Developing Culturally-appropriate Interventions in Mental Health Flashcards

1
Q

What are the 5 definitions of ‘race’?

A
  1. Biological basis – disputed/discredited evidence
  2. Race science and racial hierarchies
  3. Visible, physical differences
  4. Often externally-classified
  • Distinguish between large groups of people
  • Highlight commonalities ‘human race’
  1. May also be self-ascribed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Visible, physical differences

This is known as…?

a. Culture
b. Ethnicity
c. Race

A

c. Race

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Often externally-classified (e.g. different hair types, skin colour)

This is known as…?

a. Culture
b. Ethnicity
c. Race

A

c. Race

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Distinguish between large groups of people

This is known as…?

a. Culture
b. Ethnicity
c. Race

A

c. Race

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Highlight commonalities

This is known as…?

a. Culture
b. Ethnicity
c. Race

A

c. Race

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

May also be self-ascribed

This is known as…?

a. Culture
b. Ethnicity
c. Race

A

c. Race

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Define Ethnicity

List 2 points

A
  1. Social characteristics of a group
  2. Common ancestry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ethnicity can be defined as social characteristics of a group

What are the types of 3 social characteristics?

A
  1. Faith/religion
  2. Language
  3. Traditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ethnicity can be defined as having common ancestry as a group of people

What are common ancestries? List 2 points

A
  1. May share distinctive cultures
  2. Some overlap with nationality
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Social characteristics of a group

This is known as…?

a. Culture
b. Ethnicity
c. Race

A

b. Ethnicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Common ancestry

This is known as…?

a. Culture
b. Ethnicity
c. Race

A

b. Ethnicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the 6 definitions of culture?

A
  1. Acquired/learned
  2. Non-biological
  3. Social aspects of human life
    - Norms, Values, Beliefs, Symbols
  4. ‘Fluid’
  5. Multi-cultural – societal / individual levels
    - Professional cultures
  6. Terminology e.g., ‘culturally informed’, ‘culturally sensitive’, ‘culturally appropriate’ ‘culturally-adapted’
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Acquired/learned

This is known as…?

a. Culture
b. Ethnicity
c. Race

A

a. Culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Non-biological

This is known as…?

a. Culture
b. Ethnicity
c. Race

A

a. Culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Common ancestry
Social aspects of human life

This is known as…?

a. Culture
b. Ethnicity
c. Race

A

a. Culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Norms, Values, Beliefs, Symbols

This is known as…?

a. Culture
b. Ethnicity
c. Race

A

a. Culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Fluid

i.e. some people may say they belong to a group but this may change

This is known as…?

a. Culture
b. Ethnicity
c. Race

A

a. Culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Multi-cultural – societal / individual levels

This is known as…?

a. Culture
b. Ethnicity
c. Race

A

a. Culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What does being ‘fluid’ mean?

A

Some people may say they belong to a group but this may change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Terminology

e.g., ‘culturally informed’, ‘culturally sensitive’, ‘culturally appropriate’ ‘culturally-adapted’

This is known as…?

a. Culture
b. Ethnicity
c. Race

A

a. Culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are professional cultures?

A

e.g. Codes of conduct practiced between doctors, lawyers and other professionals

Languages used in the culture, not accessible or comprehensible to others outside of the cultural group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Doctors using certain terms that only other doctors understand

This is known as…?

a. Culture
b. Ethnicity
c. Race

A

a. Culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why does culture and mental health matter?

A

Culture and contexts shape individuals’ mental health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How does culture and contexts shape individuals’ mental health?

List 7 ways

A
  1. ‘Symptoms’, Presentation, Attribution, and Meaning
  2. Coping styles
  3. Family / community influences
  4. Help-seeking behaviours
  5. Stigma
  6. Insider/outsider perspectives
  • Marginalisation
  • Racism & discrimination
  1. Trust
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Being marginalised is linked with ___ risk of mental health difficulties

a. Higher
b. Lower

A

a. Higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

‘Cultural formulation’ highlights the effect of culture on…?

List 3 points

A
  1. Symptom expression
  2. Definition of illness
  3. Treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How does ‘cultural formulation’ highlights the effect of culture on symptom expression?

A

Cultural Explanations ‘Models’ of mental Illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How does ‘cultural formulation’ highlights the effect of culture on definition of illness?

A

Cultural factors related to the psychosocial environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How does ‘cultural formulation’ highlights the effect of culture on treatment?

A

How can we work together with the patient to propose interventions that are deemed as acceptable?

Impact of culture/cultural identity on the clinician
patient relationship

simply = How does this person’s culture contribute to their mental health experience?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

There is a(n) ______ in the incidence of psychosis and
schizophrenia among migrant and minoritised group

a. Increase
b. Decrease

A

a. Increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

There is an increase in the incidence of ____ and ____ among migrant and minoritised group

A
  1. Psychosis
  2. Schizophrenia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

There is an increase in the incidence of psychosis and
schizophrenia among migrant and minoritised group

This is especially true for…?

a. White British people
b. People of Asian origin
c. People of African and Caribbean origin
d. People of Latin American origin

A

c. People of African and Caribbean origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the schizophrenia rates (IRR) of Caribbeans compared to White British individuals?

A

IRR = 6.7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the schizophrenia rates (IRR) of Africans compared to White British individuals?

A

IRR = 4.1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the schizophrenia rates (CI) of Caribbeans compared to White British individuals?

A

CI = 5.4 - 8.3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are the schizophrenia rates (CI) of Africans compared to White British individuals?

A

CI = 3.2 - 5.3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

The schizophrenia rates of Caribbeans compared to White British individuals are …?

a. 3.5x higher
b. 8.9 x higher
c. 5.4 x higher
d. 6.7x higher

A

d. 6.7x higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

The schizophrenia rates of Africans compared to White British individuals are …?

a. 4.1 x higher
b. 6.2 x higher
c. 3.9 x higher
d. 7.4 x higher

A

a. 4.1 x higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What % of migrant and
minoritised groups are more likely to access care via CJS (criminal justice system)

A

40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What % of Black prisoners experience schizophrenia/ delusional disorder?

A

37%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What % of White prisoners experience schizophrenia/ delusional disorder?

A

9%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Migrant and minoritised groups experience ___ x more MHA (mental health act) detentions

a. 2x
b. 4x
c. 7x
d. 5.5x

A

b. 4x

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the 3 negative pathways migrant and
minoritised groups go through in terms of psychosis?

A
  1. 40% more likely access care via CJS
  2. 37% Black vs 9% White British prisoners
    schizophrenia/delusional disorder
  3. 4x more MHA detentions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What 6 disparities do people of minority ethnic backgrounds experience in terms of psychosis care?

A
  1. More coercive care
  2. Worse clinical/non-clinical outcomes
  3. Lack of culturally-informed care
  4. ‘Culturally naïve’ staff
  5. Lack of psychological therapies
  6. Often labelled ‘hard-to-reach’
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

In terms of psychosis care, people of minority ethnic backgrounds experience often being labelled as…?

A

‘Hard-to-reach’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

In terms of psychosis care, people of minority ethnic backgrounds experience lack of ____ therapies

A

Psychological therapies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

In terms of psychosis care, people of minority ethnic backgrounds experience lack of ____ care

A

Culturally-informed care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

In terms of psychosis care, people of minority ethnic backgrounds experience ___ outcomes

A

Worse clinical/ non-clinical outcomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

In terms of psychosis care, people of minority ethnic backgrounds experience more ___ care

A

Coercive care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

In terms of psychosis care, people of minority ethnic backgrounds experience more coercive care

What is the evidence for this?

A

They receive higher rates injectable anti-psychotic mediation than their White Counterparts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

They receive higher rates injectable anti-psychotic mediation than their White Counterparts

What is this evidence for?

A

In terms of psychosis care, people of minority ethnic backgrounds experience more coercive care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Minorities in metal health services or care are kept for ____ x longer that their White Counterparts

A

2.5x longer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What are the NICE guidelines for psychosis?

List 4 points

A

Individualised treatment plan options:

  1. 16 planned sessions of CBT for psychosis (CBTp)
  2. Early Intervention in Psychosis (EIP)
  3. 10 sessions of Family Intervention (FI)
  4. Alongside antipsychotic medication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

NICE Guidelines for psychosis recommends how many planned sessions of CBT for psychosis (CBTp)?

A

16 sessions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

NICE Guidelines for psychosis recommends how many sessions of Family Intervention (FI)?

A

10 sessions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

NICE Guidelines for psychosis recommends ___ intervention in psychosis

A

Early Intervention in Psychosis (EIP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

NICE Guidelines for psychosis recommends individualised treatment plan options alongside…?

A

Antipsychotic medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

List the 6 evidence for Family Intervention (FI) in schizophrenia and psychosis care

A
  1. Clinically- & cost-effective
  2. Reduces family tension
  3. Facilitates engagement & improved clinical care
  4. Reduces relapse/readmission rates
  5. Decreases lengths of stay in hospital
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

This is evidence for what treatment plan for schizophrenia and psychosis care?

Clinically- & cost-effective

a. Early Intervention in Psychosis (EIP)
b. CBT for psychosis (CBTp)
c. Family Intervention (FI)

A

c. Family Intervention (FI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

This is evidence for what treatment plan for schizophrenia and psychosis care?

Reduces family tension

a. Early Intervention in Psychosis (EIP)
b. CBT for psychosis (CBTp)
c. Family Intervention (FI)

A

c. Family Intervention (FI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

This is evidence for what treatment plan for schizophrenia and psychosis care?

Facilitates engagement & improved clinical care

a. Early Intervention in Psychosis (EIP)
b. CBT for psychosis (CBTp)
c. Family Intervention (FI)

A

c. Family Intervention (FI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

This is evidence for what treatment plan for schizophrenia and psychosis care?

Reduces relapse/readmission rates

a. Early Intervention in Psychosis (EIP)
b. CBT for psychosis (CBTp)
c. Family Intervention (FI)

A

c. Family Intervention (FI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

This is evidence for what treatment plan for schizophrenia and psychosis care?

Decreases lengths of stay in hospital

a. Early Intervention in Psychosis (EIP)
b. CBT for psychosis (CBTp)
c. Family Intervention (FI)

A

c. Family Intervention (FI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Individualised treatment plan options:

  1. 16 planned sessions of CBTp
  2. EIP
  3. 10 sessions of FI

These are the NICE guidelines for …?

A

Psychosis care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What are the limitations of the evidence for Family Interventions (FI) in schizophrenia and psychosis care?

List 3 points

A
  1. Uptake especially low in African, Caribbean and other minoritised
    groups
  2. Limited evidence for effectiveness, acceptability, accessibility with
    minoritised groups
  3. ‘Urgent need’ to develop culturally informed care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

This is a limitation of the evidence for what treatment plan for schizophrenia and psychosis care?

Uptake is especially low in African, the Caribbean and other minoritised
groups

a. Early Intervention in Psychosis (EIP)
b. CBT for psychosis (CBTp)
c. Family Intervention (FI)

A

c. Family Intervention (FI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

This is a limitation of the evidence for what treatment plan for schizophrenia and psychosis care?

Limited evidence for effectiveness, acceptability, accessibility with
minoritised groups

a. Early Intervention in Psychosis (EIP)
b. CBT for psychosis (CBTp)
c. Family Intervention (FI)

A

c. Family Intervention (FI)

68
Q

This is a limitation of the evidence for what treatment plan for schizophrenia and psychosis care?

‘Urgent need’ to develop culturally informed care

a. Early Intervention in Psychosis (EIP)
b. CBT for psychosis (CBTp)
c. Family Intervention (FI)

A

c. Family Intervention (FI)

69
Q

What % of UK practitioner psychologists are ethnically White?

A

84%

70
Q

What % of UK practitioner psychologists are ethnically Asian?

A

5%

71
Q

What % of UK practitioner psychologists are ethnically Black?

A

2%

72
Q

What % of UK practitioner psychologists are ethnically Mixed?

A

3%

73
Q

How many UK practitioner psychologists are ethnically White?

A

22,605

74
Q

How many UK practitioner psychologists are ethnically Asian?

A

1,395

75
Q

How many UK practitioner psychologists are ethnically Black?

A

510

76
Q

How many UK practitioner psychologists are ethnically Mixed?

A

830

77
Q

An approach in which patients, researchers, practitioners and the public work together, sharing power and responsibility from the start to the end of the project, including the generation [and sharing] of knowledge

This is known as…?

A

Co-producing research

78
Q

What is co-producing research?

A

An approach in which patients, researchers, practitioners and the public work together, sharing power and responsibility from the start to the end of the project, including the generation [and sharing] of knowledge

79
Q

How can we coproduce with different stakeholders?

List 3 ways

A
  1. Literature review
  2. Focus groups
  3. Consensus conference
80
Q

How can we use literature reviews to coproduce with different stakeholders?

A

We can use literature reviews to generate typical components of culturally adapted psychosocial interventions to serve as
initial framework

Key points: “more than translation”, need to incorporate important concepts
[e.g., spirituality]

81
Q

How can we use focus groups to coproduce with different stakeholders?

List 5 points

A
  1. Focus groups with Service Users, Carers, and professionals of diverse backgrounds
  2. Qualitative work, standardised model of interventions
  3. Structure and core components
  4. Address stereotypes and misconceptions of Caribbean cultures
  5. Racism “elephant in the room”
82
Q

There is no such thing as a “Caribbean culture”

Why?

A

Because different towns/areas in the Caribbean have different cultures due to geographical reasons

e.g. Town A is hotter and rains less, so people there never wear scarves whereas Town B is more windy, hence they wear scarves

e.g. Town A was colonised by the British, Town B was colonised by the Dutch, so their norms are different

83
Q

How can we use consensus conferences to coproduce with different stakeholders?

List 2 points

A
  1. Consensus conference to refine content, outcome, and delivery
  2. Experts by experience (people with the diagnosis) and profession
84
Q

Which coproduction with stakeholders does this apply to?

Generate typical components of
culturally adapted psychosocial interventions to serve as
initial framework

a. Focus group
b. Consensus conference
c. Literature review

A

c. Literature review

85
Q

Which coproduction with stakeholders does this apply to?

Involves asking Service Users, Carers, and Professionals

a. Focus group
b. Consensus conference
c. Literature review

A

a. Focus group

86
Q

Which coproduction with stakeholders does this apply to?

Structure and core components

a. Focus group
b. Consensus conference
c. Literature review

A

a. Focus group

87
Q

Which coproduction with stakeholders does this apply to?

Key points: “more than translation”, need to incorporate important concepts
[e.g., spirituality]

a. Focus group
b. Consensus conference
c. Literature review

A

c. Literature review

88
Q

Which coproduction with stakeholders does this apply to?

Refine content, outcome, and
delivery

a. Focus group
b. Consensus conference
c. Literature review

A

b. Consensus conference

89
Q

Which coproduction with stakeholders does this apply to?

Address stereotypes & misconceptions of Caribbean cultures

a. Focus group
b. Consensus conference
c. Literature review

A

a. Focus group

90
Q

Which coproduction with stakeholders does this apply to?

Experts by experience and profession

a. Focus group
b. Consensus conference
c. Literature review

A

b. Consensus conference

91
Q

Which coproduction with stakeholders does this apply to?

Addresses racism “elephant in the room”

a. Focus group
b. Consensus conference
c. Literature review

A

a. Focus group

92
Q

What is Culturally-adapted Family Intervention (CaFI) therapy?

List 6 points

A
  1. 10 x 1-hour sessions:
  2. Hybrid model: CBT-based with BFT
  3. Delivered by Lead & Co-therapist pair,
    trained in family work and cultural
    awareness
  4. Bespoke therapy manual & resources
  5. ‘Family Support Members’ (FSMs) as therapy partners
  6. CaFI:Digital (2021)
93
Q

How long are Culturally-adapted Family Intervention (CaFI) therapy?

A

10 x 1 hour sessions

94
Q

What model does the Culturally-adapted Family Intervention (CaFI) therapy follow?

A

Hybrid model: CBT-based with BFT

95
Q

Who is Culturally-adapted Family Intervention (CaFI) therapy delivered by?

A

Delivered by Lead & Co-therapist pair,
trained in family work and cultural
awareness

96
Q

What resources are used in Culturally-adapted Family Intervention (CaFI) therapy?

A

Bespoke therapy manual & resources

97
Q

Who are the therapy partners in Culturally-adapted Family Intervention (CaFI) therapy?

A

‘Family Support Members’ (FSMs)

98
Q

‘Family Support Members’ (FSMs) are known as…?

A

Therapy partners

99
Q

What therapy for psychosis is a hybrid model: CBT-based with BFT?

A

Culturally-adapted Family Intervention (CaFI)

100
Q

What therapy is delivered by Lead & Co-therapist pair, trained in family work and cultural awareness?

A

Culturally-adapted Family Intervention (CaFI)

101
Q

What therapy uses the bespoke therapy manual and resources?

A

Culturally-adapted Family Intervention (CaFI)

102
Q

What therapy considers Family Support Members’ (FSMs) as therapy
partners?

A

Culturally-adapted Family Intervention (CaFI)

103
Q

What therapy involves 10 x 1-hour sessions?

A

Culturally-adapted Family Intervention (CaFI)

104
Q

Culturally-adapted Family Intervention (CaFI) therapies are delivered by…?

A

Lead & Co-therapist pair, trained in family work and cultural awareness

105
Q

What are the 2 Bespoke Training Programmes for Therapists?

A
  1. ‘Cultural Competency’ in Family Work
  2. Culturally-adapted Family Intervention (CaFI) manual
106
Q

What are the 4 aims of ‘Cultural Competency’ in Family Work?

A
  1. Core competence to work with
    service users experiencing
    psychosis and families
  2. Impact of culture on family work
  3. Relationship between racism,
    discrimination, adversity, and
    psychological distress
  4. Power and prejudice in building
    trusting therapeutic relationships
107
Q

What are the 5 aims of the Culturally-adapted Family Intervention (CaFI) manual?

A
  1. Context of CaFI: Historical, cultural, and
    social context of African-Caribbean
    mental health in the UK
  2. Development of CaFI
  3. CaFI’s “Ethos of Delivery”
    - ‘Shared learning’ & ‘Cultural humility’ (similar to psychoeducation)
  4. Components and bespoke resources
  5. Delivering therapy in research
108
Q

Which Bespoke Training Programme for Therapists does this apply to?

Core competence to work with
service users experiencing
psychosis and families

a. ‘Cultural Competency’ in Family Work
b. Culturally-adapted Family Intervention (CaFI) manual

A

a. ‘Cultural Competency’ in Family Work

109
Q

Which Bespoke Training Programme for Therapists does this apply to?

Impact of culture on family work

a. ‘Cultural Competency’ in Family Work
b. Culturally-adapted Family Intervention (CaFI) manual

A

a. ‘Cultural Competency’ in Family Work

110
Q

Which Bespoke Training Programme for Therapists does this apply to?

Historical, cultural, and social context of African-Caribbean mental health in the UK

a. ‘Cultural Competency’ in Family Work
b. Culturally-adapted Family Intervention (CaFI) manual

A

b. Culturally-adapted Family Intervention (CaFI) manual

111
Q

Which Bespoke Training Programme for Therapists does this apply to?

Relationship between racism,
discrimination, adversity, and
psychological distress

a. ‘Cultural Competency’ in Family Work
b. Culturally-adapted Family Intervention (CaFI) manual

A

a. ‘Cultural Competency’ in Family Work

112
Q

Which Bespoke Training Programme for Therapists does this apply to?

Development of CaFI

a. ‘Cultural Competency’ in Family Work
b. Culturally-adapted Family Intervention (CaFI) manual

A

b. Culturally-adapted Family Intervention (CaFI) manual

113
Q

Which Bespoke Training Programme for Therapists does this apply to?

“Ethos of Delivery”
- ‘Shared learning’ & ‘Cultural humility’ (similar to psychoeducation)

a. ‘Cultural Competency’ in Family Work
b. Culturally-adapted Family Intervention (CaFI) manual

A

b. Culturally-adapted Family Intervention (CaFI) manual

114
Q

Which Bespoke Training Programme for Therapists does this apply to?

Components and bespoke resources

a. ‘Cultural Competency’ in Family Work
b. Culturally-adapted Family Intervention (CaFI) manual

A

b. Culturally-adapted Family Intervention (CaFI) manual

115
Q

Which Bespoke Training Programme for Therapists does this apply to?

Power and prejudice in building
trusting therapeutic relationships

a. ‘Cultural Competency’ in Family Work
b. Culturally-adapted Family Intervention (CaFI) manual

A

a. ‘Cultural Competency’ in Family Work

116
Q

Which Bespoke Training Programme for Therapists does this apply to?

Delivering therapy in research

a. ‘Cultural Competency’ in Family Work
b. Culturally-adapted Family Intervention (CaFI) manual

A

b. Culturally-adapted Family Intervention (CaFI) manual

117
Q

What are the 2 aims of feasibility studies?

A
  1. Evaluate the feasibility of culturally adapting, implementing, and evaluating Family Intervention with Caribbean-origin service users diagnosed with schizophrenia and related psychoses, their families and other key stakeholders
  2. Establish the feasibility and acceptability of delivering Family Intervention with “proxy families” (Family Support Members) where service users’ biological families are unavailable
118
Q

How can feasibility studies establish the feasibility and acceptability of delivering Family Intervention when service users’ biological families are unavailable?

A

Establish the feasibility and acceptability of delivering Family Intervention with “proxy families” (Family Support Members)

119
Q

Describe the feasibility study of Caribbean service users diagnosed with schizophrenia and related psychoses

List 4 points

A
  1. 30 service users randomised
  2. Service Users + Family/ Family Support Members = Family Unit
  3. 26 family units completed all therapy
    sessions
  4. Half involved Family Support Members
120
Q

Describe the results of the feasibility study of Caribbean service users diagnosed with schizophrenia and related psychoses

A

All service users, families, and therapists found Culturally Adapted Family Intervention (CaFI) acceptable and would recommend it to others

121
Q

According to the feasibility study of Caribbean service users diagnosed with schizophrenia and related psychoses, who found Culturally Adapted Family Intervention (CaFI) acceptable and would recommend it to others?

List 3 groups of people

A
  1. All service users
  2. Families,
  3. Therapists
122
Q

What were the limitations of the feasibility study of Caribbean service users diagnosed with schizophrenia and related psychoses?

List 4 limitations

A
  1. Lack of control group
  2. Limited sample size
  3. Insufficient power to assess effectiveness
  4. More culturally- informed therapy resources
123
Q

What are the reported service user benefits of Culturally Adapted Family Intervention (CaFI)?

List 3

A
  1. Improved understanding of illness and symptoms
  2. Better function – going into work, university and volunteering
  3. Better communication
124
Q

What are the reported family member of service user benefits of Culturally Adapted Family Intervention (CaFI)?

List 2

A
  1. Increased understanding of diagnosis/condition
  2. Better engagement and support with service users
125
Q

What are the reported healthcare professional benefits of Culturally Adapted Family Intervention (CaFI)?

List 2

A
  1. More cultural awareness and understanding of the needs of Caribbean people
  2. Using CaFI skills/materials in everyday practice
126
Q

This is a reported benefit of Culturally Adapted Family Intervention (CaFI) for which group of stakeholders?

More cultural awareness and understanding of needs of Caribbean people

a. Family member of service users
b. Service users
c. Healthcare professionals

A

c. Healthcare professionals

127
Q

This is a reported benefit of Culturally Adapted Family Intervention (CaFI) for which group of stakeholders?

Increased understanding of diagnosis/condition

a. Family member of service users
b. Service users
c. Healthcare professionals

A

a. Family member of service users

128
Q

This is a reported benefit of Culturally Adapted Family Intervention (CaFI) for which group of stakeholders?

Using CaFI skills/materials in everyday practice

a. Family member of service users
b. Service users
c. Healthcare professionals

A

c. Healthcare professionals

129
Q

This is a reported benefit of Culturally Adapted Family Intervention (CaFI) for which group of stakeholders?

Improved understanding of illness and symptoms

a. Family member of service users
b. Service users
c. Healthcare professionals

A

b. Service users

130
Q

This is a reported benefit of Culturally Adapted Family Intervention (CaFI) for which group of stakeholders?

Better function – going into work, university and volunteering

a. Family member of service users
b. Service users
c. Healthcare professionals

A

b. Service users

131
Q

This is a reported benefit of Culturally Adapted Family Intervention (CaFI) for which group of stakeholders?

Better engagement and support with service users

a. Family member of service users
b. Service users
c. Healthcare professionals

A

a. Family member of service users

132
Q

This is a reported benefit of Culturally Adapted Family Intervention (CaFI) for which group of stakeholders?

Better communication

a. Family member of service users
b. Service users
c. Healthcare professionals

A

b. Service users

133
Q

Black people are ___ more likely to be sectioned over talking therapy for mental health

a. 2x
b. 4x
c. 6x
d. 5x

A

b. 4x

134
Q

Describe the Culturally Adapted Family Intervention (CaFI) Randomised Control Trial (RCT)

List 4 points

A
  1. National 54-month RCT with ‘family units’ of Caribbean & Sub-Saharan African origin

N= 404 service users plus therapy partners

  1. North West, Midlands, London, South
  2. Evaluate cost & clinical effectiveness compared with “usual care”
  3. Embedded Process evaluation
135
Q

The Culturally Adapted Family Intervention (CaFI) Randomised Control Trial (RCT) involved an Embedded Process Evaluation

What does this Process Evaluation involve? List 4 points

A
  1. Implementation barriers/facilitators
  2. Accessibility
  3. Fidelity (someone who listens to the recording and rates the behaviour based on the description)
  4. Acceptability
136
Q

Describe the process and challenges of Culturally Adapted Family Intervention (CaFI) Randomised Control Trial (RCT)

List 5 points

A
  1. Start deferred (24 months)
  2. Covid-19 pandemic impact
  3. Closed to recruitment (Nov 2023)
  4. N= 145 recruited
  5. 60% of service users need non-family therapy partners (80% London)
137
Q

According to Culturally Adapted Family Intervention (CaFI) Randomised Control Trial (RCT), what % of service users need non-family therapy partners?

A

60%

138
Q

According to Culturally Adapted Family Intervention (CaFI) Randomised Control Trial (RCT), 60% of service users need non-family therapy partners

What % of these are people living in London?

A

80%

139
Q

How did the Covid-19 pandemic impact the Culturally Adapted Family Intervention (CaFI) Randomised Control Trial (RCT)?

List 3 ways

A
  1. Recruitment, 3 of 7 sites
  2. Access/engagement barriers
  3. Lack of NHS therapist capacity
140
Q

What are the 2 implications for research on Culturally Adapted Family Intervention (CaFI)?

List 2 points

A
  1. Research with people currently under-represented in research and clinical
    practice
  2. Different approaches, same models
141
Q

One of the implications for research on Culturally Adapted Family Intervention (CaFI) is research with people currently under-represented in research and clinical practice

What 2 factors contribute to this?

A
  1. Study design
  2. Outcome measures
142
Q

One of the implications for research on Culturally Adapted Family Intervention (CaFI) is different approaches, same models

What 5 factors contribute to this?

A
  1. ‘Real world’ vs research therapy
  2. Funding
    - Hidden costs e.g., ‘Assertive engagement’
  3. ‘Success criteria’
  4. Reporting
  5. Does not consider potential distrust
143
Q

What are the 6 implications for policy related to cultural adaptation in Mental Health?

A
  1. Delivering Race Equality in Mental Health
  2. Culturally informed/appropriate care
  3. Mental Health Act Review (2018)
  4. Patient & Carer Race Equality Framework (PCREF)
  • Pilot studies: Greater Manchester, Birmingham, London
  • National ‘rollout’ 2024
  1. ‘Evidence-based’ interventions? -> A lot of research does not involve diverse samples e.g. Low SES
  2. Evidence for cultural adaptation/competence?
144
Q

What are the 3 implications for practice in Family Interventions for Psychosis?

A
  1. FI with multicultural/multi-ethnic populations
  2. ‘Individualised’, ‘holistic’, ‘needs-led’
  3. NHS workforce and structures
145
Q

One of the implications for practice in Family Interventions for Psychosis is ‘Individualised’, ‘holistic’, ‘needs-led’

What 4 factors contribute to this?

A
  1. Therapy models – ‘Shared Learning’
  2. Communication
  3. Therapy partners e.g., FSMs
  4. Training and supervision
146
Q

One of the implications for practice in Family Interventions for Psychosis is NHS workforce and structures

What 3 factors contribute to this?

A
  1. Psychological therapies workforce planning, training and supervision
  2. ‘Cultural competence’, ‘cultural humility’
  3. Peer support/lived experience practitioners
147
Q

Research with people currently under-
represented in research and clinical
practice

This is an implication for:

a. Practice (FI Psychosis)
b. Policy
c. Research

A

c. Research

148
Q

Delivering Race Equality in Mental Health

This is an implication for:

a. Practice (FI Psychosis)
b. Policy
c. Research

A

b. Policy

149
Q

Culturally informed/appropriate care

This is an implication for:

a. Practice (FI Psychosis)
b. Policy
c. Research

A

b. Policy

150
Q

FI with multicultural/multi-ethnic populations

This is an implication for:

a. Practice (FI Psychosis)
b. Policy
c. Research

A

a. Practice (FI Psychosis)

151
Q

‘Individualised’, ‘holistic’, ‘needs-led’

This is an implication for:

a. Practice (FI Psychosis)
b. Policy
c. Research

A

a. Practice (FI Psychosis)

152
Q

Different approaches, same models

This is an implication for:

a. Practice (FI Psychosis)
b. Policy
c. Research

A

c. Research

153
Q

NHS workforce and structures

This is an implication for:

a. Practice (FI Psychosis)
b. Policy
c. Research

A

a. Practice (FI Psychosis)

154
Q

Mental Health Act Review (2018)

This is an implication for:

a. Practice (FI Psychosis)
b. Policy
c. Research

A

b. Policy

155
Q

Patient & Carer Race Equality Framework (PCREF)

This is an implication for:

a. Practice (FI Psychosis)
b. Policy
c. Research

A

b. Policy

156
Q

‘Evidence-based’ interventions?

This is an implication for:

a. Practice (FI Psychosis)
b. Policy
c. Research

A

b. Policy

157
Q

Evidence for cultural adaptation/competence?

This is an implication for:

a. Practice (FI Psychosis)
b. Policy
c. Research

A

b. Policy

158
Q

What are the 4 New Ways of Working and Researching Inequalities?

A
  1. Assets- vs deficits-based approaches
  2. “Who’s missing?”
  3. Multi-level, system-wide approaches
  4. Appropriately resourced – time, people, AND money
159
Q

What 4 things are involved in Assets- vs deficits-based approaches?

A
  1. Genuine co-production
  2. Transformational vs transactional
  3. Partnership - power-sharing and knowledge transfer (two-way)
  4. Involve end users of the research, throughout the process
160
Q

What does the “Who’s Missing?” approach to researching inequalities involve?

A

Make sure to include the ‘seldom heard’ or minoritised/ marginalised/ racialised/
‘othered’ individuals in research

161
Q

Make sure to include the ‘seldom heard’ or minoritised/ marginalised/ racialised/
‘othered’ individuals in research

Which New Way of Working and Researching Inequalities does this apply to?

a. Assets- vs deficits-based approaches
b. “Who’s missing?”
c. Multi-level, system-wide approaches
d. Appropriately resourced – time, people, AND money

A

b. “Who’s missing?”

162
Q

Genuine co-production

Which New Way of Working and Researching Inequalities does this apply to?

a. Assets- vs deficits-based approaches
b. “Who’s missing?”
c. Multi-level, system-wide approaches
d. Appropriately resourced – time, people, AND money

A

a. Assets- vs deficits-based approaches

163
Q

Transformational vs transactional

Which New Way of Working and Researching Inequalities does this apply to?

a. Assets- vs deficits-based approaches
b. “Who’s missing?”
c. Multi-level, system-wide approaches
d. Appropriately resourced – time, people, AND money

A

a. Assets- vs deficits-based approaches

164
Q

Partnership - power-sharing & knowledge transfer (two-way)

Which New Way of Working and Researching Inequalities does this apply to?

a. Assets- vs deficits-based approaches
b. “Who’s missing?”
c. Multi-level, system-wide approaches
d. Appropriately resourced – time, people, AND money

A

a. Assets- vs deficits-based approaches

165
Q

Involve end users of the research, throughout the process

Which New Way of Working and Researching Inequalities does this apply to?

a. Assets- vs deficits-based approaches
b. “Who’s missing?”
c. Multi-level, system-wide approaches
d. Appropriately resourced – time, people, AND money

A

a. Assets- vs deficits-based approaches

166
Q

Thinking of minority individuals as assets that provide valuable information for research

Which New Way of Working and Researching Inequalities does this apply to?

a. Assets- vs deficits-based approaches
b. “Who’s missing?”
c. Multi-level, system-wide approaches
d. Appropriately resourced – time, people, AND money

A

a. Assets- vs deficits-based approaches