Diversity Workgroup: COMPS

Question 1

What is cultural competence according to Huey et al., 2014?

Answer 1

Cultural competence requires the awareness of cultural differences and the application of this knowledge to diverse clients (Huey et al., 2014)

Question 2

What are four abilities that help define cultural competence for clinicians?

Answer 2

Cultural competence refers to the ability of a clinician to:

1. Understand and appreciate the cultural background of their clients
2. Recognize how cultural factors influence the client’s presenting problems, beliefs about mental health, and attitudes towards treatment
3. Adapt their therapeutic approach and interventions to be culturally appropriate and effective
4. Develop skills to work effectively with clients from diverse cultural backgrounds

Question 3

What is cultural humility?

Answer 3

Cultural humility = open attitude stance toward diverse people and groups. Cultural humility is an ongoing process of self-reflection and learning about different cultures, involving:

• Recognizing and addressing one’s own biases
• Acknowleding the limits of one’s cultural knowledge
• Showing respect and openness to other cultural perpectives

Question 4

How does cultural humility position the client and therapist?

Answer 4

Cultural humility positions the client as the expert on their own life and culture, and the therapist as the committed learner

Question 5

What is intersectionality according to PettyJohn et al., 2020?

Answer 5

Intersectionality = “an individual’s exposure to multiple, simultaneous, and interactive effects of different types of social organization and their experiences related to prejudice and power or societal oppression”

• Intersectionality accounts for various pieces of an individual’s identity.
• These identities come together (intersect) to form one’s social location, determining the power and privilege held by an individual

Question 6

How does intersectionality affect the therapeutic alliance according to PettyJohn et al., 2020?

Answer 6

• Dynamics of power and oppression are expressed at the relational level in therapy.
• As highly educated and trained professionals, therapists hold power.
• However, clients with privileged identities may hold more power than therapists with marginalized identities.
• Addressing power dynamics may be essential to the therapeutic alliance.
• Clients may not feel fully seen or understood until power dimensions are addressed.

Question 7

Ways to approach conversations about intersectionality?

Answer 7

• Use in-depth demographics form that provides opportunities for client to disclose their identities
• Conceptualize how client identities may interact with presenting problems
• Provide opportunities for client to discuss their identities and how they may interact with their presenting problems
• When therapists engage in self-disclosure, there are risks. Self-disclosures should be clinically relevant and viewed as an intervention—not as a way to ease our own anxieties

Question 9

What is the minority stress model (Meyer, 2003)?

Answer 9

The minority stress model is a model explaining how marginalized groups experience chronic stress from their minority status, leading to greater mental health issues

• Minority stress = stress coming from discrimination and stigma that is unique, chronic, and socially based
• Mental health may be at risk when the social constructs of “normality” are incongruent with the lived experience of marginalized individuals

Question 10

What are the two types of stressors in the minority stress model?

Answer 10

Distal (external) stressors:

• E.g., discrimination, rejection, violence

Proximal (internal) stressors:

• E.g., internalized stigma, anticipating rejection

Question 11

What are some factors to consider when working with transgender or gender-nonconforming clients (TGNC)?

Answer 11

TGNC population experiences higher rates of:

• emotional distress and suicide
• discrimination and harassment at school and workplace (e.g., forced to use bathrooms incongruent with their gender identity),
• and higher rates of homelessness

Question 12

What are TGNC-affirming practices that should always be in place?

Answer 12

• Having gender-neutral bathrooms
• Using inclusive language on intake/administrative forms, and
• Offering and asking about preferred pronouns

Question 13

What are the three aspects of treatment that cultural factors influence according to Gopalkrishnan, 2018?

Answer 13

1. What gets defined as a problem
2. How the problem is understood
3. What solutions are acceptable

Question 14

What important consideration must psychologists make regarding the appropriateness of an assessment for a client?

Answer 14

• Psychologists need to consider the validity of a given assessment as it applies to the person being assessed.
• Cultural and linguistic characteristics of the person may render the measure invalid!

Question 15

When working with a client who immigrated to the U.S., what are four factors to consider according to Ortiz et al., 2018?

Answer 15

1. Age they moved to the U.S.
2. Acculturation when living in the U.S.
3. Language(s) spoken at home, and
4. Amount of education in the U.S.

Knowing the client’s race and ethnicity alone does not provide enough information!

Question 16

What is Pamela Hayes’ ADDRESSING model?

Answer 16

The ADDRESSING model acronym:

• Age/Generation
• Disability status (developmental)
• Disability status (acquired)
• Religion/Spirituality
• Ethnicity
• Socioeconomic status
• Sexual orientation
• Indigenous heritage
• National origin
• Gender

Question 17

What does the ADDRESSING model help people remember?

Answer 17

1. The ADDRESSING model helps people remember different parts of a person’s identity that might affect how they see the world, how they’re treated by others, issues of privilege/discrimination, and so forth.

Question 18

What are the four approaches for handling validity issues related to cultural and linguistic differences (MENN acronym)?

Answer 18

1. Modified or adapted testing - Tests are modified but still administered primarily in English
2. English-language testing
3. Nonverbal testing
4. Native-language testing

Question 19

What is the Cultural Formulation Interview (CFI) from the DSM-5-TR?

Answer 19

The Cultural Formulation Interview (CFI) from the DSM-5-TR is a set of questions used by clinicians to understand a client’s cultural background and how it affects their mental health/presenting problems

Question 20

What are the two main versions of the CFI?

Answer 20

• Core CFI: The main interview with client, and
• CFI—Informant Version used when the clinician wants to collect collateral information from someone who knows the client (e.g., the parent of a child client)

Question 21

What are the four areas emphasized in the Core CFI?

Answer 21

1. Cultural definition of the problem
2. Cultural perceptions of cause, context, and support
3. Cultural factors affecting self-coping and past help seeking
4. Cultural factors affecting current help seeking

Question 22

MMPI-3 normative sample

Answer 22

• The MMPI-3 normative sample is significantly more diverse than previous versions’ normative samples
• Normative sample aimed to reflect 2020 U.S. Census projections
• 1,620 adults: 810 men, 810 women
• Proportionate ages, educational levels, and racial/ethnic identification
• Cultural minority populations remain underrepresented though (e.g., immigrants, indigenous populations

Question 23

What do studies demonstrate about MMPI-3 scales across racial and ethnic groups?

Answer 23

Some studies have demonstrated that the MMPI-3 scales function similarly across major racial and ethnic groups

Question 24

How were Black Americans affected by older versions of the MMPI?

Answer 24

Historically: Black Americans were often overpathologized by older versions of the MMPI, such as higher average scores on scales that measure paranoia (e.g., RC6—Ideas of Persecution)

Question 25

Native Americans and MMPI-2 scores

Answer 25

Native Americans had significantly higher average scores on many MMPI-2 scales. * Typically reflected historical trauma, oppression, or worldview differences rather than psychopathology.

Question 26

How can race-related stressors impact MMPI-3 results (and assessment results more generally)?

Answer 26

* Race-related stressors can impact MMPI-3 and other assessment results * Example: Self-reported experiences of racism in Black Americans correlated with multiple MMPI-3 scores, such as those measuring demoralization, anxiety, anger, and interpersonal stress

Question 27

How might some Latinx cultures affect MMPI-3 (and other) scores?

Answer 27

Some Latinx cultures encourage somatic expressions of cultural/emotional pain → can lead to higher scores on scales that measure somatic complaints

Question 28

What is CALP?

Answer 28

**CALP** = **Cognitive Academic Language Proficiency** = the language necessary to understand and discuss content in the classroom/at work

Question 29

What is BICS?

Answer 29

**BICS** = **Basic Interpersonal Communicative Skills** = everyday conversational language

Question 30

What is the Culture-Language Test Classification (C-LTC)?

Answer 30

C-LTC is a system that ranks how much a psychological test depends on language and culture. * Tests are classified into levels (e.g., Level 1 = least cultural/language bias; Level 4 = most)

Question 31

Which is easier to acquire, BICS or CALP? What are the typical timeframes?

Answer 31

* BICS is easier to acquire than CALP. * BICS developed in ~ 2 years, CALP in ~5—7 years. * Note: Just because a client appears fluent (i.e., they can socialize in English) doesn't mean they can understand the language needed for their academics.

Question 32

What is the Culture-Language Interpretive Matrix (C-LIM)?

Answer 32

* The C-LIM involves the cultural load and linguistic demand of a subtest * The C-LIM involves a 3x3 Matrix: (low vs. moderate vs. high) with x-axis showing increasing linguistic demand and y-axis showing increasing cultural loading

Question 33

How to use the C-LIM?

Answer 33

Map the client's assessment results along the matrix to determine whether their performance is suggestive of language or cultural bias.

Question 34

Points about gender and the MMPI-3

Answer 34

* Some evidence that the MMPI-3 scales have good psychometric properties when administerd to transgender and gender diverse (TGD) individuals (Bryant et al., 2024) * The MMPI-3 uses gendered norms * Scoring is generally based on gender identity, not assigned sex at birth * Problem: Norms are still binary (male/female)

Question 35

How can religious and spiritual beliefs influence assessment responses?

Answer 35

Religious and spiritual beliefs can influence responses to items about unusual experiences (e.g., unusual perceptual experiences)

Question 36

WAIS-IV norms

Answer 36

* Based on U.S. nationally representative sample of 2,200 individuals * ages 16 to 90 * stratified by age, sex, race/ethnicity, education level, and geographic region according to 2005 U.S. Census data. * Remember: WAIS-IV was published in 2008.

Question 37

WIAT-IV norms

Answer 37

* based on national U.S. sample of 1,832 individuals ages 4:0 to 50:11 * stratified using 2018 Census data for age, sex, race/ethnicity, parent education level, and region. * WIAT-IV published in 2020. * WIAT-IV assumes exposure to mainstream U.S. curricula.

Question 38

What populations are underrepresented in WAIS-IV/WIAT-IV norms?

Answer 38

Some groups (like Native Americans and recent immigrants) are underrepresented in WAIS-IV/WIAT-IV norms

Question 39

How do educational experiences affect WAIS-IV performance?

Answer 39

* Educational experiences significantly influence WAIS-IV performance * Participants with limited or non-Western education may score lower, not necessarily because of any cognitive deficits but because of differences in educational access, quality, and content.

Question 40

Why are WAIS tasks (and many other assessments) considered language-mediated?

Answer 40

* For the WAIS (and many other assessments), all tasks have verbal instructions, so they are to some degree language-mediated tasks. * As such, English proficiency strongly affects performance.

Question 41

What important consideration should be made when interpreting lower assessment scores for marginalized individuals?

Answer 41

Consider whether lower scores reflect gaps in opportunity rather than true differences in innate abilities

Question 42

Why does cultural response style matter for Latinx examinees (and other examinees as well)?

Answer 42

* For Latinx examinees (and all examinees for that matter), cultural response style matters. * Values like *respeto* or *simpatía* may reduce assertiveness or willingness to ask for clarification. * Similar ideas with other groups, such as Asian Americans, who come from cultures that emphasize humility, modesty, and deference to authority.