Maureen McGuire-Kuletz, Ed.D., CRC Director/Assistant Research Professor

1. Ethical Considerations for the Rehabilitation Professional: Serving Culturally Diverse Populations Maureen McGuire-Kuletz, Ed.D., CRC Director/Assistant Research Professor George Washington University RRCEP 2011 I Street, NW Suite 300 Washington, D.C. 2005 202-973-1558/mkuletz@gwu.edu

2. Learning Objectives • To discuss diversity in terms of vocational rehabilitation practices • Develop strategy for exploring cultural diversity • Explore ethics as related to professional practice with diverse populations • Analyze case studies for culturally diverse populations

3. What is Culture? • ??

4. Culture • The sum total of ways of living; including values, beliefs, esthetic standards, linguistic expression, patterns of thinking, behavioral norms, and styles of communication which a group of people develop to assure their survival in a particular physical and human environment.

5. Cross Cultural Awareness • ????

6. Cross Cultural Awareness • Refers to the basic ways of learning that behavior and ways of thinking and perceiving are cultural conditioned rather than being universal aspects of human nature. In this learning, unconscious, culturally-based assumptions and values held by individuals are brought to the surface.

7. Cultural Competence • ???

8. Cultural Competence • The ability of individuals to see beyond the boundaries of their own cultural interpretations, to be able to maintain objectivity when faced with individuals from cultures different from their won and to be able to interpret and understand the behaviors and intentions of people form other cultures nonjudgmental and without bias.

9. Terms: • INSTITUTIONAL BEHAVIOR (FAMILY; POLITICAL; RELIGIOUS; ECONOMICAL) ASSOCIATIONS • VALUES: THESE ARE DEFINED AS:BELIEFS THAT LEAD TO ACTION (E.G.: "WORK IS GOOD FOR YOUR CHARACTER"; "IT IS GOOD TO BE A VEGETARIAN"). • NORMS ARE DEFINED AS:IMPLICIT RULES OF BEHAVIOR (EG., BEING PUNCTUAL; GETTING UP EARLY). • ROLES: THESE ARE DEFINED AS: PERFORMANCE OF FUNCTIONS (E.G.: "LOVING" MOTHER;"SUBMISSIVE" WIFE; "EMPATHIC COUNSELOR").

10. STATUS: RELATIVE POSITION IN A PRESTIGE HIERARCHY  (EG., ECONOMIC,SOCIAL, PROFESIONAL). • MINORITY: A GROUP THAT RANKS AS SUBORDINATE, BASED ON DIFFERENTIALPOWER OR POPULATION SIZE.MINORITY MEMBERSHIP IS TRANSMITTED BY RULE OF DESCENT OF SPECIFIC CULTURAL AND/OR PHYSICAL TRAITS THAT ARE HELD IN LOWESTEEM BY DOMINANT SOCIETY.

11. DOMINANT: A GROUP WITH COMMON HISTORY, VALUES AND LANGUAGE SEEKING TO ADVANCE OWN INTERESTS OVER THOSE OF OTHER GROUPS BASED ON ECONOMIC AND POLITICAL POWER. • ETHNOCENTRISM: THE DOMINANT GROUP ASSUMES THAT SURVIVAL OF THE GROUP AND SOCIETY DEPENDS ON PERPETUATION OF OWN VALUES. • RACISM: THE BELIEF ON RACE SUPERIORITY (IDEOLOGICAL); NEED TO DEFINE OTHERS AS INFERIOR; (PSYCHOLOGICAL) STRUCTURED INEQUALITY; JOB BARRIERS; LOW EDUCATIONAL OPPORTUNITTIES;LOW POLITICAL PARTICIPATION.

12. DISCRIMINATION: DIFFERENTIAL AND UNEQUAL TREATMENT OF THE MINORITY GROUPS BY THE DOMINANT GROUP.  E.G.; WAGEDIFFERENTIALS; UNEQUAL ACCESS TO PROMOTION; LOW ADMISSION RATES TO SCHOOLS, ETC. WHEN DISCRIMINATION IS BASED ON RACE DIFERENCES THEN IS CALLED RACISM, OR SEXISM WHEN BASED ON SEX DIFFERENCES. • SEGREGATION: ENFORCED PATTERN OF SETTLEMENT/USE OF FACILITIESE.G., RESIDENTIAL RESTRICTIONS.  IT MAY BE BASED ONRACE, RELIGION, ETC. • PREJUDICE: UNFAVORABLE ATTITUDES TOWARD A GROUP OR INDIVIDUAL BECAUSE OF FALSE PERCEPTIONS OR STEREOTYPES

13. SEGREGATION: ENFORCED PATTERN OF SETTLEMENT/USE OF FACILITIESE.G., RESIDENTIAL RESTRICTIONS.  IT MAY BE BASED ONRACE, RELIGION, ETC. • PREJUDICE: UNFAVORABLE ATTITUDES TOWARD A GROUP OR INDIVIDUAL BECAUSE OF FALSE PERCEPTIONS OR STEREOTYPES • RELATIONSHIP PATTERNS BETWEEN DOMINANT AND MINORITY GROUPS:STABILIZED ACCOMODATION BY WHICH SUBORDINATION IS TAKEN FOR GRANTED

14. ASSIMILATION: THAT THE INDIVIDUAL OR GROUP ASSUMES THE IDENTITY AND BEHAVIORS OF THE DOMINANT CULTURE • PLURALISM: THE COEXISTENCE OF DIFFERENT GROUPS IN WHICH EACHGROUP RETAINS ITS IDENTITY AND BEHAVIORS. INTEGRATION OF DIFFERENT GROUPS BASED ON INDIVIDUAL EQUALITY. • MELTING POT: ALL DIFFERENT GROUPS MERGE INTO ONE THAT IS THE PRODUCT OF THE MIX OF ALL CULTURES. (Garcia, 2003)

15. Cultural Perceptions (adapted from Collier, 2002) • English • Japanese

16. Cultural Perceptions: • Spanish • Altabascan

17. Difference versus Disability • The side effects of culture shock can look like indicators of learning and behavior disabilities.

18. Locus of control (LOC): • Individuals who feel that LOC is external may not feel that counseling is a credible source of help. • Individuals with internal LOC more likely to take action on their own behalf ( Brown & Lent, 1992)

19. Ways to Value Diversity(Advancement Strategies, 1992)

20. Number of Persons with Disabilities • Debates continue concerning how many of us are disabled, however. Depending on the criteria used, estimates vary from a low of about 36.1 million (LaPlante, 1992) to about 54 million (National Council on Disability, 1997).

21. STAGES OF MULTICULTURAL DEVELOPMENT (Pederson, 1999) • AWARENESS • KNOWLEDGE • SKILLS

22. Awareness: • ABILITY TO JUDGE A CULTURAL SITUATIONFROM ONE'S OWN AND THE OTHER'S CULTURAL VIEWPOINT. •  AWARENESS REQUIRES:        - RECOGNIZE COMMUNICATION STYLES  (E.G., VERBAL VS NON VERBAL)        - SENSITIVITY TO NONVERBAL CUES (E.G., PROXEMICS OR HOW CLOSE A PERSON GETS TO ANOTHER WHEN INTERACTING; KINETICS OR HOW A PERSON EXPRESSES HROUGH GESTURES, ETC)       - RECOGNIZE CULTURAL AND LINGUISTIC DIFFERENCES        - SENSITIVITY TO MYTHS AND STEREOTYPES  (E.G., ALL LATINOS ARE MACHISTAS; ALL LATINO WOMEN ARE SUBMISSIVE) OF THE CULTURE

23. Awareness requires…. - CONCERN FOR WELFARE OF OTHERS         - ARTICULATE ELEMENTS OF OWN CULTURE (E.G., FORMALITY, LINEAR THINKING,  FOCUS ON VERBAL COMMUNICATION, NUCLEAR FAMILY, ETC.)          - APPRECIATE IMPORTANCE OF MULTICULTURAL  TEACHING         - AWARENESS OF RELATIONSHIPS BETWEEN  CULTURAL GROUPS (E.G., RACISM, SIMILARITIES)         - JUDGING "GOODNESS" AND "BADNESS" IN THE OTHER CULTURE (FROM THE OTHER CULTURE'S PERSPECTIVE)

24. KNOWLEDGE REQUIRES INFORMATION ABOUT: - HISTORICAL EXPERIENCES (E.G., INTERNMENT, WARS, ETC.)         - TEACHING AND LEARNING RESOURCES         - ROLES OF EDUCATION         - SOCIOECONOMIC BACKGROUNDS         - VALUES, ATTITUDES, BEHAVIORS         - CUSTOMS, SLANG         - LEARNING STYLES AND WAYS OF THINKING          - KNOWLEDGE ABOUT OWN CULTURE IN  RELATION TO THE OTHER           - PROFESSIONAL EXPERTISE IN AN AREA             VALUED BY THE OTHER CULTURE

25. SKILL DEVELOPMENT:             - APPROPRIATE TEACHING/LEARNING  TECHNIQUES AND STYLE FOR WORK IN THE                     OTHER CULTURE             - EMPATHY WITH PERSONS FROM OTHER  CULTURE 9E.G., IDENTIFY FEELINGS CORRECTLY)             - ABILITY TO RECEIVE AND ANALYZE FEEDBACK FROM PERSONS OF THE                OTHER CULTURE              - ABILITY TO DEVELOP NEW METHODS FOR WORK IN THE OTHER CULTURE (E.G., MORE OR LESS DIRECTIVE, MORE OR LESS FAMILY ORIENTED; MORE OR LESS VERBAL, ETC).

26. CULTURALLY BIASED ASSUMPTIONS: THE FOLLOWING IS A LIST OF FALSE ASSUMPTIONS THAT WE MAKE ABOUT OTHERS:

27.   - BELIEVING THAT WE SHARE A COMMON VIEW OF WHAT "NORMAL" MEANS.  - BELIEVING THAT INDIVIDUALS INSTEAD OF GROUPS ARE THE BASIC BLOCKS OF SOCIETY  - THINKING THAT OTHERS WILL UNDERSTAND OUR ABSTRACT WORDS THE SAME WAY WE DO. THIS MEANS THAT WE NEED TO PAY MORE ATTENTION TO CONTEXT SO OTHERS CAN UNDERSTAND WHAT THE CONCEPT MEANS (E.G., FAIRNESS, HUMANE, BAD, ETC.)  - THE BELIEF THAT INDEPENDENCE=DESIRABLE AND DEPENDENCE = UNDESIRABLE. FOR EXAMPLE IN MANY CULTURES INTERDEPENDENCE IS MORE IMPORTANT THAN INDEPENDENCE AS A GOAL FOR A PERSON WITH A DISABILITY. - BELIEVING THAT FORMAL COUNSELING IS BETTER THAN NATURAL SUPPORT. IN MANY CULTURES THIS MAY BE THE OPPOSITE.

28. -  THE ASSERTION THAT LINEAR THINKING IS THE NORM (DEPENDENCE ON MEASURES; CAUSE AND EFECT) THINKING OTHER CULTURES MAY VALUE COMPLEMENTARITY (TWO ASPECTS OF THE SAME REALITY) INSTEAD OF CAUSE-EFFECT RELATIONSHIPS BETWEEN TWO EVENTS.  - THE BELIEF THAT INDIVIDUALS NEED TO FIT THE SYSTEM INSTEAD OF THE SYSTEM FITTING THE INDIVIDUAL..- BELIEVING THAT HISTORICAL CONTEXT IS NOT RELEVANT AND THAT COUNSELORS NEED TO FOCUS ON IMMEDIATE EVENTS PRIMARILY.  MANY TIMES UNDERSTANDING THE CLIENT'S PERSPECTIVE REQUIRES  KNOWLEDGE OF HISTORICAL BACKGROUND THAT THE CLIENT FEELS IS RELEVANT.-  THE BELIEF THAT WE ALREADY KNOW ALL OUR CULTURALLY-BIASED ASSUMPTIONS.  WE NEED TO UNDERSTAND THAT OTHER GROUPS MAY HAVE DIFFERENT ASSUMPTIONS SO WE CAN INTEGRATE OR COORDINATE THOSE ASSUMPTIONS WITH OURS.

29. SKILLS RELATED TO RECOGNIZING SPECIFIC CLIENT RESISTANCE

30. COPING:  THE CLIENT MAY BE UNABLE TO COPE WITH THE STRESS OF THE SESSION • VALUES CONFLICT:  IT MAY BE THAT THE CLIENT PERCEIVES THE COUNSELOR IS JUST RESPONDING TO HIS OR HER OWN VALUES. • OPEN VS CLOSED QUESTIONS:  THE CLIENT MAY BE MORE COMMUNICATIVE WHEN ASKED OPEN QUESTIONS • DIRECTIONS:  THE CLIENT MAY NEED SOME SPECIFIC STEPS THAT HE/SHE MAY AGREE TO TAKE.

31.  CONFRONTATION:  IT MAY BE THAT THE COUNSELOR NEEDS TO BRING UP THE CONTRADICTION THAT THE CLIENT IS FACING (E.G., "YOU SAY YOU ARE ANGRY ABOUT YOUR EMPLOYER BUT YOUR ACTIONS DO NOT REFLECT THAT"). • INTERPRETATION;  BE AWARE THAT YOUR INTERPRETATION OF THE CLIENT'S PROBLEM MAY BE OFFENSIVE TO HIM (E.G., "WHAT YOU SEEM TO NEED IS GOING BACK TO YOUR COUNTRY"). • FOCUS ON TOPIC:  THIS IS WHEN THE COUNSLOR DRIFTS AWAY FROM WHAT THE CLIENT WANTS TO FOCUS ON (E.G., FOCUS ON JOB INSTEAD OF RACISM). • FOCUS ON GROUP:  YOU MAY BE TALKING ABOUT LATINOS IN GENERAL WHEN THE CLIENT WANTS TO TALK ABOUT HIS INDIVIDUAL SELF.

32. SELF-AWARENESS:  THE COUNSELOR MAY NEED TO BECOME AWARE OF HIS/HER ATTITUDE DURING THE SESSION (E.G., BEING PATERNALISTIC INSTEAD OF RESPECTING THE CLIENT).

33. SKILLS RELATED TO DIMINISHING THE COUNSELOR'S OWN DEFENSIVENESS WHEN WORKING WITH CLIENTS FROM DIFFERENT CULTURES:

34. SENSE OF HUMOR:  COUNSELORS DO NOT HAVE TO BE AFRAID OF USING HUMOR WHEN THEY FEEL THEY MADE A MISTAKE (E.G., MAKING THE WORNG JUDGEMENT ABOUT THE CLIENT'S CULTURAL IDENTITY). • SELF DISCLOSURE: COUNSELORS CAN MAKE SELF-DISCLOSURES WHICH ARE USUALLY VERY APPROPRIATE IN MULTICULTUTAL COUNSELING AS LONG AS THEY DO NOT DOMINATE THE SESSION (E.G., "AS A CHILEAN I CAN UNDERSTAND HOW YOU FEEL ABOUT HUMAN RIGHTS VIOLATIONS"). • DESCRIPTIVE:  THE COUNSELOR NEEDS TO BE NONJUDGEMENTAL ABOUT THE CLIENT FROM OTHER CULTURE WHICH REDUCES COUNSELOR DEFENSIVENESS.

35. SPONTANEITY:  THIS HAS TO DO WITH BEING GENUINE AS WELL WHICH MAY REDUCE THE COUNSELOR FEARS ABOUT THE CLIENT'S CULTURE. • RECEPTIVITY:  BEING OPEN AND RESPONSIVE TO THE CLIENT'S COMMUNICATIONS ABOUT THE COUNSELOR' CULTURE. • ADMITTING DEFENSIVENESS:  THE COUNSELOR IS BETTER OFF BY COMMUNICATING TO THE CLIENT HIS DEFENSIVENESS IN AN APPROPRIATE WAY (E.G., " YOU MUST KNOW THAT I FELT VERY RELUCTANT TO ADDRESS THAT TOPIC AT THE BEGINNING").

36. APOLOGIZING:  THE COUNSLOR CAN APOLOGIZE APPROPRIATELY FOR MAKING A JUDGMENT ABOUT THE CLIENT (E.G., "EXCUSE ME FOR TAKING YOUR COMMENT AS OFFENSIVE"). • MANPULATION:  DO NOT BE AFRAID TO MAKE SUGGESTIONS AND/OR GUIDE YOUR CLIENT/CUTOMER - SOMETIMES CLIENTS APPRECIATE SUGGESTIONS WHEN THEY FEEL IT IS IN  THEIR BEST INTEREST.

37. RESPECT CULTURAL DIFFERENCES WHEN COUNSELING DIFFERENT CULTURAL GROUPS

38. ETHICAL PRINCIPLES • Ethical Principles: • Translation of our beliefs about what we value • Rules of conduct that are derived from values

39. Ethical Principles: • Beneficence • Autonomy • Nonmaleficience • Justice • Fidelity

40. BENEFICENCE Definition - (be-nef-e-sens) ‘Helping others’ further their important and legitimate interests, “Do the Right Thing” Justification: * Society has an obligation to provide ‘help’ * Society is responsible for the handicap of individuals * Counselor’s information re: customer/client situation increases obligation to ‘promote good’

41. NONMALEFICENCE Nonmaleficence Definition (non-mal-ef-e-sens) • Working at and/or ensuring that ‘no harm,’ ‘no evil’; preventing negligence or harm from happening Justification • Civilized societies are responsible for doing no harm to clients.

42. AUTONOMY Concept Self-governance, liberty, privacy and being one’s own person Definition Counselors are required to recognize and honor the client/customer freedom of choice to control their own lives

43. JUSTICE Definition: • The fair allocation of caseload resources and monies to clients • Fair allocation of the counselor’s time to provide services and achieve outcomes

44. FIDELITY Definition: Keeping promises or commitments; being loyal to clients/customers, agencies and organizations Justifications: * Mutual trust based upon commitment and promises * Unequal relationship between client and counselor mandates counselor honesty

45. CRC Code of Professional Ethics for Rehabilitation Counselors: • Adopted in June 2001 by the Commission on Rehabilitation Counselor Certification • Effective January 1, 2002

46. Code of Ethics • Developed in response to the Rehabilitation Act of 1973 • Developed, in part, as a response to the need/desire to professionalize the field

47. Section of Code: • A: The Counseling Relationship • B: Confidentiality • C: Advocacy and accessibility • D: Professional responsibility • E: Relationships with other professionals • F. Evaluation, assessment, and interpretation • G: Teaching, training, supervision

48. CRC Code of Ethics: • H: Research and publication • I: Electronic communications and emerging applications • J: Business practices • K: Resolving ethical issues

49. A.2. Respecting diversity: • a. Respecting culture • b. Interventions • c. Non-discrimination

50. C.1. Advocacy • a. Attitudinal barriers