Joshua N. Hook

Religion and spirituality

Many clients highly value religious and spiritual (R/S) commitments, and many psychotherapists have accommodated secular treatments to R/S perspectives. We meta-analyzed 51 samples from 46 studies (N = 3,290) that examined the outcomes of religious accommodative therapies and nonreligious spirituality therapies. Comparisons on psychological and spiritual outcomes were made to a control condition, an alternate treatment, or a subset of those studies that used a dismantling design (similar in theory and duration of treatment, but including religious contents). Patients in R/S psychotherapies showed greater improvement than those in alternate secular psychotherapies both on psychological (d =.26) and on spiritual (d = .41) outcomes. Religiously accommodated treatments outperformed dismantling-design alternative treatments on spiritual (d = .33) but not on psychological outcomes. Clinical examples are provided and therapeutic practices are recommended.

Cultural Humility: Measuring Openness to Culturally Diverse Clients

Building on recent theory stressing multicultural orientation, as well as the development of virtues and dispositions associated with multicultural values, we introduce the construct of cultural humility, defined as having an interpersonal stance that is other-oriented rather than self-focused, characterized by respect and lack of superiority toward an individuals cultural background and experience. In 4 studies, we provide evidence for the estimated reliability and construct validity of a client-rated measure of a therapists cultural humility, and we demonstrate that client perceptions of their therapists cultural humility are positively associated with developing a strong working alliance. Furthermore, client perceptions of their therapists cultural humility were positively associated with improvement in therapy, and this relationship was mediated by a strong working alliance. We consider implications for research, practice, and training.

Report of Findings in a DSM‐5 Field Trial for Hypersexual Disorder

INTRODUCTION Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for hypersexual disorder (HD) have been proposed to capture symptoms reported by patients seeking help for out-of-control sexual behavior. The proposed criteria created by the DSM-5 Work Group on Sexual and Gender Identity Disorders require evaluation in a formal field trial. AIM This DSM-5 Field Trial was designed to assess the reliability and validity of the criteria for HD in a sample of patients seeking treatment for hypersexual behavior, a general psychiatric condition, or a substance-related disorder. METHOD Patients (N = 207) were assessed for psychopathology and HD by blinded raters to determine inter-rater reliability of the HD criteria and following a 2-week interval by a third rater to evaluate the stability of the HD criteria over time. Patients also completed a number of self-report measures to assess the validity of the HD criteria. MAIN OUTCOME MEASURES HD and psychopathology were measured by structured diagnostic interviews, the Hypersexual Behavior Inventory, Sexual Compulsivity Scale, and Hypersexual Behavior Consequences Scale. Emotional dysregulation and stress proneness were measured by facets on the NEO Personality Inventory-Revised. RESULTS Inter-rater reliability was high and the HD criteria showed good stability over time. Sensitivity and specificity indices showed that the criteria for HD accurately reflected the presenting problem among patients. The diagnostic criteria for HD showed good validity with theoretically related measures of hypersexuality, impulsivity, emotional dysregulation, and stress proneness, as well as good internal consistency. Patients assessed for HD also reported a vast array of consequences for hypersexual behavior that were significantly greater than those diagnosed with a general psychiatric condition or substance-related disorder. CONCLUSIONS The HD criteria proposed by the DSM-5 Work Group on Sexual and Gender Identity Disorders appear to demonstrate high reliability and validity when applied to patients in a clinical setting among a group of raters with modest training on assessing HD.

Cultural, Sociofamilial, and Psychological Resources That Inhibit Psychological Distress in African Americans Exposed to Stressful Life Events and Race-Related Stress

Empirical evidence suggests that African Americans (herein, all nonimmigrant persons of African heritage living in the United States) are at increased risk for exposure to stressful life events (e.g., Karlsen & Nazroo, 2002; McCord & Freeman, 1990; Thoits, 1991; Williams, Neighbors, & Jackson, 2003). Moreover, the health consequences associated with this increased risk are exacerbated by daily encounters with individual, institutional, and cultural racism (Clark, Anderson, Clark, & Williams, 1999; Harrell, 2000; Nazroo, 2003; C. E. Thompson & Neville, 1999; V. L. Thompson, 2002; Utsey & Ponterotto, 1996). Stressful life events and race-related stress have important consequences for the psychological and physical health of African Americans. As such, an important theoretical and practical question is: What protective factors can mitigate this stress and the subsequent risk for negative mental and physical health outcomes among African Americans? A significant related need is further understanding of the mechanisms whereby protective factors function to alleviate stress. In the present study, we examined the role of cultural, sociofamilial, and psychological resources in mitigating the deleterious effects of stressful life events and race-related stress in a sample of African American undergraduate college students. Our research examined the relative contributions of stressful life events versus race-related stress on psychological distress and compared two distress-deterring models (Ensel & Lin, 1991) to determine the specific mechanisms whereby psychological resources and cultural resources buffered participants from stress or enabled them to cope with psychological distress.

Empirically supported religious and spiritual therapies.

This article evaluated the efficacy status of religious and spiritual (R/S) therapies for mental health problems, including treatments for depression, anxiety, unforgiveness, eating disorders, schizophrenia, alcoholism, anger, and marital issues. Religions represented included Christianity, Islam, Taoism, and Buddhism. Some studies incorporated a generic spirituality. Several R/S therapies were found to be helpful for clients, supporting the further use and research on these therapies. There was limited evidence that R/S therapies outperformed established secular therapies, thus the decision to use an R/S therapy may be an issue of client preference and therapist comfort.

Humility: Review of measurement strategies and conceptualization as personality judgment

Humility is an understudied virtue in positive psychology. Both conceptual and methodological challenges have retarded its study. In this article, we discuss how humility has been defined. Specifically, researchers disagree whether humility refers to the accuracy of an individuals view of self, or whether humility primarily describes someones interpersonal stance toward others. We critique four approaches that researchers have used to measure humility: self-reports, implicit measures, social comparisons of self to others, and informant ratings of humility. We then theoretically elaborate on the later method, which has been mostly overlooked. Accordingly, we present a model of relational humility. We define humility as a relationship-specific personality judgment, and we describe the relationship factors that affect how humility is perceived [Funder, D.C. (1995). On the accuracy of personality judgment: A realistic approach. Psychological Review, 102, 652–670.]. Finally, we provide next steps for researchers using a relational approach.

Relational humility: conceptualizing and measuring humility as a personality judgment.

The study of humility has progressed slowly due to measurement problems. We describe a model of relational humility that conceptualizes humility as a personality judgment. In this set of 5 studies, we developed the 16-item Relational Humility Scale (RHS) and offered initial evidence for the theoretical model. In Study 1 (N = 300), we developed the RHS and its subscales—Global Humility, Superiority, and Accurate View of Self. In Study 2, we confirmed the factor structure of the scale in an independent sample (N = 196). In Study 3, we provided initial evidence supporting construct validity using an experimental design (N = 200). In Study 4 (N = 150), we provided additional evidence of construct validity by examining the relationships between humility and empathy, forgiveness, and other virtues. In Study 5 (N = 163), we adduced evidence of discriminant and incremental validity of the RHS compared with the Honesty-Humility subscale of the HEXACO–PI (Lee & Ashton, 2004).

Measuring Sexual Addiction and Compulsivity: A Critical Review of Instruments

Research has proliferated on sexual addiction in recent years, and this has led to an increase in the instruments created to measure this construct. The authors review 17 instruments that have been created to assess sexual addiction, including self-report rating scales, self-report checklists, and clinician rating scales measuring symptoms of sexual addiction, as well as self-report rating scales measuring consequences associated with sexual addiction. For each instrument, the authors describe its structure, conceptual basis, and samples studied. They also evaluate the evidence for the reliability and validity of each instrument. The instruments vary widely in their psychometric properties. Many have been created recently, and others have only been studied in specific populations. For each group of instruments, the authors make recommendations for researchers and clinicians.

Humility and the Development and Repair of Social Bonds: Two Longitudinal Studies

A theory of relational humility asserts that humility can promote strengthening social bonds. To complement prior, cross-sectional research on this topic, two longitudinal studies were conducted. In Study 1, college students in romantic relationships (N = 123), all of whom had been hurt or offended by their partners within the last two months, completed measures of humility and unforgiveness for six consecutive weeks. Relational humility predicted unforgiving motives (lagged by one time-point). In Study 2, we examined college students (N = 84) in small groups that did three tasks intended to challenge humility. Round-robin ratings were used over the course of three measurement occasions to evaluate whether trait humility predicted formation of strong social bonds. As predicted, trait humility was associated with greater group status and acceptance. We concluded that, by using longitudinal methods, there is support for the proposition that humility can help repair and form relationships with strong social bonds.

Collectivism, Forgiveness, and Social Harmony

Existing models of forgiveness and the strategies to promote forgiveness that draw from them are predominantly individualistic. As the United States becomes more diverse and counseling psychology becomes a more global field, counseling psychologists are increasingly likely to encounter clients who have a collectivistic worldview. The authors propose a theoretical model that clarifies the relationship between collectivism and forgiveness. The importance of maintaining social harmony in collectivistic cultures is central to this relationship. The model has two propositions. First, collectivistic for- giveness occurs within the broad context of social harmony, reconciliation, and relational repair. Second, collectivistic forgiveness is understood as pri- marily a decision to forgive but is motivated largely to promote and maintain group harmony rather than inner peace (as is more often the case in individ- ualistically motivated forgiveness). Finally, the authors suggest a research agenda to study collectivistic forgiveness and provide guidelines for address- ing forgiveness with collectivistic clients.