PSYC 561: Multicultural Counseling Flashcards
Acculturation
process through which individuals or groups from one culture, come into contact with and adopt practices, values, or behaviors from another culture.
- Affects identity, communication style, social interactions and can influencing how individuals navigate bi-directionally between cultures
which shapes how societies are formed
may result such as :
assimilation (complete adoption of the new culture)
integration (combining elements of both cultures)
separation (maintaining original cultural practices and rejecting the new)
marginalization (reject both cultures)
- this is important to understand bc of its affecting clients identity, health and overall well being.
Ex: Orlando is a first generation cuban male who parents fled Cuba to escape Castro’s terror. His father was prisoned during the attempt and is lucky to be alive today. Once settled in Louisiana, both Orlando’s mother and father proudly assimilate to the ways and traditions of their new American lifestyle. While the speak cuban in the home, they made ever effort to speak excellent english in public and with Orlando’s friends and their families as well as cook classic American meals and dress similarly to their neighbors. As an adult today, in a hope to integrate some of his Cuban heritage, Orlando is teaching his own children about Cuban culture and educating them on the bravery of their grandparents and what life was like for them growing up outside of America.
ADDRESSING Model
- An acronym that describes aspects of identity that are often overlooked or assumed that are necessary for case conceptualization to create curiosity and decrease assumptions
A: age
D: disability at birth
D: disability acquired
R: religion
E: ethnicity
S: socioeconomic status
S: sexual orientation
I: indigenous heritage
N: nation of origin
G: gender identity/pronouns
Ex: Ami is a 47 year old, white female born in America with no indigenous heritage. At birth Ami has no disabilities and has not acquired a disability during her lifetime. Ami is a member of the christian church but has doubts about the benefit of organized religion. Ami was born to a lower-middle class family who struggled to make ends meet but as an adult has a high socioeconomic status. Ami is a married, heterosexual female.
Anti-racism
- The active process of identifying, challenging and eliminating racism through systematic change of policies and attitudes that maintain racial inequity.
- Requires participation in the process to actively work against discrimination and bias … not enough to just “not be racist”
- Self-education about racial history and systemic inequality supports marginalized groups
- Advocating and voting for policies that promote equity
- Challenging behaviors and language that shows up in daily life
- This is important to understand bc experiencing racism can be a devastating experiences and as clinicians we must educate ourselves in best practices and core cultural competencies
Ex: Liz is a licensed therapist and white American female who works to be anti-racist by educating herself of the history of oppression in South Carolina. She participates in forums at her community center that aim to educate community members on local politics that will impact marginalized groups such as the policies of the new public school board superintendent and the redrawing of district lines that will impact upcoming state elections. Liz takes this information and disseminate it in a monthly newsletter that anyone may subscribe to.
Assimilation
- A component of Acculturation where an immigrant fully adopts a new culture’s beliefs and practices
- This can happen voluntarily or as a result of pressure to blend in by adopting local language, participating in community activities, attending local school and dressing in a fashion similar to that of the the dominate culture.
- Some consequences of assimilation could be the creation of an identity crisis, tress and anxiety from trying to “fit in”, a loss of ancestral customs which can erase cultures and risk of discrimination and microaggressions
Ex: George is a 15 yr old American Indian presenting to therapy for depression. George’s family recently moved off their native reservation to provide George with a safer environment away from drugs. George is having a terrible time assimilating and “fitting in” at the local public school and misses the traditions of his people. While he was at first excited about the adventure of living off the land, he is now anxious for most of the day as he doesn’t know where he fits in or even how to start making friends.
Bicultural
- A part of Acculturation where a person integrates two cultures
- Refers to a person who identifies with and navigates between two different cultures by adopting aspects of both cultures into everyday life, language, traditions and values.
- In bicultural societies, people may identify with multiple ethnicities, reflecting both their ancestral roots and the culture of the country where they were born or raised.
- This is important bc identifying as bicultural can present challenges when living in a society that encourages assimilation potentially causing dysfunction within self-identity
Ex: Danella is a Mexican women who met and married an American man, Richard. She has since moved to San Diego to marry him and together they have two children. Danella became a citizen of the US and her children have dual citizenship. As a family, Danella and Richard speak primarily spanish in their home and listen to hispanic music enabling their children to stay closley atttached to her native language and so that they may maintain aspects of both cultures in their daily life.
Collectivism
Psychosocial unit of family/group/collective society share a collectivist mentality rather than an individual mentality
Worldview emphasizes that sacrifices are made to meet the needs of the whole group prioretzing community, shared resources and group decision-making
- Cultures like Asain and Middle Eastern cultures subscribe to a strong collectivist mentality
- This is important to understand when considering a clients worldview, origins of self efficacy, external vs internal locus of control
- Also important to understand how a collectivist mindset may play into anxiety, isolation, depression.
Ex: Amelia is a young mother from a conservative middle eastern family. Amelia is experiencing low mood, anxiety, stomach pain and is having trouble sleeping. Amelia is physically and mentally exhausted and feels like she has to be the perfect mother, wife, daughter, sister and aunty, cousin and neighbor all the time. Amelia has felt this way for almost 2 years but has never burdened her family with this news and is seeking couseiling in privacy bc she doesn’t want to shame her family by “being weak minded”.
Coming Out Process
- A process of revealing a true gender identity or sexual orientation to others
- Within the LGBTQ+ community, this is considered to never be a “one and done” process as the individual often has to “come out” several times in their lifespan and in various ways depending on their environment
Stages are
- Confusion
- Comparison
- Tolerance
- Acceptance
- Pride
- Synthesis
important in therapy bc while this process can be a positive and transformative experience, it also can be tramatizing and have negative consequences depending on the individual’s support system, their personal world-view and their sense of worth.
Culture
- The distinct shared values, customs, beliefs, behaviors, traditions, art, food, and language of a group that shape how individual within the group think, behave and interact with each other and the world around them.
- Not geographically relevant but passed down from generation to generation - includes material (art, food, clothing) and non-material (beliefs, values, customs).
- Beliefs and behaviors that set guiding principles for everyday behaviors and practices
- This is important to increase awareness and decrease blind-spots bc an individuals culture often has a significant influence on their identity, mental health and internal frame of beliefs and behaviors
Ex: Danella is a mexican-american woman who maintains a strong connection with the hispanic culture of her youth. She speaks spanish in the home to her children, has incredibly strong ties to her family, often visiting her mother and sisters in Mexico, and goes to church every week to pray to La Virgen Maria. Danella is raising her children to appreciate the food and music that defines mexican culture and is raising them in the Catholic church just as she was raised.
Cultural Universality
- Concept that certain cultural traits are universal and shared by all human societies regardless of time, geography or cultural connect.
- Some examples are the shared universal acceptance of social hierarchy, language, art, religion, creation of family
- Suggests that some aspect of human life are shared by all people promoting empathy and respect for the human experience
- Not bound - Individuals can adopt or adapt to different cultures over time through processes like acculturation or assimilation.
- Useful to understand when dealing with populations that experience discrimination or an individual who is struggling to assimilate
Ex: Your treatment plan for George, a American Indian client who is experiencing dysfunction and possible identity crisis since moving off his native land, includes ACT therapy aimed at supporting his understanding and acceptance that some aspects of his indiginious culture are positively viewed, respected and upheld in the mainstream culture of his new community such as language, family, etc.
Culture Bound
- Refers to behaviors, manifestation and interpretation of symptoms, leading to unique syndromes recognized within specific societies.
- This is important to understand bc specific and appropriate treatments must be considered so as not to misdiagnose or unintentionally offend the client which could rupture the relationship, especially if the bounding bx is considered normal and healthy within their cultural lens
Ex: A culture-bound syndrome prevalent in Japan translates to a “fear of interpersonal relations” where individuals experience debilitating anxiety about their appearance or actions offending or embarrassing others. Symptoms include avoidance of social situations, rapid heartbeat, shortness of breath, and trembling when around people due to a persistent fear of offending others through perceived flaws like body odor or facial expressions.
Cultural Competence
- A core competence of practicing ethically and a commitment to lifelong learning
- Awareness, knowledge and skills needed to work effectively with culturally diverse populations includes cultural boundaries, respect for heritage, being aware of self-bias, and beneficence.
- This is important bc a therapist must understand the various cultural influences of a person’s cognitions, behaviors and emotions
- Peer consultation is useful to support cultural competency
Ex: As a young counselor working to gain experience with your primarily Asiain student population, you communicate upfront with your clients that if there is an aspect of their identity that miss or are not fully understanding in the context of a session, to please feel free to correct you and that you will in no way take offense.
Emic
- Remember that “M” for multicultural view
- Emphasize culture-specific norms and view from the insider’s perspective
- Cultural differences must be considered in diagnoses and treatment
- Important to understand because dysfunction can arises from within a cultural context influencing how core-beliefs, attachment styles, temperament and personal values may contribute your client’s view of themselves, others, and the world around them.
- Failing to recognize the impact of culture risks inaccurate diagnoses and inappropriate treatments.
Ex:
Etic
- “T” for *total *perspective
- Emphasize similarities and universality between cultures taking an outsider’s perspective that allows for cross-cultural comparisons.
- Downplays cultural differences.
- Believe that treatment of disorders are similar across cultures
Important to understand because dysfunction can arises from within a cultural context influencing how core-beliefs, attachment styles, temperament and personal values may contribute your client’s view of themselves, others, and the world around them.
- Failing to recognize the impact of culture risks inaccurate diagnoses and inappropriate treatments.
Ex: Mexican woman is first to go to college and moves away from home struggles with lack of family support system - clinician fails to recognize importance of collectivist culture of family
Ethnocentric Monoculturalism
- Foundational beliefs that maintain oppression believing that one’s own culture or ethnic group is superior to others, and that other cultures should conform to or adopt the dominant culture’s values and practices.
Mindset often leads to the marginalization or invalidation of different cultural perspectives.
Common in societies where one group holds power, and it reinforces inequality by promoting a singular worldview
Institutions can manifest as policies and practices that prioritize the dominant group’s norms, leading to discrimination or exclusion of minority groups.
Prevents understanding, appreciation, and respect for cultural differences.
Ex: abortion rights / white / male / law - punishable crimes
Ethnicity
- Specifically relates to identity connected to ancestry
- Ethnicity and cultural heritage are interconnected concepts, yet have distinct meanings in that ethnic identity is not subject to change and is often assigned based on one’s family and ancestral background, while cultural is a broader term that can be a matter of personal choice or influence.
- This is important to understand bc specific and appropriate treatments must be considered so as not to misdiagnose or unintentionally offend the client which could rupture the relationship.
Ex: Therapist uses the addressing model to obtain information about a client’s identity. The client identifies as a straight Mexican female who speaks Spanish and practices catholicism. Her ethnicity is hispanic. The clinician takes her ethnicity (as well as other parts of his identity) into consideration to better conceptualize the client’s case and provide an appropriate diagnosis as well as form an effective and culturally appropriate treatment plan.
Individualism
- Perspective prioritizes the needs and goals of the individual over those of the larger group
- Focuses on autonomy, self-reliance, and assertiveness
- Often found in Western cultures like the United States
Ex: HOW IS THIS RELEVANT TO THERAPY? In America, when a child turns 18 is it generally expected that they move out of their parent’s home and start an independent life. Even if attending college, their bedrooms may be turned over for use by the family/parents in another way. This type of parenting is different from collective cultures where it is common for children to live at home until marriage and then for their own parents to move in with them.
Institutional Racism
- A set of institutional policies, practices, and priorities designed to oppress minority populations and force dependence on the majority population
- Maintained by dominate races, organizations or governments
- Embedded in laws, policies, and societal norms, leading to disparities in education, healthcare, criminal justice, employment, and housing.
- Typically one of the most covert forms of racism therefore very difficult to recognize and reassemble
- Addressing institutional racism requires systemic policy changes, accountability, and a commitment to equity and inclusion.
Ex: Client’s husband is in prison for small possessing a small amount ….. lead to your depression … hypervigilance around racism …
Microaggression
- Refers to everyday put-downs, invalidations, and insults that are directed at diverse groups
- This is important to understand bc oftentimes microaggressions take place by well-intentioned people who are unaware they have engaged in behavior causing others to feel distress or harm.
3 categories:
Micro-insults although insulting, these are typically not intended to be rude or insensitive
Micro-assaults are intentionally insulting or excluding
Micro-invalidations dismiss or minimizes thoughts, feelings and position to minimize the experience of their identity.
Ex: Stopping a dark skinned mothers on the street to say, “You children are so beautiful and unique looking. Where are you from?”
Minority
- A subgroup with social, religious, ethnic, racial, or other characteristics that differ from the majority population
- The term minority can extend to cover any group that is the subject of oppression and discrimination by another more dominant group
- Minority status often puts the individual at a disadvantage
Ex: You client is a Jewish American who is concerned about the mental health of her daughter who is the only Jewish child in her private school. Her daughter does not want to participate in the traditional Christian Christmas activities ….
Multicultural Competencies
- Pillar of an evidence based practice
- Refers to the therapist’s ability to understand and
constructively relate to the uniqueness of each client in light of their cultural identity and influences - Inclusive, respective and effective EMIC consideration
3 Components.
1. Awareness ( knowing one’s own biases and views)
2. Knowledge ( information about culturally diverse groups)
3. Skills (implementation of culturally appropriate assessments and interventions)
Ex: Client is a refugee who is displaces …. clinitian is able to apply an an emic or a etic view …
Multicultural Counseling
Multicultural counseling is an approach that recognizes and respects the diverse cultural backgrounds of clients emphasizes the emic importance of how their culture, ethnicity, race, and other social factors influenced their experiences, values, and worldview.
This approach is required ethically helps build trust, foster effective communication, and promotes mental health in a culturally sensitive way building a strong therapeutic alliance.
- Emic appreciation and validation of perspectives encourages counselors to explore how racism or discrimination may have impacted a client’s well-being and to address them within the therapeutic process.
Ex:
Oppression
- A event in which people are governed in an unfair and cruel way through the misuse of authority to prevents individuals from having opportunities and freedoms
- is perpetuated and maintained by a power imbalance
- Dominant cultures will often use their status to silence “others” and “subordinate” cultural groups
- done through laws and power
- people who feel oppressed experience an external locus of control
Ex: LGBT individuals has been bullied, harassed and even lost his job because his boss did not agree with his choices
Race
- A social construct designed to categorize individuals based on visible traits.
This construct has significantly influenced social structures, leading to varying experiences and opportunities for different racial groups widely influencing experiences within societies shaping perceptions of identity and belonging.
This is important to understand a clients well-being and mental health and how their experiences of discrimination and their perception of belonging.
Ex:
Racial Identity Development Model
A 5-stage theory that emphasized the psychological process of racial identity development.
- Conformity (the depreciation of self and their culture and an appreciation for dominant culture -need to fit in)
- Dissonance (individual experiences conflict (anger, shame, depression) questioning their submission to a dominant culture)
- Resistance and Immersion (individual experiences negative attitudes toward the dominant culture and positive attitudes toward their own culture)
- **Introspection **(individual seeks to see the best of both cultures. takes pride in their culture and finds value in dominant culture)
- Integrative Awareness (individuals balance minority cultural pride with a global, inclusive perspective. ) *
Ex:
Racism
- Form of prejudice and discrimination
- The idea that “race” is used as a data point in determining ability
**Individual Racism **– Personal (racial slurs, stereotyping).
Interpersonal Racism – behaviors and interactions (workplace discrimination, racial profiling).
Institutional Racism – Policies, laws, and institutional practices that produce unequal outcomes (criminal justice).
Structural (Systemic) Racism – The broader system of racial inequality embedded in society’s institutions, culture, and history (e.g., generational wealth gaps, healthcare disparities).
When individuals from marginalized racial groups internalize negative stereotypes or believe in their own inferiority.
** Internalized Racism –** When individuals from marginalized racial groups internalize negative stereotypes or believe in their own inferiority.
White Privilege
- The most widely used racial category is the visible trait of skin color
- Refers to the unearned advantages and privileges that are afforded to people of light-colored skin
- Typically received by people of White European descent
- White privilege maintain the racial hierarchy in the United States
- Problematic when individuals oppose or reject the idea of its presence/influence and are oblivious to whiteness as a privilege and engage in bias or dis.
- Should not be rejected but it is important to meet clients with empathy and unconditional positive regard when working through how they process this in counseling.
Ex: client is a black woman who is passed up for a promotion …..
Worldview
- Composed of people’s attitudes, values, and beliefs
- that affect how people think, behave, define events, and make decisions
- Consists of basic assumptions that provide a way of thinking about the world
- Different cultures often have different worldviews
- as a clinician, we must realize that our worldview may be different than out client’s worldviews,
- Origions, mechanismas, healthy functioning,
Ex:
Counseling-relevant cultural issues for: African American clients
- strong distrust for the majority culture
- consider levels of *racial identity development *
- always ask who lives in the home / collective view in family and strong family connections which don’t have to be blood (can be from church or school)
- family and faith are important; may seek religious leaders/family members before therapists
- discuss oppression from clients view
- may respond well to community based programs (church)
- SES
- be aware of personal bias
Counseling-relevant cultural issues for: Hispanic/Latinx clients
- resistance to talking about problems because it is disrespectful to the family
- think about immigration, citizenship status and deportation
- machismo, address dad first in therapy to show respect
- man is in charge, brings home the money but women take care of the house // gender roles
- there are culturally bound illnesses within this culture
- consider client’s level of acculturation
- consider potential language barriers; may need translator, english as second language
- may consider incorporating family and religion in therapy
- collectivist society
- high stigma associate to mental heath
Counseling-relevant cultural issues for: Native American clients
- 2% of population
- 500+ recognized tribes / 1600 non recognized tribes
- Prefer tribal reference or American Indian
- may not look you in the eyes because it is seen as disrespectful
- highest rates of suicide in teenagers
- high rates of substance use disorder
- domestic violence
- connectedness to nature and spirituality
- asses where they believe they are at with cultural identity
- different tribes have different traditions
- spiritual healers important person in their culture as healer
- believe in non-interference
Counseling-relevant cultural issues for: LGBTQ+ clients
- never assume problems are because of sexual orientation or gender identity is reason for treatment
- be aware of support groups and resources
- discrimination and oppression they have faced
- ask about their pronouns and preferred name
- allow them to take the lead on sharing the coming out process
- be sure of social supports being strong and increase if necessary
- be aware of your own beliefs about this community
- high rates of suicide and bullying
- substance use disorder
- be open to helping the parents as well as the individual
Counseling-relevant cultural issues for: Asian clients
- Collective / hierarchical / patriarchal
- do not show feelings because it is not common in their culture
- may describe somatic symptoms rather than mental health symptoms
- important to address father as sign of respect in family settings
- important not to pathologies filial piety as dependence on older members of family
- Don’t touch them
- May bring gifts (accept but do not keep)
- Least responsive to group therapy
- Do not show vulnerability or loss of control
Counseling-relevant cultural issues for: Arab clients
- collective multifamily household
- men are the greatest of all
- feel marginalized as security threat
- feel as though people are distrusting of them
- islamic religion, prayers 5 times a day
- arranged marriage
- dress is different, conservative women
- value education and social status
- may expect detailed advice and direction and view therapist as experts to make decisions
Counseling-relevant cultural issues for: Jewish clients
Judaism encompasses a spectrum of observance levels, from secular to Orthodox.
Judaism is a culture as well as a religion. Do not have to acknowledge religion to be culturally Jewish.
Family plays a central role in Jewish culture, with strong emphasis on marital commitment and child-rearing.
Jewish individuals may have experienced historical and contemporary antisemitism, leading to feelings of insecurity or mistrust.
- oppression, racism, discrimination often experiences
Counseling-relevant cultural issues for: Physically Disabled clients
- never assume the present to therapy because of their physical disability
- consider aspects of personality and life to see how it may be contributing to the problem
- be aware of how society views them and how that impacts their mental health and world view
- office must be accessible
- don’t assume they dont have romantic relationships
Counseling-relevant cultural issues for: Female clients
- struggle with harassment/discrimination
- unequal rights, including pay
- therapists should understand the available resources to women for motherhood
- knowing how cultural norms or traditional gender roles are a part of their life is important
- encourage them to advocate for themselves
- more likely victims of violence than males
- androgyny
- holding onto youth, beauty can become dysfunction
Counseling-relevant cultural issues for: Male clients
- may be resistant to talking about feelings
- common to have learning disabilities
- may respond better to reframing therapy as building strength and facing problems as a sign of bravery
- use more lethal means of suicide
- do better with male clinicians
Counseling-relevant cultural issues for: Clients in poverty
- hierarchy of needs
- may have limited access to transportation to get to therapy or lack or resources (money)
- more likely to struggle with mental illness
- Race and gender to be considered for intersectionality that may be occurring
- in-home therapy may be an effective modality of treatment
- be open to working with other providers like social workers
- may have extra economic concerns such as lower quality in nursing, employment, healthcare, etc.
- do not assume poverty is why they are in therapy
