Behavioral health treatment agencies often struggle to keep clients engaged in treatment. Women clients often have additional factors such as family responsibilities, financial difficulties, or abuse histories that provide extra challenges to remaining in care. As part of a national initiative, four women-focused drug treatment agencies used process improvement to address treatment engagement. Interviews and focus groups with staff assessed the nature and extent of interventions. Women-focused drug treatment agencies selected relational-based interventions to engage clients in treatment and improved four-week treatment retention from 66% to 76%. Process improvement interventions in women-focused treatment may be useful to improve engagement.

This article examines one patient's experiences with weight bias in an inpatient eating disorder treatment setting with a focus on interactions between the patient and her primary therapist. These therapeutic interactions had multiple unintended consequences, including bolstering feelings of denial, modeling of disordered behaviors, and disrupting the therapeutic alliance. Additional instances of weight bias with other treatment professionals, including an inpatient nutritionist and psychiatrist, are briefly discussed. The article ends with several brief recommendations for how clinicians can more skillfully approach issues of weight and size in the therapeutic alliance in order to resist size-related oppressions rather than reinforce them.

This article discusses the challenges of providing treatment for women with complex dual diagnostic mental health needs. In particular, the focus is on the intersections between posttraumatic stress disorder (PTSD), serious mental illness (SMI), female gender, and veteran status. Utilizing a clinical case example, we focus our discussion on psychotherapy goals and interventions, including the advisability of engaging in trauma-focused therapy on an inpatient unit with a patient who carries an SMI diagnosis. We also address benefits and challenges of providing this type of treatment, provider reactions including burnout and diagnostic bias, and recommendations for future care for persons with similar presentations and needs.

An interview study of 15 sexual assault survivors' narratives examined positive and negative post-assault experiences with mental health professionals. Survivors who told one professional had more positive experiences than those who told multiple professionals. Qualitative analyses revealed how help seeking experiences were related to the context and nature of disclosures, survivors' readiness to disclose, trust building, social reactions received from providers, type of therapy, perceived control over recovery, and mental health system factors impacting access and quality of care. Themes from survivor's accounts illustrate how survivors perceived therapists, which can be used in training mental health professionals encountering survivors in clinical settings.

High depression and suicide rates are critical problems that have a significant impact on the lives of young Asian American women. Intimate partner violence (IPV) has been identified as a predictor of suicidality in general female samples, but no research study has examined the relationship between IPV and suicidality in a sample of 1.5 and second-generation Chinese, Korean, and Vietnamese American women. We used data collected from 173 women (aged 18-35 years) who were screened for eligibility to participate in the development and efficacy study of Asian American Women's Action for Resilience and Empowerment (AWARE). We measured the prevalence of (a) IPV, (b) lifetime suicidal ideation/intent, and (c) childhood abuse and tested the association between IPV and lifetime suicidal ideation/intent among study participants who completed the clinical screening assessments. The results indicated that seven out of 10 women in our sample experienced lifetime suicidal ideation/intent, psychological aggression was the most commonly reported form of IPV during the last six months, followed by sexual coercion, and history of physical and/or sexual partner violence had the most robust association with lifetime suicidal ideation/intent after controlling for demographic factors and childhood abuse. Our study suggests that suicide prevention and intervention programs for young 1.5 and second-generation Asian American women should not only address experiences of childhood abuse, but also incorporate culturally adapted behavioral health approaches to identify and target physical and sexual partner violence. Furthermore, any such programs need to integrate a systemic approach in addressing IPV within the context of various marginalized experiences of Asian American women.

This article focuses on the intersectionality of race, gender, and violence in the lives of Black/Afro-Latinas who have experienced childhood sexual abuse. First, we discuss the trauma of slavery, racism, and colonization in Latin America and the Caribbean, which objectifies Black bodies and renders Blackness invisible. Second, we identify institutional and interpersonal barriers to seeking trauma support. Third, we present preliminary findings from a Listening Circle among survivors who participated in the Black Latinidad: Building Siblinghood to End Child Sexual Abuse Project. Finally, we propose a racially and culturally specific, trauma-informed approach that draws on the strengths of survivors and centralizes their voices and how to intervene.

Even though approximately one in three Asian American (AA) and Pacific Islander women experience sexual assault victimization, there is a dearth of literature examining how AA women sexual assault survivors cope with this traumatic experience. This study examined AA female sexual assault survivors' choice of coping strategies post-assault and how their cognitive responses toward sexual assault victimization (e.g., attributions of self-blame, perceived control over the recovery process) relate to their use of coping strategies. Using the AA subsets of two large community studies, a total of 64 AA women ages 18 to 58 with unwanted sexual experiences after the age of 14 years were included in the analyses. Results indicated that AA survivors used and the most to cope with sexual assault. In addition, those who perceived they had less control over their recovery process tended to use more maladaptive coping strategies, such as substance abuse and behavioral disengagement (e.g., giving up). Discussions include clinical implications and recommendations for using language, modalities, and foci of interventions that are consistent with clients' and their families' worldviews (e.g., indirect inquiries, solution-focused).

Sizeism has a negative impact on women and perpetuates fat shaming. Conventional therapeutic suggestions for addressing weight concerns focuses on self-discipline rather than on the larger social, cultural, or political contexts of weight stigma. Feminist scholars, therapists, and activists have encouraged social activism to promote psychological well-being and challenge systemic weight prejudice. Results of research on health prevention and promotion efforts have begun to shift thinking away from weight loss and toward deconstructing and changing anti-fat attitudes. We highlight some individual and community-based fat activists to illustrate how their strategies and ideas challenge sizeism in a variety of areas including: the rhetoric of fat; body positivity; photography/art; nutrition/exercise; and diversity/intersectionality. Fat activism has utility within a therapeutic context especially for those who have been recipients of sizeism. We strongly encourage therapists to work closely with clients on finding sources and types of fat activism that represent their unique identities which may be more difficult for those with marginalized identities.

The purpose of this study is to compare the pathways through which multiple contextual factors influence the quality of life in Asian American and White women living with cancer. This is a secondary analysis of the data from 95 Asian American women and 113 White women. The data were analyzed using hierarchical multiple regression analyses and structural equation modeling. Multiple factors explained higher percent of total variances of the quality of life scores in Whites compared with that in Asian Americans.

Ambivalent white racial consciousness describes a push towards awareness about racial privilege and a simultaneous pull back from this knowledge into a more comfortable stance of denial. Twenty-nine White community members and undergraduate students participated in focus group discussions on race. Results indicated that participants expressed ambivalent racial consciousness when they talked about: what it means to be White, their non-racial identities, oppression, attributions for racial inequality, and interracial interactions. Deconstructing ambivalent white racial consciousness can help trainers identify points of intervention for White graduate student practitioners to critically reflect on the intersections between white racial identity and systemic oppression.