PSYC 561

Question 1

Acculturation

Answer 1

What: The process by which groups or individuals adjust their social and cultural values, ideas, and behavioral patterns of their culture of origin to those of a different culture (generally the mainstream one). Differences in acculturation within a family/couple can create stress. This is also a bidirectional relationship. Integrating dominant culture into your own.
Why: The degree to which someone is acculturated can affect treatment and their response to the therapist. This is important to keep in mind when creating treatment plans for clients.
EX: Sam, born in Japan but lives in the US is switching from a collectivist identity to an individualistic identity and experiencing issues within their family due to this acculturation.

Question 2

ADDRESSING Model

Answer 2

What: This model contributes to a full understanding of a client including their beliefs, morals, and values. This can help therapists learn these areas of bias and inexperience. The ADDRESSING model is helpful to see where the client might be a minority and what they could be struggling with when presenting to therapy.
A: Age
D: Disability at Birth
D: Disability Acquired
R: Religion
E: Ethnicity
S: Sexual Orientation
S: Socioeconomic Status
I: Indigenous Heritage
N: Nation of Origin
G: Gender (pronouns)
Why: This model is helpful in getting to know and understand who the client is and formulating treatment goals in collaboration with the client. Helps the therapist meet the client where they’re at.
EX: Sam is a new client who identifies as a cis gender, Jewish female. She is 68 years old. As her therapist does the initial interview, the therapist will want to gather information about how her Jewish heritage/faith and age are influencing her presenting problems, if at all.

Question 3

Anti-racism

Answer 3

What: This is part of developing a multicultural attitude surrounding societal change, but it’s more than having a nonracist attitude. Being an antiracist involves actively working against the racist attitudes ingrained into society in all aspects. This means working towards social change and being a social justice warrior.
Why: ACA requires counselors to be advocates to address barriers and obstacles that inhibit access and or growth and development of clients
EX: Sarah a therapist attends BLM protests in support of her minority clients to actively work against the system.

Question 4

Assimilation

Answer 4

What: The process by which an immigrant to a new culture adopts the culture’s beliefs and practices. It happens when individuals or groups of differing ethnic heritage are absorbed into the dominant culture of a society. Assimilation is common among immigrant populations that seek to blend in with the existing fabric of society and want to be seen and embraced as belonging.
Why: Individuals may feel pressure from members of the majority culture to assimilate quickly. It can impact immigrants and their children as they adopt to a new culture adopts the culture’s beliefs and practices and add to their stress. This is seen as a negative as it is giving up parts of your own culture to fit into the dominant more.
EX: Juan immigrated to the U.S. with his parents from Guatemala when he was a child. Now he is a teenager and seeking therapy over assimilation conflicts with his parents. He has fully assimilated to US culture, rejecting most aspects of his native culture, language, and customs. He is frustrated that his parents only speak Spanish at home and resist American popular culture.

Question 5

Bicultural

Answer 5

What: Having or combining the cultural attitudes and customs of two nations, peoples, or ethnic groups. This is the condition in which an individual identifies themselves as two different cultures. This provides a source of strength to identify with two different groups and have a connection with two different cultures, values, and customs.
Why: It can be difficult when one of the cultures is the dominant culture and there are societal pressures to acculturate. This is important in treating individuals with ethnic sensitivity.
EX: You are counseling the child of an immigrant. The child is bicultural because she is deeply embedded in the heritage culture at home, but is also active and knowledgeable of American culture due to interactions at school.

Question 6

Collectivism

Answer 6

What: A social or cultural tradition, ideology, or personal outlook that emphasizes the unity of the group or community rather than each person’s individuality. In many non-western cultures, identity is seen through a group orientation; most Asian, African, and South American societies tend to put more value on collectivism than do Western societies. They stress communalism, constructive interdependence, and conformity to cultural roles.
Why: This is key in treating individuals as they might have different goals and values than you as to not impose their own views. The needs and interests of individuals are sacrificed in order to meet the needs of the group as a whole which can cause a lot of distress in the client’s life.
EX: For instance, the therapist must resist passing judgements on someone she deems “too dependent” because in collectivistic cultures dependence is viewed as natural, while individualistic cultures disparage dependence.

Question 7

Coming Out Process

Answer 7

What: The process of self-identification and self-acceptance for LGBTQ+ individuals. Coming out is a lifelong process, and can include disclosures to the individual’s family, employers, or friends. It is the individual’s decision to share their sexual orientation and/or gender identity with others. Coming out can lead to rejection, anger, and grief, and the decision to do so is extremely difficult for many individuals; however it can also ultimately lead to relief and acceptance. 6-stage process; confusion, comparison, tolerance, acceptance, pride, synthesis.
Why: It is important to recognize the goal of therapy is not always for the client to come out, if they are fearing the consequences the clinician can help them develop coping skills and other environmental support. This is a significant event and clinicians working with members of the LGBTQ+ community need to understand the intricacies of the process to help individuals work through it.
EX: Luna has recently discovered she is bisexual and told her parents and they do not support her, the therapist will help Luna find good social support and coping skills to deal with the negative reaction.

Question 8

Cultural Competence

Answer 8

What: This usually involves a recognition of the diversity both between and within cultures, a capacity for cultural self-assessment, and a willingness to adapt personal behaviors and practices. The lifelong process in which one works to develop the ability to engage in actions or create conditions that maximize the optimal development of client and client systems. It is aspirational in nature and consists of counselors acquiring awareness (knowing one’s own culture, views, biases, and comfort levels of various backgrounds), knowledge (therapists knowledge of the cultural group both currently and historically, along with any barriers that group may have faced), and skills (implementing culturally appropriate interventions and receiving and sending information in ways that take into account cultural background while also recognizing one’s own personal limitations) needed to function effectively in a pluralistic democratic society, and on an organizational/societal level, advocating effectively to develop new theories, practices, policies, and organizational structures that are more responsive to all groups.
Why: This is very important for counselors to strive to get to, to make sure they are practicing with consideration to ethnicity, cultural humility, and culture and to improve cross-cultural communication and mental health outcomes. Cultural competence is not something that can be learned once, but is instead a lifelong process in which therapists must remain continually engaged.
EX: Danielle is a white therapist who is practicing on a Native American reservation. She attends ceremonies and meetings with the tribe’s elders in order to better understand how to help her clients in the context of their culture, thereby increasing her cultural competence.

Question 9

Cultural Universality

Answer 9

What: The view that values, concepts, and behaviors characteristics of diverse cultures can be viewed, understood, and judged according to the universal standards. Proponents of this view believe that culturally diverse individuals do not need treatments to be adjusted for them, but can be treated just the same as an individual from a Western culture. Belief: disorders in the DSM-5 appear in all cultures and societies and that modifications in diagnosis and treatment are required.
Why: Cultural universality is often associated with the etic orientation, but when these values are imposed on a diverse client base, there is a risk of cultural oppression and victim blaming that can negatively affect the therapeutic relationship.
EX: A therapist that takes a cultural universality approach does not spend much time assessing or exploring a client’s culture as they do not believe it affects the person’s symptoms, interpretation of treatments, or presentation of disorders.

Question 10

Culture

Answer 10

What: The values, beliefs, language, rituals, traditions, and other behaviors that are passed from one generation to another within any social group. It is the totality of the ideals, beliefs, skills, tools, customs, and institutions into which members of society are born. Frequently culture has a significant influence on one’s sense of identity.
Why: To understand the client’s internal frame of reference the counselor must understand their culture considering it has a significant influence on personal identity.
EX: A Muslim woman comes to treatment wearing a headscarf. Women cover their heads in public in her country of origin so this is a practice rooted in her culture

Question 11

Culture Bound

Answer 11

What: The description of attitudes, practices, or behaviors that are the products of a particular culture and that are not widely found in other cultures. There are some syndromes that are culture bound and can only be found in that specific culture. Mental and physical functioning, insight and the use of, the focus on the individual, patterns of communication, self-disclosure and openness, proxemics, and expressiveness are just a few things that vary from culture to culture and are culture-bound.
Why: This is a very important part of case conceptualization and diagnosis of a client.
EX: Pg 215 of textbook. The experience and perpetuation of grief is often culture-bound. If you are counseling someone of the Jewish faith that just lost her mom, it is important to know that she might grieve for an entire year based on religious underpinnings.

Question 12

Emic

Answer 12

What: This is a part of cultural competence that is a culturally specific perspective that looks at human behaviors through a cultural lens. An emic approach takes culture into account, and is more appropriate; treatment might need to be tailored for culture because certain cultural aspects cannot be generalized to others.
Why: Taking an emic approach to counseling is important because cultural considerations are key in treating clients properly.
EX: A therapist that takes an emic approach will spend a lot of time assessing or exploring a client’s culture because they believe cultural differences affect how a disorder manifests and how the client should be treated.

Question 13

Ethnicity

Answer 13

What: A characterization of people based on having a shared culture (e.g., language, food, music, dress, values, and beliefs) related to common ancestry and shared history. The fact or state of belonging to a social group that has a common national or cultural tradition.
Why: Ethnicity of a client can help inform culturally appropriate interventions, as well as provide insight to the therapist regarding client worldviews.

Question 14

Etic

Answer 14

What: The belief that human beings share broad commonalities and that the manifestation and treatment of disorders are similar across ALL cultures and societies. It’s the belief that everybody can be treated universally regardless of your culture, and their specific culture doesn’t need to be taken into account during treatment. It teaches counselors that the Western concepts of normality and abnormality can be considered universal and equally applicable across cultures.
Why: This is important because treating through a cultural lens is imperative as lifestyles, cultural values, and worldviews affect the expression and determination of disorders.
EX: A therapist that takes an etic approach does not spend much time assessing or exploring a client’s culture because they believe cultural differences do not affect how a disorder manifests and should be treated.

Question 15

Ethnocentric Monculturalism

Answer 15

What: Ethnocentric monoculturalism is the belief that one’s own culture or ethnicity is superior to everyone else’s. There are three main beliefs to this concept. The first being that their own cultural heritage is above every other heritage around them. The second being that those who are of color are automatically inferior since their cultural heritage is inferior. And the third is that the ‘superior’ group has the right to impose their cultural heritage (language, values, beliefs) on the ‘inferior’ group
Why: This is the heart of the oppressor-oppressed relationship and affects trust and self-disclosure in therapy. This tends to be an issue when a minority client is seeking therapy from a therapist of the dominant culture.
EX: A clinician has a client referred to them by a doctor for refusing to undergo a surgery the doctor deemed necessary. The client is an indigenous Native from the Amazon and acknowledges he has a medical issue, but does not believe in Western medical practices. He believes the medicine men in his village were wiser and more skilled. The ethnocentric therapist considers this idea ignorant and encourages him to go through with the surgery, ignoring his personal, culture bound beliefs.

Question 16

Individualism

Answer 16

What: A social or cultural tradition, ideology, or personal outlook that emphasizes the individual and their rights, independence, and relationships with other individuals. The Western world embraces this view which focuses on the autonomy of the individual and promotes freedom of action for the individual over the collective. The individual is the psychosocial unit of operation, the individual has primary responsibility for his or her own actions, independence and autonomy are highly valued and rewarded, and no one should be internally directed or controlled.
Why: This is an important distinction to make during treatment as to not come to any erroneous conclusion and decisions during the therapeutic process. It is important to see how the client views self and relation to others in therapy.
EX: When counseling someone from an individualistic background, the therapist should allow the client to guide and inform therapeutic goals because he/she likely values autonomy. When working with a client from a collectivistic background, the therapist might be required to do a little bit of advice giving.

Question 17

Institutional Racism

Answer 17

What: Differential treatment of individuals on the basis of their racial group resulting from policies, practices, and procedures of institutions—such as school, health care, law enforcement, and criminal justice systems—that marginalize diverse racial groups. This is done by sanctioning unequal goals, unequal status, and unequal access to goods and services.
Why: This is the hardest racism to recognize as it is ingrained in culture. This is a difficult idea for people who think of themselves as fair and just but of the dominant culture to comprehend as they are not hurt by the system that tends to put a lot of people behind.
EX: An African American client that you are counseling for depression details the institutional racism that her family has had to endure. Her husband and the father of her children was unfairly imprisoned due to the third strike policy. He was sent to jail for years over a personal bag of weed. You empathize with her and help her come to terms with this new reality for her family

Question 18

Microaggression

Answer 18

What: These are everyday slights, put-downs, invalidations, and insults directed at socially devalued group members by well-intentioned people who often are unaware that they have engaged in such biased and harmful behavior. Microaggressions serve to undermine their humanity through exposure to racial hostility and assumptions of inferiority. They tend to be subtle, unintentional, and indirect; often occur in situations in which there are alternative explanations; represent unconscious and ingrained beliefs and attitudes; and are more likely to occur when people pretend not to notice differences.
microinsults (unintentional ways of being insensitive/demeaning)
microassault (blatant, hostile - conveys bias and prejudice)
microinvalidation (dismiss, exclude other person’s experience/beliefs)
Why: A lifetime of microaggressions can have a major harmful impact on the psychological well-being of victims.
EX: A white woman tells a Black woman that she loves her hair and asks to touch it. This is a microaggression because the white woman thinks she is being complimentary, but she is actually dehumanizing the other woman by exotifying her hair

Question 19

Minority

Answer 19

What: A population subgroup (e.g., ethnic, racial, social, religious, or other group) with differential power than those deemed to hold the majority power in the population. It can also cover any group that is the subject of oppression and discrimination, whether or not it literally compromises a minority of the population.
Why: Being a member of a minority in a mono-cultural society often puts one at a significant disadvantage, which can significantly impact the individual who is a minority’s life and well-being.
EX: As a white therapist, I am part of the majority in the US. I must recognize that I may not understand a minority group member’s unique experiences and I must be open to learning about it from that member

Question 20

Multicultural competencies

Answer 20

What: Multiculturalism leads to social justice initiatives and actions. It includes quadrants (privilege, oppressed statuses), domains (counselor self-awareness, client worldview, counseling relationships, and counseling and advocacy interventions), and competencies (attitudes, beliefs, skills, and action). Counselor self-awareness, counselor knowledge of client worldview, the counseling relationship, and Culturally appropriate counseling and advocacy interventions
Why: Being aware of the different levels of competencies is crucial when practicing with multicultural competence.
EX: A multiculturally competent therapist working with diverse populations will understand her own limitations in understanding the marginalized experience, routinely seek education about marginalized groups, and seek training to build her skills in working with these groups.

Question 21

Multicultural Counseling

Answer 21

What: The therapist defines goals and uses treatments that are consistent with an individual’s cultural values. The therapist must recognize that their values may not be the same as that of their culturally diverse client, but that does not give them the right to pressure their client to accept their values. The therapist must also recognize some behaviors considered deviant in Western society are not considered deviant in the culture of their clients. use ADDRESSING model to gather information about the client
Why: It can and should be used with any therapeutic approach or methodology, because it allows the therapist to fully understand the client and not come at it with any biases.
EX: A therapist treating an Asian American client is careful when defining goals not to impose his individualistic values on his client, who has more of a collectivist perspective

Question 22

Multicultural Perspective in Counseling

Answer 22

What: This perspective recognizes the differences between and within clients and how their cultures may impact their values. A counselor must maintain awareness of her own cultural biases and values in order to prevent her from interfering with interactions with culturally diverse clients.
Why: Counselors are also responsible for cultivating knowledge about different cultures and skills that are useful with culturally diverse clients. Helps with an emic approach to treating clients.
EX: a therapist being aware of their own bias and not letting it interfere with how they treat clients that come from a different culture/background (growing up poor but then treating the rich).

Question 23

Oppression

Answer 23

What: Oppression is the abuse of power whereby a dominant group engages in unjust, harsh, or cruel activities that perpetuate an attitude or belief toward a marginalized group that is reinforced by society and maintained by a power imbalance. Person’s of color and members of other marginalized groups live under a societal umbrella of individual, institutional, and cultural forces that often demean them, disadvantage them, and deny them equal access and opportunity. These experiences of oppression are a social reality for many marginalized groups and affects the perception of helping professional in multicultural counseling
Why: Mental health professionals must become aware of the dynamics that form their clients’ worldview and the struggles they have faced to bring them to therapy. Chronic oppression can lower self-esteem, reduce opportunity, lead to anger, anxiety or depression or internalized oppression. This is reinforced by society and maintained by a power imbalance.
EX: Marvin is a young gay male coming to therapy for depression. He describes the oppression he experiences at school, work, and even in his family: - he is bullied at school. He comes for treatment for symptoms of depression due to oppression from peers

Question 24

Poverty and Mental Illness

Answer 24

What: Studies show a direct correlation between poverty and mental illness. Impoverished people are 2-3 times more likely to develop mental illness than those w/ higher SES. Living in poverty for any significant length of time increases all sorts of risk factors for mental health problems. One will likely live in a neighborhood more prone to violence, exposing them to more trauma and risk for personal violence. It often precedes the development of emotional problems like anxiety and depression and is conducive to the development. They face extra risk of PTSD, violence, aggression, substance abuse, and academic difficulties.
Why: These families must deal with economic stressors like unemployment and lack of affordable housing, which can lead to mental health disorders.
EX: Richard grew up in a poor family that didn’t have access to mental health or medical resources to help him when he began to show signs of schizophrenia. He began to self-medicate with drugs. As an adult, he is unhoused and has spent time in and out of psychiatric wards of hospitals and prisons for actions related to his addiction and mental illness.

Question 25

Race

Answer 25

What: The social construction and categorization of people based on perceived shared physical traits that result in the maintenance of a sociopolitical hierarchy. This is a socially defined concept sometimes used to designate a proportion, or “subdivision.” The most widely used human racial categories are based on visible traits (especially skin color, facial features, and hair texture) and self-identification. Race is a social construct with no significant biological basis.
Why: Race is a key part of the ADDRESSING model and can play a role in issues brought into the therapy room, so making room for race being a factor in a client’s problems is important but one should not assume it is an issue. It is also important to address the difference in privilege and worldview and the impact on the therapeutic relationship if the counselor of a different racial identity than the client.
EX: An African American therapist that has experienced racist events may have negative reactions towards a client that expresses microaggressions in the therapy session. These reactions, and the microaggressions are due in part to her race.

Question 26

Racial Identity Development Model

Answer 26

What: 5 stage theory of developing a racial identity. Based on the Minority Identity Development model, this is Sue and Sue’s elaboration and adjustment of the previous model.It includes 4 attitudes, towards self, towards others of the same group, towards others of a different marginalized group, and towards the dominant group. 5 Stages:
Conformity - preference for dominant culture
Dissonance - event happens - challenging beliefs of conformity
Resistance + immersion - accept minority values/culture - reject dominant - anger at oppression and guilt for previous stages
Introspection - proactive to find self - pride for culture
Integrative awareness - commit to social change
Why: This model is extremely important to consider when treating clients as it can sensitize therapists to the role of oppression on worldview. It can help lead to possible interventions. It will show within-group differences to the therapist as well as how sociopolitical factors influence and shape identity. It can help alert counselors to the potential challenges associated at each status of this model. The attitudes of clients towards the therapist will differ depending on what stage of the model they are in
EX: Luca is in the dissonance stage and tends to show anger towards the therapist, the conformity stage prefers a therapist of the dominant group as they are self-depreciating and lean towards the dominant culture’s values.

Question 27

Racism

Answer 27

What: Racism is a form of prejudice that generally includes negative emotional reactions to members of the group, acceptance of negative stereotypes, and racial discrimination against individuals; in some cases it leads to violence. Types - institutional, individual, & cultural. The belief that race is the primary determinant of abilities and traits and that one race is superior to other races
Why: This tends to be a key issue in therapy even if some might not see it at first, most minorities have experienced some type of racism or microaggressions that can contribute to their problems. Systemic racism is a key issue in minorities.
EX:

Question 28

White Privilege

Answer 28

What: Set of advantages and/or immunities that white people benefit from on a daily basis beyond those common to all others. It’s characterized by, having the power to define reality, possessing unconscious stereotypes that people of color are less competent and capable, deceiving the self that one is not prejudiced, and being oblivious to how whiteness disadvantages people of color and advantages white people.
Why: White privilege is not the same as racism; frequently the people who benefit from white privilege are unaware and do not identify as racist or prejudiced. Understanding that this will inevitably exist can be key in a white counselor gaining cultural competence and providing better treatment to minority clients.
EX: When a white male therapist tells his African American client that he does not see her as being Black and that he “doesn’t see color at all” this is a demonstration of his white privilege. He has grown up with the ‘privilege’ of ignoring race because it has not affected him in the same way that it has affected her.

Question 29

White Racial Identity Development

Answer 29

What: This refers to the process of White individuals developing racial consciousness and a nonracist White identity. Two stage models include Hardiman White Racial Identity Model and Helms White Racial Identity Model. Helms’ model is the most elaborate and well-known. She assumes racism is a central and intimate part of being a White American, and her model describes movement through two general phases to develop a healthy White identity: abandonment of racism and defining a nonracist White identity. Six specific racial identity statuses are distributed evenly within the two phases: contact, disintegration, reintegration in phase 1 and pseudo-independence, immersion, autonomy in phase 2.
Why: The higher level of White identity development, the greater the reported multicultural counseling competence, positive opinions towards minority groups, and good therapeutic alliances.
EX:

Question 30

Worldview

Answer 30

What: The fundamental understanding of the universe and of humankind’s place within it held by a person, a culture, or a subculture. A worldview will be influential in the material development of a culture, as well as the theories a culture may produce. This will affect a client’s practical attitudes and behaviors.
Why: A person’s worldview is a framework for making decisions and includes beliefs about life, reality, and meaning. Different cultures frequently have different worldviews. It is important for a counselor to understand each client’s worldview and be careful not to impose their own.
EX: When counseling someone from a collectivist background, the therapist must be careful not to impose her worldview on the client. For instance, the therapist must resist passing judgements on someone he/she deems “too dependent” because in collectivistic cultures dependence is not viewed as badly as it is in individualistic cultures.

Question 31

African American Clients

Answer 31

What: African American preferences for counselor ethnicity are often related to their current stage of racial identity. Cultural sensitivity is extremely important for the counselor. The family is made up of both blood relatives and fictive kin, so the therapist should work to strengthen and increase functionality of the existing family structure rather than change it. Religion and spirituality is generally important to African Americans. Considering racial bias in the school setting that discriminates against African Americans is important as to not put the blame on the child. They experience racism and can sometimes be seen has committing more crime. Therapists should assess both the problems confronting the client as well as the client’s response to the situation. The four interactive factors to consider while working with AA clients are racial oppression and the reactions to it, influence of the majority culture, influence of Afro-American culture, and personal experiences and endowments. More likely to terminate early, stigma associated with getting help. Important to note where they are in their racial identity development, as they may react negatively to a white therapist.
EX: Bianca is a Black woman seeking therapy for the first time. She directly challenges the therapist and asks if she really knows what she’s talking about. Bianca’s confrontational attitude may be indicative of where she is in her racial identity development, and the therapist must be careful not to get defensive, or to take it personally.

Question 32

Hispanic/Latino Clients

Answer 32

What: Assessing acculturation level is important, engaging with a warm, respectful manner. Psychoeducation is key, assessing if a translator is needed, confidentiality, Personalismo - treat therapist as friend and bring gifts but should not be seen as boundary crossing & should be respected, gender roles in this culture is important, family is quite important-familismo and collectivism. Biculturalism is important as well. Immigration policies, high stigma with mental illness. Machismo, men expected to be strong and provider for family.
EX: The Martinez family came to therapy because the father was hearing voices and sounds no one else heard. The therapist talked about the father’s problems in front of the entire family, using the son to translate, without realizing that the family’s hierarchical family structure would prohibit the son from taking on such a role.

Question 33

Native American Clients

Answer 33

What: Tribal relationships are very important to assess and how it relates to personal identity. The idea of family generally includes the extended family, and collectivism is strong. Spirituality is important, with respect to traditional values can be a protective factor. There are educational gaps between the majority cultures. Acculturation conflicts impact this group a lot as well. Substance use is a key concern as well. Exploring the ethnic identity and adherence to traditional values is key, while having an understanding of the history of injustice this group has experienced, client-centered listening style, goals should not just be oriented to the individual. Poverty, each tribe has its own heritage. Harmony with nature, mindful. Domestic violence, depression, anxiety, suicidality. Eye contact sign of disrespect. Healer, shaman, chief if possible. Non-directive interventions are better.
EX: 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 34

LGBT Clients

Answer 34

What: Know how the client identifies and what they prefer to be called, in terms of both gender and sexuality. Be aware of where they are in the coming out process. Common disorders include depression, anxiety, etc. Higher rates of suicide and bullying in schools High rates of homelessness and drug use. Intersectionality is important to consider Important to create a safe space with an atmosphere of understanding and acceptance - use gender neutral language (including in assessments) Remember the issue at hand may have nothing to do with sexual orientation.
Why: Make sure to know community support systems and programs.* If aiding in the coming out process, ensure the individual is prepared for every possible reaction
Advocate and social justice, hate crimes an issue, sometimes issue isnt sexuality/gender based, can be hard to develop a healthy self identity
EX: June identifies as lesbian on her intake form. Her therapist should note her sexual orientation, but not assume that her presenting problem will necessarily be related to her sexuality.

Question 35

Asian Clients

Answer 35

What: Generally private people, collectivistic- consider family and community, may look to the therapist as an expert, hierarchical and patriarchal family relationship. Strong emotional displays are considered immature and show a lack of self-control. Counseling techniques showing directly on emotions might be uncomfortable, as well as direct eye contact. Holistic view of mind body, acculturation conflicts and gaps between parent and kids. Racism, discrimination. Parental academic and occupational pressure to please parents. Tend to look for an immediate solution, so attempting to use time-limited approaches can be helpful. Discussing confidentiality can aid in therapeutic alliance. Focus on positive aspects, least responsive to group therapy.
EX

Question 36

Arab Clients

Answer 36

What: Acculturation, racism, religion are important. The family style differs greatly but generalizations of interpersonal interactions, interdependence among family members are important. Hierarchical family structure, keep in mind gender differences. Identifying your own biases is important, legal problems might come up during treatment, there can be a negative view towards the counselor and receiving help. Modifying cognitive distortions can be helpful but through an Islamic lens. Post 9/11 racism, mistrust of authority figures. Women stereotypes of being submissive, women western values can contradict with theirs. Diverse group in terms of religion, culture etc.
EX

Question 37

Jewish Clients

Answer 37

What: Discrimination towards Jewish people is very prevalent, there are some very religious jews and not religious jews who still identify as Jewish, this is important to assess during treatment. Culture is not just a religion, historical incidents like the holocaust can be important. Oppression experienced, consulting with rabbis, becoming knowledgeable about Jewish culture, culturally adapted interventions is key, respecting holidays, there is a value in therapy in this culture.
EX: Orthodox have higher stigma of therapy, and orthodox are less accepting of LGBTQ. Jewish LGBTQ client comes in for treatment

Question 38

Physically Disabled Clients

Answer 38

What: Depression can be higher in this population, risk for substance abuse, there are invisible disabilities that should be assessed through outside sources as well, emphasis on self-advocacy and empowerment, sense of control, religion and spirituality is high, sexual satisfaction, finding meaning in one’s experience, ableism, disability should not be the sole issue discussed. Including family is important, helping with planning during environmental changes, counselors should be advocates, incorporate disability into interventions if necessary, redirect internalized self-blame, reframe to find strengths, advocacy. Office should be ADA accessible, person-first language, and countertransference.
EX: A therapist is looking for office space for her private practice. She immediately rules out locations that are not ADA compliant (stairs only, etc.). She also incorporates accessibility into her policies, such as allowing service animals, accepting checks without requiring a driver’s license, and offering important documentation in an audio and braille version.

Question 39

Female Clients

Answer 39

What: Gender differences, sexual assault, economic and employment barriers, higher rates of depression, impact of power imbalances on females, domestic violence, patriarchal society, microaggression, sexism, bias in education and workplaces, tightrope of being too feminine and too masculine, sexual objectification, social pressure to look young and attractive, unrealistic body ideals, expected to prioritize needs of others
EX:

Question 40

Male Clients

Answer 40

What: higher rates of learning disorders, adhd, disciplinary problems, expressing and coping with negative emotions, toxic masculinity and societal expectations, financial pressures, violence and aggression rates, relationship problems, difficulties at work, homophobia, needing to the best, crisis work- less likely to seek out help because it is considered weak but if they do it is most likely crisis, solution-focused rather than discussing feelings, not taught how to deal with emotions, increase rates of violence and discrimination for ethnic minorities.
EX: Toxic masculinity; models based on men but work mainly towards women; less likely to seek out help bc it can be seen as weak and if they do seek help it is in crisis

Question 41

Clients in Poverty

Answer 41

What: Hierarchy of needs, making sure basic needs are being met, connecting to resources, can lead to psychiatric issues, educational barriers, and advocacy roles are important. Discrimination and stereotypes of being lazy and drug addiction, social exclusion, unsafe environments can exposure risk to violence and trauma, a lot of practical problems like limited transportation and inflexible work schedules
EX: Jen is referred to treatment from a domestic violence clinic. It will be important to assess her basic safety and employment needs before doing deeper psychological work.