Karni Kissil

‘We are survivors too’: African-American youths' experiences of coping with parental breast cancer

Objective: To explore how African‐American youth cope with the diagnosis and treatment of parental breast cancer, and to identify culturally sensitive ways to recruit and sustain participation of this vulnerable population in intervention programs.

It Has Been a Good Growing Experience for Me: Growth Experiences Among African American Youth Coping With Parental Cancer

This qualitative focus group study describes posttraumatic growth experiences of African American adolescents currently coping with parental breast cancer. Twelve adolescents participated in three focus groups assessing their experiences with parental cancer. Spontaneous accounts of posttraumatic growth were reported by all participants. A content analysis revealed reports in four of the five domains of posttraumatic growth identified by Tedeschi and Calhoun (1996) which included: greater appreciation for life, enhanced interpersonal relationships, increased sense of personal strengths, and changed priorities. An additional domain, change in health behaviors and attitudes, also emerged. These findings add important knowledge to the developing field of research in posttraumatic growth in populations where available research is scarce, especially among adolescents and racial minorities.

A culturally adapted family intervention for African American families coping with parental cancer: Outcomes of a pilot study

The primary objective of this 2‐year pilot study was to evaluate the effectiveness of a culturally adapted family intervention in improving family communication among African American parents coping with cancer and their school‐age children. A secondary objective was to determine its impact on other symptoms of psychosocial distress (depression and anxiety). The third objective was to assess for acceptability and feasibility.

“They Paid No Mind to My State of Mind”: African American Breast Cancer Patients’ Experiences of Cancer Care Delivery

This qualitative study describes experiences of cancer care delivery for nine African-American breast cancer patients. Three focus groups captured participants’ experiences with the diagnosis and treatment of breast cancer and parenting their children. Spontaneous accounts describing their interactions with oncology staff were reported by all breast cancer patients. Content analysis revealed five themes: interaction with physicians, power and authority of physicians, collaboration between physicians and mental health professionals, navigating the system, and involvement of the family in the treatment process. These themes may help in developing culturally sensitive training programs for oncology providers to improve the quality of cancer care.

African American Parents’ Experiences Navigating Breast Cancer While Caring for Their Children

African American parents who are navigating breast cancer while parenting their school-age children are an understudied population. We used family systems and sociocultural theories to conduct three focus groups with a total sample of 9 African American parents to understand how they cared for their school-age children (ages 11 to 18) while coping with the diagnosis and treatment of breast cancer. Our content analysis of these focus groups yielded themes that described a variety of ways they protected their children from the emotional consequences of breast cancer. Seven primary themes emerged: (a) increased desire to protect their children, (b) parental concerns for children’s coping, (c) openness and transparency with children, (d) reliance on children for support, (e) calibration of their own responses, (f) use of the illness experience as a teachable moment for children, and (g) reliance on others for parenting support. Clinicians and researchers can improve their care by developing culturally sensitive family intervention programs that promote family resilience.

Attachment-Based Family Therapy for Adolescent Self-Injury

There is growing awareness in the popular media and in clinical reports of the increasing prevalence of self-injury, especially among adolescents. Self-injury affects the entire family and is, in turn, affected by the family system. Thus, family therapy is an important component when working with adolescents who are still dependent on their families. However, available treatments, for the most part, do not address the relational-systemic aspects of self-harm, and treat only the individual. This article situates self-harm within the relational framework of adolescent attachment theory and presents a case study demonstrating the treatment of adolescent self-injury with attachment-based family therapy.

The Prostitution Debate in Feminism: Current Trends, Policy and Clinical Issues Facing an Invisible Population

Throughout history, prostitution has been controversial. Ambivalent attitudes towards prostitution have been part of the feminist discussion for over a century. While feminist scholars agree that inequality within patriarchal hierarchy is the core problem in prostitution, they have been polarized about whether classist or sexist inequality is the primary issue and consequently, on viewing the prostitute as either a coerced victim or an entrepreneur. This article reviews the feminist critique of prostitution and current issues in feminist literature. Changes in policies and social practices are discussed as well as clinical considerations for family therapists working with this vulnerable population.

Doing Therapy in a Foreign Land: When the Therapist Is “Not From Here”

The psychotherapy field has been paying closer attention to how therapists’ characteristics, history, and styles affect therapeutic encounters and contribute to successful therapy outcomes. Therapists have been encouraged to increase self-awareness of their own socio-cultural dimensions to optimally connect with clients. However, the experience of therapists’ own immigration has received little attention. This article highlights the experience of immigration as important for understanding the self of the therapist, describing core experiences related to immigration for immigrant therapists in the United States. This article additionally describes how these experiences can affect immigrant therapists’ clinical encounters. Finally, recommendations are provided for immigrant therapists, clinical supervisors, and training programs.

Health Disparities in Procreation: Unequal Access to Assisted Reproductive Technologies

There is a significant increase in the use of assisted reproductive technology to treat infertility, yet access to services is not equal for all women in the United States. Some marginalized groups face significant barriers accessing assisted reproductive technology. The authors review obstacles preventing marginalized populations from procreating, based on class, race and ethnicity, age, marital status, sexual orientation, and disability. The sociopolitical climate in the United States that maintains these obstacles is evaluated by the authors in this article. Finally, suggestions are provided for structural changes to decrease disparities in access to assisted reproductive technology and recommendations for family therapists working with clients who are unable to access assisted reproductive technology.

Lessons learned in developing a culturally adapted intervention for African-American families coping with parental cancer.

Prior clinical research supports the effectiveness of cancer support groups for cancer patients and their families, yet African-American families continue to be underrepresented in cancer support groups and in cancer clinical research studies. In order to fill this gap, we developed and evaluated a culturally adapted family support group for African-American families coping with parental cancer. We encountered unexpected challenges in overcoming barriers to recruitment, partnering with oncology providers, and building trust with the African-American community and African-American families coping with parental cancer. We describe actions taken during the two phases of this study and lessons learned along the way about recruiting and engaging African-American families in cancer support group studies, partnering with oncology providers, networking with the African-American community, and the importance of demonstrating cultural sensitivity to overcome the understandable historical legacy of mistrust.