Respectful counseling cube
Religion and spirituality (R), economic class background (E), sexual identity (S), psychological maturity (P), ethnic and racial identity (E), chronological stage (C), trauma (T), family background (F), unique physical characteristics (U), and geographical location (L); other cross cutting factors are styles of communication, heritage and history, immigration and migration, level of acculturation, and perspectives on health, illness and healing
Exploring stage of counseling
Purpose is to help clients determine where they are in relationship to the problems they are facing; attending process includes eye contact, body language, and verbal tracking skills; questioning and reflecting process includes open ended questioning, paraphrasing, and summarizing skills ; high levels of client to talk, minimal counselor talk; counselor communicates acceptance, empathy, and positive regard
Understanding stage of counseling
Purpose is to help clients recognize where they are in relationship to where they want to be with regard to the problems they are facing; interchangeable empathy process includes stating feelings and content, self disclosure, and asking for concrete and specific expression; additive empathy process includes immediacy, identifying general problem situations, actions taken, and feelings, and caring confrontation skills; Clients should have a fresh perspective or be able to generate new viewpoints regarding their life challenges
Acting stage of counseling
Purpose is to help client identify what they need to do to get to where they want to be with regards to problems; decision-making process includes the skills of deciding, choosing, and identifying consequences; counselor helps client decide to change ineffective coping behaviors or continue to allow these behaviors to be problematic; counselor outlines the thoughts and feelings that previously prevented client from implementing change while exploring the positive values as a result of the decision; contracting process includes the skills of reaching agreements, setting deadlines, and reviewing goals and actions to determine outcomes
Cultural competence
Ability to honor and respect believes, languages, interpersonal styles, and behaviors of individuals and families in counseling as well as staff members
Culture
Conceptual system by a community or society to structure the way people view the world; set of believes, norms, values that influence the way people live, relate and organize their world; most of us belong to multiple cultural groups and have multiple cultural experiences; subculture, diversity in each
Race
More biological category based on genetic traits, physical characteristics; assume people with same physical traits have same beliefs and values (social construct)
Ethnicity
Implies a sense of belonging, shared social identity, values, beliefs and origins, heritage
Cultural identity
Affiliation or identification with a particular group or groups, but shaped by lots of factors; develops and changes over time
Continuum of cultural competence (5 parts)
- Cultural destructiveness-negates relevance of culture, mainstream culture/current services are superior, none other need to be considered 2. Cultural incapacity-conform to agency services rather than adapt to client needs, mainstream/dominant client culture is used as norm, biased services 3. Cultural blindness-all groups are alike with similar experiences, more alike than different, same treatment approaches, approaching all clients as individuals negates the need to focus on cultural factors 4. Cultural pre-competence-acknowledge the need for more training, knowledge of culture and need for appropriate services/strategies for culturally diverse clients and populations, still lacks skills/information to act on that acknowledgment and recognition 5. Cultural competence and proficiency-develop, evaluate, improve culturally specific and congruent services, differences among cultural groups are recognized and integrated into all parts of counseling process
Acculturation
Process of learning and adopting elements of another culture into one’s original culture, often used to describe adoption from majority culture into minority culture
4 Levels of acculturation
- Assimilation-complete adoption of new cultural ways 2. Segmented assimilation-not adopting mainstream bod adopting pieces of other cultures outside of mainstream 3. Biculturalism-adopts and identifies with both mainstream culture and own culture, equally adapt in both 4. Enculturation-adopt the culture that surrounds them, used to indicate it is one’s native culture and lifeways that got valued/adopt it
Core elements of cultural competence
Cultural awareness, general cultural knowledge, cultural knowledge of behavioral health, cultural skill development
Counselor self-knowledge
How does own cultural heritage shape perceptions of normality, abnormality and the counseling process; cultures, attitudes, beliefs, assumptions, biases, own racial/ethnic/cultural identity, Be aware of clients perception of power of counselor and how it affects trust, practice with in the limits of one’s competence
Five stages of racial/cultural identity development R/CID
- Conformity-positive toward or prefers dominant cultural values, may devalue own race or other racial/ethnic groups 2. Dissonance and appreciating-questions identity, recognizes conflicting messages of dominant mainstream cultural groups, growing sense of own cultural heritage, dominant culture not all good, sees racism 3. Resistance and immersion-positive towards and prefers own culture, rejects values of dominant society, distressed and anger towards dominant culture, values own characteristics without question, eliminate oppression within own group, growing appreciation for other racial/ethnic groups 4. Introspection-focus on personal identity apart from own cultural group, psychological cost of strong feelings about dominant culture, no culture (dominant, own, other) is all good or all bad, conflicts of loyalty as perspective broadens 5. Integrative awareness-secure, confident sense of racial/cultural identity, multicultural, pride in racial identity and cultural heritage, support/appreciate all diverse/oppressed groups
Seven stages of White racial identity development WRID
- Naïveté-minimal awareness of other races, may or may not get messages about other racial groups, ethnocentric view of culture 2. Conformity-universality of norms and believes, White American groups are more highly developed, OK with disparity of treatment 3. Dissonance-chance to examine own biases/prejudices, sees that dominant society oppresses other racial/cultural groups, recognizes racism, feel shame/guilt/anger/depression, question previous believes 4. Resistance and immersion-aware of racism in self and society, angry about messages about other groups, guilty for being part of the system, over identify with other group 5. Introspection-redefine being white American, recognize inability to fully understand other groups, maybe disconnected from white American group 6. Integrative awareness-appreciates racial, ethnic and cultural diversity, aware of sociopolitical influences of racism, internalizes nonracist identity 7. Commitment to antiracist action-social action against oppression and disparity (speaks out) even if pressure not to by dominant culture or if pressured to conform rather than align with people of color
Counseling skills
Frame issues in culturally relevant ways, allow for complexity within cultural context (avoid simple solutions to complex problems), allow for variations of personal space, sensitivity to cultural meanings of touch, explore culturally based experiences of power/powerlessness, adjust communication styles, interpret emotional expression in cultural context, expand roles and practices (more flexible, directive versus non-directive, connect with client’s community, what role does client expect)
Native American clients
May perceive persistent eye contact, direct questions, repetitive paraphrasing and summarizing as being invasive and authoritative; may prefer more circular questioning, analogies, metaphors, imagery, stories related to the issues or problems, and the use of silence; Match clients nonverbals; ask permission and always give thanks; understand cultural identity and link to tribal identity; holistic view of healing-physical, emotional, spiritual-individual and community; healing through living in harmony with nature; more willing to participate in therapeutic activities involving social and family relationships (identify what constitutes family for client-elders, same clan, tribal members)
Asian American clients
Direct eye contact, demonstrative body language, and continuous verbal tracking may be perceived as impolite, especially if level of acculturation is minimal; more likely to present with somatic/physical complaints than symptoms of psychological or emotional distress; May believe that stoic acceptance is the most appropriate response to adversity; shame and humiliation are big themes, especially with regard to not bringing shame to family, need to allow to save face and protect dignity of client and family; look to counselor for expertise and authority, prefer formalism/directive; need spirituality and traditional healing practices as part of treatment; mutual aid societies or associations are important; helpful to educate them on all parts of counseling process, concrete plan for treatment, solution focused and brief therapy approaches
African-American clients
Likelihood of cultural mistrust of white American counselors, related to past racist and discriminatory practices; need to address issue of race and validate experiences of racism and its reality in their lives as part of building collaborative client counselor relationship and establishing trust; Communication style can be more aggressive in body language and intense in vocabulary; include extended family network for support and coping; cultural and religious institutions play important role in treatment, include faith communities in counseling, involve familiar cultural symbols; Strategies promoting empowerment, emphasizing strengths rather than deficits
Hispanic and Latino clients
Acculturation stress, economic issues, immigration laws, and racial discrimination have major role in contributing to mental health issues; important role of nuclear and extended family in counseling, close ties to family and community, family traditions are important, family structure is hierarchical and special authority is given to the elderly, parents and males; high Catholicism, can be a source of strength, notion of sacrifice as good and wrongs need to be endured, making it difficult to be assertive
-
Humanistic Theories10
-
Multicultural Counseling21
-
Motivational Interviewing3
-
Rational Emotive Behavior Therapy9
-
Reality Therapy18
-
Behavioral Therapy17
-
Cognitive Behavioral Therapy25
-
Psychodynamic Therapy9
-
Person-centered Therapy18
-
Adlerian/Individual Psychology9
-
Gestalt Therapy11
-
Solution Focused Brief Therapy15
