Transcript Slide 1
Training Psychologists in Clinical
Work with Triply Stigmatized Youth:
Ethnic Minority, Sexual Orientation
Minority, and HIV-Positive
The Adolescent Initiative at
The Children’s Hospital of Philadelphia
Jerilynn Radcliffe, PhD, ABPP – Psychologist
Linda A. Hawkins, MSEd – Mental Health Counselor
Training Needs
Youth with HIV are a rapidly increasing clinical
population.
CDC (2008). Largest increases in HIV diagnoses
among youth of color below the age of 25, especially
sexual minority males, a triply stigmatized group
within contemporary U.S. society.
Health needs of youth with HIV significant:
Adherence to medical care and medication
Wide range of medical complications
Lifestyle modifications required, but difficult
Social impact within families and communities
Plan for Today’s Talk
Describe the training areas available when
working with youth living with HIV
Present our approach to training future
psychologists in effective work with these
youth
Share resources we’ve found helpful
Areas for Training
HIV as a disease and stigmatizing condition
Cultural sensitivity for ethnicity, HIV stigma,
sexual orientation diversity
Disclosure and adherence issues
HIV-related family disruptions
Mental health problems: depression, posttraumatic stress
Legal and ethical issues
Effective participation in multidisciplinary care
team
Training Methods
Case Review
Journal Club
Mental health screenings
Hands on training in outreach, engagement
Group counseling participation
In vivo and audiotaped sessions
Participation in clinic-based mental health
research
Formal presentations
Case Review
Weekly multidisciplinary team meeting
where all patients to be seen that week
are presented, discussed, and planned for.
Incorporates medical, nursing, social work,
mental health, wellness counseling, and
research planning
Follow-up discussions of all patients seen
the week prior are also held in Case
Review.
Journal Club
Meets monthly, one hour
Mental health team members, including all
psychology trainees
Leadership rotates among all participants
Topics selected according to current
clinical and research interests
Outreach, Engagement
In vivo demonstrations of effective
outreach techniques of youth
Case conceptualizations
Shadowing psychiatry
Role-playing
Community based learning
Movies, television shows, music, popular press
Mental Health Screenings
Standard of care: Yearly Beck Depression
Inventory-II screens
Optional for cognitive status: Wechsler
Abbreviated Scale of Intelligence
Yearly mental health “check-in”
Therapy/Counseling
Psychotherapy with individual youth re
adjustment to illness, psychosocial
stressors
Participation in monthly peer group
meetings as invited co-leader or presenter
Supervision Modalities
Audiotaped sessions
In vivo sessions with mental health
professionals
Weekly case conceptualizations
Participation in Clinic-Based
Research
Trainees participate in the design,
implementation, and analysis of research
findings.
Recent studies
Post-traumatic stress
Spirituality and religiosity
Transition to adult care
Sexual health risk
Presentations
Leadership in Neurodevelopmental
Education (LEND)
Graduate Professional Education (GPE)
Posters and oral presentations of research
Presentation on Program to Departmental
Psychology Seminar
Professional Presentations
HIV Disease Resources
HIV as a disease
Kalichman, S. (1998). Understanding AIDS,
Second Edition. Washington, DC: American
Psychological Association.
Bartlett, J. & Finkbeiner, A. (2006). The Guide
to Living with HIV. Baltimore, MD: The Johns
Hopkins University Press.
Cultural Sensitivity Resources
R. Savin-Williams (2001). Mom, Dad, I’m Gay:
How Families Negotiate Coming Out.
Washington, DC: APA.
D’Augelli, A.R., & Patterson, C.J. (2001).
Lesbian, Gay, Bisexual Identities and Youth:
Psychological Perspectives. New York: Oxford
University Press.
Ryan, C., & Futterman, D. (1997). Lesbian and
Gay Youth: Care and Counseling. Adolescent
Medicine: State of the Art Review, 8(2).
Philadelphia, PA: Hanley & Belfus, Inc.
Cultural Sensitivity Resources
African American
Weston, K. (1991). Families We Chose:
Lesbians, Gays, Kinship. New York: Columbia
University Press.
Boykin, K. (1996). One More River to Cross:
Black & Gay in America. New York: Doubleday
Press.
Myrick, R. (1999). In the Life: Culture-specific
HIV communication programs designed for
African American men who have sex with men.
The Journal of Sex Research, 36(2), 159-170
Cultural Sensitivity Resources
Latina Women
Lijtmaer, R. (1998). Psychotherapy with Latina
Women. Feminism & Psychology, 8(4), 537543.
Youth
Luna, G.C. (1997). Youths Living with HIV:
Self-Evident Truths. Binghamton, NY:
Hawthorn Press.
http://www.advocatesforyouth.org/
Cultural Sensitivity Resources
Transgender Individuals
Lev, A.I. (2004). Transgender Emergence:
Therapeutic Guidelines for Working with GenderVariant People and Their Families. New York, NY:
The Haworth Clinical Practice Press
Coleman, E., Bockting, W., & Kirk, S. (2001).
Transgender & HIV: Risks, prevention and care.
Binghamton, NY: Hawthorn Press.
Mental Health Resources
HIV-related mental health issues for youth
Donenberg, G., & Pao, M. (2005). Youths
and HIV/AIDS: Psychiatry’s role in a changing
epidemic. Journal of the American Academy
of Child & Adolescent Psychiatry, 44(8), 728747.
O’Connor, M. (1997). Treating the
Psychological Consequences of HIV. San
Francisco, CA: Jossey-Bass.
http://mentalhealthAIDS.samhsa.gov
Legal & Ethical Resources
Pope, K., & Vasquez, M.J.T. (2007). Ethics in
Psychotherapy & Counseling: A Practical
Guide. San Francisco, CA: Jossey-Bass.
Anderson, J.R., & Barret, B. (2001). Ethics in
HIV-related Psychotherapy: Clinical Decision
Making in Complex Cases. Washington, DC:
American Psychological Association.
What We’ve Learned
Importance of both formal and informal
learning experiences
Value of summarizing the experience
through formal presentations
Clinical work and research offer important
and complementary learning opportunities
Plans for the Future
Continue to develop library of resources
for trainees
Involve trainees in advocacy on behalf of
HIV-infected youth throughout the City of
Philadelphia
Deepest Appreciation
Graduate Program in Psychology
Project HOPE (American Psychological
Association) for ongoing support around
HIV-specific training
APA-approved Internship Program at
CHOP (Paul Robins, PhD & Mary Rourke,
PhD, Co-Directors)
Postdoctoral Fellowship Program at CHOP
(Melissa Alderfer, Director)