Mental Health Care Practitioners’ Construing about non-White people: Implications for Cultural Competence and the Therapeutic Alliance

Australia is a country known for its multicultural population. The country has a broad range of visa schemes and a rapidly increasing overall intake of migrants. Australia thus provides a particularly rich case study of a migrant-receiving country undergoing rapid transformation. This diversity results in the need for mental health care systems and practitioners to adapt to a range of health and wellbeing needs of individuals and groups across cultural, linguistic, and ethnic backgrounds. This goal is challenged by the prevailing and overarching sociopolitical and ethnocultural construct of Whiteness, which is present in Australia, other Western nations and much of the world. To both acknowledge and understand this construct, and its consequences, within the context of mental health and wellbeing, this thesis examined the ways in which mental health practitioners in Australia construe non-White people. The research also sought to ascertain the links between practitioners’ construals of Whiteness and their cultural competence as well as their therapeutic alliance with non-White clients. This research is important as it helps to expose the modes by which Whiteness may influence construing and may provide more clarity on how Whiteness, its invisibility and processes work in the context of mental health care

Making sense of sex with people with Cerebral Palsy

Constructions of sexuality and disability have been discussed widely by scholars across a number of fields. However, there has been relatively little research on how people with Cerebral Palsy construct their own sexuality and the salience of the socio-sexual schema which are involved in this process. As such this study aimed to address three questions; 1) the relative salience of public, interactional and private sexual schema in the construction of sexuality for people with Cerebral Palsy, 2) how people with Cerebral Palsy construct sexual participation, and particularly sexual spontaneity and, 3) how people with Cerebral Palsy describe their sexuality. This project utilized a hermeneutic phenomenological approach to explore these questions. In doing so, this study helps fill the gap between how sexuality and disability is constructed external to the individual and how the individual constructs their own sexuality. For this research, seven in-depth, semi-structured interviews were conducted with five men and two women with moderate to severe Cerebral Palsy. Participant data indicated that how people with Cerebral Palsy perceive sexual experiences with others (interactional) is the most influential factor in the construction of their sexuality. Public influences were cumulatively the second most important factor in the construction of sexuality by people with Cerebral Palsy. Finally, private influences were cumulatively the least influential factor in the construction of their sexuality. Sexual spontaneity primarily was a derivative of sexual exploration. Furthermore, participants defined sexual spontaneity as liberating and allowed them to experience their sexuality with others relatively independent of normative sexual scripts. Participants also described their sexuality primarily in terms of major transitions and experiences which involved others. Based on the findings sexual theory needs to be more cognizant of sexual agency as primary in the construction of sexuality with significant disability. In addition, healthcare providers and people with Cerebral Palsy are likely to be successful partners in sexual health when they promote positive and agentic constructions of sexuality with significant disability. The findings emphasize that people with Cerebral Palsy are cognizant and intelligent agents in the construction of their sexuality. Their articulations, understandings and descriptions of their sexuality demonstrate their interest and awareness in their sexuality and issues related to it. People with Cerebral Palsy are sexual agents and beings who empower themselves

Making sense of sex with people with Cerebral Palsy

Constructions of sexuality and disability have been discussed widely by scholars across a number of fields. However, there has been relatively little research on how people with Cerebral Palsy construct their own sexuality and the salience of the socio-sexual schema which are involved in this process. As such this study aimed to address three questions; 1) the relative salience of public, interactional and private sexual schema in the construction of sexuality for people with Cerebral Palsy, 2) how people with Cerebral Palsy construct sexual participation, and particularly sexual spontaneity and, 3) how people with Cerebral Palsy describe their sexuality. This project utilized a hermeneutic phenomenological approach to explore these questions. In doing so, this study helps fill the gap between how sexuality and disability is constructed external to the individual and how the individual constructs their own sexuality. For this research, seven in-depth, semi-structured interviews were conducted with five men and two women with moderate to severe Cerebral Palsy. Participant data indicated that how people with Cerebral Palsy perceive sexual experiences with others (interactional) is the most influential factor in the construction of their sexuality. Public influences were cumulatively the second most important factor in the construction of sexuality by people with Cerebral Palsy. Finally, private influences were cumulatively the least influential factor in the construction of their sexuality. Sexual spontaneity primarily was a derivative of sexual exploration. Furthermore, participants defined sexual spontaneity as liberating and allowed them to experience their sexuality with others relatively independent of normative sexual scripts. Participants also described their sexuality primarily in terms of major transitions and experiences which involved others. Based on the findings sexual theory needs to be more cognizant of sexual agency as primary in the construction of sexuality with significant disability. In addition, healthcare providers and people with Cerebral Palsy are likely to be successful partners in sexual health when they promote positive and agentic constructions of sexuality with significant disability. The findings emphasize that people with Cerebral Palsy are cognizant and intelligent agents in the construction of their sexuality. Their articulations, understandings and descriptions of their sexuality demonstrate their interest and awareness in their sexuality and issues related to it. People with Cerebral Palsy are sexual agents and beings who empower themselves

Evaluating Person-Oriented Measures to Understand Sexuality with Cerebral Palsy: Procedures and Applications

This paper is based on a research which explored sexual scripts in the lives of people with cerebral palsy. To assess the utility of the study protocol, aimed at exploring the relative salience of public, interactional and private sexual scripts as described by people with cerebral palsy, a pilot study was conducted. This paper discusses the development and results of the pilot study used to test the accessibility and trustworthiness (credibility, transferability, dependability, and confirmability) of the study protocol. This paper also outlines the utilization of the pilot study in the modification of the final study protocol. Consistent with the aims of the pilot study networks were established which facilitated recruitment of individuals within the sampling frame and also provided participants for the main study. The trustworthiness of the study was confirmed through an assessment of the credibility, transferability, dependability and confirmability of the interview guide. Transferability was achieved through the provision of evidence of the analytic process which may allow other researchers to repeat, as closely as possible the procedures of this project. Dependability and confirmability of the data collection, analysis, theory production and the level to which the study’s findings are supported by the collected data were ensured through the employment of an independent audit of the research methods by a competent peer. The pilot study confirmed the availability of participant networks as well as the accessibility and trustworthiness of the study protocol. Pilot studies continue to be a medium to test research methodology and apply necessary amendments in order to conduct larger studies

Culture Clash: Shona (Zimbabwean) Migrant Women’s Experiences with Communicating about Sexual Health and Wellbeing across Cultures and Generations

This paper discusses the influence of cross-cultural modes of communication on perceptions of sexual health and wellbeing for Shona (Zimbabwean) women living in Australia and their children. Data was collected using focus groups in South  Australia with fourteen women, between the ages of 29 and 53. Transcripts were  analysed thematically. The women primarily constructed sexual health and  wellbeing  in customary Shona ways, which not only maintain secrecy about sexual health and wellbeing discourse, but also prohibit parents from talking to children about sexual health as such talk is reserved for particular kin and non-kin  relationships. These constructions however became more fluid the longer the women resided in Australia. For these women the notions of sexual health and wellbeing are a negotiation between Australian constructs and those from Shona culture,  especially when applied to their children. This research highlights the potential influence of various cultural world views on sexual health communication among African migrant women and their children and questions the appropriateness of sexual health and wellbeing campaigns and their responsiveness for cross-cultural youth. Keywords: Africa, cross-cultural, Australia, intergenerational, sexual health, intercultural communicatio

Conceptualizing Sex with Cerebral Palsy: A Phenomenological Exploration of Private Constructions of Sexuality Using Sexual Script Theory

This study explored how people with cerebral palsy (CP) negotiated and perceived their sexual interactions with others. In doing so, this research discusses participant conceptualizations of sexuality with CP. In-depth, semi-structured interviews were conducted with two women and five men with moderate to severe cerebral palsy from Canada and Australia. The interview discourse focused on how, if at all, private/internal constructions of sexuality influenced the way in which participants expressed and negotiated their sexuality. Interview data were thematically analyzed using NVivo and manual line-by-line analysis.Notably, accepting oneself was important to people with cerebral palsy’s sense of sexuality. By critically discounting exclusionary or negative sexual schema, people with cerebral palsy learn to be more accepting of their abilities and attribute positive conceptualizations to themselves and their sexual identity. Participants had mixed perceptions of body esteem as an aspect of their sexuality. Downward social comparisons were associated with positive body esteem. Negative body esteem could be an after effect of the lack of resources to support people with cerebral palsy in their sexual participation (i.e., sexual surrogates, workers, sexual facilitation from care providers, privacy or accessibility to transport) (see Earle, 1999). Participants also believed their sexual agency was constrained. For instance, they were apprehensive about explicitly asking for what they required from a sexual partner for fear that they may seem overly demanding, which could frustrate a sexual partner or end a relationship. For people with CP personal agency yields more satisfying socio-sexual outcomes. The present study suggests that people with cerebral palsy do in fact recognize that being sexually agential would increase their sense of sexual satisfaction and empowerment. Further, participants believed that sexual agency could be enhanced with personal effort. In this regard, the ability to make (and exercise) choice when negotiating sexuality reinforces conceptualizations of oneself as a sexually desirable being

Understanding Experiences of Sexuality with Cerebral Palsy through Sexual Script Theory

This study explored how people with cerebral palsy (CP) negotiated and perceived their sexual interactions with others. In doing so, this research discusses participant conceptualizations of sexuality with CP. In-depth, semi-structured interviews were conducted with two women and five men with moderate to severe cerebral palsy from Canada and Australia. The interview discourse focused on how, if at all, interactional constructions of sexuality influenced the way in which participants expressed and negotiated their sexuality. Interview data were thematically analyzed using NVivo and manual line-by-line analysis. Negotiated sexuality with partners, and communication styles influenced understandings of sexuality with CP. Partner validation was important to participant understanding sexuality as was the style and quality of communication about sexuality between sexual partners. Sexuality was meaningful with a sense of closeness, experiences of affection and reciprocity. Personal sexual agency enabled negotiation of preferred sexuality as did perceived levels of socio-sexual compatibility. The findings confirm that sexuality is socially negotiated. For people with CP personal agency yields more satisfying socio-sexual outcomes. In this regard, the ability to make (and exercise) choice when negotiating interactional sexual experiences reinforces conceptualizations of oneself as a sexual being and sexual equal

Conceptualizing Sex with Cerebral Palsy: A Phenomenological Exploration of Private Constructions of Sexuality Using Sexual Script Theory

This study explored how people with cerebral palsy (CP) negotiated and perceived their sexual interactions with others. In doing so, this research discusses participant conceptualizations of sexuality with CP. In-depth, semi-structured interviews were conducted with two women and five men with moderate to severe cerebral palsy from Canada and Australia. The interview discourse focused on how, if at all, private/internal constructions of sexuality influenced the way in which participants expressed and negotiated their sexuality. Interview data were thematically analyzed using NVivo and manual line-by-line analysis.Notably, accepting oneself was important to people with cerebral palsy’s sense of sexuality. By critically discounting exclusionary or negative sexual schema, people with cerebral palsy learn to be more accepting of their abilities and attribute positive conceptualizations to themselves and their sexual identity. Participants had mixed perceptions of body esteem as an aspect of their sexuality. Downward social comparisons were associated with positive body esteem. Negative body esteem could be an after effect of the lack of resources to support people with cerebral palsy in their sexual participation (i.e., sexual surrogates, workers, sexual facilitation from care providers, privacy or accessibility to transport) (see Earle, 1999). Participants also believed their sexual agency was constrained. For instance, they were apprehensive about explicitly asking for what they required from a sexual partner for fear that they may seem overly demanding, which could frustrate a sexual partner or end a relationship. For people with CP personal agency yields more satisfying socio-sexual outcomes. The present study suggests that people with cerebral palsy do in fact recognize that being sexually agential would increase their sense of sexual satisfaction and empowerment. Further, participants believed that sexual agency could be enhanced with personal effort. In this regard, the ability to make (and exercise) choice when negotiating sexuality reinforces conceptualizations of oneself as a sexually desirable being

A systematic review of factors influencing condom use among female sex workers

A systematic review of research published in English was conducted across seven electronic databases in public health, social and psychological sciences. The aim was to ascertain the factors that influence condom use among female sex workers in the commercial sex industry globally. The perspectives and experiences of 29,112 female sex workers (FSWs) and 1,792 male clients of FSWs with regards to condom use are represented across the 47 studies included in this review. Key themes comprised of Perceived self-efficacy, Relationship Types, Condom use and Attitudes, Violence and Abuse, Location and Support, Knowledge and Perceived Risk, Perception and Perspectives of Male Clients, Drug and Alcohol use, Criminalisation and Price and Payment. Female sex workers are defined as a high-risk population for HIV/AIDS. Condoms were used less frequently in situations where structural and cultural determinants heavily impacted the experiences and decisions of FSWs. Cultural contextual factors also heavily impacted on the perspectives and perceptions of male clients and their attitudes towards condom use. Criminalization and anti-sex work legislation in many of the countries where these studies were conducted meant that FSWs were a socially marginalised and ostracized population. Recommendations are explored for theory, practice and education and future research

A systematic review on LGBTIQ intimate partner violence from a Western perspective

Intimate Partner Violence (IPV) as experienced by minority populations is poorly understood. Within the Western world, the Lesbian, Gay, Bisexual, Transgender, Intersex, and Queer or Questioning LGBTIQ population is one such group which suffers from misrepresentations and misunderstandings. In Western nations, IPV is primarily constructed as perpetrated by men and experienced by women. However, for the LGBTIQ population, this dichotomous view of IPV is inaccurate and invalidating. A systematic review was conducted to investigate the level of LGBTIQ inclusivity within IPV discourses in the Western world as discussed in peer-reviewed literature. In particular, the review sought to understand how media, advocacy, policy, and legislation shape LGBTIQ IPV experiences and resulting discourses. The literature search was conducted between June 2018 and January 2019. The search included five electronic databases in psychology, health, and social sciences. Of the 206 articles identified by the search, 21 were reviewed. The review analyzed literature using a thematic approach. Eight key themes emerged, indicating media, legislation, policy, and advocacy are not entirely inclusive concerning LGBTIQ IPV. The review found that pervasive attitudes like heterosexism, cissexism, homophobia, transphobia, and biphobia reinforce institutional barriers and limited LGBTIQ IPV reporting. In addition, the review found low service and provider competency levels, and more broadly, the research was limited. It is likely that heteronormative frameworks and discourses mean many aspects of LGBTIQ IPV are still under-researched. Without a more robust inclusion of diversity in discourses on IPV, services and supports for LGBTIQ people will continue to be limited and based on heteronormative frameworks of victimhood