1. Multicultural Competencein Consumer Operated Services Vetta L. Sanders Thompson University of Missouri - St. Louis

2. Multicultural Competence • Cultural Competence Is A Process. • Components of Cultural Competence • Skills • Values • Knowledge

3. Critical Issues and Behaviors Affected By Culture • Patterns of decision making • Social interaction • Patterns of handling emotions • Definition of mental illness • Theory of disease • Roles, expectations, obligations, in relation to age, sex, class, kinship

4. Multiculturalism • Refers to: • ethnic • racial • refugee • immigrant • linguistic groups • religious groups • gender and sexual orientation • able-bodiness • socio-economic status

5. What Is Cultural Competence? • Willingness to adapt or adjust the way one works to take into consideration cultural differences • Basic knowledge of a client’s culture • Understanding that culture affects the way people behave, communicate, and problem solve • Awareness of own cultural values, awareness of and acceptance of cultural difference

6. Characteristics of the Culturally Competent(Sue, 1998) • Scientific Mindedness - hypothesis testing, creative data collection, decision making based on data. • Dynamic Sizing - knowing when to generalize & be inclusive; when to individualize & be exclusive. • Culture Specific Expertise

7. Credibility Based on Culture Specific Expertise (Sue & Sue, 1987) • Ascribed Credibility - Education, Professional Status, Group Membership • Achieved Credibility - Psychological Skill • Problem Conceptualization • Goals • Intervention or Problem Resolution Strategies

8. Credibility Cont’d • Factors Affecting Problem Conceptualization and Goal Setting • Immigration or Refugee Status • Reason for Immigration • Acculturation & Stress Related to Acculturation • Identity Issues and Concerns • Religious & Spiritual Beliefs • Discriminatory Experiences • Social Status • Access to Adequate Resources

9. Credibility Cont’d • Factors Influencing Intervention • Respect for the rights and roles of the consumer • Values & beliefs of the culture • Community Institutions • Environmental factors • income • employment status • housing options • transportation needs

10. Basic Communication • Language, Dialect, Slang • Use of Interpreters • Interpretation of Tests or Assessments • Translation of Measures • Differences in word, phrase meaning • Communication impaired by factors not related to speech (non-verbal) • Differences in relating style, etiquette • Communication Cont’d • Ability to initiate cultural dialogue in a respectful manner • Openness to feedback, non-defensive

11. Culture & Treatment • “Cultural Fit” between services provided and cultural beliefs and practices of clients and significant others important in: • reducing attrition • attaining positive treatment outcome • Caution: There is diversity within ethnic groups that must be considered (socioeconomic background, urban/ rural, nationality).

12. Facilitating Treatment & Intervention • Language affects the working alliance • The use of interpreters assists, but cannot overcome issues of longer therapy time, loss of nuances, discomfort, erroneous translations. • Use and awareness of community & cultural resources. • Explanation of therapy and therapist role (may be unfamiliar).

13. Facilitating Treatment • Psychoeducation for client & family • assists in knowledge of diagnosis, prognosis, symptoms • reduces stigma • Consider support for ethnic/culture specific support groups when requested or necessary (Bae & Kung, 2000).

14. References Arthur, T. E. (2000). Issues in culturally competent mental health services for people of color, Psychiatric Rehabilitation Skills, 4, 426-447. Bae, S. W. & Kung, W. W. (2000). Family Intervention for Asian Americans with a Schizophrenic Patient in the Family. American Journal of Orthopsychiatry, 70, 532-541. Basic Behavioral Science Task Force of the National Advisory Mental Health Council (1996). Basic behavioral science research for mental health: Sociocultural and environmental processes. American Psychologist, 51, 722-731. Sue, S. (1998). In Search of Cultural Competence in Psychotherapy and Counseling. American Psychologist, 53, 440-448. Sue, D. & Sue, S. (1987). Cultural factors in the clinical assessment of Asian Americans. Journal of Consulting and Clinical Psychology, 55, 479-487. Thompson Sanders, V. L.. (1997, March/April). Psychological practices in a multicultural society.The Missouri Psychologist,11-13.