Multicultural

Question 1

ICIR

Answer 1

-in control of own outcomes
-responsible for own success/failures

Question 2

ICER

Answer 2

-determines own outcomes
-others are responsible from keeping them from doing so.

Question 3

ECER

Answer 3

-little or no control over outcomes
-have no responsibility over themselves

Question 4

ECIR

Answer 4

-little control over outcomes
-take responsibility for failures

Question 5

What LC & LR are seen most in American culture

Answer 5

ICIR

Question 6

Most challenging client for a White therapist (worldview)

Answer 6

ICER

Question 7

Acculturation

Answer 7

1.Integration
2.Assimilation
3.Separation
4. Marginilization

Question 8

Healthy Cultural Paranoia

Answer 8

1.Functional paranoia (pathological)
2. Cultural paranoia (due to racism)

*Race of therapist is most important when the client has both functional and cultural paranoia (prefer Black therapist)

Question 9

Racial Microaggressions

Answer 9

Microassaults (explicit racism)
Microinsults (verbal or nonverbal - assumptions)
Microinvalidation (negate thoughts, feelings or POC)

Question 10

Tight vs. Loose Cultures

Answer 10

Tight
-strong social norms
-low tolerance for deviant behavior
*citizens are more likely to conform and want stability
**higher conscientiousness and lower openness to new experiences

Loose
-weak social norms
-high tolerance for deviant behavior
citizens are more likely to engage in deviant behavior and are more open to change.
**lower conscientiousness and higher openness to new experiences

Question 11

High vs. Low Context Communication

Answer 11

High
-group understanding
-nonverbal messages
-knowledge is situational
-similar to minority groups

Low
-verbal messages
-independent of the context
-characteristics of White population

*When client is high communication and therapist is Low, there becomes issues in treatment.

Question 12

Minority stress theory

Answer 12

Sexual minorities

proximal
-stress with in the person

distal
-stress external to the person

Question 13

Recent disclosure of sexuality, lesbian vs. gay men

Answer 13

Lesbian = decrease in depression and anxiety

Gay men = increase in depression and anxiety

Question 14

Racial-Cultural Identity Development Model

Answer 14

Atkinson et al.,

1. Conformity
   (neutral or negative view of minorities)
2. Dissonance
   (questions attitudes towards minorities)
3. Resistance & Immersion
   (negative attitudes towards majority and positive towards own)
4. Introspection
   (questions alliance to own group)
5. Integrated awareness
   (aware of positive and negative of all groups)

Question 15

Black Racial Identity Development Model

Answer 15

Cross,

1. Pre-encounter
   (idealize White culture)
2. Encounter
   (Question White & Black culture/ aware of racisms effects on their lives)
3. Emersion/Immersion
   (Reject White Culture, and engage in Black culture )
4. Internalization
   (defensiveness to race decreases/ internalized Black identity/ activism/ )

Question 16

Multidimensional Model of Racial Identity

Answer 16

Seller et al.,

1. Racial salience (specific time and situation)
2. Racial Centrality (placed importance of race)
3. Racial Regard (private - positive or negative & public- belief of how others view Blacks)
4. Racial Ideology (Belief of how Blacks should live in society).

Question 17

White Racial Identity Development Model

Answer 17

Helms

1. Contact
   (lack of awareness of racism/ “Colorblind” )
2. Disintegration
   (Aware of racial dilemma / confusion & anxiety / overly identify with minority group)
3. Reintegration
   (attempt to resolve stage 2 dilemma / believe whites are victims)
4. Pseudo independence
   (superficial tolerance for minorities / faced with events that cause questioning around White & minority groups)
5. Emerson/Immersion
   (What does it mean to be White? search for personal mean of racism)
6. Autonomy
   (non-racist White identity)

Question 18

Homosexuality Development

Answer 18

Troiden

1. Sensitization (feeling different from same sex
   peers)
2. Identity Confusion (suspect they are gay)
3. Identity Assumption (acceptance of identity)
4. Identity Commitment (internalized identity)

Question 19

Multidimensional Model of Heterosexual Identity Development

Answer 19

Worthington et al.,

1. Unexplored Commitment (micro& macroscial acceptance of sexual behavior)
2. Active exploration (experimentation)
3. Diffusion (absent around all exploration)
4. Deepening & Commitment (commitment to sexual needs)
5. Synthesis (integration of sexual identity)

Question 20

Cultural socialization vs. preparation for biases (effects on black identity)

Answer 20

cultural socialization has been more consistently linked to the development of a positive ethnic identity than preparation for bias has.

Question 21

Etic

Answer 21

belief that behaviors is similar across cultures

Question 22

emic

Answer 22

belief that behaviors are affected by culture and symptoms are not universal.

Question 23

Autoplastic

Answer 23

change in the client to adapt to environment to change behavior.

Question 24

Alloplastic

Answer 24

change in the environment to fit the clients needs.

Question 25

Culture Encapsulation

Answer 25

inability for therapist to work effectively with other ethnic/ cultural backgrounds. *insensitive to cultural differences *takes etic view

Question 26

Credibility & gift giving

Answer 26

*Asian and non-western clients Credibility: -trustworthiness -Ascribed status - age, gender, etc. -Achieve status - education Gift giving -providing reassurance -normalizing -treatment that reduces symptoms *direct benefit should be given as soon as possible to establish credibility and reduce premature termination.

Question 27

African American Clients

Answer 27

Keep in mind: -cultural paranoia -experience with racism Presenting problem: -include nuclear and extended family -roles are flexible (male and female) - egalitarian -Empower the client by problem solving skills Interventions: -egalitarian relationship -time-limited -problem-solving -use multisystems approach (ecological)

Question 28

Native American Clients

Answer 28

Keep in mind: -adherence to collateral family system (tribe) -cooperation, sharing, generosity are important -interest of tribe take priority Wellness= healthy mind-body-spirit Illness = disharmony (mind-body-spirit) *more emphasis on non-verbal communication *listening is viewed as more important *direct eye contact = disrespect *firm handshake = aggression Interventions: -collaborative-client centered approach -Network therapy

Question 29

Hispanic clients

Answer 29

*Psychological symptoms often seen as somatic complaints. Keep in mind: -religious beliefs -emphasizes family over self *Patriarchal (male dominant culture) Intervention: -adopt a formal style (Formalismo) for first session -Use a personal style (Personismo) for later sessions *CBT *Solution Focused *Family therapy *Group therapy **Quento-therapy (use of folk-tails)

Question 30

Asian clients

Answer 30

Holistic view = mind and body *Psychological symptoms often seen as somatic complaints. Keep in mind: -Families are hierarchical (Patriarchal) -adherence to traditional gender roles -emphasizes family needs over self -Shame = powerful motivator -silences and avoiding eye contact is seen as respectful Intervention: -Maintain formal style throughout therapy *CBT *Solution focused and brief *Focus on family *Expect therapist to give resultions

Question 31

Sexual minorities and mental illness

Answer 31

Minorities are 2x more likely to have a diagnosis *Bisexual individuals are seen to be most effected

Question 32

Sexual minorities and seeking therapy

Answer 32

Gay men more likely than lesbian women to seek therapy. Bisexual men and women seek therapy equally

Question 33

(Research study) Sexual identity milestones in gay men

Answer 33

Milestones: 1.awareness 2.identified 3. sexual experience 4. disclosure to friend 5. disclosure to family Cohorts (18 -25 y.o.) (34 - 41 y.o.) & (52- 59 y.o.) *Younger cohorts experiences milestone earlier in life. 18-25 y.o. experienced the milestones earlier than 34 - 41 and 52 - 59, this continued through the cohorts as 34 - 41 experienced milestones earlier in life compared to 52 - 59 y.o.

Question 34

Sexual milestones & mental health

Answer 34

Overall the greater extend of disclosure of sexuality the greater self-esteem and lower anxiety.

Question 35

Age, Gender and sexual milestones

Answer 35

-Boys typically have first sexual experience with same sex partner before girls. -Boys and girls disclose around the same age. Average age of acceptance of identity: Males: 19 - 21 years old Females: 21 - 23 years old

Question 36

Older Adults & mental illness

Answer 36

*Mental illness is lower in adults with the exception of NCD. Most common: -Anxiety -Depression Depression: -more likely to complain about physical and cognitive symptoms rather than emotions. 1. fatigue 2. head aches 3. pain 4. impaired memory Anxiety: -report similar to depression 1. insomnia 2. irritability 3. weight loss Treatment: -psychotherapy is effective -May respond slower to treatment -Benefits when treatment is tailored to cognitive, sensory and physical needs.