Integrating French second-language experiences into clinical psychology training to enhance retention of English-speaking trainees

Context: Minority communities need access to linguistically/culturally sensitive mental health services. In this respect, Québec Anglophones face a retention challenge: Many English-speaking clinical psychology trainee students leave Québec upon graduation, thereby reducing the available pool of English-speaking mental health practitioners. Reasons include linguistic challenges in establishing a sustainable clinical practice in Québec, such as inability to meet French-language requirements of the Ordre des psychologues du Québec and/or inability to build a practice that includes Francophone clients. Concordia's Psychology Department is instituting a novel approach to addressing this challenge by integrating French-language experiences for English-speaking trainees into its program. This provides the project setting; we will closely study Concordia's experience and conduct a systematic review of literature on relevant best practices.

Main objective: Deliver a report on best practices for French second-language training and assessment for trainees in clinical psychology with a focus on potential implications for trainee retention.

Procedures: Procedures include (1) Examining the literature worldwide on best practices for language-training of mental health clinicians; (2) Interviewing 30 Concordia clinical psychology trainees; (3) Interviewing participating clinical supervisors; (4) Consulting community-based practicing clinicians about experiences using their secondlanguage-French with Francophone clients.

Data analyses: Systematic Reviews of the literature; Qualitative Analyses of interview data.

Outputs:

• Evidence synthesis: Following interviews with trainees and supervisors, the team conducted a global systematic review to identify best practices for second-language training of mental health clinicians, aligned with the study’s qualitative analysis.

• Final report (forthcoming): Will present theory- and evidence-based guidelines for integrating French second-language training into clinical psychology programs.

• Expected impact: Improved retention of English-speaking trainees in Québec and enhanced access to mental health services for English-speaking communities.

• Knowledge sharing: The final report will be disseminated to higher education institutions and Centres intégrés universitaires de santé et de services sociaux to support collaboration and strengthen health and social services for English-speaking populations.

Linguistically- and Culturally-Sensitive Psychotherapy: Evaluating an Approach to Assessment and Treatment

The Centre for Clinical Research in Health (CCRH) successfully established a university- funded state-of-the-art research clinic at Concordia University (of which the principal investigator is co-founding member). The clinic is launching an evidence-based, culturally-sensitive psychotherapy program for migrants with anxiety and/or depression. This larger project provides investigators with a valuable opportunity to evaluate the effectiveness of language-sensitive mental health interventions in a real-life clinical setting.

It is therefore proposed to: (1) Integrate research tools (developed with previous Dialogue McGill funding) into the assessment battery completed by all clients completing the treatment protocol used with migrant clients at CCRH. (2) Use qualitative techniques to study video-recordings and transcripts of actual clinical sessions to study the consequences of language discordance on effective communication and treatment. (3) Use quantitative analysis techniques to test whether potential problems identified by the assessment battery are linked to problematic features of actual clinical interactions. Hypotheses are: H1: Indices related to better functioning in a given language will predict fewer in-session communication difficulties when the treatment is conducted in that language. H2: Fewer in-session communication difficulties will predict more rapid symptom improvement.

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Outputs:

1. Unknown. (2020, May). Cultural scripts for normalcy and deviancy: A mixed-methods approach to understanding mental illness in new contexts [Presentation]. Interacting Minds Center, Aarhus, Denmark

2. Unknown. (2019, November). Linguistically- and Culturally-Sensitive Psychotherapy: A Proposal [Presentation]. Centre for Clinical Research in Health, Montreal, Quebec.

Communication Networks of Linguistic Minorities: Who Talks to Whom About Health?

There is a considerable literature documenting the help-seeking pathways of patients. The early stages usually involve considerable negotiation within a person’s existing social network before outside help is sought. The team has previously developed a social network measure designed to assess linguistic characteristics of social networks (Ryder & Segalowitz, funded by Dialogue McGill) as well as a measure of second language health communication anxiety (Segalowitz & Ryder, funded by Dialogue McGill). The overarching goal of this project is to finalize the adaptation of these measures to Multilanguage settings, establish their psychometric properties, and explore the interrelations of these instruments in Francophone and Anglophone community samples. To this end the project has proposes the following objectives: (1) Adapt the acculturation battery for use in multilingual settings. (2) Translate the adapted acculturation battery into French (the other measures have already been translated). (3) Implement an online system to deliver the entire set of measures in either language. (4) Evaluate the overall set of measures in Francophone and Anglophone community samples.

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Outputs:

1. Zhao, Y., Segalowitz, N., Voloshyn, A., Chamoux, E., & Ryder, A. G. (2021). Language Barriers to Healthcare for Linguistic Minorities: The Case of Second Language-specific Health Communication Anxiety. Health communication, 36(3), 334–346. https://doi.org/10.1080/10410236.2019.1692488

2. Ryder, A. G., Doucerain, M. M., Dere, J., Jurick, T., Zhou, B., & Zhou, X. (in press). From acculturation and psychopathology to cultural-clinical psychology. For M. Gelfand, C.-Y. Chiu, & Y.-Y. Hong (Eds), Advances in culture and psychology (vol. 8). Oxford, U.K.: Oxford University Press.

3. Chang, J., Pak, S., Doucerain, M. M., & Ryder, A. G. (2019, January). Validation of the AIM as a well-being and acculturation measurement tool [Poster presentation]. Sixth Annual Conference of the Centre for Clinical Research in Health, Montreal, QC, Canada

4. Tao, D., Doucerain, M. M., Segalowitz N., & Ryder, A. G. (2018, October). Social network and mental health help-seeking attitudes: The case of Chinese migrants in Montreal [Poster presentation]. 5th International Convention of the World Association of Cultural Psychiatry, New York, NY, USA

5. Tao, D., Doucerain, M. M., Segalowtiz N., & Ryder, A.G. (2018, July). What’s the relationship between one’s social network and mental health help-seeking attitudes? The case of Chinese migrants in Montreal. Paper presented at the 24th International Congress of International Association of Cross-Cultural Psychology, Guelph, ON, Canada