Building Multicultural Competence

1. Building Multicultural Competence Pamela A. Hays, Ph.D. www.drpamelahays.com

2. Agenda The Personal Work (9am-12pm) -Personal qualities & essential knowledge -Cultural self-assessment Lunch (12-1pm) The Interpersonal Work (1-4pm) -Understanding identities -Building relationships -ADDRESSING Culture in the Classroom

3. The ADDRESSING Framework Cultural InfluencesMinority Groups Age/generational Children, adolescents, elders Developmental disabilities People with developmental disabilities Disabilities acquired People with disabilities acquired later in life Religion & Spirituality Religious minority cultures Ethnic & racial identity Ethnic & racial minority cultures Socioeconomic status People of lower status by educ, income, occup, rural/urban habitat Sexual orientation Gay, lesbian, & bisexual people Indigenous heritage Indigenous/Aboriginal/Native people National origin Refugees, immigrants, international students Gender Women, transgender people

4. Two Categories of Work • Personal • Interpersonal

5. Personal Work a) Personal Qualities b) Essential Knowledge

6. A major obstacle to the development of these Qualities, Abilities & Knowledge is DEFENSIVENESS.

7. Think of a situation with a person in which you began feeling defensive: • What led to your defensive feelings? • What were your physical sensations & emotions? • What were you thinking? • What did you do? What did you say? • What did the other person do & say? • Did you spiral down or were you able to stop the spiral?

8. Preventing Defensive Behaviors • Become aware of physical sensations related to feelings of defensiveness. • In the moment, take a deep breath, exhale slowly, and focus on your breath. • Refrain from defensive behaviors . • Ask yourself: What does this person want? • Try focusing on the content (vs. voice tone, volume, or nonverbal behaviors ).

9. Preventing Defensive Behaviors… 6. Question the need for this person's views to match your own. 7. Reframe irritations & annoyances as opportunities for growth. 8. Recognize your need for additional information and/or experience. 9. If appropriate, discuss the limitations of your knowledge and experience with the person. 10. If appropriate & possible, use humor.

10. Essential Knowledge 1. Bias is best thought of as a tendency to think, act, or feel in a particular way.

11. Essential Knowledge… 2. We’re all biased but we don’t all belong to dominant cultural groups. 3. Bias + Power = Systems of privilege (‘isms).

12. Essential Knowledge… 4. Nonprivileged members are socialized to be aware of the lines separating those who have privilege from those who do not. 5. Privileged members are socialized to ignore these lines & differences. 6. Privilege separates people & cuts both Privileged & Nonprivileged off from valuable knowledge.

13. Cultural Self-Assessment Age/generational-- Developmental disabilities-- Disabilities acquired later in life-- Religion & Spirituality-- Ethnic & racial identity-- Socioeconomic status-- Sexual orientation-- Indigenous heritage-- National origin-- Gender --

14. Values Permeating Psychotherapy • emotional expressiveness • individualism & independence • assertiveness • self-disclosure • verbal skills • insight

15. ADDRESSING Cultural Influences on Ourselves • Name 3 values supported by your family, peers, & culture as you were growing up. Did the dominant culture support these values? • Were these values shaped by any social movements during your teenage & early adult years? • How do these values relate to your current occupation?

16. Resolving Value Conflicts • Look for a shared or similar value. • Recognize differences in expression of a value. • Recognize differences in the priority given to values. • Use positive language to describe these differences.

17. 3 Ways to Fill Knowledge Gaps & Change Bias • Individual work • Critical thinking re: info • Peer-level, close relationships w/ diverse people

18. II. The Interpersonal Work: Understanding Identities • When developing hypotheses, use the ADDRESSING framework as a reminder of identities that may be meaningful for a person.

19. Understanding Identities • Remember that a particular identity may have one meaning in the dominant culture, another in a minority culture, & another person-specific meaning.

20. Questions for Clients a. How would you describe yourself? b. Would you tell me about your cultural heritage or background? c. Did you have a religious upbringing? Do you have a religious connection or spiritual practice now? d. How would you describe your childhood? What was your family’s economic situation growing up?

21. Questions for Clients… e. Do you have experience with disability, or been a caregiver for someone who does? f. Are there ways in which your disability is part of this… [presenting problem]? g. What did it mean to grow up as a girl/boy in your culture and family? h. Do you currently have a partner? Could you tell me about the significant intimate relationships you have had?

22. Understanding Identities 3. Be aware of your own perceived/visible identity re: interactions with clients & students.

23. Understanding Identities: Questions for Oneself a. How am I being perceived by this person, based on my visible identity? b. How might my identities interact with those of this person? c. How might my identities and experiences limit my understanding of this person?

24. Building Relationships 1. Remember respect.

25. Culturally Related Personal Strengths • pride in one’s culture • religious faith or spirituality • artistic and musical abilities • bilingual and multilingual skills • group-specific social skills • sense of humor • culturally-related knowledge and practical skills (e.g., fishing, hunting, farming, medicinal plants) • culture-specific beliefs that help one cope (e.g., with racism, prejudice, discrimination) • respectful attitude towards the natural environment • commitment to helping one’s own group (i.e., through social action) • wisdom from experience

26. Interpersonal Cultural Supports • extended families including non-blood-related • cultural or group-specific networks • religious communities • traditional celebrations and rituals • recreational, playful activities • story-telling activities that make meaning and pass on history of the group • involvement in political/social action group • a child who excels in school

27. Environmental Cultural Supports • altar in home to honor deceased family members • space for prayer and meditation • culture-specific art and music • culturally preferred foods for cooking & eating • animals to care for • gardening area • access to outdoors for subsistence or recreational fishing, hunting, farming, observing night sky • communities that facilitate social interaction by location or design

28. Building Relationships 2. Adapt to the person’s language pace. 3. Do not assume knowledge of an individual’s personal experience, even if you are knowledgeable about their culture. 4. Be prepared for the possibility of multiple relationships.

29. Building Relationships… 5. Be aware of different meanings of nonverbal communication (gestures, eye contact, silence). 6. Recognize cultural differences re: physical space. 7. Do not touch assistive devices without asking.

30. Building Relationships… 8. Consider what your office location, accessibility, and furnishings communicate. 9. Avoid psychological jargon and if the other person uses it, ask about its meaning. 10. Continually use critical thinking re: meanings of verbal & nonverbal communication.

31. ADDRESSING Culture in the Classroom:Four Dimensions Of Teaching & Learning • Instructor • Students • Course content • Teaching methods (Marchesani & Adams, 1992)

32. ADDRESSING Culture:Program Strategies • Course requirements (1 cr3crintegration) • Integrate required readings throughout program • Diversity committee of faculty, staff, students • Use ADDRESSING acronym to comb all written and visual materials for diversity. • Fund guest speakers.

33. Assessing Clients’ Needs 1. Respect cultural norms re: styles of questioning & types of questions. 2. Look for multiple sources of info & think systemically. 3. Use cultural history to understand personal history.

34. Assessing Clients’ Needs 4.Ask about the client’s understanding of the situation, problem, and health care practices. 5. Develop Tx plans, set goals, & choose interventions collaboratively.

35. Assessing Clients’ Needs 6. Consider family systems. a. Define family broadly b. Recognize power differentials

36. Is power distributed by: Age or generational status (including couples with a large age difference)? How does this interact with gender? DD physical or mental abilities? Religious commitment or leadership? Interaction w/ gender? Ethnic or Indigenous heritage (e.g. Who holds the dominant cultural identity in bi- or multicultural couples/families? Are there differences in status related to skin color or other ethnically related characteristics?) Socioeconomic status (i.e. Who makes the money, or holds the highest status by income, education, or occupation?) Sexual orientation (Do LGBT members hold lower status?) National origin (e.g. Who is a citizen or holds a work visa? Who speaks English most fluently)? Gender?

37. Assessing Clients’ Needs 7. When judging unusual perceptions, beliefs or behaviors, recognize cultural differences.

38. Preventing Inaccurate Conclusions 1. How might my judgment be influenced by the ADDRESSING influences on me? 2. Might there be some info I don’t have that is important in understanding the client’s view? 3. Could there be a positive, culturally related purpose for the behavior, belief, or feeling that I judge dysfunctional?

39. Assessing Clients’ Needs 8. Remember: a traumatic experience is culturally influenced and person- specific. 9. Be careful re: the use of diagnoses, especially Personality Disorders. • Actively look for culturally related strengths and supports.

40. Strengths & Supports: Key Questions • What do you consider your strengths & supports? What would your mom/kids/friend say? • Do you have a connection to any religion or spiritual practice?