CHAPTER 13 CULTURALLY COMPETENT ASSESSMENT

1. CHAPTER 13CULTURALLY COMPETENT ASSESSMENT

2. Introduction • It is important to accurately assess, diagnose, and treat clients. • Cultural characteristics need to be taken into account. • Counselors are not objective and do hold stereotypes and biases.

3. Therapist Variables Affecting Diagnosis • Some common diagnostic errors include: • Confirmatory strategy • Attribution errors • Judgmental heuristics • Diagnostic overshadowing • To guard against these, it is important for counselors to develop cultural competence (i.e., knowledge, awareness, and skills).

4. Contextual and Collaborative Assessment • A collaborative approach also endorses the client and counselor working together to construct an accurate definition of the problem. • The contextual viewpoint acknowledges that both the client and the counselor are embedded in systems such as family, work, and culture.

5. Collaborative Conceptualization Model Proceed using the following steps: • Use both clinician skill and client perspective to understand the problem. • Collaborate and jointly define the problem. • Jointly formulate a hypothesis regarding the cause of the problem. • Jointly develop ways to confirm or disconfirm the hypothesis. • Test out the hypothesis using both the client and the counselor as evaluators. • If the conceptualization appears to be valid, develop a treatment plan. • If the hypothesis is not borne out, the counselor and client collect additional data and formulate new, testable hypotheses.

6. Collaborating on Intervention Strategies • Intervention strategies should be based on research facilitating qualities possessed by counselors, client characteristics, and techniques. • Interventions should not be rigidly applied. • Consensus between counselor and client regarding course of therapy allows the therapeutic relationship to strengthen. • Client therefore develops confidence in the treatment as well as hope and optimism.

7. Culturally Sensitive Intake Interviews • Identifying information: Other than demographic information and inquiries about cultural groups to which the client feels connected, also ask about primary language use in the home. • Presenting problem: Obtain his/her perception of the problem and be sure to consider issues such as prejudice or oppression. • History of presenting problem: Get a chronological account of the problem and understand how cultural issues might be related to the problem. • Psychosocial history: Be sure to assess social background, values and belief (questions for inquiry are presented in the chapter). • Abuse history: Always ask questions around physical, sexual and emotional abuse history.

8. Culturally Sensitive Intake Interviews • Strengths: Identify culturally relevant strengths such as pride in one’s identity or culture. • Medical history: Assess medical or physical conditions that may be related to psychological problems; inquire about indigenous healing practices. • Substance abuse history: Assess substance and alcohol use; ask questions about family history as well. • Risk of harm to self or others: Assess harm and ask questions about clients’ emotional state.

9. Implications for Clinical Practice • Infuse cultural competence into assessment, diagnosis, and treatment. • Evaluate ones’ cultural competence. • Infuse cultural issues into intake interviews. • Do not stereotype clients or overgeneralize based on the information presented in the text. • Clients must be viewed in their totality, as unique individuals.