Transcript Multicultural Perspectives and Diversity Issues

Multicultural Perspectives and
Diversity Issues
Chapter Four
How do you define multicultural?
The Need for a Multicultural
Emphasis
• Traditional therapy-western development.
• We are working in an increasingly diverse society.
• All counseling can be thought of as multicultural
if culture is broadly defined to include not only
race, ethnicity, and nationality, but also gender,
age, social class, sexual orientation, and disability
(Das, 1995).
Multicultural Terminology
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Multiculturalism
Cultural Diversity
Multicultural Counseling
Diversity
Diversity-Sensitive
Counseling
• Culture-Centered
Counseling
• Ethnicity
• Ethnic Minority Group
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Cultural Empathy
Stereotypes
Racism
Unintentional Racism
Cultural Racism
Cultural Tunnel Vision
Culturally
Encapsulated
Multicultural Terminology
• Ethnicity: a sense of identity that stems
from common ancestry, history, nationality,
religion, and race.
• Ethnic Minority Group: a group of people
who have been singled out for differential
and unequal treatment and who regard
themselves as objects of collective
discrimination.
Multicultural Terminology
continued
• Multiculturalism: a generic term that
indicates any relationship between and
within two or more diverse groups.
• Cultural diversity: the spectrum of
differences that exists among groups of
people with definable and unique cultural
backgrounds.
Multicultural Terminology
continued
• Multicultural counseling: a helping role and
process that uses approaches and defines goals
consistent with the life experiences and cultural
values of clients, balancing the importance of
individualism versus collectivism in assessment,
diagnosis, and treatment.
• Diversity: individual differences such as age,
gender, sexual orientation, religion, and physical
ability or disability.
Multicultural Terminology
continued
• Diversity-sensitive counseling: a concept that
includes age, culture, disability, education level,
ethnicity, gender, language, physique, race,
religion, residential location, sexual orientation,
socioeconomic situation, and trauma.
• Cultural empathy: therapists’ awareness of
clients’ worldviews, which are acknowledged in
relation to therapists’ awareness of their own
personal biases.
Multicultural Terminology
continued
• Culture-centered counseling: a threestage developmental sequence, from
multicultural awareness to knowledge and
comprehension to skills and applications.
• Stereotypes: oversimplified and uncritical
generalizations about individuals who are
identified as belonging to a specific group.
Multicultural Terminology
continued
• Racism: any pattern of behavior that, solely
because of race or culture, denies access to
opportunities or privileges to members of one
racial or cultural group while perpetuating access
to opportunities and privileges to members of
another racial or cultural group.
• Unintentional racism: racism that is subtle,
indirect, and outside our conscious awareness.
Multicultural Terminology
continued
• Cultural racism: the belief that one
group’s history, way of life, religion, values,
and traditions are superior to others.
The Problem of Cultural Tunnel
Vision
• Many new students in training ONLY know
their own culture.
• Cultural tunnel vision: a perception of
reality based on a very limited set of
cultural experiences.
• Students may misinterpret a healthy
response by the client to the helper’s
cultural/theoretical bias as “resistance.”
Characteristics of the “Culturally
Encapsulated” Counselor
• Defines reality according to one set of cultural
assumptions.
• Shows insensitivity to cultural variations.
• Accepts assumptions without proof for fear of
disproving his/her own assumptions.
• Fails to evaluate other viewpoints and makes little
attempt to accommodate others’ behavior.
• Is trapped in one way of thinking that resists
adaptation and rejects alternatives.
– (Wrenn, 1962 & 1985)
Learning to Address “Cultural
Pluralism”
• Cultural pluralism: a perspective that recognizes
the complexity of cultures and values the diversity
of beliefs and values.
– Learning about your own culture helps you acquire
multicultural competence.
– Self-exploration makes learning about race, cultures,
and experiences of clients a manageable process.
– “Pluralistic” is cited twice in Tennessee Chapter 450
under Rule 450-1-.01(29) & 450-1-.02(2d) relating to
the practice of a professional counselor or professional
counselor as a mental health service provider
Reaching Diverse Client
Populations
• Identify resources in the client’s family and the
larger community and use them in delivering
culturally sensitive services.
• Due to psychology being based on Western
assumptions, the influence and impact of racial
and cultural socialization has not always been
considered.
• Minority clients are underrepresented in mental
health, and many stop coming after 1 or 2
sessions.
Reaching Diverse Client
Populations cont.
• The medical model of clinical counseling.
• Culturally encapsulated counselors may
assume that a lack of assertiveness is a sign
of dysfunctional behavior that should be
changed.
Ethics Codes from a Diversity
Perspective
• Therapists should try to uncover and respect
cultural and experiential differences.
• Counselors are expected to become aware
of their own attitudes and biases that can
interfere with cultural competence.
• Counselors are prohibited from
discriminating.
Cultural Values & Assumptions
in Therapy
• Sue & Sue (2003) feel counselors need to include
support systems such as family, friends,
community, self-help programs, and occupational
networks in their perception of mental health
practices.
• The diversity-sensitive counseling movement
focuses attention on the problems of
discrimination, oppression, and racism.
– Some believe this movement lacks moderation and tries
to force its agenda on counseling practice.
Western vs. Eastern Values
• Contemporary theories of therapy are grounded in
Western assumptions, yet most view the world
differently.
• Has there been too great of a focus on
individualism and not enough on broader social
contexts?
• There is a growing belief that religion and
spirituality need to be included in counseling
practice.
Non-Western Values
• Confucian:
• The middle way
– Balance
• An ideal relationship
between human beings
• Reciprocity
– The other person’s reaction
• Sincerity-congruent with
one’s actions
• Tao-the path or way:
• Harmony of opposites
& relativity
• Simplicity
• Reversal & Cyclicity
• Nonaction
– being natural
Non-Western Values
• Hindu-Character of the
person over action:
• Dharma–
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Restraint of anger
Truthfulness of speech
An agreeable nature
Forgiveness
Purity of conduct
Avoidance of conflict
• Ahimsa– Noninjury & nonviolent
action
• Islamic-5 Major Classes
of Ethics or Acts:
• Forbidden
• Undesirable
– Can be avoided
• Neutral
• Desirable-not obligatory
• Good or desirable
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Justice
Benefit
Truthfulness
Willing good (intentions)
Challenging Professionals’
Stereotypical Beliefs
• “Lack of motivation”
• “Talk therapy”
• Practitioners who counsel clients without an
awareness of their own stereotypical beliefs
can easily cause harm to their clients.
Assumptions about SelfDisclosure
• “Self-disclosure is essential for the therapeutic
process to work”.
– Sharing personal problems in some cultures reflects
poorly on one’s family.
• In many cultures dance, circumlocutions, and
rituals may precede intimate disclosures.
• If your techniques are not working with a client,
you must learn other ways of connecting with this
client.
Assumptions about Assertiveness
• It is better to be assertive than to be
nonassertive.
• Asian Americans are often viewed as
nonassertive and passive, but this
assumption has not been supported by
research according to Sue & Sue (1985).
Assumptions: Self-Actualization
& Trusting Relationships
• Many assume that it is important for the client to
become a fully functioning person.
– Counselors may focus on what they feel is best for the
client and forget to think about how this might impact
others in the life of the client.
• Many middle class Americans readily talk about
their personal lives.
• Many Asian Americans, Hispanics, and Native
Americans have been brought up not to speak until
spoken to, especially elders or authority figures.
Assumptions about Nonverbal
Behavior
• Americans tend to feel uncomfortable with silence
and tend to talk to ease their tension.
• Silence may be a sign of respect and politeness in
some cultures.
• Direct eye contact, physical gestures, and probing
personal questions may be seen as offensively
intrusive by clients from another culture.
– Among some Native American and Hispanic groups,
eye contact by the young is a sign of disrespect.
Assumptions about Directness &
Respect
• Western approaches tend to stress directness
– Other cultures directness is perceived as a sign
of rudeness.
• Some cultures prefer to deal with problems
indirectly.
• Deference as a sign of respect in other
cultures outside America.
Addressing Sexual Orientation
• In 1973, the American Psychiatric Association
stopped labeling homosexuality as a form of
mental illness.
• In 1975, the mental health system began to treat
the problems of people who are GLBT rather than
treating them as a problem.
• Mental health professionals who have negative
reactions to homosexuality are likely to impose
their own values and attitudes, or convey
disapproval.
Addressing Sexual Orientation
continued
• Serious damage to a client can occur when a
client discloses their sexual orientation well
into an established therapeutic relationship.
• The APA developed a committee on lesbian,
gay, and bisexual concerns and they
developed guidelines for psychotherapy (pp.
128-9).
– The guidelines are relevant to all mental health
professionals, not just to psychologists.
Value Issues of Gay and Lesbian
Clients
• Concealing sexual orientation or “coming
out.”
• Loss of friends.
• Clinicians who work with gay men need to
be able to talk with their clients about “safesex” practices.
Educating Counselors about the
Concerns of Clients
• Before therapists provide mental health
services to people who are GLBT or their
children, they should complete formal,
systematic training on sexual diversity.
• A study to assess psychologists’ attitudes
toward parenting found that they held
affirming attitudes toward parents who are
gay or lesbian.
Educating Counselors about
Concerns of Clients continued…
• Practitioners post-graduate training topics:
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Coming out
Family estrangement
Support system development
Internalized homophobia
Court Case about a Therapist’s
Refusal to Counsel Gay Clients
• Ms. Bruff was fired by her employer for her
refusal to “counsel anyone on any subject that
went against her religion”.
• She was offered several other job opportunities
within the agency and she turned them down.
• The courts eventually found that she was not
improperly dismissed and that the company made
reasonable attempts to accommodate her religious
beliefs.
The “Bruff” Case continued
• In a counseling relationship, it is not the
client’s place to adjust to the therapist’s
values.
The “Bruff” Case continued
• What is your position?
• Our authors felt that Bruff should have
informed her potential clients in writing
about her religious convictions and moral
opposition pertaining to homosexuality.
– They also question whether she should have
had a position in a public counseling agency
given her inexperience and ineffectiveness
working with diverse client populations.
Matching Client & Counselor
• C.H. Patterson (1996) states that ALL
counseling is multicultural.
– According to him, all clients belong to multiple
groups that influence their perceptions, belief,
attitudes, and behavior.
– This belief allows room for clinicians to
effectively work with clients who differ from
themselves in a number of significant ways.
Matching Client & Counselor
continued
• Counselors become too analytical about
what they say and do when they are overly
self-conscious about their ability to work
with diverse client populations.
• The more differences between the client and
the therapist, the stronger the need to
collaboratively find meaning and
understanding.
Matching Client & Counselor
continued
• If there are differences between the client
and the therapist, should the clinician or the
client address this?
– Most clients will not initiate this conversation
due to the power differential between them and
the therapist.
– Therefore, the therapist should directly address
these differences.
Matching Client & Counselor
continued
• Corey, et. al., (2007) express that the counseling
process is ever-changing, that clinicians must stay
with the client and be led by the client into the
most important areas for him or her.
• Monitor your internal dialogue and use it as part
of the therapy process rather than to strive to
discover the ideal match.
• The most important aspects of culture-centered
counseling can be learned, but not necessarily
taught.
Matching Client & Counselor
continued
• Pay attention to the voices within you and
within your clients.
• You only hear the spoken content if your
approach is rigid and concrete.
• Unintentional racism can be more
dangerous than those who are more open
with their prejudices.
Signs of a culturally ineffective
counselor
• Being afraid to face the differences between
you and your clients.
• Refusing to accept the reality of these
differences.
• Perceiving the differences as problematic.
• Feeling uncomfortable working out these
differences.
How to Learn to Work with
Clients that Differ from Us
• Be trained in multicultural perspectives, both
academic and experiential.
• Agree with the client to develop a working
therapeutic relationship.
• Be flexible in applying theories and techniques to
specific situations.
• Be open to being challenged and tested.
• Be aware of your own value systems, of potential
stereotyping and any traces of prejudice, and of
your cultural countertransference.
Multicultural Training for Mental
Health Workers
• Referral should not be viewed as a solution
to the problem of inadequately trained
helpers.
• You may not have the luxury of referral.
• CACREP standards call for supervised
practicum experiences that include people
from the environments in which the trainee
is preparing to work.
Characteristics of the Culturally
Skilled Counselor
• Understands their attitudes and beliefs about
race, culture, ethnicity, gender, and sexual
orientation.
• Understands his or her own worldview.
• Develops skills, intervention techniques,
and strategies necessary to serve diverse
client groups.
Characteristics of the Culturally
Skilled Counselor continued
• La Roche & Maxie (2003) believe that acquiring
cultural competence is an active and lifelong
learning process, rather than a fixed state that is
arrived at.
• Multicultural competencies: a set of knowledge
and skills that are essential to the culturally skilled
practitioner.
• You can find the essential attributes of culturally
competent counselors on pp. 143-144 in our text.
Hermeneutic (Interpretation)
Model of EDM
• An ethical dilemma
• The counselor’s, supervisor’s, & client’s
– values, race, ethnicity, gender, personal history, etc.
• Agency policies
• Geographic region & culture
•
Local, state, & federal laws
• Professional codes of ethics
• Professional knowledge
• Ethical theories
– (Houser, Wilcezenski, & Ham, 2006)