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This paper explores the complex dynamics and multilayered mechanisms of this abuse in Australian Evangelical Christianity. As such, we call on clinical social workers to lead the effort to address racial disparities within mental health services.Ĭhristian communities teaching traditional theology and ethics, which treat diverse sexualities and gender expansive identities as sinful, can be places where faithful LGBTQIA + people are subject to spiritual abuse. These findings yield important insights about potential bias among healthcare providers, educators, and clinical social workers and warrant further research, training for professionals, and culturally responsive interventions. Our study demonstrates that while ACEs are harmful for all children, providers’ identification of internalizing and externalizing disorders appears to occur differentially based on the race of the child they diagnose. Moreover, when examining racial disparities in mental health diagnoses by ACE score, the present study found that the severity of these disparities increased at higher ACE scores. Race was also found to be a significant predictor of diagnoses, as Black children were less likely to be diagnosed with anxiety or depression and more likely to be diagnosed with behavioral problems. ACE score was a significant predictor of all three diagnoses and presented a dose–response relationship. Using data from the 2017 National Survey of Children’s Health, racial disparities in internalizing (i.e., depression, anxiety) and externalizing (i.e., behavioral/conduct problems) mental health diagnoses were analyzed using logistic regression. This study examines how racial disparities and ACEs contribute to childhood diagnoses of internalizing and externalizing disorders.
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However, the literature to date has hardly examined the relationship between ACEs and diagnostic disparities based on race. Although grateful for the safety of virtual therapeutic encounters, clinicians mourned the loss of an embodied encounter, experienced depletion of energy beyond Zoom fatigue, and nonetheless recognized their clients’ and their own abilities to adapt.Ī substantial evidence base has established both that adverse childhood experiences (ACEs) deleteriously impact youth mental health outcomes and that racial biases in diagnosing youth are common among mental health professionals. We find three broad themes: (1) It is a “much more remote relationship” (2) The "connection…remains surprisingly strong" and (3) It is “energetically taxing.” Each reflects clinicians’ views of the TR as altered, but surprisingly resilient. Temporally, we focused on how these adaptations occurred during the initial part of the pandemic before vaccination was available and while the TR was still adapting to teletherapy videoconferencing under the duress of pandemic crises. In this secondary analysis focused on the TR, we analyze the clinicians’ (N = 448) spontaneous narratives about facets of the TR.
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In response to the COVID-19 pandemic and the rapid transition to videoconferencing for therapeutic encounters, we employed a cross-sectional exploratory survey with 1490 respondents to understand how practitioners adapted to the changes. The therapeutic relationship (TR), including its therapeutic frame, is the foundation of the therapeutic endeavor.