Abstract

Psychologists often encounter clients from varied language and cultural backgrounds, which can pose challenges to the process of helping. The case of "Mary," an unmarried, 24-year-old Chinese international student in the U.S., embodies these dynamics and offers insights into how culture and language shape, and are shaped by, the therapy alliance, process, and outcome in bilingual therapy. Mary was seen in individual therapy that combined a multicultural, relational psychodynamic, humanistic, client-centered, and solution-focused approach by one of the authors  (Y.X.) for 10 sessions (over a 14-week period, with four cancellations); and the therapy was supervised by the other author (J.N.F.). Mary’s presenting problems included challenges in adjusting to her new environment, including a decline in self-confidence and difficulties in her social life, which led to significant anxiety in her daily life. To enhance understanding of the course of therapy, we employed an adapted version of the Critical Incidents Technique (CIT) to analyze significant moments in Mary’s 10 sessions. We focus on the role of language use in bilingual therapy, exploring its functionality as both (a) a buffer against the intense impact of emotional and traumatic experiences, and (b) as a bridge that can foster deeper psychological engagement. We highlight the mechanisms by which the therapist, with supervision, attempted to provide Mary with a meaningful and helpful psychotherapeutic experience. The core theme in our analysis of the case includes the ways that Mary uses her primary (Mandarin) and secondary (English) languages to avoid, and then access, hurtful and traumatic experiences.

Continuing Education Information

2 CE Credits, Instructional Level: Intermediate

2 Contact Hours (New York Board of Psychology)

Learning Objectives:

1. Explain how language choice can function as a bridge in bilingual therapy.
2. Identify components of the adapted version of the Critical Incidents Technique (CIT) employed in Mary's sessions.
3. Analyze core themes and the implementation of bilingual therapy in Mary's case study.

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CE Disclaimers

The National Register of Health Service Psychologists is approved by the American Psychological Association to sponsor continuing education for psychologists. The National Register maintains responsibility for this program and its content.

The National Register of Health Service Psychologists is recognized by the New York State Education Department’s State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0010

Abstract

Outcomes following spine surgery vary widely, and a substantial proportion of patients continue to experience persistent postoperative pain, functional limitations, and reduced quality of life following surgical intervention. Psychological factors—including depression, pain catastrophizing, and baseline disability—are among the most consistent predictors of poorer postoperative outcomes and persistent spinal pain syndrome following surgery. Despite growing evidence supporting psychosocial risk assessment, systematic psychological screening remains inconsistently implemented across many spine programs. This article presents a practical psychological risk stratification framework integrating three brief and widely validated instruments: the Pain Catastrophizing Scale (PCS), the Patient Health Questionnaire-9 (PHQ-9), and the Oswestry Disability Index (ODI). Together, these measures assess cognitive, emotional, and functional domains associated with surgical outcomes. The article reviews current evidence regarding psychosocial predictors of postoperative outcomes, outlines clinically informed risk thresholds, and describes behavioral health intervention pathways for low-, moderate-, and high-risk patients. Multidisciplinary implementation strategies, psychological treatment approaches, and mental health equity considerations relevant to integrated spine care are also discussed. Integrating psychosocial screening into multidisciplinary spine surgery pathways may improve patient preparation, guide behavioral health referrals, enhance postoperative rehabilitation engagement, and support more individualized perioperative care.

Continuing Education Information

1 CE Credit, Instructional Level: Intermediate

1 Contact Hour (New York Board of Psychology)

Disclosures: Author has no conflicts of interest to disclose. Generative AI was not used for the development or content.

Learning Objectives:

1. Describe the roles of the Pain Catastrophizing Scale (PCS), Patient Health Questionnaire-9 (PHQ-9), and Oswestry Disability Index (ODI) in the preoperative assessment of patients undergoing spine surgery.
2. Utilize psychological risk stratification to recognize appropiate multidisciplinary interteventions.
3. Explain the purpose of risk stratification before spine surgery.

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CE Disclaimers

The National Register of Health Service Psychologists is approved by the American Psychological Association to sponsor continuing education for psychologists. The National Register maintains responsibility for this program and its content.

The National Register of Health Service Psychologists is recognized by the New York State Education Department’s State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0010

You have not yet registered for this course. Register today and access this course any time under "My Courses/Registrations"

Abstract

Chronic pain is highly prevalent among older adults and contributes to disability, psychological distress, social isolation, and increased healthcare utilization. Older adults remain vulnerable to underassessment and undertreatment due to diagnostic complexity, comorbidity burden, polypharmacy, and limited access to behavioral health services. This article provides an applied overview of evidence-based assessment and intervention strategies for chronic pain among older adults within health service psychology settings. Using a clinical vignette to frame common presentation patterns, key diagnostic considerations and best practices in biopsychosocial pain assessment are reviewed, alongside integrated behavioral interventions such as CBT for chronic pain, ACT, mindfulness-based approaches, behavioral activation, and graded activity pacing. Clinical and ethical challenges—including autonomy/beneficence balance, opioid-related risk, and access inequities—are discussed. Practical recommendations for interdisciplinary collaboration and outcome monitoring are offered to support functional restoration and quality of life in later adulthood.

Continuing Education Information

1 CE Credit, Instructional Level: Intermediate

1 Contact Hour (New York Board of Psychology)

Disclosures: Author has no conflicts of interest to disclose. Generative AI was not used for the development or content.

Learning Objectives:

1. Identify factors related to chronic pain among older adults
2. Explain how developmental age impacts vulnerability to underassessment and undertreatment
3. Apply diagnostic considerations, best practices in biopsychosocial pain assessment, and integrated behavioral interventions to older adults with chronic pain

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CE Disclaimers

The National Register of Health Service Psychologists is approved by the American Psychological Association to sponsor continuing education for psychologists. The National Register maintains responsibility for this program and its content.

The National Register of Health Service Psychologists is recognized by the New York State Education Department’s State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0010

You have not yet registered for this course. Register today and access this course any time under "My Courses/Registrations"

Abstract

Adolescents experiencing mental health concerns often encounter barriers to engagement and access, including language differences, stigma, and system fragmentation. This article presents a clinical model for addressing these challenges through a multilevel ecological approach that integrates assessment, relational engagement, family involvement, and system coordination. A clinical vignette illustrates how developmentally responsive strategies, including the structured inclusion of supervised non-clinical providers, can enhance engagement and extend service capacity. Emphasis is placed on culturally and linguistically appropriate care, particularly for families navigating barriers to access. Practice considerations highlight the importance of integrating clinical services with workforce and community-based supports to improve continuity of care and reduce disparities in youth mental health outcomes.

Continuing Education Information

1 CE Credit, Instructional Level: Intermediate

1 Contact Hour (New York Board of Psychology)

Disclosures: Author has no conflicts of interest to disclose. Generative AI was not used for the development or content.

Learning Objectives:

1. Identify relevant barriers to mental health access for adolescents
2. Describe the importance of culturally and linguistically appropriate care for families navigating access barriers
3. Apply strategies to integrate clinical service with community-based supports

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CE Disclaimers

The National Register of Health Service Psychologists is approved by the American Psychological Association to sponsor continuing education for psychologists. The National Register maintains responsibility for this program and its content.

The National Register of Health Service Psychologists is recognized by the New York State Education Department’s State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0010

You have not yet registered for this course. Register today and access this course any time under "My Courses/Registrations"

Abstract

Neuropsychological assessment plays a critical role in contemporary healthcare by integrating objective test performance, psychiatric factors, and functional outcomes into a unified clinical formulation. This function is especially vital in rural settings, where limited specialty access, fragmented referral pathways, and diagnostic delays are common. Using a clinical vignette of a 67-year-old rural patient with suspected neurodegenerative decline, this paper highlights complexities such as mixed medical and psychiatric contributors, performance validity concerns, caregiver burden, and restricted follow-up care. We outline how structured case formulation, diathesis–stress conceptualization, culturally responsive communication, and interdisciplinary collaboration can reduce diagnostic ambiguity while avoiding premature etiological conclusions. Emphasis is placed on assessment as an intervention in resource-limited systems, where neuropsychological evaluation can serve as a central organizing point, translating complex clinical data into actionable recommendations for patients, families, and providers.

Continuing Education Information

1 CE Credit, Instructional Level: Intermediate

1 Contact Hour (New York Board of Psychology)

Disclosures: Authors have no conflicts of interest to disclose. Generative AI was not used for the development or content.

Learning Objectives:

1. Identify structural barrers in rural settings.
2. Describe ethical considerations during psychological testing and interventions.
3. Explain the purpose of neuropsychological reports in rural healthcare systems.

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CE Disclaimers

The National Register of Health Service Psychologists is approved by the American Psychological Association to sponsor continuing education for psychologists. The National Register maintains responsibility for this program and its content.

The National Register of Health Service Psychologists is recognized by the New York State Education Department’s State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0010

You have not yet registered for this course. Register today and access this course any time under "My Courses/Registrations"