Research
Future Projects
Supervised Therapists as Real Therapists: A non-inferiority randomized clinical trial comparing the effectiveness of therapy offered by resettled refugees and therapy offered by licensed clinicians
I am in the process of writing a grant which will compare treatment outcomes between resettled refugees receiving mental health services from licensed clinical therapists and recently-trained supervised therapists without advanced degrees. Supervised therapists have shown long-standing effectiveness in treating mental health symptoms, and offer a potential solution to the treatment gap in psychology.
Sexual Violence Measurement in Refugee Women: A dissertation measurement validation
Refugee and other forcibly displaced women experience high rates of sexual violence, with multiple negative mental and physical health consequences. However, many of these women do not report their experiences and often do not receive the health care and support they need to heal. This community-based participatory research project collaborates with women from Afghanistan, Latin America, the Great Lakes region of Africa, Iraq, and Syria to develop and validate a culturally appropriate measure of sexual violence exposure to facilitate in future work our understanding, prevention, and treatment of sexual violence and its effects on women’s mental health.
Published Projects
Predictors of mental health outcomes of three refugee groups in an advocacy-based intervention: A precision medicine perspective
For refugees exposed to violence, culture may be a crucial factor in predicting treatment outcomes. A multi-level generalized linear mode found an advocacy-based intervention reduced symptoms of distress for Afghan and Great Lakes African refugees, but not Iraqi and Syrian refugees, highlighting varying mental health needs. Further, different predictors of mental health outcomes were important to each group, suggesting a heterogeneous path to symptom remission, however, these predictors did not moderate treatment effectiveness, suggesting active treatment ingredients may not be what we expect.
Persistence of the association between mental health and resource access: A longitudinal reciprocal model in a diverse refugee sample
Stress associated with resource deprivation is an active social determinant of mental health. A longitudinal reciprocal model was analyzed between resource access and measures of depression, anxiety and PTSD symptoms. Participants included resettled refugees from three geocultural regions. The results showed that resource access and mental health symptoms were not reciprocally related. Although resource deprivation is predictive of mental health symptoms among resettled refugees, the effect may not persist in the long term. Delaying resource access may result in the development of more chronic mental health disorders.
Sustaining psychotherapist effectiveness and independence: An exploratory study with displaced persons in Kurdistan, Iraq.
Local psychotherapists are a promising solution for improving access to mental health services. In this exploratory, community-engaged study, longitudinal data were collected from 28 Arabic-speaking displaced persons seeking mental health services from a locally operated nonprofit in the autonomous Kurdistan Region in northern Iraq. Treatment was provided by local therapists previously trained in evidence-based treatments. Both PTSD scores and depression scores decreased with a large effect. Findings suggest that local psychotherapists may provide a linchpin solution to crises of access in global mental health.
Social Vulnerabilities and Spatial Access to Primary Healthcare through Car and Public Transportation System in the Albuquerque, NM, Metropolitan Area: Assessing Disparities through GIS and Multilevel Modeling
Primary healthcare (PHC) is a keystone component of population health. However, inequities in public transportation access hinder equitable usage of PHC services. A generalized linear mixed-effect model (GLMEM) was constructed to test the effects of sociodemographic and community area correlates on both car and bus transit spatial access to PHC in the Albuquerque, NM metropolitan area. Results indicate a disproportionate burden of low PHC access among disadvantaged population groups who rely heavily on public transportation. These results necessitate targeted interventions to reduce these disparities in access to PHC.
Geocultural variation in correlates of psychological distress among refugees resettled in the United States
This study examined whether the associations between common mental health disorder (CMD) symptoms and predictors of CMDs varied cross-culturally. Participants were refugees from three geocultural regions (Afghanistan, Great Lakes region of Africa, and Iraq and Syria) who recently resettled in the United States. Multilevel generalized linear modeling found CMD symptoms likely present differently across cultures, with various predictors are more salient depending on cultural backgrounds and differential experiences. These findings have implications for cross-cultural assessment research and mental health.