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This article provides commentary on a spatial meta-analysis published by Price and colleagues (2021); it provides valuable preliminary evidence that a dimension of cultural sexism can countervail efforts for psychotherapy to succeed in samples that focus on girls aged four to 18. Our own study reveals cultural sexism to be markedly associated with at least three macro-level factors: cultural tightness, historical slaveholding (and by implication racism), and sex education inclusiveness. The fact that cultural sexism can be so well predicted by these factors is additional evidence that cultural sexism is real, yet it also suggests caution in interpreting these effects as merely reflecting cultural sexism. Surely, the reality is more complex. Thus, we believe that understanding effects of interventions at the macro level requires a more extensive model, one that incorporates objective measures of sexism beyond markers such as income, income inequality, poverty, and education, and meaningfully theorizes about how such dimensions might interact. For example, sexism is logically more pernicious to the extent that a culture is tight; nation-level changes such as same-sex marriage would seem to have considerable potential to improve mental health for affected individuals; finally, media avenues also are a potentially extremely powerful force as these easily cross artificial spatial boundaries. Our findings further suggest that understanding the structural policy components of cultural sexism, of which this essay is merely a beginning, could inform future interventions to improve the psychological health outcomes for adolescent girls. Along these lines, the same meta-analytic framework could be used to assess the success of psychotherapy interventions not only for girls but also boys and others, especially those at the intersection of stigmatized identities (e.g., sexual minorities of color). The results from such models promise to point the way to improved therapies. As a final note, consider again that all of the factors we have discussed here are correlational. The very factors that appear to undercut therapeutic success may be the factors that make individuals more susceptible to mental health problems in the first place. Individuals have needs left wanting or even worsened by the local cultures that envelope them, a prediction that at least one ecological model makes. Thus, interventions might succeed in the sense that a young person comes to develop self-worth and perhaps even to experience lower anxiety levels. An intervention might thus succeed in the very short term—because needs are so deep—yet fail in the long run because surrounding networks are so strongly countervailing.
Johnson, Blair T. and Curley, Christine M., "Divining Structural Factors Related to Intervention Success or Failure: Cultural Sexism versus Other Macro-Level Factors" (2021). CHIP Documents. 38.
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