those who endorsed a combination of Western and Indian beliefs and practices (n = 14). Most parents acknowledged traditional beliefs and practices only when specifically asked and did not volunteer this information. Professionals need to avoid assuming there is a universal set of attitudes and practices related to autism when working with culturally diverse families.
Technologies such as smartphones and digital cameras are an increasingly ubiquitous part of modem life, and the increasing convenience of these electronic tools provides psychotherapists with opportunities to incorporate these technologies into psychotherapy. In the face of so much opportunity, psychotherapists must Ieam how to incorporate these tools effectively and responsibly. The authors present three case studies that demonstrate the use of digital technology to individualize and enhance the efficiency of existing evidence-based treatments. In the first, digital pictures were used to track the treatment progress of a client who compulsively hoards. In the second, a smartphone was used to record a personalized progressive muscle relaxation file for a client with agoraphobia, hypochondriasis, and generalized anxiety disorder. In the third, a smartphone was used to photograph and send pictures of in-session work to a client with trichotillomania and generalized anxiety disorder. The implications and ethical considerations of using technology in psychotherapeutic settings are explored, and practical strategies are provided for incorporating common digital technology into psychotherapeutic practice.New technology has frequently been implemented as an adjunct to cognitive-behavioral psychotherapy, from early computerassisted systematic desensitization (Lang, Melamed, & Hart, 1970) to the recent virtual/augmented reality-assisted exposure treatment (Botella, Bretón-López, Quero, Baños, & García-Palacios, 2010). While technology has influenced and expanded the practice of psychology in some cases, such as with telehealth and virtual reality applications, technology has not revolutionized the field in the way it has with some other domains in health care, such as radiology, surgery, or dentistry. This may be in part because new technology is, at least initially, often too expensive for private psychotherapists or community-based clinics, where most psychotherapy services are provided (Boschen & Casey, 2008).There are at least two ways in which technology can significantly influence current practice in a field. First, cutting-edge technology provides such a leap forward in knowledge, methods, and capability that it revolutionizes practice in the way that scanning technologies have changed neurology, to use an example from another field. Revolution can also occur when a technology becomes ubiquitous and integrates itself into the cultural and social Editor's Note. This is one of 19 accepted articles received in response to an open call for submissions on Telehealth and Technology Innovations in Professional Psychology.-MCR ALISON M. EONTA received her MS in Clinical Psychology from Virginia Commonwealth University and is currently pursuing her PhD in the program. Her areas of research and practice include anxiety disorders (specifically posttraumatic stress disorder), behavioral medicine, and psychophysiology. LILLIAN M. CHRISTON received her MA in psychology from the University of Richmond and is currently pursuing he...
Children with incarcerated mothers are at high risk for developing problem behaviors. Fifty children (6-12 years; 62% girls) participated in summer camps, along with adult mentors. Regression analyses of child and adult measures of child's emotion self-regulation and callousunemotional traits, and a child measure of moral emotions, showed that poor emotion regulation, along with low levels of guilt and high levels of shame, predicted children's externalizing behaviors, while only low levels of guilt predicted a unique subset of child characteristics called callous-unemotional traits. Children who experienced healthy guilt for misdeeds were better able to control their behavior. Adults noted the ability of children with callous/ unemotional traits to manage and regulate their emotions, while poor emotion regulation was more predictive of the cluster of externalizing problems. Discussion focuses on prevention efforts aimed at teaching emotion self-regulation and the implications of the high levels of callousunemotional traits in this population of children.
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