561- Cultural Issues in Psychological Practice Flashcards
(41 cards)
Acculturation
Part of cultural issues in psychological practice, this is the process used by the minority culture to adjust to the majority culture by adapting various aspects of the majority culture in an attempt to blend in and have better opportunities. This can also be seen bidirectionally, with majority culture adapting certain aspects of the minority culture. This occurs at the individual and group level. Acculturation can result in acculturation stress - not unlike post traumatic stress, this type of stress refers to the anxiety depression, and conflict, which accompany moving into a new culture. It should be a factor that guides the therapists section of interventions.
EXAMPLE: You are seeing a client that recently immigrated to the United States from Brazil. He is under a lot of stress as he navigates American culture and acculturates. As his therapist, you will need to help him navigate through this stress and learn to adapt various aspects of American culture without abandoning his Brazilian culture.
ADDRESSING model
Part of practicing from a multicultural perspective, ADDRESSING is an acronym of cultural influences and client factors to be aware of in case conceptualization and treatment. Including these dimensions of identity on intake paperwork can help therapists understand the client more fully. ADDRESSING stands for age and generational influences, developmental disability -disabled from birth, disability that is acquired -may have developed at any point in lifespan, religion and spiritual orientation, ethnic and racial identity, socioeconomic status, sexual orientation, indigenous heritage, national origin, and gender. Its a great way to learn information on a client’s worldview.
Example: Sam is a new client who identifies as a cis gender, Jewish female. She is 68 years old. As her therapist does the initial interview, the therapist will want to gather information about how her Jewish heritage/faith and age are influencing her presenting problems, if at all.
Anti-racism
Part of multicultural advocacy in counseling, this term refers to actively identifying and opposing racism. It involves advocating policy change, behaviors, and beliefs that perpetuate racism. The process of anti-racism equips people with the tools needed to combat both institutional and systemic racism as well as discrimination through the promotion of diversity. The overall goal of antiracism is to eliminate racism and work toward equality. This is important when it comes to addressing biases a clinician may have. The ACA requires counselors to be activists for their clients when there is something preventing growth and change.
Example:
Assimilation
Part of cultural issues in counseling, this is the process by which a person or group adopts a new culture to the point of virtually replacing their original culture, leaving only trace elements behind. Assimilation is common among immigrant populations that seek to blend in with the existing fabric of society and want to be seen and embraced as belonging. Individuals may feel pressure from members of the majority culture to assimilate quickly. Generally seen as negative compared to acculturation.
Example: Juan immigrated to the U.S. with his parents from Guatemala when he was a child. Now he is a teenager and seeking therapy over assimilation conflicts with his parents. He has fully assimilated to US culture, rejecting most aspects of his native culture, language, and customs. He is frustrated that his parents only speak Spanish at home and resist American popular culture.
Bicultural
Part of client factors, this is having or combining the cultural attitudes and customs of two nations, peoples, or ethnic groups. An individual who is bicultural is conversant with both sets of values and customs. Identifying with two or more cultures, typically seen with one’s heritage culture and the culture of the country or region in which one has settled. Maintaining biculturality can be difficult if the majority culture pressures assimilation. Being bicultural is a source of strength but negotiating dual group membership can cause problems for many marginalized group members. This is important when considering a client’s worldview.
Example: You are counseling the child of an immigrant. The child is bicultural because she is deeply embedded in the heritage culture at home, but is also active and knowledgeable of American culture due to interactions at school.
Collectivism
This is part of multicultural understanding as the philosophical, political, economic or social outlook that emphasizes the interdependence of every human in some collective group and the priority of group goals over individual goals; a way of life in some cultures in which the group is the primary unit, not the individual. The needs and interests of individuals are sacrificed in order to meet the needs of the group as a whole. This philosophy is prominent in Eastern cultures. It is in strong contrast to the prevailing sentiment in the United States, which is individualism. Counselors with backgrounds from individualistic cultures need to take this into account when designing interventions for clients from a collectivistic culture.
Example: When counseling someone from a collectivist culture, the therapist must be careful not to impose his/her own individualistic viewpoint on the client. For instance, the therapist must resist passing judgements on someone she deems “too dependent” because in collectivistic cultures dependence is viewed as natural, while individualistic cultures disparage dependence.
Coming out process
This is part of counseling relevant issues, coming out is the process in which individuals reveal that they identify as part of the LGBTQ community. Not everyone goes through the same process or the same steps. This is not a linear process and the individual typically has to “come out” many times throughout their life. There are positives and negatives of coming out. Important to consider all consequences when counseling a client thinking about coming out. Positives include building self esteem, building more genuine relationships, and being a role model to others. Negatives include rejection, harassment, discrimination, and loss of social support. 6 Stages of Coming Out: - Confusion- question and wonder about sexuality; might experience denial - Comparison- accept possibility that you may be gay - Tolerance- acceptance increases, may isolate self because self-concept is becoming different from society’s expectations - Acceptance- have resolved most ?s concerning sexual identity and have accepted self - Pride- begin to feel pride; immerse self in LGB culture; may feel anger with or reject hetero community - Synthesis- integrate sexual identity with other aspects of self so it is just one part of whole identity. Feel more congruence. Its important to recognize that the goal of therapy isn’t always for the client to come out. Clinicians can help them expand environmental supports and develop coping skills.
Example: A 20 year old male was seeking therapy due to anxiety about his sexual orientation. He explained to the therapist that his family would never accept him if they found out he was homosexual, but that he had to tell someone. The therapist offered help and together they explored the consequences of coming out process. He role played coming out to his dad with the therapist.
Cultural competence
Therapist’s ability to understand the various influences of culture on a person’s behavior and interactions. Can be defined in three different areas: Awareness, Knowledge, and Skills. -Awareness includes knowing one’s own culture, views, biases, and comfort levels of various backgrounds. -Knowledge refers to the therapist’s knowledge of the cultural group both currently and historically, along with any barriers that group may have faced. -Skills refer to implementing culturally appropriate interventions and receiving and sending information in ways that take into account cultural background; also recognizing one’s own personal limitations. Cultural humility is also involved. Cultural competence is not something that can be learned once, but is instead a lifelong process in which therapists must remain continually engaged.
Example: Danielle is a white therapist who is practicing on a Native American reservation. She attends ceremonies and meetings with tribe’s elders in order to better understand how to help her clients in the context of their culture, thereby increasing her cultural competence.
Cultural universality
In contrast to cultural relativism, this is the view that the concepts of normality and abnormality can be universally be applied, regardless of culture. Proponents of this view believe that culturally diverse individuals do not need treatments to be adjusted for them, but can be treated just the same as an individual from a Western culture. When these values are imposed clients can engage in victim blaming.
Example: A therapist that takes a cultural universality approach does not spend much time assessing or exploring a client’s culture as they do not believe it affects the person’s symptoms, interpretation of treatments, or presentation of disorders.
Culture
Culture consists of all those things that people have learned to do, believe, value, and enjoy. It is the totality of the ideals, beliefs, skills, tools, customs, and institutions into which members of society are born. Frequently culture has a significant influence on one’s sense of identity, and to understand the client’s internal frame of reference the counselor must understand their culture.
Example: A Muslim woman comes to treatment wearing a head scarf. Woman cover their heads in public in her country of origin so this is a practice rooted in her culture.
Culture-bound
Refers to behaviors that are linked to a specific culture or tied to a specific group of people and their values and beliefs. Certain syndromes and disorders may be culture bound, as well as certain treatments. A counselor must be careful not to diagnose something that is considered normal in a culture as a disorder, and also must be sure to be aware of disorders that occur only in specific cultures. Values can be culture bound as well, such as emotional expressiveness, insight, and self-disclosure.
EXAMPLE: The experience and perpetuation of grief is often culture-bound. If you are counseling someone of the Jewish faith that just lost her mom, it is important to know that she might grieve for an entire year based on religious underpinnings.
Emic
The belief that cultural differences must be considered in the diagnosis and treatment of culturally diverse groups (Remember Emic - me, multicultural). The emic perspective emphasizes culture-specific norms and views clients in the context of his/her own culture. What is true for one client might not be true for another. If counselors are practicing emically then they are coming from a multicultural perspective.
EXAMPLE: A therapist that takes an emic approach will spend a lot of time assessing or exploring a client’s culture because they believe cultural differences affect how a disorder manifests and how the client should be treated.
Ethnicity
Unlike race, its more of a social category. The fact or state of belonging to a social group that has a common national or cultural tradition. Ethnicity generally describes a group’s sense of possessing a shared identity informed by a common language, culture, or religion. Racial and ethnic identities often overlap. It can be important to understand when examine cultural-relevant issues and developing culturally appropriate interventions.
EXAMPLE: The Martinez family came to therapy because the father was hearing voices and sounds no one else heard. The therapist talked about the father’s problems in front of the entire family, using the son to translate, without realizing that the family’s Hispanic ethnicity would prohibit the son from taking on such a role.
Etic
The belief that human beings share broad commonalities and that the manifestation and treatment of disorders are similar across ALL cultures and societies (remember etic - Total). The etic perspective emphasizes similarities between all people, assumes universality, and downplays culture-based differences. It teaches counselors that universality can be a bad thing and is important when different cultures express syndromes differently.
EXAMPLE: A therapist that takes an etic approach does not spend much time assessing or exploring a client’s culture because they believe cultural differences do not affect how a disorder manifests and should be treated
Ethnocentric monoculturalism
Ethnocentric monoculturalism is the consideration of one culture as being the standard, normal, and most valuable. Any other culture by comparison is seen as inferior, abnormal, and exotic. It is defined by five components. The first is the belief in the superiority of the dominant group. This means the values, beliefs, language, traditions, physical characteristics, and norms of the dominant group are seen as the most civilized, most advanced, and normative. The second component is the belief in the inferiority of others. The third is the power of the dominant group to impose their cultural standards and values on others. The fourth component is manifestation in institutions, meaning that the dominant culture’s values and beliefs are apparent and embedded within policies, practices, and societal structures and institutions. The last component is the invisible veil. This refers to how people see and interpret everything in life through their own values, experiences, and beliefs because of their cultural conditioning. This operates outside of an individual’s conscious awareness and causes them to assume everyone shares the same perceptions of the world. Is at the heart of the oppressor/oppressed relationship and affects trust in the therapeutic relationship. It can also be at the heart of the minority culture seeking therapy.
Ethnocentric monoculturalism is the consideration of one culture as being the standard, normal, and most valuable. Any other culture by comparison is seen as inferior, abnormal, and exotic. It is defined by five components. The first is the belief in the superiority of the dominant group. This means the values, beliefs, language, traditions, physical characteristics, and norms of the dominant group are seen as the most civilized, most advanced, and normative. The second component is the belief in the inferiority of others. The third is the power of the dominant group to impose their cultural standards and values on others. The fourth component is manifestation in institutions, meaning that the dominant culture’s values and beliefs are apparent and embedded within policies, practices, and societal structures and institutions. The last component is the invisible veil. This refers to how people see and interpret everything in life through their own values, experiences, and beliefs because of their cultural conditioning. This operates outside of an individual’s conscious awareness and causes them to assume everyone shares the same perceptions of the world.
Example:
Individualism
The philosophical, political, economic or social outlook that emphasizes the independence and worth of every human and the priority of individual goals. The Western world embraces this view which focuses on the autonomy of the individual and promotes freedom of action for the individual over the collective. From this view people are considered “good” if they are strong, self-reliant, assertive and independent. Being dependent upon others is often considered weak. Its important to know how the client views self in relation to others in therapy.
EXAMPLE: When counseling someone from an individualistic background, the therapist should allow the client to guide and inform therapeutic goals because he/she likely values autonomy. When working with a client from a collectivistic background, the therapist might be required to do a little bit of advice giving.
Institutional racism
Institutional racism refers to policies, priorities and accepted normative patterns that are designed to subjugate, oppress, and force dependence of individuals and groups on a larger society by sanctioning unequal goals, unequal status, and unequal access to goods and services. Institutional racism may include police practices, unemployment, housing and education issues, discriminatory practices and inadequate welfare programs. Prejudiced attitudes can be found in many cultural elements, including language, education, religion, norms of morality, economics and aesthetics. This is the hardest racism to recognize and works to disempower entire minority groups within the society. When treating clients who have experienced this, it is important for therapists to help them recognize that this is an external factor and separate from the client.
EXAMPLE: An African American client that you are counseling for depression details the institutional racism that her family has had to endure. Her husband and the father of her children was unfairly imprisoned due to the third strike policy. He was sent to jail for years over a personal bag of weed. You empathize with her and help her come to terms with this new reality for her family.
Microaggression
Microaggressions are the everyday slights, put-downs, invalidations, and insults directed to socially devalued group members by well-intentioned people who often are unaware that they have engaged in such biased and harmful behaviors. Three categories of microaggressions: microinsults (unintentional ways of being insensitive/demeaning); micro assault (blatant, hostile – conveys bias and prejudice), and microinvalidation (dismiss, exclude other person’s experience/beliefs).
Example: A white woman tells a Black woman that she loves her hair and asks to touch it. This is a microaggression because the white woman thinks she is being complimentary, but she is actually dehumanizing the other woman by exotifying her hair.
Minority
An ethnic, racial, religious, or other group having a distinctive presence within a larger society and who differ from the dominant and majority culture in one or more ways, including but not limited to culture, race, sexual orientation, or country of origin. Being a member of a minority group in a mono-cultural society often puts one at a significant disadvantage. It can cover any group that is the subject of oppression and discrimination.
EXAMPLE: As a white therapist, I am part of the majority in the US. I must recognize that I may not understand a minority group member’s unique experiences and I must be open to learning about it from that member.
Multicultural competencies
Multicultural competence has three components: awareness, knowledge, and skills. - Awareness includes knowing one’s own culture, views, biases, and comfort levels of various backgrounds. Awareness can be developed via awareness activities which change the person’s attitudes, opinions and personal perspective (i.e. journal in multicultural class, immersion) - Knowledge refers to the therapist’s knowledge of the cultural group both currently and historically, their worldview, and any barriers that group may have faced. Can be developed by learning facts and seeking accurate data (i.e. research, reading books). - Skills refer to implementing culturally appropriate interventions and receiving and sending information in ways that take into account cultural background. Skill-building activities involve the application of awareness and knowledge in applied settings with diverse clients (i.e. seeking supervision on new skills).
EXAMPLE: A multiculturally competent therapist working with diverse populations will understand her own limitations in understanding the marginalized experience, routinely seek education about marginalized groups, and seek training to build her skills in working with these groups.
Multicultural competencies: It is the acknowledgement that multiculturalism leads to social justice initiatives and actions. It includes quadrants (privilege, oppressed statuses), domains (counselor self-awareness, client worldview, counseling relationships, and counseling and advocacy interventions), and competencies (attitudes, beliefs, skills, and action). This is important to keep in mind when practicing with cultural competence.
Multicultural counseling
This is a framework for counseling in which the therapist defines goals and uses treatments that are consistent with an individual’s cultural values. The therapist must recognize that their values may not be the same as that of their culturally diverse client, but that does not give them the right to pressure their client to accept their values. The therapist must also recognize some behaviors considered deviant in Western society are not considered deviant in the culture of their clients.
Take into account: race, ethnicity, gender, sexuality, social status, disability, history of oppression, acculturation. How you integrate into practice.
EXAMPLE: A therapist treating an Asian American client is careful when defining goals not to impose his individualistic values on his client, who has more of a Multicultural counseling is an approach to counseling that requires that the counselor consider not only the racial and ethnic background of their clients, but also their age and other social categories including gender identity, sexual orientation, religion, disability status, immigration status, and social class/socioeconomic status. Therapists using multicultural counseling view a client’s presenting issues in the context of their various social identities. Additionally, it involves understanding the history of oppression, marginalization, and power, or lack thereof, in order to see how the combination of all of these factors impacts the client’s experience. It can and should be used with any therapeutic approach or methodology. collectivist perspective.
Multicultural perspective in counseling
This perspective recognizes the differences between and within clients and how their cultures may impact their values. According to this perspective, a counselor must maintain awareness of her own cultural biases and values in order to prevent her from interfering with interactions with culturally diverse clients. Counselors are also responsible for cultivating knowledge about different cultures and skills that are useful with culturally diverse clients. The perspective.
EXAMPLE: Josie, a therapist that uses a multicultural perspective, was raised in an impoverished environment, in which the family constantly struggled to put food on the table. Because of her experience, she feels many who are wealthy are wasteful and unappreciative. She must be careful of this bias when working with wealthy clients so she does not harbor resentment or negativity towards a client.
Oppression
Oppression is the abuse of power whereby a dominant group engages in unjust, harsh, or cruel activities that perpetuate an attitude or belief toward a marginalized group that is reinforced by society and maintained by a power imbalance. The dominant culture frequently will use its power to marginalize, silence, and otherwise subordinate other cultures. Cultural oppression may occur without the oppressor realizing it; in light of this, the therapist must take steps to be very aware of any ways they may be oppressive to culturally diverse clients. Chronic oppression can lower self-esteem, reduce opportunities, can lead to anger/anxiety/depression and can lead to internalized oppression.
EXAMPLE: Marvin is a young gay male coming to therapy for depression. He describes the oppression he experiences at school, work, and even in his family: - he is bullied at school. - He has been both physically and verbally attacked by his peers. - When he first came out, he lost his job because his boss didn’t approve of his “lifestyle.” - He is bombarded daily with negative stereotypes of homosexuality from the media, family and friends, and religion.
Poverty and mental illness
Studies show a direct correlation between poverty and mental illness. Impoverished people are 2 to 3 times more likely to develop mental illness than those w/ higher SES. These families must deal with economic stressors like unemployment and lack of affordable housing, which can lead to mental health disorders. There is also a strong association between poverty and substance abuse. Substance abuse only perpetuates a cycle of poverty. These environments can increase the risk of exposure to violence and trauma.
Example: Richard grew up in a poor family that didn’t have access to mental health or medical resources to help him when he began to show signs of schizophrenia. He began to self-medicate with drugs. As an adult, he is unhoused and has spent time in and out of psychiatric wards of hospitals and prisons for actions related to his addiction and mental illness.
