The challenges observed in health-service-psychology (HSP) training during COVID-19 revealed systemic and philosophical issues that preexisted the pandemic but became more visible during the global health crisis. In a position article written by 23 trainees across different sites and training specializations, we use lessons learned from COVID-19 as a touchstone for a call to action in HSP training. Historically, trainee voices have been conspicuously absent from literature about clinical training. We describe long-standing dilemmas in HSP training that were exacerbated by the pandemic and will continue to require resolution after the pandemic has subsided. We make recommendations for systems-level changes that would advance equity and sustainability in HSP training. This article advances the conversation about HSP training by including the perspective of trainees as essential stakeholders.
Use of alcohol and cannabis together so their effects overlap (simultaneous use) is common among college students and associated with numerous negative consequences. The aim of this study was to gain insight into college students' recent simultaneous use events in order to inform future studies (i.e., generate hypotheses, inform measures/assessments of simultaneous use, and identify factors influencing simultaneous use). Qualitative interviews of simultaneous use experiences among heavy drinking college students (n = 38) were conducted to better understand reasons for simultaneous use, evaluations of simultaneous use events, and patterns of substance use during simultaneous use events. Findings indicated that students' reasons for simultaneous use included traditional four-factor motive types (i.e., social, conformity, enhancement, and coping), cross-fading motives, harm reduction motives (e.g., to drink less), and reactive/situational reasons (e.g., because it was offered/available). There was variability in participants' subjective evaluations of how positive versus negative simultaneous use events were and how this compared to single-substance events. Evaluation of simultaneous use events depended on patterns of use, external and internal context, and consequences experienced. Additionally, patterns of simultaneous use including order of substances, timing of using each substance, and quantities of substances used were highly variable across participants. Notably, participants endorsed patterns of use they perceived to reduce negative consequences during simultaneous use events. Further research on reasons for simultaneous use and patterns of use may help identify simultaneous use occasions that result in greater risk; identification of high-risk simultaneous use occasions and evaluation of these occasions can then help inform targeted interventions.
Public Health Significance StatementThis study highlights variations in reasons for simultaneous alcohol and cannabis use, evaluations for simultaneous use, and patterns of use. Understanding reasons and corresponding patterns of simultaneous use may help to identify risky simultaneous use occasions. Understanding evaluations of these occasions may help to predict future substance use behavior and inform prevention and intervention efforts aimed at reducing simultaneous use and associated harms.
This study examined the associations among heterosexual women (HW) and sexual minority women (SMW; for example, lesbian and bisexual), adolescent and adult sexual victimization experiences, childhood experiences of abuse, coping strategies, and mental health symptoms. Participants were 177 women recruited across the United States via the Internet to complete an online survey. Participants first completed the Sexual Experiences Survey and then described qualitatively their most distressing and/or severe sexual victimization experience. They were asked to include situational (e.g., location, alcohol, and drug use) and interpersonal features (e.g., relationship to perpetrator) of their experience. They then completed self-report questionnaires on childhood sexual abuse, coping with substances, coping through self-blame, social reactions to their assault disclosure, and symptoms of anxiety, depression, and somatization. Nonparametric tests were used to examine associations among the variables. There were no significant differences between SMW and HW in terms of the contextual features (i.e., situational, interpersonal) of their most distressing (i.e., severe) sexual victimization experiences or their postassault experiences. However, results revealed significant associations between sexual minority status and both victimization severity and sexual revictimization, with SMW reporting more severe victimization histories and higher rates of sexual revictimization relative to HW. In addition, there was a significant difference between SMW and HW with respect to coping through substances, with SMW reporting more substance use relative to HW. Future work should endeavor to identify the reasons for these important differences and seek to develop appropriate interventions for SMW who have experienced sexual violence.
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