Innovative training program strategies to promote multicultural competence

1. Innovative training program strategies to promote multicultural competence Richard Scott, Ph.D., University of MemphisKimberly Hays, Ph.D., Illinois State University

2. BELIEFS AND ATTITUDES KNOWLEDGE SKILLS

3. KNOWLEDGE • Building a more sophisticated understanding of others • Gaining information about specific groups (systems, traditions, psychosocial norms, sociopolitical history) • Racial identity development • Understanding limitations (knowing what you don’t know) • Learning without stereotyping

4. SKILLS • Providing culturally sensitive clinical services • Research literature on providing effective treatment to particular populations • Adapting interventions to be culturally sensitive • Identifying and intervening when a microaggression occurs • Using supervision to enchance interventions

5. BELIEFS AND ATTITUDES • Personal beliefs and attitudes towards others who may be perceived as different • Development requires introspection and self-awareness as well as an awareness of systemic issues (i.e., privilege) • May be more difficult to develop compared to knowledge/skills

6. Competency Benchmark (Fouad et al., 2009)Self as shaped by individual and cultural diversity

7. Competency Benchmark (Fouad et al., 2009)Others as shaped by individual/cultural diversity

8. Competency Benchmark (Fouad et al., 2009)Interaction of Self/Others, individual/cultural diversity

9. Competency Benchmark (Fouad et al., 2009)Applications based on individual/cultural context

10. Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists- APA 2002 • Guideline #1: Psychologists are encouraged to recognize that, as cultural beings, they may hold attitudes and beliefs that can detrimentally influence their perceptions of and interactions with individuals who are ethnically and racially different from themselves. • Guideline #2: Psychologists are encouraged to recognize the importance of multicultural sensitivity/responsiveness, knowledge, and understanding about ethnically and racially different individuals

11. Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists- APA 2002 • Guideline #3: As educators, psychologists are encouraged to employ the constructs of multiculturalism and diversity in psychological education. • Guideline #4: Culturally sensitive psychological researchers are encouraged to recognize the importance of conducting culture–centered and ethical psychological research among persons from ethnic, linguistic, and racial minority backgrounds.

12. Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists- APA 2002 • Guideline #5: Psychologists strive to apply culturally–appropriate skills in clinical and other applied psychological practices. • Guideline #6: Psychologists are encouraged to use organizational change processes to support culturally informed organizational (policy) development and practices.

13. Guidelines and Principles of Accreditation 2009 (G&P) To be replaced at some point with the Standards of Accreditation (AoP)

14. Domain A: Eligibility • 5. The program engages in actions that indicate respect for and understanding of cultural and individual diversity. This is is reflected in the program’s policies for the recruitment, retention, and development of staff and interns, and in didactic and experiential training that fosters an understanding of cultural and individual diversity as it relates to professional practice. The program has nondiscriminatory policies and operating conditions, and it avoids any actions that would restrict program access or completion on grounds that are irrelevant to success in graduate training or the profession.

15. Domain B: Curriculum • In achieving it’s objectives, the program requires that all interns demonstrate an intermediate to advanced level of professional psychological skills, abilities, proficiencies, competencies, and knowledge in the areas of, • A) theories and methods of assessment and diagnosis and effective intervention • B) theories and or methods of consultation, evaluation and supervision • C) Strategies of scholarly inquiry and • (d) Issues of cultural and individual diversity that are • relevant to all of the above;

16. Domain D: Cultural and Individual Differences and Diversity The program recognizes the importance of cultural and individual differences and diversity in the training of psychologists.. • 1. The program has made systematic, coherent, and long-term efforts to attract and retain interns and staff from differing ethnic, racial, and personal backgrounds into the program. Consistent with such efforts, it acts to ensure a supportive and encouraging learning environment appropriate for the training of diverse individuals and the provision of training opportunities for a broad spectrum of individuals. Further, the program avoids any actions that would restrict program access on grounds that are irrelevant to success in graduate training.

17. Domain D: Cultural and Individual Differences and Diversity continued: • 2. The program has and implements a thoughtful and coherent plan to provide students with relevant knowledge and experiences about the role of cultural and individual diversity in psychological phenomena and professional practice. It engages in positive efforts designed to ensure that interns will have opportunities to learn about cultural and individual diversity as they relate to the practice of psychology. The avenues by which these goals are achieved are to be developed by the program.

18. Domain E: Intern Staff Relations: • The program shows respect for cultural and individual diversity among their interns by treating them in accord with the principles contained in Domain A, Section 5 of this document.

19. The Standards of Accreditation in Health Service Psychology SoA (2013) What has changed for internships….. • Place competencies and their assessment together in the SoA (Standard II). • Replace “model” with program aims and a set of profession-wide competencies (Standard II.B). A set of profession-wide competencies was derived through a multi-step process that identified points of consensus across the various sets of competencies in the literature. • Required profession-wide competency areas included in SoA: • Evidence-based practice in intervention. • Evidence-based practice in assessment. • Ethical and legal standards. • Individual and cultural diversity. • Research. • Professional values and attitudes. • Communication and interpersonal skills. • Consultation/interprofessional/interdisciplinary. • Supervision. • Reflective practice.

20. The Standards of Accreditation in Health Service Psychology SoA (2013) Competency Definition from SoA: Individual and cultural diversity: Demonstrates appropriate knowledge, skills and attitudes about cultural and individual differences in all professional roles

21. The Standards of Accreditation in Health Service Psychology SoA (2013) What has changed for internships….. Require programs to engage in review of their diversity practices for Students and Faculty

22. Professional Psychology in health care services: A Blueprint for Education and Training (2013) Competency: Professionalism Individual and Cultural Diversity Exhibit awareness, sensitivity, and skills to work professionally with diverse individuals, groups, and communities that represent various cultural and personal backgrounds and characteristics defined broadly and consistent with relevant APA practice guidelines. Be knowledegable about the literature on diversity factors and health disparities and apply that knowledge to practice Exhibit awareness, sensitivity, and skills to work with diverse individuals across the health professions

23. Guidelines for Competency-based Clinical Supervision in Health Service Psychology Education and Training Programs. • Supervisors strive to develop and maintain self-awareness regarding their diversity competence, which includes attitudes, knowledge, and skills. • Supervisors planfully strive to enhance their diversity competence to establish a respectful supervisory relationship and to facilitate the diversity competence of their supervisees. • To maintain their own diversity competence, supervisors should pursue ongoing training in this area as part of their professional development and as an element of life-long learning.

24. Barriers • Color-blindness (denying, distorting, and minimizing the existence of race and racism) • White Privilege (invisible package of unearned assets that one can count on cashing in each day) • Guilt (emotional reaction to the pervasiveness of racism, sexism, etc. which can create discomfort, shame, resistance)

25. Barriers • Facilitating a safe environment is necessary to reduce anxiety and improve authentic engagement (Sue et al., 2009) • Social Desirability • Fear of judgment (being perceived as racist, lacking knowledge, etc.) and making mistakes influence socially desirable responses (Chao et al., 2011)

26. Developing multicultural competence in trainees • The more training, the better! The quantity of multicultural training is a significant predictor of increased multicultural competence (Johnson & Williams, 2014) • Integration (weaving throughout training program) • Tailoring diversity training to internship setting

27. Developing multicultural competence in trainees • Self-efficacy vs. competence • Reflective self-awareness (biases, blindspots, etc.) • Balance of didactic/experiential activities

29. Orientation Activities Addressing Diversity • Share Agency Values/Mission • Goal Chat time to discuss backgrounds and cultural history • Panel Presentations Campus offices • “Welcome Week” volunteering (BSU, Tunnel of Oppression) • Social Justice activity in Staff Retreat – work at Food Bank

30. Activities Addressing Diversity • Seminar on Case Formulation: ADDRESSING MODEL (Pamela Hays, 2001) • Weekly Diversity Seminar – readings, discussions, cultural events, presenting in seminar • Intern Case Conference – incorporating a prompt to address diversity issues within the case. • Diversity Project : Individual Choice vs. Group Activity

31. Activities Addressing Diversity • Diversity Committee membership for two interns • In-house Professional Growth and Development, twice a year, focused on diversity and multicultural issues • Involvement in Intern Selection and discussions of valuing/assessing sensitivity to diversity

32. Activities Addressing Diversity • Case Assignment to maximize exposure to diverse and underrepresented clients, prompts in paperwork to address issues • Funding to attend Diversity related training or workshops (U of I Dennis May; YWCA Racial Justice) • Bringing in Presenters for PG&D (Transgender issues, Spirituality Issues, Latino/Latina Issues)

34. Diverse student population • Nearly 40% of our students are African-American • Large non-traditional student population (Average age of student : 29 years old) • Commuter campus : less than 10% of our students live on campus • Low SES, many of our students are juggling family, work, and school responsibilities

35. Memphis • Population : 655,000 • 63% : African-American • Musical legacy (Blues, Rock & Roll, Beale) • Martin Luther King, Jr. assassinated in Memphis

36. Experiential activities

37. Diversity Seminar • Used to be part of professional development seminar, met monthly • moved to biweekly, 1 ½-hour seminar • Didactic and experiential

38. Culture sharing • Thank you, ACCTA!!! • Senior staff contribute first, interns present later • Role-modeling openness, authenticity, and taking risks • Builds staff cohesion

39. Discussion • What do you use in your setting that you have found helpful developing multicultural competence? • What are some of the barriers and obstacles that you run into? • Funding to attend Diversity related training or workshops (U of I Dennis May; YWCA Racial Justice)

40. References American Psychological Association. (2011d). Revised competency benchmarks for professional psychology. Retrieved from: http://www.apa.org/ed/graduate/revised- competencybenchmarks.doc. American Psychological Association Commission on Accreditation. (2009). Guidelines and principles for accreditation of programs in professional psychology. Washington, DC: Author. American Psychological Association. (2003). Guidelines for multicultural psychotherapy proficiency for psychologists: Implications for education and training, research and clinical practice. American Psychologist, 58, 377-402. American Psychological Association (2003). Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists. August 2002. Retrieved from doi: 10.1037/0003-066X.58.5.377

41. References American Psychology Association Board of Educational Affairs (BEA). (2011). BEA statement on accreditation. November, 2011. Retrieved from http://apaoutside.apa.org/ EducCSS/Public/pdfs/BEA_Statement_Accreditation.pdf American Psychological Association Commission on Accreditation. (2014). Standards of Accreditation in Health Service Psychology (SoA). Retrieved January 27, 2014 from http://apps.apa.org/accredcomment/default.aspx. Chao, R. C., Wei, M., Good, G. E., & Flores, L. Y. (2011). Race/ethnicity,color-blind racial attitudes, and multicultural counseling competence: The moderating effects of multicultural counseling training. Journal of Counseling Psychology, 58, 72– 82. Fouad, N.; Grus, C.; Hatcher, R.; Kaslow, N.; Hutchings, P.; Madson, M..; Collins Jr., F.; Crossman, R. (2009). Competency benchmarks: A model for understanding and measuring competence in professional psychology across training levels. Training and Education in Professional Psychology, 3, 5 – 26. Hays, P. (2001). Addressing cultural complexities in practice: A framework for clnicans and counselors. Washington DC: American Psychological Association.

42. References Health Service Psychology Education Collaborative. (2013). Professional psychology in health care services: A blueprint for education and training. American Psychologist, 68, 411-426. Doi: 10.1037/A0033265 Johnson, A. & Williams, D.J. (2014). White Racial Identity, Color-Blind Racial Atitudes, and Multicultural Counseling Competence. Cultural Diversity and Ethnic Minority Psychology, 16, 1 – 10. Sue, D. W., Lin, A. I., Torino, G. C., Capodilupo, C. M., & Rivera, D. P. (2009). Racial microaggressions and difficult dialogues on race in the classroom. Cultural Diversity and Ethnic Minority Psychology, 15, 183–190.