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Research Themes

Joseph E. Trimble
Western Washington University

Research Themes

          My research and scholarship involves exploring, lecturing, and writing about the following topics: providing mental health services for American Indians and Alaska Natives and ethnocultural populations, the ethical conduct of research with ethnocultural populations, collaborative research to identify and develop cultural strategies for prevention and intervention of psychosocial disorders in rural Alaska Native communities, advancing the science of community-level interventions, exploring the foundations of multicultural psychology through use of meta-analysis procedures, design culturally resonant measures to assess and understand well-being, and explore the various cultural elements and characteristics of leaders from different ethnocultural backgrounds including the refinement of a scale to assess leadership preferences.

          Currently, there is a need to provide culturally responsive mental health services and programming to families from diverse backgrounds (see Surgeon General of the United States, 2001). Culturally responsive programming incorporates the importance of culture, the assessment of cross cultural relations, vigilance toward the dynamics that result from cultural differences, the expansion of cultural knowledge, and the adaptation of services to meet culturally unique needs. Although many scholars support the importance of such programming, they also recognize serious shortcomings in the knowledge base examining how culture affects the developmental pathways of people from all developmental life stages.

          To respond to these and other concerns I have been involved in research and scholarship in the multicultural mental health counseling and psychotherapy fields. In my writings and collaboration with my colleagues we continue to ask ourselves the following complex questions: Can one select one of the many cultural competencies and explain their generic importance? How does one solve the “ethical dilemma” facing multicultural counselors? To what extent is multiculturalism becoming a “fourth force” in counseling? What are the most important positive consequences of a multicultural perspective?

          Additionally, there is considerable discussion about the universal and cultural components of the counseling experience---disentangling the humanly universal from the culturally distinctive--- while providing services to people in multicultural contexts.  In the search for universal truth counselors have sometimes supported the status quo. Multicultural counselors have frequently rebelled against that conformity. In the search for cultural patterns that connect people with one another the measures of similarity and difference may be artifacts of our own cultural perspective. In the search for world view or “globalization are we doing more harm than good? In our search for empathy, whose guidelines for relationships are most relevant? In the search for excellence can we become too dependent on technology? Additional questions concerning this theme include:  To what extent do multicultural counselors uphold the status quo and what are the consequences? In what specific ways would cultural patterns affect the style, technique and atmosphere of counseling? What are the potential problems facing counselors that are brought about by globalization? How do you adapt your definitions of empathy and relationships across cultures? What is the relative importance of a counselor’s technical skill, experience, sensitivity and knowledge in counseling across cultures?

 

Ethical and Principled Conduct of Research

In the past two decades, there has been a dramatic increase in mental health research conducted among ethnic and nationalistic groups. As the interest increased so have the concerns of many ethnic communities about research in general and the presence of researchers in their communities. The rising community concerns accompanied with the emergence of community-based research review committees presents extraordinary challenges for researchers – challenges that are only beginning to be fully and seriously acknowledged at methodological, procedural, and conceptual levels. The most important challenge though is the actual responsible conduct of researchers while they are in the field and the relationship they establish with their respondents.

          The purpose of my research and scholarship in this area of inquiry is to raise points to encourage ethical decision making for research with ethnocultural populations that reflect the unique historical and socio-cultural realities of ethnic and racial people and their communities. A secondary objective is to provide linkages between irresponsible research and cultural incompetence. My writings in this area follow three ethical dimensions of culturally sensitive research: 1). Applying a cultural perspective to the evaluation of research risk and benefits; 2) .Developing and implementing culturally respectful informed consent procedures and culturally appropriate confidentiality and disclosure policies; and 3). Engaging in community and participant consultation with a standard of “principled cultural sensitivity.”

          The need and rationale for the inquiry is multifold. It emerges from the increasing distrust ethnocultural communities are expressing towards researchers. Countless community members are intolerant and unforgiving of past research efforts for a variety of valid reasons; much of their suspicion and concerns derives from the cultural incompetence and insensitivity of researchers. Researchers should be prepared to collaborate with the communities, share results that have practical value, and accept the conditions imposed by the community in gaining access to respondents. Additionally, researchers must be aware of scientific, social, and political factors governing definitions of race, ethnicity, and culture, understand within-group differences, and become familiar with skills in constructing culturally valid assessment instruments. My chapters and articles on the topic can be found in the publication section.

 

Cultural Values, Coping, and Hope in Yup'ik Communities Facing Rapid Cultural Change.

Referred to as Qungasvik (kung-az-vik - toolbox in the Yup’ik language) my colleagues and I through the Center for Alaska Native Health Research at the University of Alaska Fairbanks are working with Yup’ik community members, to develop a multilevel (individual, family, peer, and community) intervention that uses a culturally-based alcohol and drug use and suicide prevention framework focused on culturally-meaningful “reflective” processes about alcohol consequences and “reasons for life”. The intervention itself is based on a Yup’ik indigenous theory of change and process approach to building strengths and protections against drug use and suicide. We developed a manual of operations containing details of the indigenous intervention process that provides an outline for the cultural practices and values guiding the process along with specific prevention activities that the community chooses from and adapts to their local cultural context.

          A feasibility pilot study in two communities showed that the intervention a) could be implemented in rural Yup’ik communities, b) produce measurable effects on ultimate and intermediate outcome measures, and c) exhibited a dose-response effect, with dose defined as number of intervention activities attended and response defined as measured growth in protective factors. A follow-up comparative effectiveness study found statistically significant outcomes in a high compared to low intervention dose community, demonstrating a key factor in successful implementation is the level of community resources devoted to intervention. These findings led us to conclude a prevention trial is within reach. However, we must first replicate the pilot findings in a trial with adequate power, time, and resources.

          Thus, we are: a) assessing the efficacy of the Qungasvik intervention through a group community level trial using an interrupted time series design with wait-listed control, and b) examining mechanisms of change in response to intervention. Some of the specific aims of the research are: 1). To test the Qungasvik intervention efficacy through impact on the ultimate outcome variables of reasons for life and reflective processes on alcohol use consequences, and on suicidal ideation and alcohol use, and 2). Toexamine the mechanisms of change in response to the Qungasvik intervention through: (a) Self-report Measures: intermediate outcome measures of individual, family, peer, and community protective factors; (b) Social Network Assessment: social network characteristics of supportive relationships with elders, immediate and extended kinship relations, adults, and peers; and (c) Process Evaluation and Qualitative Description: community member perspectives on process and impact of the intervention through qualitative interviewing and grounded theory analysis techniques.  Several publications have been generated from the research and those I’m involved in are included in the publication section.

Foundations of Multicultural Psychology through Use of Meta-Analysis Procedures

Multicultural psychology and counseling and psychotherapy are emerging disciplines with the potential to inform therapists of cultural considerations relevant to mental health.  It is based on the premise that the ethical provision of mental health services should include an accurate accounting of clients’ cultural lifeways and thoughtways. As an emerging discipline, it has developed guidelines for therapists seeking to be more effective in their work and it has become increasingly influential across the mental health professions, most recently in the revised standards for psychology graduate programs and internships. Although exceptions persist, multicultural perspectives are becoming increasingly normative among mental health professionals. 

          But to what extent are the tenets and guidelines for practice that have arisen from multicultural perspectives based on research evidence?  Psychologists and other mental health professionals understand the benefits of using data to inform practice and policy but to what extent has that occurred? A solid research foundation is essential to the credibility and long-term effectiveness of multicultural guidelines for practitioners.

          The primary purpose of our meta-analysis research was to summarize research data to inform mental health practices relevant to client race and ethnicity, two delimited aspects of multiculturalism.  Using meta-analytic methods to summarize data in a majority of chapters, the research addresses questions that are fundamental to the discipline.  For instance, how large are racial discrepancies in mental health service utilization and client retention, and what factors predict those racial discrepancies?  To what degree are perceptions of racism and ethnic identity associated with psychological well-being?  To what extent can therapists’ training in multicultural issues and their level of multicultural competence benefit diverse clients?  These are among the key questions relevant not only to the therapist but also to every therapist who works in a multicultural world.

          With my colleague, Timothy B Smith at Brigham Young University, together with a few undergraduate and graduate students at BYU and WWU we analyzed published journal articles on a variety of multicultural mental health topics such as ethnic identity, acculturation, well-being, treatment attendance, client counselor therapist matching, clinic utilization, and experiences with discrimination and racism. The study combined information on cultural and racial factors as they relate to psychotherapy and aimed to give psychotherapists clear and evidence based information they can use in the field. The elaborate meta-analysis representing more than 4.7 million clients in 130 published research studies provided us with data on racial inequities in mental health service utilization. 

          The meta-analyses revealed that racial and ethnic discrepancies have decreased somewhat, but are still substantial. African-Americans are 21 percent less likely than white European-Americans to use mental health services, for example. Hispanics and Latinos are 25 percent less likely. We concluded that it's not just a matter of socioeconomic status. Many researches and practitioners have long assumed that differences in income and health insurance access account for disparities. Our data show that race is an equally independent predictor of mental health utilization.

          The study appears along with eight other meta-analyses on cultural issues such as the association of experiences of racism and ethnic identity with individuals’ well-being. The results of our extensive study can be found in our book, Foundations of Multicultural Psychology: Research to Inform Effective Practice. The book’s table of contents and a sample chapter can be found in my publication section

Global and Culturally Diverse Leaders and Leadership

With the growing population diversity and mobility not only in the United States, but also throughout the world, leaders and followers will find themselves in more heterogeneous contexts within organizations and communities than ever before. Leaders of tomorrow need to be responsive to rapid change, prepared to lead a diverse workforce, and practiced in ways that are culturally responsive and competent in meeting the needs of a diverse population within an interconnected global society. This demands that leadership theories and research need to be more inclusive and robust if they are to remain relevant.

          The goals of the research are: 1). To understanding how the different worldviews and lived experiences of leaders influence their leadership style; 2).To include social justice, and ethical and cultural values which are not typically included the mainstream Eurocentric dialogue about leadership; 3). To recognize how social identities of leaders (e.g., gender, race, ethnicity, sexual orientation, religious) intersect with leader identities and may result in biases that influence perceptions, shape leader behaviors, and influence appraisals of leader effectiveness; and 4). To examine the exchange between diverse leaders and diverse followers and between leaders and diverse contexts which shape the enactment of leadership. Our earlier research and scholarship led to the publication of our book (with Jean Lau Chin). Diversity and Leadership.

          Based on our literature search and interviews with various leaders from different countries we conclude there is the need for a new culturally resonant model of leadership. A new model should present a more diverse and globally based perspective. Sixty-four leadership characteristics were derived from the current literature on leadership and from structured interviews and focus groups obtained from different ethnically diverse samples. The current research is part of an ongoing study regarding cultural differences in what are believed to be the necessary characteristics of outstanding leadership.

          Using a multiple-item scale of these dimensions, we discovered that respondents preferred leadership dimensions reflecting several culturally-specific leadership styles. The respondents ranked the following leadership characteristics as highly important: integrity, authenticity, communicator, adaptability, collaborative, resilient, and culturally sensitive while they ranked the following as lowest in importance: self-centered, status conscious, aggressive, dominant, competitive and individualistic. These findings suggest that dimensions might carry different value or semantic meaning across different social identity groups or lived experiences.
Last summer 2015 with the assistance of one of my graduate students, Josh Thompson, we conducted an on-line survey using Qualtrics and found some interesting leadership preferences from our sample. Respondents identified their preferred political affiliation after checking their preferred leadership descriptors and characteristics. In general, our Republican sample preferred leaders who are: competitive, emotionally tough, forceful, aggressive, conflict inducer, dominant, celebrity, and self-centered. The Democrat sample preferred leaders who are: honest, integrity, adaptability, self-knowledge, caring, authentic, compassionate, communicator, warmth, and motivating. The preferences appear to be reflected in the characteristics of those currently running for a Presidential nomination for both political parties here in the USA.

          The ongoing research has led to the eventual publication of two more books on the topic. The first one is titled, Global and Culturally Diverse Leaders and Leadership: New Dimensions, Opportunities, and Challenges for Business, Industry, Education and Society (with Jean Lau Chin and Joseph G. Garcia).  It will be a volume in the International Leadership Association’s series and will be published by Emerald Press, Ltd. In England. The second book titled, Building Bridges to Inclusive Leadership through the Lens of Cultural Narratives. Through the use of personal narratives and case studies, selected diverse leadership styles will be presented to illustrate the importance of diversity in our lives, communities and workplace. Current theories and research on leadership neglect the influence of diversity in accessing leadership positions and the exercise of that leadership. Classic leadership training models often presume simply one ideal type of leader. This “idealized model” continues to exist in the corporate, higher education, science, and political sectors.