08a_Diversity Issues: Psychotherapy with Specific Groups Flashcards
African Americans
Worldview
Interconnectedness of all things
Emphasis of group welfare over individual needs
African Americans
View of Family
Extended kinship network
Includes nuclear and extended family members, as well as nonbiological individuals
The church can also be an important part of the extended family
African Americans
Familial roles
Flexible–adults and children may adopt multiple roles
Egalitarian relationships between men and women
African Americans
“Healthy Cultural Paranoia”
Mistrust related to oppressive social history in U.S.
African Americans
Systems incorporated into treatment
Extended family and non-blood kin
The church and other community resources
Social service agencies
African Americans
Therapeutic approaches
Time-limited
Directive
Goal oriented
Problem-solving
African Americans
Therapeutic relationship
Foster empowerment by promoting egalitarianism
Address concerns/reactions if therapist is of a different racial background in initial session
Native Alaskans
Worldview
Spiritual and holistic orientation to life
Emphasis on harmony with nature
Illness is viewed as a result of disharmony
Native Alaskans
View of Family
Emphasis on extended family and tribe vs. individual needs
Consensual collateral social organization and decision-making
Native Alaskans
Perception of Passage of Time
Emphasis on personal and seasonal rhythms
Present-oriented
Native Alaskans
Interpersonal relations Values
Strong sense of cooperation and generosity
Native Alaskans
Is recommended that clinicians become familiar with:
Historical events that affected their lives
Their relationships with White Americans
Native Alaskans
Therapist preference
Therapist who helps them reaffirm the VALUES of their own culture
Distrustful of attempts to provide therapy in a “value-free” environment
Native Alaskans
Initial sessions Rapport /Trust building
Demonstrating familiarity with and respect for client’s culture admitting any lack of knowledge
Native Alaskans:
Therapeutic approaches
Collaborative
Problem solving
Client-centered
*Incorporating elders, and other traditional healers
Native Alaskans:
Therapeutic Style to Avoid
Do NOT use highly directive or confrontational techniques
Native Alaskans:
Network Therapy
Incorporation of family community members into treatment
Psychological problems are framed within context of family, workplace, community, and other social systems
(i.e., Network)
Asian Americans:
Essential Initial Information Gathering
Country of origin
Acculturation status
Asian Americans:
Country of Origin and Acculturation Status effect of therapy
Limiting customs
Social relationships
Attitudes toward mental illness
Attitudes toward psychotherapy
Asian Americans:
Family Dynamics
Hierarchical family structure
Traditional gender roles
Asian Americans:
Emphases of Interpersonal Relationships
Harmony
Interdependence
Mutual loyalty and obligation
Asian Americans:
Cultural Value of Restraining Strong Emotions
Prevent disruption of peace and harmony
Prevent bringing shame onto the family
Asian Americans:
Preferred Therapeutic Approaches
Focus on alleviating specific symptoms
Directive
Structured
Goal-oriented
Problem-solving
Asian Americans:
Role of therapist
Knowledgeable expert
Authority figure
Expected to give concrete advice
Asian Americans: Therapy Guidelines
Formalism
Address family members in a way that reflects their status
Respect conversational distance
Asian Americans:
Function of shame and obligation
Reinforce adherence to prescribed roles and responsibilities
Asian Americans:
Modesty and self-deprecation
*Not necessarily signs of low self-esteem
Asian Americans: Therapy Guidelines
Establishing credibility
Early in therapy, disclose information about educational background and experience
Asian Americans: Therapy Guidelines
Preventing Premature Termination
Provide client with immediate and meaningful benefit
“therapeutic gifts”
Asian Americans: Therapy Guidelines
Somatic complaints
Common to express mental-health problems as biological/physiological/medical complaints
Asian Americans: Therapy Guidelines
Emotions vs. Behaviors
Primary focus on Behaviors often more effective
Ways to Modify EBT’s for Increased Effectiveness with Asian American clients
Focus more on the family than on individual
Incorporate cultural and social factors
Hispanic/Latino Americans:
Importance of Family
Family welfare is valued over individual welfare
Strong allegiance to family over other concerns
Hispanic/Latino Americans:
Interpersonal Values
Interdependence is both healthy and necessary
High value on connectedness and sharing
Hispanic/Latino Americans:
Attitudes toward personal disclosure
Discussing intimate personal details with strangers (e.g. therapist) is highly Unacceptable
Problems should be handled within the family
Hispanic/Latino Americans:
Worldview
Concrete, tangible approach to life
Compared to abstract, long-term perspective
Hispanic/Latino Americans:
Locus of control
External:
Luck
Supernatural forces
Acts of God
Hispanic/Latino Americans:
Therapeutic approaches
Active
Directive
Multimodal approach
Family therapy
Hispanic/Latino Americans:
Family therapy
Recommended for Hispanic/Latino clients
Reinforces view of “familismo” and extended family
Hispanic/Latino Americans:
Family Dynamics and Roles
Patriarchal family structure
Inflexible sex roles
*Parent-child dynamic is often stronger than husband-wife and other family relationships
Hispanic/Latino Americans:
Acculturation
Differences in the degree of acculturation within a family are often a source of individual and family problems
Hispanic/Latino Americans:
Somatic complaints
Similar to Asian Americans, Hispanic clients may often express mental health problems as somatic complaints
Sexual Minorities:
Etiology of higher rates of psychological problems
Due to prejudice and discrimination
*Not due to sexual orientation itself
Sexual Minorities:
Effects of stigmatization
Withdrawal
Isolation
Internalized homophobia
Sexual Minorities:
Internalized Homophobia
Acceptance of heterosexual society’s negative evaluations
Incorporation of evaluations into self-concept
Sexual Minorities:
Consequences of Internalized Homophobia
Low self-esteem
Self-doubt/self-hatred
Sense of powerlessness
Denial of one’s sexual orientation
Self-destructive behavior
Sexual Minorities:
Therapeutic approaches
Identifying and correcting cognitive distortions
Provided training in assertiveness and coping skills
Activating social support systems
LGBT individuals are more likely to experience:
Depression
Anxiety
Substance Abuse
Higher risk for suicidality
