08a_Diversity Issues: Psychotherapy with Specific Groups Flashcards by Nikos Rebetis

African Americans

Worldview

Interconnectedness of all things

Emphasis of group welfare over individual needs

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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

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African Americans

Familial roles

Flexible–adults and children may adopt multiple roles

Egalitarian relationships between men and women

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African Americans

“Healthy Cultural Paranoia”

Mistrust related to oppressive social history in U.S.

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African Americans

Systems incorporated into treatment

Extended family and non-blood kin

The church and other community resources

Social service agencies

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African Americans

Therapeutic approaches

Time-limited

Directive

Goal oriented

Problem-solving

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African Americans

Therapeutic relationship

Foster empowerment by promoting egalitarianism

Address concerns/reactions if therapist is of a different racial background in initial session

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Native Alaskans

Worldview

Spiritual and holistic orientation to life

Emphasis on harmony with nature

Illness is viewed as a result of disharmony

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Native Alaskans

View of Family

Emphasis on extended family and tribe vs. individual needs

Consensual collateral social organization and decision-making

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Native Alaskans

Perception of Passage of Time

Emphasis on personal and seasonal rhythms

Present-oriented

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Native Alaskans

Interpersonal relations Values

Strong sense of cooperation and generosity

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Native Alaskans

Is recommended that clinicians become familiar with:

Historical events that affected their lives

Their relationships with White Americans

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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

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Native Alaskans

Initial sessions Rapport /Trust building

Demonstrating familiarity with and respect for client’s culture admitting any lack of knowledge

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Native Alaskans:

Therapeutic approaches

Collaborative

Problem solving

Client-centered

*Incorporating elders, and other traditional healers

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Native Alaskans:

Therapeutic Style to Avoid

Do NOT use highly directive or confrontational techniques

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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)

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Asian Americans:

Essential Initial Information Gathering

Country of origin

Acculturation status

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Asian Americans:

Country of Origin and Acculturation Status effect of therapy

Limiting customs

Social relationships

Attitudes toward mental illness

Attitudes toward psychotherapy

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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