Multicultural Flashcards
ICIR
-in control of own outcomes
-responsible for own success/failures
ICER
-determines own outcomes
-others are responsible from keeping them from doing so.
ECER
-little or no control over outcomes
-have no responsibility over themselves
ECIR
-little control over outcomes
-take responsibility for failures
What LC & LR are seen most in American culture
ICIR
Most challenging client for a White therapist (worldview)
ICER
Acculturation
1.Integration
2.Assimilation
3.Separation
4. Marginilization
Healthy Cultural Paranoia
1.Functional paranoia (pathological)
2. Cultural paranoia (due to racism)
*Race of therapist is most important when the client has both functional and cultural paranoia (prefer Black therapist)
Racial Microaggressions
Microassaults (explicit racism)
Microinsults (verbal or nonverbal - assumptions)
Microinvalidation (negate thoughts, feelings or POC)
Tight vs. Loose Cultures
Tight
-strong social norms
-low tolerance for deviant behavior
*citizens are more likely to conform and want stability
**higher conscientiousness and lower openness to new experiences
Loose
-weak social norms
-high tolerance for deviant behavior
citizens are more likely to engage in deviant behavior and are more open to change.
**lower conscientiousness and higher openness to new experiences
High vs. Low Context Communication
High
-group understanding
-nonverbal messages
-knowledge is situational
-similar to minority groups
Low
-verbal messages
-independent of the context
-characteristics of White population
*When client is high communication and therapist is Low, there becomes issues in treatment.
Minority stress theory
Sexual minorities
proximal
-stress with in the person
distal
-stress external to the person
Recent disclosure of sexuality, lesbian vs. gay men
Lesbian = decrease in depression and anxiety
Gay men = increase in depression and anxiety
Racial-Cultural Identity Development Model
Atkinson et al.,
- Conformity
(neutral or negative view of minorities) - Dissonance
(questions attitudes towards minorities) - Resistance & Immersion
(negative attitudes towards majority and positive towards own) - Introspection
(questions alliance to own group) - Integrated awareness
(aware of positive and negative of all groups)
Black Racial Identity Development Model
Cross,
- Pre-encounter
(idealize White culture) - Encounter
(Question White & Black culture/ aware of racisms effects on their lives) - Emersion/Immersion
(Reject White Culture, and engage in Black culture ) - Internalization
(defensiveness to race decreases/ internalized Black identity/ activism/ )
Multidimensional Model of Racial Identity
Seller et al.,
- Racial salience (specific time and situation)
- Racial Centrality (placed importance of race)
- Racial Regard (private - positive or negative & public- belief of how others view Blacks)
- Racial Ideology (Belief of how Blacks should live in society).
White Racial Identity Development Model
Helms
- Contact
(lack of awareness of racism/ “Colorblind” ) - Disintegration
(Aware of racial dilemma / confusion & anxiety / overly identify with minority group) - Reintegration
(attempt to resolve stage 2 dilemma / believe whites are victims) - Pseudo independence
(superficial tolerance for minorities / faced with events that cause questioning around White & minority groups) - Emerson/Immersion
(What does it mean to be White? search for personal mean of racism) - Autonomy
(non-racist White identity)
Homosexuality Development
Troiden
- Sensitization (feeling different from same sex
peers) - Identity Confusion (suspect they are gay)
- Identity Assumption (acceptance of identity)
- Identity Commitment (internalized identity)
Multidimensional Model of Heterosexual Identity Development
Worthington et al.,
- Unexplored Commitment (micro& macroscial acceptance of sexual behavior)
- Active exploration (experimentation)
- Diffusion (absent around all exploration)
- Deepening & Commitment (commitment to sexual needs)
- Synthesis (integration of sexual identity)
Cultural socialization vs. preparation for biases (effects on black identity)
cultural socialization has been more consistently linked to the development of a positive ethnic identity than preparation for bias has.
Etic
belief that behaviors is similar across cultures
emic
belief that behaviors are affected by culture and symptoms are not universal.
Autoplastic
change in the client to adapt to environment to change behavior.
Alloplastic
change in the environment to fit the clients needs.
Culture Encapsulation
inability for therapist to work effectively with other ethnic/ cultural backgrounds.
*insensitive to cultural differences
*takes etic view
Credibility & gift giving
*Asian and non-western clients
Credibility:
-trustworthiness
-Ascribed status - age, gender, etc.
-Achieve status - education
Gift giving
-providing reassurance
-normalizing
-treatment that reduces symptoms
*direct benefit should be given as soon as possible to establish credibility and reduce premature termination.
African American Clients
Keep in mind:
-cultural paranoia
-experience with racism
Presenting problem:
-include nuclear and extended family
-roles are flexible (male and female) - egalitarian
-Empower the client by problem solving skills
Interventions:
-egalitarian relationship
-time-limited
-problem-solving
-use multisystems approach (ecological)
Native American Clients
Keep in mind:
-adherence to collateral family system (tribe)
-cooperation, sharing, generosity are important
-interest of tribe take priority
Wellness= healthy mind-body-spirit
Illness = disharmony (mind-body-spirit)
*more emphasis on non-verbal communication
*listening is viewed as more important
*direct eye contact = disrespect
*firm handshake = aggression
Interventions:
-collaborative-client centered approach
-Network therapy
Hispanic clients
*Psychological symptoms often seen as somatic complaints.
Keep in mind:
-religious beliefs
-emphasizes family over self
*Patriarchal (male dominant culture)
Intervention:
-adopt a formal style (Formalismo) for first session
-Use a personal style (Personismo) for later sessions
*CBT
*Solution Focused
*Family therapy
*Group therapy
**Quento-therapy (use of folk-tails)
Asian clients
Holistic view = mind and body
*Psychological symptoms often seen as somatic complaints.
Keep in mind:
-Families are hierarchical (Patriarchal)
-adherence to traditional gender roles
-emphasizes family needs over self
-Shame = powerful motivator
-silences and avoiding eye contact is seen as respectful
Intervention:
-Maintain formal style throughout therapy
*CBT
*Solution focused and brief
*Focus on family
*Expect therapist to give resultions
Sexual minorities and mental illness
Minorities are 2x more likely to have a diagnosis
*Bisexual individuals are seen to be most effected
Sexual minorities and seeking therapy
Gay men more likely than lesbian women to seek therapy.
Bisexual men and women seek therapy equally
(Research study) Sexual identity milestones in gay men
Milestones:
1.awareness
2.identified
3. sexual experience
4. disclosure to friend
5. disclosure to family
Cohorts (18 -25 y.o.) (34 - 41 y.o.) & (52- 59 y.o.)
*Younger cohorts experiences milestone earlier in life.
18-25 y.o. experienced the milestones earlier than 34 - 41 and 52 - 59, this continued through the cohorts as 34 - 41 experienced milestones earlier in life compared to 52 - 59 y.o.
Sexual milestones & mental health
Overall the greater extend of disclosure of sexuality the greater self-esteem and lower anxiety.
Age, Gender and sexual milestones
-Boys typically have first sexual experience with same sex partner before girls.
-Boys and girls disclose around the same age.
Average age of acceptance of identity:
Males: 19 - 21 years old
Females: 21 - 23 years old
Older Adults & mental illness
*Mental illness is lower in adults with the exception of NCD.
Most common:
-Anxiety
-Depression
Depression:
-more likely to complain about physical and cognitive symptoms rather than emotions.
1. fatigue 2. head aches 3. pain 4. impaired memory
Anxiety:
-report similar to depression
1. insomnia 2. irritability 3. weight loss
Treatment:
-psychotherapy is effective
-May respond slower to treatment
-Benefits when treatment is tailored to cognitive, sensory and physical needs.
