561 - DEENA'S VERSION Culture Issues in Psych Practice

Question 1

acculturation

Answer 1

WHERE: culture issues in psych practice

WHAT: The process by which a group/person changes social and cultural values from their original culture to align with a diff culture (usually a mainstream one)
- MAINTAINS ELEMENTS FROM ORIGINAL CULTURE
- can create stress/conflict if difference levels of acculturation in a fam or relationship.

WHY: Different levels of acculturation affects how clients perceive and respond to the therapist. It is important to keep this in mind when creating a treatment plan. To increase efficacy of treatment and strength the therapeutic relationship, the therapist may alter their approached to align with the clients cultural values and norms.

EXAMPLE: A 30-year-old client had recently moved to the US from Japan. She speaks some English, but struggles with cultural differences and feels lonely. The therapist addresses things with the woman such as cultural stress and finding her a social support group.

Question 2

ADDRESSING model

Answer 2

WHERE: cultural issues in psychological practice

WHAT: Helps to fully understand a client. Helpful to see in what way the client may be in a marginalized group.
A- age
D- disability at birth
D- disability acquirred
R- religion
E- ethnicity
S- sexual orientation
S- socioeconomic status
I- indigenous heritage
N- nation of origin
G- gender

WHY: This model allows for the therapist to consider a range of culture factors that influence a client’s identity and their experiences. It aids in creating relevant and effective treatment goals.

EXAMPLE: Dahlia is an 18 year old with no disabilities, she is Buddhist, Indian, a lesbian, upper class, no indigenous heritage, was born in the USA, and is a CIS gendered girl. The therapist will gather information about how aspects of her identity may be influencing her presenting problems.

Question 3

anti-racism

Answer 3

WHERE: cultural issues in psychological practice

WHAT: Involves actively working against the racist attitudes ingrained within society by working towards change and being a social justice warrior.
Apart of developing a multicultural attitude surrounding societal change.

WHY: A therapist having an anti-racist attitude means they are advocates for minority groups and they address systemic injustices that prevent growth and development of clients.

EXAMPLE: A therapist may validate and reassure a client that feels they were a victim of racism. They may reinforce the fact that racism is real, and it can have a real effect on one’s mental health. Outside of sessions, the therapist may participate in BLM protests to advocate, empower, and work against systems of oppressions.

Question 4

assimilation

Answer 4

WHERE: cultural issues in psychological practice

WHAT: The process of a person adopting a new culture’s beliefs and practices and LOSE THEIR ORIGINAL CULTURE/features
- individuals/groups of a foreign culture are absorbed into the dominant culture of a society
- common among immigrant populations that seek to blend into society– want to belong

WHY: Clients who are assimilating into a new culture may face unique challenges, such as identity conflict and social isolation. Adopting new norms and practices can cause stress. Therapists may also help clients find a balance between their native culture and the new culture to help clients stay authentic while also fitting into their new environment.

EXAMPLE: A client immigrated to the USA from Egypt when he was a child. Now, as a teen, he is seeking therapy due to assimilation conflicts with his family. He has fully assimilated to US culture and has rejected/forgotten must of his native culture (the language, the customs, etc.). His parents only speak Arabic at home and resist/reject American culture.

Question 5

bicultural

Answer 5

WHERE: cultural issues in psychological practice

WHAT: When a person has identifies with two different cultural identities // is able to function in two different cultural environments
- a bicultural person is. aware of the dominant culture’s + their native culture’s values, beliefs, and norms
- incl. language, values, customs, and norms

Maintaining/being bicultural may be difficult for the individual if the majority, dominant culture is pressuring assimilation.

WHY: While seeing bicultural clients, the therapist may need to assist in managing conflicts/discrepancies between the two cultures, support acculturation, and facilitate a positive self-identity. Maintaining/being bicultural may be difficult for the individual, especially if the dominant culture is pressuring assimilation

EXAMPLE: Mariam is a teenage bicultural girl who was born in the USA, but her parents were born in Egypt. Her and her family spend summer months in Egypt. She speaks both Arabic and English, and feels apart of both Egyptian and American culture. Mariam came to therapy because she feels conflicted between the traditional Egyptian values and the more liberal American ones.

Question 6

coming out process

Answer 6

WHERE: cultural issues in psychological practice

WHAT: The process of self-identification and self-acceptance for LGBTQ+ people.
- can include disclosures of one’s sexual orientation and/or gender identity to people in their life.
- may lead to rejection and anger, or relief and acceptance.

6 Stage Process: confusion, comparison, tolerance, acceptance, pride, synthesis

WHY: Coming out is a significant even, and therapists working with the LGBT+ community need to understand the significance and the intricacies of the process in order to adequately support clients.
Can also help clients work through their fears of the possible consequences of coming out.

EXAMPLE: John is a 18 year old boy. He recently came out to his close friends and told them he was gay. He is unsure of whether or not/how to tell his very conservative parents. He came to therapy due to ambivalence, stress, and fear of rejection.

Question 7

cultural competence

Answer 7

WHAT: A lifelong process where a person aspires to understand, appreciate, advocate, and interact effectively with people from diverse cultural backgrounds.

Involves…
- being aware of one’s own cultural worldview and biases
- collecting knowledge of different cultural groups (practices, history, barriers, etc.)
- developing cross-cultural skills to provide appropriate interventions (taking into account clients’ cultural background, finding the best tx)

WHY: Important that therapists continue to work on their cultural competence. It helps to build trust, and allows the therapist to deliver the most effective treatment. Having good cultural competence can reduce offending the client (via micro aggressions or misunderstandings), which all reduces the rest of harming the alliance. It is a lifelong process to enhance one’s self-awareness, and learning to better respond to the needs of diverse populations.

EXAMPLE: A therapist is seeing a client that comes from a collectivistic, non-Western culture. The therapist knows to accommodate their treatment to the client, and consider the client’s strong importance on community. This increases the chances of a better outcome and stronger rapport.

Question 8

cultural universality

Answer 8

WHAT: Aspects of the human experience that are shared universally by everyone.
Includes certain…
- basic emotional responses
- behaviors
- psychological needs and processes
- experiences

WHY: Important as it provides a foundation to understand a client and helps to prevent the therapist from imposing non-universal values upon a client. Important for therapists to balance cultural universality with cultural specificity in order to provide the most effective and cultural sensitive care. Promotes empathy and connection.

EXAMPLE: A therapist that takes a cultural universality approach does not sped much time exploring a client’s cultural, as they do not believe it’s relevant to the person’s symptom presentation, diagnosis, or treatment application.

Question 9

culture

Answer 9

WHAT: Shared set of values, ideals, beliefs, practices, traditions, and languages to a particular group that is passed down generations.
Includes…
- way of life
- customs/rituals
- social behaviors

Has a significant impact on one’s sense of identity + how the interact and perceive the world.

WHY: Important to be aware of and understand a client’s cultural background, as it may have a significant impact on their sense of identity, and how they interact with and perceive the world. One’s cultural values may affect how they respond to certain therapy techniques and treatments. The therapist should be mindful to stay respectful and aware of cultural barriers and biases.

EXAMPLE: A male therapist is seeing a new client who is a Muslim woman that wears a hijab. The therapist does not outstretch his hand to the client, as he aware that in Islamic culture unmarried or unrelated men and women are not to touch.

Question 10

culture bound

Answer 10

WHAT: Behaviors, practices, beliefs, or conditions that are specific to a particular culture. The may not be present or understood outside of that cultural context.
opposite of cultural universality
Includes…
- (emotional) expressiveness
- openness
- self disclosure
- patterns of communication

WHY: Important to know how certain symptoms and disorders occur/present in the context of a culture. The therapist should also be able to discern from abnormal behavior from normal behavior within a culture. Important aspect when conceptualizing, diagnosing, and planning treatment.

EXAMPLE: In Jewish culture, the experience and prolonged-ness of grief is culture-bound. This contrasts the Western, DSM-5 guidelines for typical grieving periods. A culturally competent therapist should be aware of this culture bound feature, and not misdiagnose or mistreat this client.

Question 11

emic

Answer 11

WHAT: Refers to a perspective that focuses on culture-specific norms and views the clients in the context of their culture.
- seeks to understand cultural phenomena from the PERSPECTIVE OF AN INSIDER

WHY: Important, when using an emic approach, to remember that treatment will need to be tailored based upon cultural differences. An emic approach is crucial to have the best understanding of a client, and allows for best possible treatment outcome.

EXAMPLE: A therapist that uses an emic approach may spend time exploring a client’s cultural, as they believe cultural differences are relevant to symptom/disorder presentation and response to treatment.

Question 12

ethnicity

Answer 12

WHAT: A group of people that share an identity: culture, ancestry/history, nationality, or region.
*racial and ethnic identities often overlap

WHY: Important to remember that treatment may need to be tailored based upon ethnic differences. Recognizing and incorporating ethnicity into therapy helps to tailor tx, build trust, and provide culturally competent care.

EXAMPLE: A therapist is seeing an Asian client that is saying they are feeling burnt out from the pressure to achieve academically. The therapist may take into account the influence of cultural and ethnic values. Rather than labeling the client’s symptoms as abnormal, the therapist may explain how these aspects may impact the client’s stress and help them cope.

Question 13

etic

Answer 13

WHAT: Refers to a perspective that uses and OUTSIDER’S PERSPECTIVE, emphasizes similarities between all people, assumes universality, and ignores culture-based differences.
+ presentation and treatment of disorders are similar across ALL cultures

WHY: Important to balance etic perspectives with emic ones to avoid cultural insensitivity. Etic perspectives view Western concepts of normality as universal and applicable across cultures.

EXAMPLE: A therapist that uses an etic approach may not spend time exploring a client’s cultural, as they do not believe cultural differences are relevant to symptom/disorder presentation and response to treatment. Maslow’s Hierarchy of Needs uses an etic approach.

Question 14

ethnocentric monoculturalism

Answer 14

WHAT: The belief that one’s own culture/ethnicity is superior to all other ones. Becomes problematic when a dominant culture attempts to assimilation all other cultures into it.

3 main beliefs -
1) their own culture is about all other ones
2) POC are inferior
3) the ‘superior’ group has the right to impose their culture upon ‘inferior’ groups

WHY: Important for a therapist to be careful as to not exude any ethnocentrism. It’s especially relevant if a minority client is seeking treatment from a white therapist. The therapist exuding any ethnocentric beliefs or biases will negatively affect the therapeutic relationship.

EXAMPLE: A therapist is seeing a client that is refusing an operation that has been deemed necessary by their (Western) doctor. The client is Native American, does not believe in Western medicine, and trusts the medicine men in their community to be wiser and more skilled. The ethnocentric therapist ignores the client’s culture-bound beliefs, thinks the client is ignorant, and encourages him to have the surgery.

Question 15

individualism

Answer 15

WHAT: A social and cultural approach to life that emphasizes autonomy, self-reliance, and personal goals/gain.
- people are encourages to prioritize their personal needs over those of the group

WHY: Important to know that the Western world is individualistic, and that not all groups favor individualism. Is is important for the therapist to be aware of a clients individualism vs collectivism perspectives, as to plan the most effective treatment and not damage the alliance.

EXAMPLE: While seeing a client from an individualistic background, the therapist should allow the client to independently create their own goals. A treatment like CBT may be beneficial, as CBT values autonomy and self-help/reliance.

Question 16

institutional racism

Answer 16

WHAT: The policies, practices, and procedures within institutions that systematically result in unequal access to resources and opportunities based on race. It creates inequality and disadvantages for POC

Embedded into systems of society such as…
- legal system
- education system
- healthcare system
- discriminatory employment practices

WHY: Important to address the effects of institutional racism with a POC client. It validates the client’s experiences and empowers them. It also may be difficult for white clients to understand how they contribute to this form of racism if they are not racist on a personal level.

EXAMPLE: An African American client is telling her therapist how she was passed over for a job promotion. The client had the same qualifications and had been employed at the company longer than the white coworker that got the job. The therapist and client discuss how this was likely an instance of institutional racism and the therapist supports and validates the client’s feelings.

Question 17

microaggression

Answer 17

WHAT: A brief, intentional or accidental insulting behavior or comment directed at a member of a minority group. They are hostile, assume inferiority of the targeted group, and convey bias & prejudice.

Include…
- microinsults (unintentional, demeaning)
- microassult (blatant, hostile)
- microinvalidation (dismiss other person’s experiences/beliefs)

WHY: Important to be aware of what can be a microaggression so as to not commit one yourself. Also, continued experiences of microaggressions can be damaging to ones’ self-esteem and mental health.

EXAMPLE: A therapist is seeing a new client that is Middle Eastern. The therapist tries to compliment the client by saying they speak English so well and there is no accent. The client is offended and hurt, and informs the therapist she was born in the US and only speaks English. The client does not return to the therapist due to this microinsult.

Question 18

minority

Answer 18

WHAT: A population subset that has distinct ethnic, racial, and/or cultural characteristics. Typically marginalized/disadvantaged as compared to the dominant group.
- minority status often associated with reduced access to resources, opportunities, and less power in society

also includes any group that is subject to oppression and discrimination (women, LGBT, etc.)

WHY: Important to understand the implications of being a minority while treating minority clients. The oppression and discrimination minorities face can negatively impact their life and well-being. Having a sufficient understanding of this ensures tx addresses the unique experiences and needs of minority clients.

EXAMPLE: A straight, white, male therapist that is not in any minority groups must recognize his privilege, and know he must learn secondhand the experience of being a minority.

Question 19

multicultural competencies

Answer 19

WHAT: Refers to the…
- Awareness of one’s own culture, views, and biases
- Knowledge of diverse groups and disadvantages placed upon them
- Skills to select and tailor appropriate treatment
… needed to work with clients from multicultural backgrounds.

WHY: Important as they ensure therapist is inclusive, respectful, and tailored to be most effective for the needs of each client.

EXAMPLE: A multiculturally competent therapist working with a diverse population with be aware of the limits of her knowledge regarding experiences of minorities. She will seek out education and information to further build her skills and awareness.

Question 20

multicultural perspective in counseling

Answer 20

WHAT: The therapist understands and integrates the client’s cultural values into the therapuetic process
- therapist should be aware of their own biases and be careful to not impose upon the client
- acknowledges that some behaviors may abnormal in the Western world, but are norms within a different culture
- one’s culture affects their experience, values, and behavior
use ADDRESSING model to gather info

WHY: Important to remember that a client’s culture may affect their symptom presentation, and that treatment will need to be tailored based upon cultural differences. Using a multicultural perspective to counseling helps to reduce bias, understand the client, and allows for best possible treatment outcomes.

EXAMPLE: A therapist is working with an Asian-American client to define goals for treatment. The therapist is aware of their own individualistic values, and is careful as to not impose them upon the client who has collectivistic values. The therapist is aware that the client’s culture may generate goals different from a client of a different culture.

Question 21

oppression

Answer 21

WHAT: Mistreatment and discrimination of minority groups by a dominant group.
Involves…
- unfair and unequal treatment
- disadvantage to minority group
- abuse of power
- limits of opportunities and access to resources

WHY: Important to remember the role oppression may play in clients’ well-being. Chronic oppression can lead to low self esteem, anxiety, depression, and the client could internalize the oppressive beliefs. The therapist should support the client in navigating and overcoming the barriers set in place.

EXAMPLE: A therapist is seeing a 17 year old gay male. The client describes that he is bullied at school and ostracized by other students. He is now presenting with symptoms of depression, anxiety, and low self esteem as a result.

Question 22

poverty and mental illness

Answer 22

WHAT: Poverty = SES conditions in which people lack the financial resources to meet their basic needs (food, shelter, healthcare, etc.)
Living in poverty for a long time increases the risk of…
- mental illness
- trauma
- experiences of violence
- substance abuse

WHY: Important for therapists to ensure low SES clients have access to their basic needs before beginning any additional treatment. Understanding the relationship between poverty and mental illness aids in case conceptualization, psychoeducation, and treatment planning.

EXAMPLE: A client comes to therapy due to depressive symptoms. After some conversation, the therapist learns the client is going to be evicted from their home in a month. Before the therapist addresses the client’s depression, they will help them find resources to ensure the client will not be homeless following their eviction.

Question 23

race

Answer 23

WHAT: A social construct that categorizes people based on their physical characteristics + ethnicity.
- used to maintain social hierarchies and power dynamics
- has no biological basis

WHY: Race is a key part of the ADDRESSING model, and can influence clients’ presenting concerns and response to treatment. Important for the therapist to understand how a client’s race affects their identity, if at all.

EXAMPLE: A therapist has just begun seeing a 15 year old African-American girl. She attends a primarily white school and describes being bullied and ostracized by her white peers. She is now presenting with symptoms of depression and low self esteem as a result.

Question 24

racial identity development model

Answer 24

WHAT: 5 stage theory that outlines the process of development of a POC’s racial identity. It highlights one’s attitudes towards themselves, others of their same racial group, others of another marginalized group, and towards the dominant group.

• Stage 1 = Conformity
• preference for dominant culture
• Stage 2 = Dissonance
• new information or experiences makes them question their beliefs and values
• can lead to confusion, shame, anger, depression
• Stage 3 = Resistance and Immersion
• accepting their own culture
• rejecting and anger at dominant culture
• can lead to anger and guilt for past oppression
• Stage 4 = Introspection
• finding their self identity within their culture
• pride for their culture
• less anger towards dominant culture
• Stage 5 = Integrative Awareness
• commitment to advocate for social change

WHY: The model is a tool to help understand, explain, and support a client. It can indicate to therapists potentional challenges a client may be facing depending on which stage they seem to be in. Important to know the process may not be linear, and does not take into consideration additional client factors (SES, gender, etc.)

EXAMPLE: A 17 year old Arab-American girl has just began therapy due to depressive symptoms. She tells the therapist she wishes she could look like her white peers. She feels embarrassed when friends come to her house because there is cultural decoration everywhere, and wishes her family was ‘normal’. This client is in the first stage, conformity.

Question 25

racism

Answer 25

WHAT: A system of prejudicial beliefs, practices, and structures that perpetuate discrimination and inequality on the basis of race/ethnicity. Occurs on a personal, institution, and systemic level.
Includes…
- negative emotional reactions to members of a racial group
- belief in negative stereotypes
- belief that other racial groups are inferior
- belief that race biologically determines abilities and traits
- (micro)agressions

WHY: Important for therapists to be aware of how racism on each level may affect a client and their presenting issue(s). A therapist should validate a client’s experiences with racism, support them in coping with and overcoming the barriers set in place.

EXAMPLE: A therapist has just begun seeing a 15 year old African-American girl. She attends a primarily white school and describes being bullied and ostracized by her white peers. She is now presenting with symptoms of depression and low self esteem as a result of her classmates’ racism.

Question 26

white privilege

Answer 26

WHAT: The advantages white people have over other races.
4 Characteristics-
1) having the power to define their reality
2) having (un)conscious biases that POC are inferior
3) believing they are not prejudiced
4) being blind to their white privledge

WHY: Important to know white privilege affects the experience of all people. Acknowledge white privilege helps to understand clients, and better support them to cope with and overcome the barriers set in place. Creates a culturally aware and more effective treatment.

EXAMPLE: An African-American client is telling his white therapist his experience of racial discrimination at work. The therapist says he “doesn’t see color”, which is a demonstration of his white privilege. The therapist has grown up with the privilege of not seeing race, because his race has not affected him in the same way the client’s race has affected her. The therapist is neglecting to see their biases and privilege which may damage the alliance.

Question 27

white racial identity development

Answer 27

WHAT: The process of white people developing a non racist identity and become aware of the implications of racism. Racism is assumed to be a ventral part of being a white American.

2 General Phases = abandonment of racism & defining a non racist white identity

6 Specific Phases =
1) Contact
- oblivious to racism and the significance of one’s race in society
- believing they’re not racist
2) Disintegration
- person identifies conflicting beliefs (I’m not racist, but my daughter can’t marry a black man)
3) Reintegration
- in an attempt to resolve dissonance from stage 2, person fully identifies with white superiority
4) Pseudo-Independence
- new information or event removes person from reintegration phase
- new awareness of race and racism
- may identify with struggles of POC
5) Immersion/Emersion Status
- confront their own biases
- work to combat racism and oppression
6) Autonomy Status
- acceptance of their white role in perpetuating racism
- knowledgable about and comfortable with racial and cultural differences

WHY: This model is important for understanding how white clients may perceive and react to race and racism. A therapist may help a client progress through the model, supporting them in developing self awareness, personal growth, and an informed, empathic, anti-racist stance.

EXAMPLE: An African-American client is telling his white therapist his experience of racial discrimination at work. The therapist says he “doesn’t see color”, which is a demonstration of his white privilege. The therapist is oblivious to racism and the significance of the client’s race to society. The therapist is neglecting to see his biases and privilege will damage the alliance.

Question 28

worldview

Answer 28

WHAT: The perspective through which an individual or group interprets and responds to the world around them.
Involves…
- beliefs, values, assumptions, and attitudes
- personal insights about reality
- misinformation + lack of knowledge
- biases and prejudices

WHY: Important as a client’s worldview will affect their attitudes and behaviors. Different cultures will often have different worldviews. Important for a therapist to understand a client’s worldview, and to not impose their own worldview upon a client.

EXAMPLE: A therapist is working with an Asian-American client that holds collectivistic world views. The therapist holds individualistic world views, and must be care as to not impose their own attitudes and ideals upon the client, or passing judgements about the client being ‘too dependent’ or dependence being a negative thing.

Question 29

counseling-relevant cultural issues for: African American

Answer 29

WHAT:
Four interactive factors to consider while working with AA clients:
1) racial oppression + reactions to is
2) influence of the majority culture
3) influence of Afro-American culture
4) influence of personal experiences

• Consider racial bias and discrimination again AA + important to not place blame on client
• Therapist should assess systemic issues affecting client + client’s response to situation
• Power and privilege may affect treatment
• Strong family and community ties
  *** depending on location in racial identity development, may have negative reaction towards white therapists

WHY: The counselor may need to identify any biases they may hold. Important to consider how one’s cultural and racial differences may affect them during therapy + affect their response to treatment. Important to be knowledge and aware of cultural differences– offending the client could greatly hinder a therapeutic alliance. Important to have an understanding of the history of injustice this group has experienced. Important to not overgeneralize.

EXAMPLE: A Black woman, Jessica, is seeking treatment for the first time. She directly challenges the therapist and asks what she knows about her experience being Black in America. Jessica’s confrontational attitude may be indicative of where she is in her racial identity development. Therapist must be mindful to not take her outburst personally or get defensive.

Question 30

counseling-relevant cultural issues for: Hispanic/Latino

Answer 30

WHAT:
Personalismo
- accepting small gifts
- seen as form of multicultural competency
- not seen as boundary crossing in this case
- rejecting gift may hinder therapeutic relationship

Familismo
- Latin cultural value
- dedication, commitment, and loyalty to family
- gender roles important (machismo= men expected to provide and be strong)
- immigration policies
- high stigma with mental illness

WHY: The counselor may need to identify any biases they may hold. Important to consider how one’s cultural and racial differences may affect them during therapy + affect their response to treatment. Important to be knowledge and aware of cultural differences– offending the client could greatly hinder a therapeutic alliance. Important to have an understanding of the history of injustice this group has experienced. Important to tailor treatment to each individual.

EXAMPLE: The Gomez family came to therapy due to increasing levels of conflict at home. The father did not speak English, so their son functioned as a translator. The therapist spoke of the father’s problems in front of the entire family. This + the son being the translator created tension, as it went against the rules of the family’s hierarchical structure.

Question 31

counseling-relevant cultural issues for: Native American

Answer 31

WHAT:
- the family includes extended family – collectivistic!!
- spirituality + respect of traditional values important (can be protective factor)
- acculturation conflicts prominent – explore client’s ethic identity + their own adherence to traditional values
- domestic violence, depression, anxiety, suicidality substance use prominent
- client’s relation to tribe is important to assess + how it relates to personal identity
- goals should not just be oriented to the individual

WHY: Important to consider how one’s cultural and racial differences may affect them during therapy + affect their response to treatment. Important to be knowledge and aware of cultural differences– offending the client could greatly hinder a therapeutic alliance. Important to have an understanding of the history of injustice this group has experienced. Important to tailor treatment to each individual.

EXAMPLE: Jenny is at a personal crossroads and is feeling anguished about her decision. She seeks therapy, and mentions looking for signs in nature and relying heavily on advice from her family on what to do. Her therapist should be sensitive and respectful of these sources of information, understanding that Jenny’s collectivistic culture values communing with nature and family. Dismissing these sources as irrelevant would be a mistake.

Question 32

counseling-relevant cultural issues for: LGBT

Answer 32

WHERE: 561 cultural issues in psych practice

WHAT:
- know the client’s gender + sexual identity and their pronouns
- be aware of the coming out process
- common disorders: depression, anxiety, substance abuse
- high rates of suicide, bullying homelessness
- know of community support systems

*use gender neutral language esp during assessments
**remember presenting issue may have nothing to do with sexual or gender identity

Intersectionality is important to consider Important to create a safe space with an atmosphere of understanding and acceptance

WHY: Important to consider how one’s differences may affect them during therapy + affect their response to treatment. Need to create an especially safe space with an atmosphere of understanding and acceptance. Offending the client could greatly hinder a therapeutic alliance. If aiding the client in the coming out process, ensure they are prepared for every possible reaction. Can be hard to develop a healthy self identity when dealing with conflicts regarding sexual and/or gender identity.

EXAMPLE: Tyler is a college student who has sought therapy for symptoms of depression and anxiety. Since starting college, he has been open about his sexual orientation. However, he is not out to his family and is nervous about coming out when he returns home for the summer. The therapist may connect Tyler with community support systems in his home town, and work to prepare him for any reactions from his family to him coming out.

Question 33

counseling-relevant cultural issues for: Asian

Answer 33

WHERE: 561 cultural issues in psych practice

WHAT:
- collectivistic people– need to consider family and. community
- hierarchal and patriarchal family
- emotional display seen as immature and as a lack of self control –> techniques on showing emotions may be uncomfortable
- acculturation conflicts (inc. gap between child and parent), racism, and discrimination common
- discussing confidentiality may aid in therapeutic alliance !
* least responsive to group therapy

WHY: The counselor may need to identify any biases they may hold. Important to consider how one’s cultural and racial differences may affect them during therapy + affect their response to treatment. Important to be knowledge and aware of cultural differences– offending the client could greatly hinder a therapeutic alliance. Important to have an understanding of the history of injustice this group has experienced. Important to tailor treatment to each individual.

EXAMPLE: Jenny is a client that has sought treatment for her depressive symptoms. She says her parents don’t approve of therapy and is worried about them finding out about what she talks about. The therapist may explain confidentiality and reassure Jenny her parents do not have access to anything discussed in session.

Question 34

counseling-relevant cultural issues for: Arab

Answer 34

WHERE: 561 culture issues in psych practice

WHAT:
- interdependence among family members
- hierarchal family structure – keep in mind gender role differences within family
- modifying cognitive distortions using Islam
- common: acculturation issues, racism (esp post 9/11), religion, mistrust of authority figures
- western values may contradict Arab ones

WHY: The counselor may need to identify any biases they may hold. Important to consider how one’s cultural and racial differences may affect them during therapy + affect their response to treatment. Important to be knowledge and aware of cultural differences– offending the client could greatly hinder a therapeutic alliance. Important to have an understanding of the history of injustice this group has experienced. Important to tailor treatment to each individual.

EXAMPLE: Mariam is seeking treatment due to her anxiety, which she believes is stemming from her home life. She is unhappy living at home, but her parents will not allow her to move out on her own, even though she is financially independent. The therapist may help Mariam see if there is a way to gain her independence while also preserving her relationship with her parents.

Question 35

counseling-relevant cultural issues for: Jewish

Answer 35

WHERE: 561 culture issues in psych practice

WHAT:
- need to assess if client identify as a religious Jew or solely a cultural Jew
- may be helpful for therapist to consult with rabbis + become knowledgable about Jewish culture
- cultural adapted/compatible interventions! (respect holidays, etc.)
- oppression, racism, discrimination often experienced

WHY: The counselor may need to identify any biases they may hold. Important to consider how one’s cultural and racial differences may affect them during therapy + affect their response to treatment. Important to be knowledge and aware of cultural differences– offending the client could greatly hinder a therapeutic alliance. Important to have an understanding of the history of injustice this group has experienced. Important to tailor treatment to each individual.

EXAMPLE: John is a Jewish client who is struggling with accepting he’s gay due to his religious upbringing. The therapist may work with John on self-acceptance using a culturally adapted/compatible intervention.

Question 36

counseling-relevant cultural issues for: physically disabled

Answer 36

WHERE: 561 cultural issues in psych practice

WHAT:
- should assess for invisible disabilities too!!
- should emphasize on self advocacy, empowerment, finding meaning in one’s experience, sexual satisfaction, and the client’s sense of control
- therapy may need to… redirect internalized self-blame, reframe to find client’s strengths, advocate
- client’s disability should not be the sole issue discussed
- may be helpful to include family in treatment (esp when planning for environment changes)
- common experiences: ableism, depression, substance abuse
- !! office should be ADA accessible!!

WHY: Important to consider how one’s differences may affect them during therapy + affect their response to treatment. Need to create an especially safe space with an atmosphere of understanding and empowerment. Important to not assume client is not capable of doing certain things. Offending the client could greatly hinder a therapeutic alliance.

EXAMPLE: A therapist is looking for offices for her new private practice. She immediately rules out any spaces that are not compliant with the ADA’s guidelines for accessibility (i.e. stairs only). She also incorporates accessibility into her policies (allowing service animals, offering documents in audio and braille versions).

Question 37

counseling-relevant cultural issues for: female

Answer 37

WHERE: 561 culture issues in psych practice

WHAT:
- common: discrimination/sexism/biases, SA, economic + employment barriers, DV, depression
- consider impact of power imbalances on females/living in a patriarchal society
- tightrope of being too feminine or too masculine
- impacts of sexual objectification
- social beauty standards/pressures, body ideals
- expected to ‘mother’ – prioritize needs of others

WHY: The counselor may need to identify any biases they may hold. Important to consider how one’s gender may affect them during therapy + affect their response to treatment. Offending the client could greatly hinder a therapeutic alliance. Therapist may need to educate themselves on things women experience. Important to have an understanding of the history of injustice this group has experienced. Important to tailor treatment to each individual.

EXAMPLE: Caroline is a client who is seeking therapy due to her overwhelming anxiety due to her dislike of her appearance. She feels that she’s unattractive and has begun restricting her food intake to lose weight.
The therapist should understand it is common for female clients to have (negative) concerns surrounding their appearances and beauty standards.

Question 38

counseling-relevant cultural issues for: male

Answer 38

WHERE: 561 culture issues in psych practice

WHAT:
- common: learning disorders, ADHD, disciplinary problems, violence, aggression, discrimination for ethnic minorities
- men may face issues with expressing and coping with negative emotions, toxic masculinity, and societal expectations
- less likely to seek and continue treatment due to being seen as weak – more likely if client is in a crisis
- solution focused better received rather than discussing emotions

WHY: The counselor may need to identify any biases they may hold. Important to consider how one’s gender may affect them during therapy + affect their response to treatment. Offending the client could greatly hinder a therapeutic alliance. Therapist may need to educate themselves on things men experience. If client is a minority, important to have an understanding of the history of injustice this group has experienced. Important to tailor treatment to each individual.

EXAMPLE: Tom has come into therapy after going through a very bad breakup. He tells the therapist he doesn’t want to talk about his feelings and he just wants to be told how to feel better. The therapist may used solution-oriented present-focused interventions with Tom.

Question 39

counseling-relevant cultural issues for: clients in poverty

Answer 39

WHERE: 561 culture issues in psych practice

WHAT:
- consider client’s hierarchy of needs – ensure basic needs are met – not having needs met may lead to psychological issues
- common: discrimination and stereotypes of being lazy/on drugs, social exclusion
- unsafe environments increase risk of violence and trauma
- may face barrier to treatment such as transportation and inflexible work schedule
- educational barriers (money, work, time)
- advocacy !

WHY: Important to understand no meaningful work can be done in therapy if a client doesn’t have basic needs met– it could be the basis for client’s psychological problems. The counselor may need to identify any biases they may hold. Important to consider how one’s SES may affect them during therapy + affect their response to treatment. Offending the client could greatly hinder a therapeutic alliance. Therapist may need to educate themselves on things people in poverty experience. Important to have an understanding of the history of injustice this group has experienced. Important to tailor treatment to each individual.

EXAMPLE: Grace has been referred to treatment from a domestic violence clinic. Since leaving her partner, she is not employed and falls below the poverty line. The therapist should asses if her basic needs are met (safety, food, shelter, etc.) before doing deeper psychological work.