Multicultural Counseling: The Factors, the Theories and Applications

Multicultural Counseling: The Factors, the Theories and Applications Michele D. Aluoch, LPCC River of Life Professional Counseling LLC c. 2013

Defining “Multicultural” Language Race- the biology of a person, sociopolitical Culture Ethnicity- construct based on shared language, culture, traditions, and history Gender Age Socioeconomic status Spiritual views/other values

Defining “Multicultural” CULTURE =“any group of people who identify or associate with one another on the basis of some common purpose, need, or similarity of background” (e.g. music, living arrangements, beliefs, hobbies, etc.), “those who have agreement about the way its done” (Hendricks, K.T., 2005)

Defining “Multicultural” the coming together of two or more people from different cultural backgrounds in a helping relationship.” (Torres-Rivers, E., Phan, L.T., Maddux, C., Wilbur, M.P., & Garrett, M.T., 2001)

What do we call “America?” Melting pot- put all into one culture Tossed salad- distinct yet create a new whole Patchwork quilt- interdependent yet unique

Multicultural Competence Multicultural competence- the extent to which counselors possess appropriate levels of self-awareness, knowledge, and skills in working with individuals from diverse cultural backgrounds

Risks if Not Multiculturally Competent Without training: Cultural encapsulation Reactions based on stereo types Ignoring cultural differences Avoiding critical subjects Focusing on techniques to the exclusion of client factors KEY= Counseling is not culture free!!!

History of Multicultural Counseling(Robinson, D.T., & Morris, J.R., 2000) Used to be called “minority counseling.” As recently as 2000, only 80% required multicultural counseling and only at the one course level. Only 49% of psych /counseling programs integrated the issue of multicultural counseling across course

Multicultural Counseling Domains professional identity social and cultural diversity human growth and development career development helping relationships group work assessment research and program evaluation

Methods of Equipping Counselors to be Multicultural Competent Taking a multicultural course Infusing multicultural content into courses Both of above

Methods of Equipping Counselors to be Multicultural Competent Traditional strategies- reading assignments, videos, lectures Exposure strategies- presentations by a representative of a given group Participatory strategies- class discussions, simulations, role plays re. personal views, biases, and life experiences Experiential exercises- exchange counseling, community based interventions, use of clinical games in class

Multicultural Supervision Successful multicultural supervision- “things you said or did (as the supervisor) that led to successfully facilitating the supervisee’s growth and development as a person and a professional or that led to a successful bridging of ethnic/cultural barriers between the supervisor and the supervisee.” (Dressel, J.L, Consoli, A.J., Kim, B.S.K., & Atkinson, D.R., 2007)

Why Multicultural Training Is Important Changing population of U.S. Issues of rapport building and empathy Reducing premature termination Remaining client focused Designing individualistic effective intervention Reducing risk for operating beyond scope of practice Awareness of competencies needed with different cultures To reduce risk of cultural encapsulation To begin to correct incomplete and inaccurate assumptions that may lead to misdiagnosis or unhealthy applications of treatment To remain clinically relevant to the needs of each individual To test the organizational mission, policies and procedures, and approaches used for applicability to all persons served

Multicultural Games- Purposes To sensitive counselors in training to potential issues To overcome sense of powerlessness To deal with the norms of society vs. personal norms To allow for childlike discovery of important factors To test and experiment with approaches with different cultures

Multicultural Games- Examples: BafaBafa- * simulated cultures (Apha and Beta groups- each learn everything about the other culture then interact and then switch) Step Forward/Step Back- like Mother, May I? * Characters created with various cultural attributes * May move forward or backward so many steps based on the degree to which some things may or may not be factors in a cultural character’s life Cultural Jeopardy- *Used to recall and apply knowledge of information about cultures May I help You?- *game of trying out counseling approaches on various cultures of clients and seeing how it goes Evaluation: experiences, feelings, knowledge, self awareness

Teaching MulticulturallyFier, E.B., & Ramsey, M., 2005 Instructors need to examine own biases Gaps in ethical codes Requires that the power differential and hierarchy be minimized

Testing MulticulturallyHill, J.S., Robbins, R.R., & Pace, T.M., 2012 Tests not normed on various cultures Tests invalid for cultural issues and pathology Ex: MMPI-2

Multicultural AssessmentGerstein, L.H., Rountree, C., & Ordonez, A., 2007 Counselors- go in with hypothesis and tend to seek confirmations- confirmation bias Anthropologists- open ended, hear the story Ideals, beliefs, values, explanations, evaluations, symbols, historical stories, behaviors, experiences Suggestion- move toward this open-ended, client driven approach for assessment

Supervisory Behaviors in Successful Multicultural Supervision(Dressel, J.L, Consoli, A.J., Kim, B.S.K., & Atkinson, D.R., 2007) Creating a safe environment for discussion of multicultural issues, Developing my own self awareness about cultural ethnic identity biases Communicating acceptance of and respect for supervisees’ culture Listening to and demonstrating genuine respect for supervisees’ ideas about how culture influences the clinical interaction Providing openness, genuineness, empathy, warmth, nonjudgmental stance Validating integration of supervisees’ professional and racial/ethnic identities and helping to explore potential blocks to this process Discussing and supporting multicultural perspectives as they relate to the supervisee’ clinical work

Supervisory Behaviors in Successful Multicultural Supervision(Dressel, J.L, Consoli, A.J., Kim, B.S.K., & Atkinson, D.R., 2007) Tending to feelings of discomfort experienced by trainees concerning multicultural issues Supporting supervisees own racial/ethnic identity development Presenting myself nondefensively by tolerating anger, rage, and fear around multicultural issues Providing supervisees a multiculturally diverse caseload to ensure breadth of clinical experience Attending to racial/ethnic ethnic cultural differences reflected in parallel process issues 9supervisor/supervisee and supervisee/client) Discussing realities of racism/oppression and acknowledging that race is always an issue. Acknowledging, discussing, and respecting racial/ethnic multicultural similarities and differences between myself and supervisees and exploring feelings concerning this

Supervisory Behaviors in Successful Multicultural Supervision(Dressel, J.L, Consoli, A.J., Kim, B.S.K., & Atkinson, D.R., 2007) Addressing a broad range of differences (e.g. learning styles, interpersonal needs, social orientation, religious/spiritual beliefs, and race) Checking out the supervisory expectation with supervisees Initiating discussion about the importance of culture Acknowledging and discussing power issues in supervision that may be related to racial/ethnic multicultural differences Encouraging supervisees to share, within supervision, their personal and professional cultural background and experiences Consulting colleagues willingly about my own reactions to racial/ethnic concerns from supervision Acknowledging my own lack of knowledge on racial/ethnic multicultural differences and inviting supervises to give me feedback and teach me

Supervisory Behaviors in Successful Multicultural Supervision(Dressel, J.L, Consoli, A.J., Kim, B.S.K., & Atkinson, D.R., 2007) Testing hypotheses about my supervisees, not accepting “just one view“ Self-disclosing aspects of my own cultural background Engaging supervisees in peer review with each other's cases through case conferences Seeking understanding of supervisees' culture through both didactic and experiential means on my own Providing written and verbal feedback regarding supervisees' multicultural interactions with staff and clients Providing multicultural readings and related training experiences for supervisees Being willing to confront supervisee's inadequate skills, listening if that is challenged on grounds of cultural insensitivity, but not backing away from my own standards and values

Supervisory Behaviors in Successful Multicultural Supervision(Dressel, J.L, Consoli, A.J., Kim, B.S.K., & Atkinson, D.R., 2007) Allowing supervisees to see my clinical work in cross-cultural counseling and/or consultation through tapes or live observation Letting supervisees take responsibility Providing supervisees with information about various cultures Offering supervisees mentorship and other collaborative professional opportunities with me (e.g., co-led presentations, coauthored papers) Departing from Western theoretical perspectives in supervision Having supervisees keep a journal that documents personal reactions to interactions with seminar facilitator and intern colleagues

Supervisory Behaviors in UnsuccessfulMulticultural Supervision (Dressel, J.L, Consoli, A.J., Kim, B.S.K., & Atkinson, D.R., 2007) Lacking awareness regarding my own racial/ethnic/cultural biases and stereotyping Overlooking and/or failing to discuss cultural issues Becoming defensive around racial/ethnic/cultural issues Failing to establish a working alliance and safe environment Not recognizing the power of the supervisory role Making assumptions about the supervisees' experiences or beliefs, based on their ethnicity or culture Presenting a particular point of view that was rigid and dogmatic Ignoring gender issues in relation to cultural/socioeconomic backgrounds of myself and my supervisees Not acknowledging or discussing racial/ethnic/cultural differences between myself and my supervisees

Supervisory Behaviors in UnsuccessfulMulticultural Supervision (Dressel, J.L, Consoli, A.J., Kim, B.S.K., & Atkinson, D.R., 2007) Not exploring together the impact of different cultural, socioeconomic, and gender backgrounds on how we conceptualize clients and the therapy process Being inattentive and insensitive to supervisees' insecurities in addressing muiticulturalism/racism Not supporting and encouraging a supervisee's own racial/ethnic identity development Not having a diverse caseload for supervisees thus limiting opportunities for discussion of racial/ethnic/cultural issues Failing to recognize my own position of racial/ethnic privilege Treating supervisees as "spokespersons" for their whole racial/ethnic group Invalidating importance of multicultural supervision by not dedicating enough time to it

Supervisory Behaviors in UnsuccessfulMulticultural Supervision (Dressel, J.L, Consoli, A.J., Kim, B.S.K., & Atkinson, D.R., 2007) Not learning about and considering supervisees' racial/ethnic/cultural background Not acknowledging and encouraging supervisees when they use issues of ethnicity in an appropriate and relevant manner in the course of their work with clients Assuming supervisees' cultural awareness without justification Having poor boundaries that were intended to create openness but instead contributed to dual role conflicts with supervisees Insufficient consultation/peer supervision for me to work out my own racial/ethnic/cultural issues Not inviting supervisees to bring [it] to my attention if it feels [to them] that I have done/said something they see as racial Inhibiting my own interventions for fear of being perceived as culturally insensitive

Supervisory Behaviors in UnsuccessfulMulticultural Supervision (Dressel, J.L, Consoli, A.J., Kim, B.S.K., & Atkinson, D.R., 2007) Assuming, without justification, a racial/ethnic/cultural barrier being a developmental issue for the client Focusing too much on content and not enough on process Misinterpreting body language/nonverbal communication of supervisees Lack of focus on mutual goal setting Becoming too preachy about racism/prejudice Allowing discourse that may inhibit supervisees' free expression Discussing power issues in individual context only and not in a cultural context Not providing enough structure for supervisees who held culturally based expectations for structure Addressing issues of race/ethnicity/culture with supervisees who are not ready for them Demonstrating workaholic style that intimidates supervisees

General Guidelines Should be both practical and clinical Balance between narrowly defined characteristics of a culture versus individualized characteristic across culture Letting the client determine how central/not important cultural issues are Should be both didactic and experiential Should be integrated into the counselor’s professional identity Should be incorporated into clinical supervision, practicum, internships, and ongoing clinical interactions

Areas of Multicultural CompetenciesTo Address Attitudes Self awareness- cognitive and affective Sensitivity to others Personal background/life experiences Personal limits of competency Sources of discomfort Knowledge Personal multicultural heritage Historical oppression, discrimination, stereotyping Social impact of personal style and values

Areas of Multicultural CompetenciesTo Address Skills Training Relevant research Active involvement with cultural groups outside counseling office (not clients) Ongoing consultation Culturally appropriate interventions Bilingual (if helpful) Awareness of appropriate referral sources and resources in the community Willingness to adapt as needed (assessment/testing, evaluation, clinical goals, style)

Self Evaluation- Multicultural Competency Relinquishing absolute truths Accepting multiple perspectives Critically analyzing techniques and interventions to choose ones with bets fit for a given client Hearing how someone’s cultural traditions, values, beliefs, and worldviews affect their intrapersonal and interpersonal interactions

Self Evaluation- Multicultural Competency Developing interventions which are culturally sensitive Refuse to use counseling approaches which produce negative, oppressive, or unethical results

Multicultural Counseling Skill Subscale Items Green, R.G., Klerman, Stern, M., Bailey, K., Chambers, K., Calridge, R., Jones, G., Kitson, G., Leek, S., Leisey, M., Vadas, K., Walker, K. (2005): See 50% of my clients more than once Recognize cultural mistakes quickly and recover Use several methods of assessment Able to distinguish between need for brief and long term services Effective crisis interventions Various practice skills and techniques Compatible verbals and nonverbals

Multicultural Counseling Skill Subscale Items Solving problems in unfamiliar settings Having an understanding of racial and ethnic minority groups. Understanding the legalities of immigration. Extensive professional or collegial interactions with minority individuals. Enjoying interacting with people from different cultures. Advocating for people of different cultures. Seeking workshops on multicultural competency

Multicultural Counseling Skill Subscale Items Understanding the roles of age, gender, SES, roles. Self examination of cultural biases. Knowing and applying research methods regarding multicultural practice. Awareness of changing practices for populations served. Monitoring any defensiveness. Working with clients on issues of acculturation if needed. Dealing in non-stereotyped ways.

Multicultural CompetencyCaldwell, L.D., Tarver, D.D., Iwmoto, D.K., Herzberg, S.E., Cerda-Lizarraga, P., & Mack, T. (April 2008). 1. Color blindness- more homogenous classification of clients 2. Client focused 3.Acknowledegmnet of individual differences 4. Textbook consistent treatment 5. Skills- based 6. Self integration

Cultural AuditingCollins, S., Arthur, N., & Wong-Wylie, G., 2010 To make sure counseling assessment and interventions are consistent with what is helpful for the client 1. establishing rapport What conflicts in values might arise? How might my prior history of working with clients from a similar group affect my working with this client? What are my client’s cultural norms?

Cultural AuditingCollins, S., Arthur, N., & Wong-Wylie, G., 2010 2. development of trust and respect: What information about the counseling process might the client require to understand the roles and processes involved? What do I bring to this encounter as a person who will support or hinder the development of trust and respect? What can I do to enhance credibility as someone who can help the client reach his or her goals?

Cultural AuditingCollins, S., Arthur, N., & Wong-Wylie, G., 2010 3. Potential influences of culture on interventions: Celeistwilingnessto return to counseling? What ere the cleiont;snormaswithrelationshipo to time, scheduling, and who praticiaptes in cousnling? 4. Potential influences on the client: What assumption sod I have about this? What do I assume is similar? Difrenet? What are my hypotheses about the cleint’s concerns? What aspects of my worldview might confluct with this client? Am I open to modifying my assumptions?

Cultural AuditingCollins, S., Arthur, N., & Wong-Wylie, G., 2010 5. View of culture on presenting concerns: What od I believe about human nature and development? What assumptions do I have about change? 6. Client’s views on presenting concerns: What is the client’s sense of where the problem is located? How might the client’s conceptualization differ from mine because of his cultural identity?

Cultural AuditingCollins, S., Arthur, N., & Wong-Wylie, G., 2010 7. Sociopolitical influences: What is the role of acculturation? How might my own level of identity support or hinder my client? 8. Definition of client goals: What methods are consistent with the goals the client would like to see?

Cultural AuditingCollins, S., Arthur, N., & Wong-Wylie, G., 2010 9. Influences of culture on interventions: What types of interaction would address this client’s presenting concerns? Am I open to incorporating native practices? What would the client consider indicators if success? 10. Client progress in counseling: Indicators of success? 11. The influence of culture on termination: What are cultural meanings of endings for this person?

Multicultural Assessment AreasBraun, F.K., Fine, E.S., Grief, D.C., Devenney, J.M., 2010 1. increase self awareness 2. account for clients’ multiple identifications 3. form working hypotheses 4. establish base rates 5. determine sociocultural and sociopolitical contexts 6. find unique qualities 7. determine physical factors 8. psychological conditions and stressors 9. find out which identities shifted over time

Video Interview of Michele Aluoch Components of Effective Multicultural Counseling

Counseling Empathy Versus Cultural Empathy Empathy in general: understanding the person’s frame of reference communicating that understanding to him/her effectively Cultural empathy: “retaining one’s separate cultural identity and simultaneously being aware of and accepting cultural values and beliefs of the client.” 1. validating the inner experience of the client 2. acknowledging the client’s subjective world

Counseling Empathy VersusCultural Empathy Verbal Communication Language Phrases Slang Nonverbals Touch Look Gestures Intonation Dress Smell Body movements Proximity

Alternative View: UniversalismKinnier, R.T., Dixon, A.L., Barratt, T.M., & Moyer, E.L. (January 2008) Are there some things that should be universal for all people? Are there some truths and factors that are mostly agreed upon? Opposite moral relativism Criteria=90% or more

Cultural Empathy Describe what the client is experiencing in words he/she can validate. Express interest in learning more about the client’s experience. Clarify language and communication meanings. Convey an honest desire to be helpful to the client Face, rather than ignoring or overlooking, cultural differences. Discuss cultural differences if they are central and pertinent to that individual’s counseling. You feel ______________ when/because _____________ and in the future you wish _________________. Get 3 Yes es.

Effective Cross- Cultural Counseling Sincerity- good intention, real-ness Service energy- Communicating client value Knowledge of the client’s culture- experience, study/research, or allowing client to teach you Nonjudgmental- avoiding jumping to conclusions and personal prejudices, framing in context, let go of being “the authority” Resourcefulness- Linking to community resources Sensitivity- awareness of what is/is not an issue for that client Historical awareness- knowing the background of this cultural group, society, gender, community, religious or political group, etc. Ongoing critical reflection- ongoing personal assessment and assessment of the counseling situation

Multicultural Counseling: The Factors, the Theories and Applications