Culturally Competent Counseling: Working with Diverse Clients

1. Working with Diverse Clients Chapter Eight

2. The Changing Face of America • One-third of Americans are ethnic minorities. • Past immigrants were European; recent immigrants are from Latin America and Asia. • Immigrants want to assert their cultural heritage. • Changes in the religious composition • Diversity in Christianity • Changes in sex-role identity and the role of women • Increased awareness and acceptance of sexual minorities • Increased awareness and sensitivity to other special groups • See Figure 8.1, p. 226

3. Developing Cultural Competence • The ideal training program will provide more than a desire to help people. • It will provide you with expertise at working with clients from diverse backgrounds. • It will provide you with a multicultural perspective. • It will provide you with attitudes, knowledge, and skills and different cultures. • It will provide you with models which you can apply to your work with people from diverse backgrounds. • Let’s take a look

4. Multicultural Counseling Competence Model • It is important for helpers to have • Appropriate attitudes and beliefs. • Knowledge about their clients’ culture. • Repertoire of skills and tools. • Helpers must apply each of the above in each of the three areas below: • Awareness of the client’s world. • Awareness of the helper’s own cultural values. • Ability to use culturally appropriate intervention and strategies. • See visual, top of p. 228 and descriptions that follow

5. Multicultural Counseling Competence Model • Attitudes and beliefs — awareness of the helper’s own background, biases, stereotypes, and values; acceptance of the difference between the helper and client • Knowledge— of the helper’s own cultural heritage and of the group from which the client comes; awareness of how social and political issues can negatively affect clients • Read Box 8.1 • Skills • Generic interviewing and helping skills • Specialized skills and interventions • Understanding verbal and nonverbal language • Understanding the impact of family and society • Ability to collaborate, advocate, and refer • Read Box 8.2

6. The RESPECTFUL Model Explore these 10 factors: R—Religious and spirituality E—Economic class background S—Sexual identity P—Psychological development and maturity E—Ethnic/cultural/racial background C—Chronological-developmental challenges T—Threats to the personal well-being of the client F—Family history and dynamics U—Unique physical characteristics L—Language and location of residence

7. Tripartite Model of Personal Identity • Model for understanding how a client is the same as the helper and how a client is different from the helper • Three levels: individual, group, and universal • Review and discuss Figure 8.3 on page 231

8. Guidelines for Working with Diverse Clients • The Role of Culture and Race in the Helping Relationship • Although there are many differences between cultures and ethnic groups, these broad suggestions can be applied to all groups: • Have the right attitudes, beliefs, knowledge, and skills. • Do not let language be a barrier. • Understand the racial/cultural identity of the client. • Check that you are accurately interpreting nonverbal communication. • Use alternative methods as well as conversation. • Examine how social/political issues affect your client. • Encourage clients to share culturally significant and personally relevant items. • Vary the helping environment.

9. Guidelines for Working with Diverse Clients (Cont’d) • The Role of Religion in the Helping Relationship • Helpers need to understand the diversity of religious beliefs in America. • Have the right attitudes, beliefs, knowledge, and skills. • Determine the clients’ religious background early in the relationship. • Ask the client how important religion is to them. • Assess the level of faith development. • Do not make false assumptions. • Become familiar with religious holidays and beliefs. • Understand that region can affect a client on an unconscious level.

10. Guidelines for Working with Diverse Clients (Cont’d) • Role of Gender in the Helping Relationship (Gender-Aware Helping) • Respect the right of the clients to choose their own gender role, regardless of political correctness. • Common differences between men and women (See Table 8.1) • Guidelines for Helping Women • Have right attitudes and beliefs, knowledge, and skills • Assure you adapted helping approach for women • Establish relationship, give up your power, demystify relationship • Identify social/political issues related to client’s problems • Validate and legitimize a woman’s angry feelings toward her predicament • Learn about women’s issues and help healing with this new knowledge. • Provide a safe environment as clients understand new connections with women. • Provide a safe environment to help women understand their anger toward men. • Help clients deal with conflicting feelings between traditional and newfound values. • Facilitate the integration of new identity. • Say goodbye.

11. Guidelines for Working with Diverse Clients (Cont’d) • Gender Aware Helping (Cont’d) • Guidelines for Helping Men • Have right attitudes and beliefs, knowledge, and skills • Accept men where they are; build trust. • Do not push them to express feelings. • Early in the helping relationship, validate men’s feelings, regardless of what they are (men have fragile egos!). • Validate the man’s view of how he has been constrained by stereotypes. • Develop goals. • Discuss developmental issues. • Slowly encourage expression of new feelings. • Encourage behavioral change. • Explore underlying issues and reinforce new ways of thinking and new behaviors • Encourage integration of new ways of thinking and new behaviors. • Encourage male relationships. • Say goodbye

12. Guidelines for Working with Diverse Clients (Cont’d) • Gay, Bisexual, and Lesbian Individuals in the Helping Relationship • Sexual orientation is determined early in life by biological factors. • Although social factors may be an influence, choice is not an option. • Stereotypes flourish: 48% of Americans believe that homosexuality is morally wrong. • Guidelines: • A helper needs to have the right attitudes, beliefs, knowledge, and skills. • Have a gay, lesbian, and bisexual friendly office • Help clients to understand and combat oppression of society. • Have an affirmative and non heterosexist attitude. • Do not jump to conclusions about lifestyle. • Understand the differences between gay, lesbian, and bisexuals. • Know about community resources that may be helpful. • Know identity issues. • Understand the complexity of sexuality. • Understand the idiosyncrasies of different religious views regarding homosexuality. • Recognize unique issues these clients may have.

13. Guidelines for Working with Diverse Clients (Cont’d) • The Homeless and the Poor in the Helping Relationship • 700,000 people homeless each day • 19% of children live in poverty • Guidelines • A helper needs to have the right attitudes, beliefs, knowledge, and skills. • Focus on client’s social issues (e.g., help clients obtain basic needs if necessary) • Know the ethnic background of a client. • Be knowledgeable about health risks. • Be prepared to deal with multiple issues. • Be knowledgeable about developmental delays; be ready to refer. • Understand psychological effects. • Know community resources. • Be an advocate and stay committed.

14. Guidelines for Working with Diverse Clients (Cont’d) • The Older Person in the Helping Relationship • About 13% of the population is over 65. • By 2030, 20% will be over 65 • Guidelines • A helper needs to have the right attitudes, beliefs, knowledge, and skills. • Adapt your helping style to fit the clients’ physical needs. • Build a trusting relationship. • Be knowledgeable about issues many older persons face. • Know about possible and probable health changes. • Have empathy for changes in interpersonal relationships. • Know about physical and psychological causes of sexual dysfunction. • Involve the clients’ family and friends.

15. Guidelines for Working with Diverse Clients (Cont’d) • HIV-Positive Individuals in the Helping Relationship • Over one million people are living with HIV; 1 in 5 are unaware of it. • In world, 33 million children and adults are living with HIV • 600,00 Americans have died from AIDS • Guidelines • A helper needs to have the right attitudes, beliefs, knowledge, and skills. • Know the cultural background of your client. • Understand the disease; combat myths. • Be prepared to take on uncommon roles. • Be prepared to deal with unique treatment issues. • Deal with your own feelings about mortality. • Understand ethical and legal implications. • Offer a “strength based” approach.

16. Guidelines for Working with Diverse Clients (Cont’d) • The Chronically Mentally Ill in the Helping Relationship • 26% of Americans are diagnosed with a mental disorder every year. • 26% of homeless people may have psychiatric or mental health problems. • Guidelines • A helper needs to have the right attitudes, beliefs, knowledge, and skills. • Help clients understand their illness. • Help client work through feelings concerning his or her mental illness. • Ensure attendance. • Assure compliance with medication , • Assure ccuratediagnosis. • Revaluate treatment plans; do not give up. • Involve the clients’ family. • Know resources.

17. Guidelines for Working with Diverse Clients (Cont’d) • Individuals with Disabilities in the Helping Relationship • Approximately 54.4 million Americans have a disability (18.7%) • Many different kinds of disabilities. • Federal rules offer the right to many services. • Guidelines • A helper needs to have the right attitudes, beliefs, knowledge, and skills. • Have knowledge of the many disabling conditions • Help clients understand their disability. • Assist the client with the grieving process. • Know referral sources. • Know the law; inform your client of the law. • Refer for vocational/career counseling. • Include the family. • Be an advocate. • Empower your clients.

18. Ethical, Professional, and Legal Issues/Effective HSPs • Making Wise Decisions • Ethical codes can “reflect the dominant culture’s values at the expense of minority values” (Ridley, et al., 2001, p. 187) • Therefore, we need to make wise decisions when following our ethical code… do they embody bias? Should we make decisions in other ways (moral decision-making) • Whatever you do—do it wisely. • The Effective Human Service Professional • Cultural competence can be achieved in many ways (see list top of p. 247). • Remembers that learning is a lifelong process.

19. Summary • The cultural/ethnic/religious mix in America today • How to work with diverse populations • The Multicultural Competence model • The RESPECTFUL model • The Tripartite model • General guidelines about working with a range of special groups of people • Ethical, professional, and legal issues

20. Exercises • See pp. 250-254 • Offensive terms and jokes • Gaining knowledge about specific groups • Ethical dilemmas