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Matching patients with therapists in culturally diverse rehabilitation services during civil unrest

  • Management and Policy Paper
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International Journal of Health Economics and Management Aims and scope Submit manuscript

Abstract

A primary consideration in rehabilitation is the compatibility between clinicians and patients, where cultural diversity is a defining feature for both. The intricacies of cultural considerations in patient-clinician matching are heightened in areas of conflict and civil unrest. This paper presents three perspectives of the significance of cultural considerations in such assignments: patient-centred approach - prioritizing patients’ preferences; professional-centred approach - clinicians’ safety, social-emotional, and training needs; and utilitarian approach - what is best for the majority. A case study from an Israeli rehabilitation clinic is presented to exhibit the multifaceted considerations in patient-clinician matching within areas of conflict and civil unrest. The reconciliation of these three approaches in the context of cultural diversity is discussed, suggesting the benefit of a case-by-case strategy involving combinations of the three. Further research could examine how this might feasibly and beneficially optimize outcomes for all in culturally diverse societies in times of unrest.

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References

  • Allen, S. B. (2015). The nurse-patient assignment. The Journal of Nursing Administration, 45(12), 628–635.

    Article  PubMed  Google Scholar 

  • American Psychological Association. (2002). Ethical principles of psychologists and code of conduct. American Psychological Association, 57(12), 1060–1073.

    Article  Google Scholar 

  • Andrade, G. (2019). Medical ethics and the trolley problem. Journal of Medical Ethics and History of Medicine, 12, 3.

    PubMed  PubMed Central  Google Scholar 

  • Ben-Shalom, U., Hitman, G., Orr, R. T., & Rickover, I. (2022). Perceptions of security and civic services among the arab minority youth in Israel: Empirical testing of attraction and repulsion forces. Ethnopolitics, 1–16.

  • Braveman, P. A., Kumanyika, S., Fielding, J., LaVeist, T., Borrell, L. N., Manderscheid, R., & Troutman, A. (2011). Health disparities and health equity: The issue is justice. American Journal of Public Health, 101(S1), S149–S155.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cabral, R. R., & Smith, T. B. (2011). Racial/ethnic matching of clients and therapists in mental health services: A meta-analytic review of preferences, perceptions, and outcomes. Journal of Counseling Psychology, 58(4), 537–554.

    Article  PubMed  Google Scholar 

  • Cervi, L., & Divon, T. (2023). Playful activism: Memetic performances of palestinian resistance in TikTok# challenges. Social Media + Society, 9(1), 20563051231157607.

    Article  Google Scholar 

  • Chang, D. F., & Yoon, P. (2011). Ethnic minority clients’ perceptions of the significance of race in cross-racial therapy relationships. Psychotherapy Research, 21(5), 567–582.

    Article  PubMed  Google Scholar 

  • Chao, P. J., Steffen, J. J., & Heiby, E. M. (2012). The effects of working alliance and client-clinician ethnic match on recovery status. Community Mental Health Journal, 48(1), 91–97.

    Article  PubMed  Google Scholar 

  • Constantino, M. J., Boswell, J. F., Coyne, A. E., Swales, T. P., & Kraus, D. R. (2021). Effect of matching therapists to patients vs assignment as usual on adult psychotherapy outcomes: A randomized clinical trial. JAMA Psychiatry, 78(9), 960–969.

    Article  PubMed  Google Scholar 

  • Croft, A. (2013). Promoting access to education for disabled children in low-income countries: Do we need to know how many disabled children there are? International Journal of Educational Development, 33(3), 233–243.

    Article  Google Scholar 

  • Dekel, U. (2021). Operation guardian of the walls: The need for an integrated multi-front strategy. INSS Insight, 1467 (May).

  • Elran, M., Padan, C., Shenhar, G., & Sofer, H. (2021). Operation Guardian of the Walls: Lessons for the civilian front. INSS Insight, 1476 (June).

  • Ertl, M. M., Mann-Saumier, M., Martin, R. A., Graves, D. F., & Altarriba, J. (2019). The impossibility of client–therapist “match”: Implications and future directions for multicultural competency. Journal of Mental Health Counseling, 41(4), 312–326.

    Article  Google Scholar 

  • FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: A systematic review. BMC Medical Ethics, 18(1), 1–18.

    Article  Google Scholar 

  • Flicker, S. M., Waldron, H. B., Turner, C. W., Brody, J. L., & Hops, H. (2008). Ethnic matching and treatment outcome with hispanic and anglo substance-abusing adolescents in family therapy. Journal of Family Psychology, 22(3), 439.

    Article  PubMed  Google Scholar 

  • Florian, L. (2007). Reimagining special education. The SAGE handbook of special education, 7–20. Sage.

  • Gamst, G., Dana, R. H., Der-Karabetian, A., & Kramer, T. (2004). Ethnic match and treatment outcomes for child and adolescent mental health center clients. Journal of Counseling & Development, 82(4), 457–465.

    Article  Google Scholar 

  • Garb, H. N. (1997). Race bias, social class bias, and gender bias in clinical judgment. Clinical Psychology: Science and Practice, 4(2), 99.

    Google Scholar 

  • Gopalkrishnan, N. (2018). Cultural diversity and mental health: Considerations for policy and practice. Frontiers in Public Health, 6, 179.

    Article  PubMed  PubMed Central  Google Scholar 

  • Green, D., Callands, T. A., Radcliffe, A. M., Luebbe, A. M., & Klonoff, E. A. (2009). Clinical psychology students’ perceptions of diversity training: A study of exposure and satisfaction. Journal of Clinical Psychology, 65(10), 1056–1070.

    Article  PubMed  Google Scholar 

  • Harsanyi, J. (1976). Rule utilitarianism and decision theory. [Berkeley]: Center for Research in Management Science, University of California, Berkeley.

  • Heled, E. (2020). Mind in rehabilitation. eBookPro Press.

  • Helms, J. E., & Richardson, T. Q. (1997). How “multiculturalism” obscures race and culture as differential aspects of counseling competency. In D. B. Pope-Davis, & H. L. K. Coleman (Eds.), Multicultural counseling competencies: Assessment, education and training & supervision (pp. 60–79). Sage.

  • Hook, J. N., Farrell, J. E., Davis, D. E., DeBlaere, C., Van Tongeren, D. R., & Utsey, S. O. (2016). Cultural humility and racial microaggressions in counseling. Journal of Counseling Psychology, 63(3), 269.

    Article  PubMed  Google Scholar 

  • Hurria, A., Togawa, K., Mohile, S. G., Owusu, C., Klepin, H. D., Gross, C. P., Lichtman, S. M., Gajra, A., Bhatia, S., Katheria, V., Klapper, S., Hansen, K., Ramani, R., Lachs, M., Wong, F. L., & Tew, W. P. (2011). Predicting chemotherapy toxicity in older adults with cancer: A prospective multicenter study. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 29(25), 3457–3465. https://doi.org/10.1200/JCO.2011.34.762

  • Kahane, G., Everett, J., Earp, B., Farias, M., & Savulescu, J. (2015). Utilitarian’ judgments in sacrificial moral dilemmas do not reflect impartial concern for the greater good. Cognition, 134, 193–209.

    Article  PubMed  PubMed Central  Google Scholar 

  • Karlsson, R. (2005). Ethnic matching between therapist and patient in psychotherapy: An overview of findings, together with methodological and conceptual issues. Cultural Diversity and Ethnic Minority Psychology, 11(2), 113.

    Article  PubMed  Google Scholar 

  • Keshet, Y., (2019). Ethnic discordance: Why do some patients prefer to be treated by physicians from other ethnic groups? Social Sciences Medicine, 235, 112358. https://doi.org/10.1016/j.socscimed.2019.112358

  • Kugelmass, H. (2016). Sorry, I’m not accepting new patients” - an audit study of access to mental health care. Journal of Health and Social Behavior, 57(2), 168–183.

    Article  PubMed  Google Scholar 

  • Lavie, E., Elran, M., Shahbari, I., Sawaed, K., & Essa, J. (2021). INSS Insight No. 14, May 3, 2021 Jewish-Arab Relations in Israel, April-May.

  • Mack, P. (2004). Utilitarian ethics in healthcare. International Journal of the Computer the Internet and Management, 12(3), 63–72.

    Google Scholar 

  • Maina, I. W., Belton, T. D., Ginzberg, S., Singh, A., & Johnson, T. J. (2018). A decade of studying implicit racial/ethnic bias in healthcare providers using the implicit association test. Social Science & Medicine, 199, 219–229.

    Article  Google Scholar 

  • Mangione, L., Borden, K. A., Nadkarni, L., Evarts, K., & Hyde, K. (2018). Mentoring in clinical psychology programs: Broadening and deepening. Training and Education in Professional Psychology, 12(1), 4–13. https://doi.org/10.1037/tep0000167.

    Article  Google Scholar 

  • Maramba, G. G., & Nagayama Hall, G. C. (2002). Meta-analyses of ethnic match as a predictor of dropout, utilization, and level of functioning. Cultural Diversity and Ethnic Minority Psychology, 8(3), 290.

    Article  PubMed  Google Scholar 

  • McIlvried, E. J., Wall, J. R., Kohout, J., Keys, S., & Goreczny, A. (2010). Graduate training in clinical psychology: Student perspectives on selecting a program. Training and Education in Professional Psychology, 4(2), 105.

    Article  Google Scholar 

  • Mella, A. J. (2021). An integrative literature review on selecting patient assignments for undergraduate nursing students in the clinical setting. Nurse Education Today, 107, 105103.

    Article  PubMed  Google Scholar 

  • Mill, J. S. (1879). Utilitarianism (pp. 8–17). Longmans, Green and Company.

  • Moletta, L., Pierobon, E., Capovilla, G., Costantini, M., Salvador, R., Merigliano, S., & Valmasoni, M. (2020). International guidelines and recommendations for surgery during Covid-19 pandemic: A systematic review. International Journal of Surgery, 79, 180–188.

    Article  PubMed  Google Scholar 

  • Muran, J. C., & Barber, J. P. (Eds.). (2010). The therapeutic alliance: An evidence-based guide to practice. Guilford Press.

  • Nair, L., & Adetayo, O. A. (2019). Cultural competence and ethnic diversity in healthcare. Plastic and Reconstructive Surgery Global Open, 7(5).

  • Pearson, A., Srivastava, R., Craig, D., Tucker, D., Grinspun, D., Bajnok, I., & Gi, A. A. (2007). Systematic review on embracing cultural diversity for developing and sustaining a healthy work environment in healthcare. International Journal of Evidence-Based Healthcare, 5(1), 54–91.

    PubMed  Google Scholar 

  • Reiser, S. J. (2003). What modern physicians can learn from Hippocrates. Cancer: Interdisciplinary International Journal of the American Cancer Society, 98(8), 1555–1558.

    Article  Google Scholar 

  • Sayette, M. A., & Mayne, T. J. (1990). Survey of current clinical and research trends in clinical psychology. American Psychologist, 45(11), 1263.

    Article  CAS  PubMed  Google Scholar 

  • Shirazi, M., Ponzer, S., Zarghi, N., Keshmiri, F., Motlagh, M. K., Zavareh, D. K., & Khankeh, H. R. (2020). Inter-cultural and cross-cultural communication through physicians’ lens: Perceptions and experiences. International Journal of Medical Education, 11, 158.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sue, D. W. (2001). Multidimensional facets of cultural competence. The Counseling Psychologist, 29(6), 790–821.

  • Sue, D. W., Bernier, J. E., Durran, A., Feinberg, L., Pedersen, P., Smith, E. J., & Vasquez- Nuttall, E. (1982). Position paper: Cross-cultural counseling competencies. The Counseling Psychologist, 10, 45–52.

    Article  Google Scholar 

  • Traub, S. J., Stewart, C. F., Didehban, R., Bartley, A. C., Saghafian, S., Smith, V. D., & Lipinski, C. A. (2016). Emergency department rotational patient assignment. Annals of Emergency Medicine, 67(2), 206–215.

    Article  PubMed  Google Scholar 

  • Vasquez, M. J. (2007). Cultural difference and the therapeutic alliance: An evidence-based analysis. American Psychologist, 62(8), 878.

    Article  Google Scholar 

  • Virupaksha, H. G., Kumar, A., & Nirmala, B. P. (2014). Migration and mental health: An interface. Journal of Natural Science Biology and Medicine, 5(2), 233.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Zane, N., & Ku, H. (2014). Effects of ethnic match, gender match, acculturation, cultural identity, and face concern on self-disclosure in counseling for Asian Americans. Asian American Journal of Psychology, 5(1), 66–74.

    Article  Google Scholar 

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Correspondence to Stuart B. Kamenetsky.

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Kamenetsky, S.B., Chen, V. & Heled, E. Matching patients with therapists in culturally diverse rehabilitation services during civil unrest. Int J Health Econ Manag. (2023). https://doi.org/10.1007/s10754-023-09359-8

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