Rural survivors of sexual assault and domestic violence experience considerable difficulties accessing mental health services. Similarly, graduate psychology training programs located in rural locations have historically been limited in their ability to provide trainees with extensive exposure to specific client populations. With the advent of distal technologies-especially secure, encrypted videoconferencing capabilities-it is now possible to connect rural clients with specialized, mental health services provided by university-based training clinics. This article reviews mental health care needs and treatment barriers experienced by rural populations, and describes an innovative solution to begin to address these problems. Specifically, a partnership between a university-based mental health care clinic and 3 rural domestic violence/rape crisis centers is described, and preliminary treatment outcome data are presented. Training benefits reported by graduate student therapists and satisfaction ratings provided by crisis center staff and advocates are also presented and discussed.

Although empirically supported treatments for posttraumatic stress disorder (PTSD) and depression have been available for some time, many Mandarin-speaking Chinese immigrants who seek treatment do not receive such services due to living in rural areas. Fortunately, advances in videoconferencing-based technologies are improving rural trauma survivors' access to remote specialty clinics. Presently, little is known about feasibility and efficacy of psychotherapy provided through distance technologies for clients unable to access local services in their native languages. The present two case studies attempt to partially address this void by providing an account of treatment implemented via videoconferencing with two Mandarin-speaking women from a small Wyoming town. Not only was therapy effective in reducing the severity of PTSD and depressive symptoms for both clients, but treatment gains were also maintained for 4 months following therapy. Connecting and effectively treating two Mandarin-speaking clients using telehealth compellingly demonstrated innovations to expand services and tailor treatments.

Resilience capacity has been found to be associated with individuals’ flexibility and adaptability when dealing with adversity-related stress. Previous research suggested that resilience capacity may play an important role in moderating the relationships between exposure to traumatic events and severity of post-traumatic stress disorder (PTSD) symptoms and cultural factors may be associated with that process. However, adequate research of the mechanisms on how culture may relate to the relationship between resilience and PTSD is still lacking. The present study attempted to explore potential mediators associated with the relationship between culture and resilience capacity among trauma survivors and focused on the potential mediating associations of cultural variables (independent/interdependent self-construal, dialectical thinking, and familism). Levels of culture-related variables among three cultural regions (America, Hong Kong, and Mainland China) were assessed and analyzed. The results of a bootstrapping analysis indicated that independent self-construal and dialectical thinking each significantly mediated the relationship between culture and resilience capacity. Cultural and clinical implications of these findings and suggestions for future research were explored.

Resilience capacity has been associated with individuals’ flexibility and adaptability in responding to potential trauma. Culture-related appraisals influence not only interpretations of etiology of posttraumatic stress disorder (PTSD) and perception of severity of PTSD symptoms but also flexible coping strategies. However, adequate research of the mechanisms on how culture may affect the relationship between resilience and PTSD does not yet exist. The present study focused on whether and how culture (America, Hong Kong, and Mainland China) moderated the relationship between resilience capacity and severity of posttraumatic distress. Data were collected at three research sites (America, Hong Kong, and Mainland China) where 558 trauma survivors were recruited. Measures included the Life Events Checklist ( LEC-5), the PTSD Checklist for DSM-5 ( PCL-5), and the Revised Connor-Davidson Resilience Scale ( CD-RISC-R). The results of one-way analysis of variance (ANOVA) indicated that American participants were more resilient than the participants in Hong Kong and Mainland China. The results of multiple regression indicated that frequency of exposure to trauma was a weaker predictor of severity of PTSD symptoms at high versus low levels of resilience capacity. The results also indicated a weaker moderating effect of Hong Kong versus American culture on the relation between resilience capacity and PTSD. This pilot study highlighted East–West cultural differences in the baselines of resilience capacity and posttraumatic stress and may motivate clinicians and researchers to reevaluate Western diagnostic criteria to psychological trauma conceptualization and treatment for non-Western populations.

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