Multiculturalism in the treatment process

1. Multiculturalism in the treatment process Amy Levin, CASAC, MS Counseling June 21st 2011

2. WHAT IS MULTICULTURALism? The recognition of race, ethnicity, language, sexual orientation, gender, age, disability, class status, education, religious\spiritual orientation, and other cultural dimensions.

3. WHAT IS MULTICULTURAL DIVERSITY COUNSELING ? Counseling which recognizes diversity and embraces approaches that support the worth, dignity, potential and uniqueness of individuals within their historical, cultural, economic, political and psychosocial contexts.

4. TheCulture Conundrum The Big “C” Culture – How the World Sees You Race Ethnicity Gender Groups Developing a Common Identity and The Little “c” culture – How You See Yourself Individual Culture Identity Not Tied to a Specific Group Honoring Complexity of All of Us

5. Multi-cultural Timeline -1954 Supreme Court strikes down “separate but equal doctrine of segregated education” also For the first time recognized “Psychological Research” in a Supreme Court decision.

6. Multi-cultural Timeline -1964 Passage of the Civil Rights Act set the stage for sociopolitical movements and legislation to address rights of equity and access based on gender, age, disability, national origin, religion, sexual orientation, ethnicity and race.

7. Multi-cultural Timeline -1971 The National Institute of Mental Health establishes an office in Minority Research.

8. Multi-cultural Timeline -1985 Reorganized to include ethnic minority focused research.

9. Multi-cultural Timeline -2000 Healthcare and Mental Health disparities subject of Surgeon General’s Reports.

10. Multi-cultural Timeline -2002 American Psychological Association adopts guidelines in psychology education and training.Empirical studies start.

11. Multi-cultural Timeline -2009 BarackObama “ multiculturalism is a national strength.”

12. Why can’t we just be color blind? Proponents of color blindness argue that assimilating minorities into the dominant group is best for everyone. This approach however does not reduce inequities. instead Recognizing and appreciating group similarities and “differences” is considered to aid harmonious interactions between people from different backgrounds. www. UGA.edu/news

13. Evidence supporting a multicultural approach

14. Population Projections for USA Projections of the Population by Sex, Race, and Hispanic Origin for the United States: 2010 to 2050" (Excel). U.S. Census Bureau. http://www.census.gov/population/www/projections/files/nation/summary/np2008-t4.xls. Retrieved 2010-10-24.

15. Westchester Countydemographics – 2010 Source - Race and Hispanic Origin by Municipality, Westchester County, 2010

16. Primary forces for change Immigration Rates Differential Birth Rates (Ethnic minority groups - higher birth rates) Intermarriage increase

17. Multiculturalism – the 4th force in psychology Paul Peterson First – Psychoanalysis – Freud Second – Behaviorism – Parlor, Thorndike, Watson & Skinner Third – Humanism – Rogers Fourth - Multiculturalism – Sue, Peterson, White, Ivey, Bernal & Trimble

18. Themes of Multiculturalism – It is no longer possible for psychologists to ignore their own culture or the cultures of their clients. A multicultural perspective makes our understanding of human behavior clearer and more meaningful.

19. Ethnocentrism Misinterpretation and misjudgment based on looking at another person’s behavior from your own cultural perspective. Ethnocentric misjudgments result in culturally biased interventions and can have serious impact in mental health settings where behavior is seen as an indicator of health or pathology.

20. Multicultural counseling techniques Establish a relationship of trust with a client. Do not pretend you know what you do not know

21. Multicultural counseling techniques Remember that a person can be a part of several cultures at one time.

22. Multicultural counseling techniques Ask clients to teach you what you do not know.

23. OtherMulticultural counseling techniques Provide a respectful, open environment. Be flexible. Be an expert in the field of counseling, but not in the clients’ lives. Say, “I do not know what it is like to be…” Do not create issues, but address them when they arise. Do not fight with people, but respond to their statements. Apologize when wrong. Learn how to deal with people you dislike. Seek other counselors for support. Remember the commonalities among all people. Learning the Language of Addiction Counseling, Geri Miller

24. What is multicultural counseling/therapy “Multicultural counseling and therapy can be defined as both a helping role and process that uses modalities and defines goals consistent with the life experiences and cultural values of clients, recognizes client identities to include individual, group, and universal dimensions, advocates the use of universal and culture-specific strategies and roles in the healing process, and balances the importance of individualism and collectivism in the assessment, diagnosis, and treatment of client and client systems.” ( D.W. Sue &Torino, 2005 )

25. Seven Focus areas in multicultural counseling Race Ethnicity Gender Sexual Orientation Disability Aging Socioeconomic Class Immigration

26. Seven Focus areas in multicultural counseling Race Ethnicity Gender Sexual Orientation Disability Aging Socioeconomic Class Immigration

27. Seven Focus areas in multicultural counseling “61% of African Americans believe the federal response to the disaster caused by Hurricane Katrina would have faster if white populations had been involved.” (Washington, 2005)

28. Seven Focus areas in multicultural counseling “The experience of perceived racial discrimination leads to lower levels of mastery and higher levels of psychological distress” (Broman, Mavaddat & Hsu, 2000)

29. Seven Focus areas in multicultural counseling “When I was about 11 my parents sat me down and told me that there would be people who would hate me simply because I was Black.” Brittany-Pace student, Autumn 2010

30. Seven Focus areas in multicultural counseling “An eighth grader came up to me. If you’re a (n-word) why don’t you have big lips. Today almost 33 years later I could pick him out of a line-up.” Soledad O’Brien – CNN Journalist.

31. Seven Focus areas in multicultural counseling Race Ethnicity Gender Sexual Orientation Disability Aging Socioeconomic Class Immigration

32. Seven Focus areas in multicultural counseling “Different Hispanic groups concentrated in different regions of the country, have little knowledge of each other and are often as surprised as non-Hispanics to discover the cultural gulfs that separate them.” Diller

33. Seven Focus areas in multicultural counseling Factors increasing the risk for Psychological difficulties include, bi-lingualism, immigration and rapid acculturation, inter-generational conflict, poverty and racism.

34. Seven Focus areas in multicultural counseling “Of the 1,314 hate crimes motivated by religious bias, the overwhelming number have been anti-Jewish (68.5%). The second highest (11.1%) were anti-Islamic.” Uniform Crime Statistics, 2003

35. Seven Focus areas in multicultural counseling A Jewish client requested that an appointment not be scheduled on Yom Kippur. The therapist’s response was “What, do you need to pray or something?” (client felt humiliated, de-valued, ashamed and unsupported.) (Sue)

36. Seven Focus areas in multicultural counseling “The story of victimization and its subtle ripple through the generations is not unlike that reported by adult survivors of sexual abuse. Life has moved on and the survivors can be functionally quite successful, but an irrational undertone of guilt and shame seems to blight their self-esteem like an oil slick. untouched by the tides of time.” Monica McGoldrick.

37. Seven Focus areas in multicultural counseling Race Ethnicity Gender Sexual Orientation Disability Aging Socioeconomic Class Immigration

38. Seven Focus areas in multicultural counseling The owner of a famous Philadelphia cheese steak joint put up this sign because of the number of people who could not order in English, primarily immigrants from Latin America and Asia. Associated Press, 2006

39. Seven Focus areas in multicultural counseling Race Ethnicity Gender Sexual Orientation Disability Aging Socioeconomic Class Immigration

40. Seven Focus areas in multicultural counseling Pentagon guidelines that classify homosexuality as a mental disorder have been changed because of concerns expressed by mental health professionals. Officials removed it from this category and placed it with conditions such as bed-wetting, stammering, sleepwalking, and insect venom allergies. (Baldor, 2006)

41. Seven Focus areas in multicultural counseling “Transgendered people are the second-class citizens, and bisexuals are below even them. We’re the white trash of the gay world, a group whom it is socially acceptable not to accept. Feeling awkward among straights is what it feels like to be bi. Being distrusted among gays is what it feels like too.” (Pajor, 2005)

42. Seven Focus areas in multicultural counseling Race Ethnicity Gender Sexual Orientation Disability Aging Socioeconomic Class Immigration

43. Seven Focus areas in multicultural counseling “Class-bound factors related to socio-economic status may place those suffering from poverty at a disadvantage and deny them the necessary help they need.” Sue.

44. Seven Focus areas in multicultural counseling “Not confronting one’s own classist attitudes can lead to a phenomenon called white trashism, with descriptors like trailer parkismand redneck.”

45. Seven Focus areas in multicultural counseling Race Ethnicity Gender Sexual Orientation Disability Aging Socioeconomic Class Immigration

46. Seven Focus areas in multicultural counseling “You want to take your medicine now, don’t you?” Elderspeak such as this refers to the use of patronizing speech similar to baby talk with exaggerated intonation, elevated pitch and use of childish names such as “honey” and “good girl.” Many older adults consider elderspeak demeaning and patronizing. It is important to avoid the use of such communication, simplification of speech or repetition should be employed only in cases indicated by the person’s communication level.

47. Seven Focus areas in multicultural counseling I am not elderly, I am old and proud of it. I am aged, like a good cheese. I am a walking history book, an elder of the tribe, tested, tempered, wise …I can leave parties early…. I enjoy melancholy, even revel in it. (Frankel, 1998)

48. multiculturalism and substance abuse Look at addiction within the culture of the client and present a framework for assessment of use which covers 5 areas pertaining to client’s culture Arnodeo & Jones

49. multiculturalism and substance abuse Statistics on Drug usage within last 30 days National Survey on Drug Use and Health SAMHSA,2003b

50. multiculturalism and substance abuse Statistics on Alcohol usage within last 30 days National Survey on Drug Use and Health SAMHSA,2003b