5/13/16

Being a Multicultural Counselor

Evidence Based Practice (EBP)

and Multiculturalism
! The importance of evidence-based practice (EBP) is
becoming increasingly accepted in the field of
multicultural psychology.
! Although there is optimism about the convergence of
these forces, there is still resistance to EBP among
some individuals within the field.
! Conflicts often exist between the values espoused in
conventional psychology and the cultural values and
beliefs of ethnic minorities.
! Multiculturalism without strong research risks
becoming an empty political value, and EBT without
cultural sensitivity risks irrelevancy

Evidence Based Practice (EBP)

and Multiculturalism

! Conventional delivery of Western-based therapies

does not reach ethnic and cultural minorities.

! EBPs offer an opportunity for infusing

multicultural and diversity sensitivity to therapy.

! EBPs integrate culturally sensitive strategies.

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Empirically Supported
Treatment (EST)
! Empirically supported treatment (EST)
typically involves a very specific treatment
protocol for specific disorders and is
conducted using manuals.

! Cultural adaptations of ESTs are becoming

common.

Empirically Supported Treatment

(EST)
Cultural adaptions can include factors such as
! Engagement strategies relationship building
! Activity schedules making activity schedules
to combat depression
! Assertiveness training finding culturally
sensitive approaches to assertiveness
! Cognitive restructuring use culturally sensitive
approaches to encourage follow through

Empirically Supported
Relationships (ESRs)
The empirically supported relationship
variables include
! The therapeutic alliance
! Emotional or interpersonal bond
! Empathy
! Self-disclosure
! Management of countertransference
! Goal consensus

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Question

! What might harm the development of these

variables (below) in a relationship?

! The therapeutic alliance

! Emotional or interpersonal bond
! Empathy
! Self-disclosure
! Management of countertransference
! Goal consensus

Ask yourself
! Does the client seem to be responding positively to
my relational style?
! Have I succeeded in developing a collaborative and
supportive relationships with this client?
! What do I need to change to build this working
alliance?
! How is this client responding to what I am saying?
! What are the clients verbal and bodily cues
communicating?

Evidence-Based Practice (EBP) and

Diversity Issues in Counseling

Evidence-based practice (EBP) refers to the

integration of the best available research with
clinical expertise in the context of patient
characteristics, culture, and preferences.

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Three Pillars of Evidence-Based

Practice

EBPClient Focused

EBP focus is on the client and the

consideration for cultural variables; EBP sets
the stages for a multiculturally sensitive
counseling relationship.

Question
! What is your reaction to EBP, especially as it applies to
ethnic minorities and other diverse populations?
! It is clear that using an EBP approach requires greater
time and effort on the part of clinicians to develop a
treatment plan. The implication is that counselors must
do out-of-office education or consultation regarding what
is available in the research literature that would help
inform their practice.
" Is such an approach too time consuming?
" Given that EBP research is exploding in the field, how would
you keep current or informed as a practitioner?

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Legitimacy of Cultural
Syndromes
Hmong nightmare death

Beliefs about spirit possession

Different worldviews

Implications for mental health professionals

The Shaman as Therapist:

Commonalities

# The healers credibility is crucial for

effective therapy.
# Be familiar with clients culture.
# Show compassion.
# Be competent with clients language
preference.

INDIGENOUS HEALING
GUIDELINES
1. DO NOT INVALIDATE THE INDIGENOUS CULTURAL BELIEF
SYSTEMS OF YOUR CULTURALLY DIVERSE CLIENTS.

! On the surface, the assumptions of indigenous healing

methods might appear radically different from our own.
When we encounter them, we are often shocked, find such
beliefs to be unscientific and are likely to negate, invalidate,
or dismiss them.

! Such an attitude will have the effect of invalidating our

clients as well, because these beliefs are central to their
worldview and reflect their cultural identity.

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INDIGENOUS HEALING
GUIDELINES
2. BECOME KNOWLEDGEABLE ABOUT INDIGENOUS BELIEFS
AND HEALING PRACTICES.

Counselors/therapists have a professional responsibility to

become knowledgeable about and conversant with the
assumptions and practices of indigenous healing so that a
desensitization and normalization process can occur.

By becoming knowledgeable and understanding of

indigenous helping approaches, the therapist will avoid
equating differences with deviance!

INDIGENOUS HEALING
GUIDELINES
3. REALIZE THAT LEARNING ABOUT INDIGENOUS HEALING
AND BELIEFS ENTAILS EXPERIENTIAL OR LIVED REALITIES.

While reading books about non-Western forms of healing

and attending seminars and lectures on the topic are valuable
and helpful, understanding culturally different perspectives
must be supplemented by lived experience.

Even when we travel abroad, few of us actively place

ourselves in situations that are unfamiliar, because doing so
evokes discomfort, anxiety, and a feeling of differentness.

INDIGENOUS HEALING
GUIDELINES
4. AVOID OVERPATHOLOGIZING AND UNDERPATHOLOGIZING
A CULTURALLY DIFFERENT CLIENTS PROBLEMS.
!Therapists or counselors who are culturally unaware and who
believe primarily in a universal psychology may oftentimes be
culturally insensitive and inclined to see differences as deviance.
They may be guilty of overpathologizing a culturally different
clients problems by seeing them as more severe and pathological
than they truly may be.

!There is a danger, however, of also underpathologizing a culturally

different clients symptoms as well. While being understanding of a
clients cultural context, having knowledge of culture-bound
syndromes, and being aware of cultural relativism are desirable,
being oversensitive to these factors may predispose the therapist to
minimize problems, thereby underpathologizing disorders.

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INDIGENOUS HEALING
GUIDELINES
5. BE WILLING TO CONSULT WITH TRADITIONAL HEALERS
AND/OR MAKE USE OF THEIR SERVICES.

!Mental health professionals must be willing and able to form

partnerships with indigenous healers or develop community liaisons.

!Such an outreach has several advantages: (a) traditional healers

may provide knowledge and insights into client populations that
would prove of value to the delivery of mental health services; (b)
such an alliance will ultimately enhance the cultural credibility of
therapists; and (c) it allows for referral to traditional healers
(shamans, religious leaders, etc.) in which treatment is rooted in
cultural traditions.

INDIGENOUS HEALING
GUIDELINES
6. RECOGNIZE THAT SPIRITUALITY IS AN INTIMATE ASPECT OF
THE HUMAN CONDITION AND A LEGITIMATE ASPECT OF
MENTAL HEALTH WORK.

! Spirituality is
a belief in a higher power that allows us to
make meaning of life and the universe. It may or may not be
linked to a formal religion, but there is little doubt that it is a
powerful force in the human condition.

! Many groups accept the prevalence of spirituality in nearly

all aspects of life; thus, separating it from ones existence is not
possible.

INDIGENOUS HEALING
GUIDELINES
7. BE WILLING TO EXPAND YOUR DEFINITION OF THE HELPING
ROLE TO COMMUNITY WORK AND INVOLVEMENT.

!More than anything else, indigenous healing is community oriented

and focused. Culturally competent mental health professionals must
begin to expand their definition of the helping role to encompass a
greater community involvement.

!The in-the-office setting is, oftentimes, nonfunctional in minority

communities. Culturally sensitive helping requires making home
visits, going to community centers, and visiting places of worship
and other areas within the community. The types of help most likely
to prevent mental health problems are building and maintaining
healthy connections with ones family, ones god(s), and ones
universe.

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Dangers and Benefits of

Spirituality
! Although more than 80% of the U.S. population indicate
religion as being important to their lives, therapists tend to
shy away from this topic in session.

! Spirituality is a broader concept than religion, and speaks to

the thoughts, feelings, and behaviors related to a
transcendent state.

! Recent research suggests that there is a positive association

between religion/spirituality and optimal health outcomes,
and more mental health professionals are incorporating it
into their practices.

One Minute Paper

! Do you consider yourself to be a religious
and/or spiritual person?
! How might your religious or spiritual views
affect your work as a counselor?
! What if your client holds beliefs that were
very different from your own? How might
that affect your work with a client?
! What can you do to minimize this effect?

Awareness, Knowledge, and

Skill
! Do you think youre ready to be a culturally
competent counselor?

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Process
! It it possible to earn an A grade in he
multicultural awareness, knowledge, and skill
competencies?
! Did you underestimate your level of
competence before taking this test?
! Did you overestimate your level of
competence before taking this test?
! What are the consequences of not having
multicultural competence?
! How do you plan to increase your level of
multicultural competence?