Acculturation theories often describe how individuals in the United States adopt and incorporate dominant cultural values, beliefs, and behaviors such as individualism and selfreliance. Theorists tend to perceive dominant cultural values as "accessible to everyone," even though some dominant cultural values, such as preserving White racial status, are reserved for White people. In this article, the authors posit that White supremacist ideology is suffused within dominant cultural values, connecting the array of cultural values into a coherent whole and bearing with it an explicit status for White people and people of color. Consequently, the authors frame acculturation as a continuing process wherein some people of color learn explicitly via racism, microaggressions, and racial trauma about their racial positionality; White racial space; and how they are supposed to accommodate White people's needs, status, and emotions. The authors suggest that acculturation may mean that the person of color learns to avoid racial discourse to minimize eliciting White fragility and distress. Moreover, acculturation allows the person of color to live in proximity to White people because the person of color has become unthreatening and racially innocuous. The authors provide recommendations for research and clinical practice focused on understanding the connections between ideology, racism, microaggressions and ways to create psychological healing.

Stigma is one of the main barriers for the full implementation of mental health services in low- and middle-income countries (LMICs). Recently, many initiatives to reduce stigma have been launched in these settings. Nevertheless, the extent to which these interventions are effective and culturally sensitive remains largely unknown. The present review addresses these two issues by conducting a comprehensive evaluation of interventions to reduce stigma toward mental illness that have been implemented in LMICs. We conducted a scoping review of scientific papers in the following databases: PubMed, Google Scholar, EBSCO, OVID, Embase, and SciELO. Keywords in English, Spanish, and Portuguese were included. Articles published from January 1990 to December 2017 were incorporated into this article. Overall, the studies were of low-to-medium methodological quality—most only included evaluations after intervention or short follow-up periods (1–3 months). The majority of programs focused on improving knowledge and attitudes through the education of healthcare professionals, community members, or consumers. Only 20% (5/25) of the interventions considered cultural values, meanings, and practices. This gap is discussed in the light of evidence from cultural studies conducted in both low and high income countries. Considering the methodological shortcomings and the absence of cultural adaptation, future efforts should consider better research designs, with longer follow-up periods, and more suitable strategies to incorporate relevant cultural features of each community.

Objective: Over the last 3 decades, group treatment researchers have become increasingly knowledgeable of the impact of within-group dependency on analyses of group treatment data and of mutual influence processes that occur within therapy groups. Despite these advancements, there remains a lack of consensus on the magnitude of mutual influence, or group effects, in group treatment research. As such, this study sought to estimate the size of group effects on members' posttreatment outcomes by meta-analyzing the intraclass correlation coefficients (ICCs) in group treatment research. In addition, we tested several moderators of the ICC, including outcome type, outcome reactivity, outcome specificity, group format, treatment length, and group size. Method: Using robust variance estimations, we metaanalyzed 169 effect sizes from 37 group treatment studies. Results: Findings indicated an average ICC of 0.06. Group size, group format, treatment length, outcome specificity, and outcome type did not significantly moderate the ICC; however, we did find evidence to suggest that the ICC varies as a function of outcome reactivity, with observer-rated outcome measures resulting in the largest ICC. Conclusion: These findings suggest that interdependence in group treatment research is an important concept both theoretically and statistically. What is the public health significance of this article?This study found that therapy groups account for 6% of the variability in group treatment outcomes. Outcome reactivity significantly moderated the intraclass correlation coefficient (ICC) in group treatment research, such that the largest ICCs were associated with observer-rated outcome measures. Interdependence in group treatment research is important both theoretically and statistically.

The present study discusses clinical supervision from the perspectives of 20 international counseling psychology trainees with a focus on English-specific experiences in training. Using concept mapping, we identified four clusters of sociolinguistic experiences in clinical settings: Growth and Strength Through Embracing Vulnerability, Barriers to Showing Clinical Potential, Fear of Being Seen as Incompetent, and Self-Doubt About Therapeutic Performance and Relationships. Helpful supervisory events included seven clusters: Genuine Curiosity and Understanding, Exploration and Validation Regarding Linguistic Identity, Affirmation and Illumination of Strengths, Facilitation of Clinical Communication, Multicultural Awareness and Cultural Humility, Humanity and Compassion, and Externalization and De-emphasis of the Act of Language use Itself. Lastly, unhelpful supervisory events fell into seven clusters: Seeking Understanding From a Deficits-Lens, Lack of Self-Awareness and Cultural Humility, Acts of Disrespect, Disregard and Lack of Interest, Judgment and Over-Correction, Disempowerment, and Superficial Fixes. Implications for practice and advocacy and suggestions for future research are discussed.

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