Lecture 6 Flashcards
Definitions
Race - socially constructed rather than biologically determined, the category to which others assign individuals on the basis of physical characteristics such as skin color or hair type, and the generalizations and stereotypes made as a result. Ethnicity - the acceptance of the group mores and practices of one’s culture of origin and the concomitant sense of belonging. Culture - the shared values, norms, traditions, customs, arts, history, folklore, and institutions of a group of people. Multicultural - interactions between individuals from minority ethnic and racial groups in the US and the dominant European-American culture. Multiculturalism/diversity - recognition of the broad scope of dimensions of race, ethnicity, language, sexual orientation, gender, age, disability, class status, education, religious orientation, and other cultural dimensions.
Vail Conference
- 1st attention to culture as a variable in clinical practice. Recommended that psychologists should become more knowledgeable. Recommended training in cultural diversity in all psychology doctoral programs. Argued that untrained or incompetent engaging in unethical behavior. But no recommendations on how.
APA, ethics, and ethnicity
1979 - the office of ethnic minority affairs (OEMA) was established. 1980 - the board of ethnic minority affairs (BEMA) was established. 1986 - the APA’s accreditation domains and standards were altered to include cultural diversity as a component of effective training. 1990 - BEMA replaced by the Committee on Ethnic Minority Affairs (CEMA).
APA Membership
2002 - 2.1 hispanic, 1.7 AA, 1.7 Asian/PI. 2017 - 1.8 hispanic, 1.2 AA, 1.6 Asian/PI
APA ethical principles
First mention of issues relevant to ethnic minority groups 1981. But no recommendations (what it means or how you become competent). 1992 - proactive suggestions. 1.08 human differences - obtain training etc. to ensure competence of service (although still no definition of competence). Standards in 2002 - Principle A, Principle D, Principle E, 2.01 b and d (competence), 3.01 unfair discrimination, 3.03 other harassment, 3.10 informed consent, 9.02 b and c use of assessments, 9.06 interpreting assessment results
Dimensions of competency
Sue et al. 1982. Beliefs - understanding own biases, unknowingly putting our own world view onto others, self-knowledge, being more open to diversity issues. Knowledge - becoming knowledgeable about different cultures. Skills - understand how knowledge needs to be applied in working with people.
Conscious clause laws
In some states, saying that you can’t make students work with diverse populations/those who have different values. There was a case with someone refusing to work with someone who’s gay, another case, states wanting to prohibit universities from dismissing students for refusal.
APA 2002
Guidelines first official commitment from APA to address these issues - (guidelines on multicultural education, training, research, practice, and organizational change for psychologists 2002). Guidelines for providers of psychological services to ethnic, linguistic, and culturally diverse populations. APA task force on the delivery of services to ethnic minority populations (approved by APA council of reps in 1990).
Other things
Preparing professional psychologists to serve a diverse public: a core requirement in doctoral education and training. (APA board of education work group 2013). Council of the national psychological associations for the advancement of minority issues - guidelines for research in ethnic minority communities 2000. Psychological treatment of ethnic minority populations 2003. Cultural diversity and ethnic minority psychology - journal of APA division 45 - society for the psychological study of ethnic minority issues. Universal declaration of ethical principles for psychologists - international union of psychological science (2008).
Culturally and sociopolitically relevant factors in a client’s history
Generational history - number of generations in the country, manner of coming to the country. Citizenship or residency status (number of years in the country, parental history of migration, refugee or immigration). Fluency in standard English (and other languages/dialects). Extent of family support or disintegration from family. Availability of community resources. Level of education. Change in social status as a result of coming to country. Work history. Level of stress related to acculturation (APA 2002).
Disparities in health and MH treatment
50% of minorities say they’ve been offended by something the therapist said. If you’re sensitive, more likely to get forgiveness. People would prefer someone similar to them, but among those who don’t, it’s how they’re treated by the therapist - approach therapist takes may not fit with person’s cultural beliefs, have to check if it fits with them and what they want to do, needs to be collaborative. Disparities - differences in treatment provided to members of different racial or ethnic groups that are not justified by underlying mental health conditions or preferences. Ethnic minority populations receive less and lower quality health care than whites (DHHS, 2000). US Surgeon general’s report Mental health culture race and ethnicity (2001), national center on minority and health disparities established in 2000, institute of medicine evaluated health disparities - unequal treatment (Smedley et al 2003). Agency for healthcare research and quality (AHRQ), patient protection and affordable care act 2010.
Underutilization of services
Ethnic minorities are less likely to utilize available mental health resources, this may be because of: lack of cultural diversity in therapists, distrust of services, perspectives that therapy can be used as an oppressive instrument of those in power to mistreat large groups of people, less access. Also more premature dropout among minorities.
Therapy environment
Psychologists should be aware of the environment in which they practice (e.g. office) and how it appears to clients. Psychologists should consider office practices (e.g. bilingual phone service)
Psychological interventions
Familiarize self with unique worldviews and cultural backgrounds of clients. Learn about their background, learn appropriate helping practices, may require non traditional interventions, seek out community leaders and other change agents, examine traditional therapy interventions for cultural appropriateness and expand as needed.
