Multicultural Competency Development

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• Multicultural Competency Development
• Fernando A. Ortiz, Ph.D.

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CHAPTER 1THE MULTICULTURAL JOURNEY TO CULTURAL
COMPETENCE
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Emotional Roadblocks to the Path of Cultural
Competence

• Strong emotions such as
• anger, sadness, and defensiveness are displayed
  when discussing experiences of race, culture,
  gender, and other sociodemographic variables

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Emotional Roadblocks to the Path of Cultural
Competence

• These feelings can enhance or negate a deeper
  understanding of the worldviews of culturally
  diverse clients
• Disturbing feelings serve to protect us from
  having to examine our own prejudices and biases
  (Winter, 1977)
• Multiculturalism deals with real human
  experiences and it would behoove the reader to
  understand his/her emotional reactions on the
  journey to cultural competence

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Common Emotions

• I FEEL GUILTY, I could be doing more
• I FEEL ANGRY, I dont like to feel like Im
  wrong
• I FEEL DEFENSIVE, Why blame me, I do enough
  already

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Common Emotions

• I FEEL TRUNED OFF, I have other priorities in
  life
• I FEEL HELPLESS, The problem is too bigwhat can
  I do?
• I FEEL AFRAID, I am going to do somethingI
  dont know what will happen

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Implications for Clinical Practice

• Do not allow your own emotional reactions negate
  the stories of the most disempowered in society
• Try to acknowledge your inherited biases openly
  so that you can listen to your clients in a
  non-defensive way
• Experiences with people of color will enhance
  ones cultural competence
• Explore yourself as a racial/cultural being
• Try to understand what your intense emotions mean
  for you when they arise
• Do not squelch dissent or disagreements
• Take an active role in exploring yourself

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CHAPTER 2THE SUPERORDINATE NATURE OF
MULTICULTURAL COUNSELING AND THERAPY
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Themes from the Difficult Dialogue

• Cultural Universality (etic) vs. Cultural
  Relativism (emic)
• Emotional Consequences of Race
• Inclusive vs. Exclusive nature of
  Multiculturalism
• Sociopolitical Nature of Counseling/Therapy
• The Nature of Multicultural Counseling Competence

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Tripartite Framework

• Individual Level
• Group Level
• Universal Level

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Tripartite Framework Model
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What is MCT?

• 1. MCT broadens the perspective of the helping
  relationship. The individualistic approach is
  balanced with a collectivistic reality that we
  are embedded in our families, significant others,
  our communities and culture.
• Working with a client is not perceived as solely
  an individual matter, but as an individual who is
  a product of his or her social and cultural
  context. As a result, systemic influences are
  seen as equally important as individual ones.

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What is MCT?

• 2. MCT expands the repertoire of helping
  responses. Traditional therapeutic taboos are
  questioned.
• Five taboos derived from monocultural code of
  ethics/standards of practice are especially
  important as examples

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Therapeutic Taboos

• 1. Therapists do not give advice and suggestion
  (it fosters dependency).
• 2. Therapists do not self disclose their
  thoughts and feelings (it is unprofessional).
• 3. Therapists do not barter with clients (it
  changes the nature of the therapeutic
  relationship).
• 4. Therapists do not serve dual role
  relationships with clients (there is a potential
  loss of objectivity).
• 5. Therapists do not accept gifts from clients
  (it unduly obligates them).

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BECOMING CULTURALLY COMPETENT

• Cultural competence is the ability to engage in
  actions or create conditions that maximize the
  optimal development of client and client systems.
  It is the acquisition of awareness, knowledge,
  and skills needed to function effectively in a
  pluralistic democratic society (ability to
  communicate, interact, negotiate, and intervene
  on behalf of clients from diverse backgrounds),
  and on an organizational/societal level,
  advocating effectively to develop new theories,
  practices, policies and organizational structures
  that are more responsive to all groups.

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BECOMING CULTURALLY COMPETENT

• l. Having all of us become culturally aware of
  our own values, biases and assumptions about
  human behavior.
• What stereotypes, perceptions, and beliefs do we
  hold about culturally diverse groups that may
  hinder our ability to form a helpful and
  effective relationship?
• What are the worldviews they bring to the
  interpersonal encounter? What value systems are
  inherent in the professionals theory of helping,
  educating, administrating, and what values
  underlie the strategies and techniques used in
  these situations?
• Without such an awareness and understanding, we
  may inadvertently assume that everyone shares our
  world view. When this happens, we may become
  guilty of cultural oppression, imposing values on
  our culturally diverse clients.

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BECOMING CULTURALLY COMPETENT

• 2. Having all of us acquire knowledge and
  understanding of the worldview of culturally
  diverse groups and individuals.
• What biases, values and assumptions about human
  behavior do these groups hold?
• Is there such a thing as an African American,
  Asian American, Latino(a)/Hispanic American or
  American Indian worldview? Do other culturally
  different groups (women, the physically
  challenged, gays/lesbians, etc.) also have
  different world views?

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BECOMING CULTURALLY COMPETENT

• 3. Having each of us begin the process of
  developing appropriate and effective helping,
  teaching, communication and intervention
  strategies in working with culturally diverse
  groups and individuals.
• This means prevention as well as remediation
  approaches, and systems intervention as well as
  traditional one-to-one relationships.
• Equally important is the ability to make use of
  existing indigenous-helping/healing approaches
  and structures which may already exist in the
  minority community.

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BECOMING CULTURALLY COMPETENT

• 4. Understanding how organizational and
  institutional forces may either enhance or negate
  the development of multicultural competence.
• It does little good for any of us to be
  culturally competent when the very organization
  that employs us are filled with monocultural
  policies and practices.
• In many cases, organizational customs do not
  value or allow the use of cultural knowledge or
  skills. Some organizations may even actively
  discourage, negate, or punish multicultural
  expressions. Thus, it is imperative to view
  multicultural competence for organizations as
  well.
• Developing new rules, regulations, policies,
  practices, and structures within organizations
  which enhance multiculturalism are important.

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Implications for Counseling

• Realize that you are a product of cultural
  conditioning and that you are not immune from
  inheriting biases associated with culturally
  diverse groups in our society
• Be aware that persons of color, gays/lesbians,
  women, and other groups may perceive mental
  illness/health and the healing process
  differently than do Euro-Americans
• Be aware that Euro-American healing standards
  originate from a cultural context and represent
  only one form of helping that exists on an equal
  plane with others
• Realize that the concept of cultural competence
  is more inclusive and superordinate than is the
  traditional definition of clinical competence.

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Implications for Counseling

• Realize that organizational/societal policies,
  practices, and structures may represent
  oppressive obstacles that prevent equal access
  and opportunity. If that is the case, systems
  intervention is most appropriate
• Use modalities that are consistent with the
  lifestyles and cultural systems of clients

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CHAPTER 3THE POLITICS OF COUNSELING AND
PSYCHOTHERAPY
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Katrina and Counseling?

• Katrina is a prime example of the clash of racial
  realities and the multitude of political issues
  that are likely to arise in clinical sessions
  between counselors and culturally diverse clients
• Counseling and psychotherapy do not take place in
  a vacuum isolated from the larger
  social-political influences of our societal
  climate      

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The Diversification of the United States

• Nowhere is diversification of society more
  evident than in the workplace where three major
  trends can be observed
• the graying of the workforce
• the feminization of the workforce
• the changing complexion of the workforce

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Graying of the Workforce

• As the baby boomers head into old age, the
  elderly population of those 65 and older will
  surge to 53.3 million by 2020
• In 2005, 70 of workers were in the 25-54 age
  group and workers 55 and older rose 15     

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Implications

• Lack of knowledge concerning issues of the
  elderly and the implications of an aging
  population on mental health needs
• In American society, the elderly suffer from
  beliefs and attitudes of society (stereotypes)
  that diminish their social status
• The elderly are increasingly at the mercy of
  governmental policies and company changes in
  social security and pension funds
• Social service agencies are ill prepared to deal
  with the social and mental health needs of the
  elderly

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Feminization of the Workforce and Society

• Over a fifteen year period from 1990 to 2005
  women accounted for 62 of the net increase in
  the civilian labor force
• However, women continue to occupy the lower rungs
  of the occupational ladder but are still
  responsible for most of the domestic
  responsibilities

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Implications

• Women are subjected to greater number of
  stressors than their male counterparts due to
  issues related to family life and role strain
• Family relationships and structures have
  progressively changed as we have moved from a
  traditional single-earner, two-parent family to
  two-wage earners
• Women continue to be paid less than men, and 25
  of children will be on welfare at some point
  before reaching adulthood

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The Changing Complexion of the Workforce and
Society

• From 1990 to 2000, the U.S. population increased
  13 to over 281 million (U.S. Bureau of the
  Census, 2001)
• Projections indicate that persons of color will
  constitute a numerical majority sometime between
  2030 and 2050 (D. W. Sue et al., 1998)
• The rapid demographic shift stems from two major
  trends immigration rates and differential
  birthrates

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Implications

• By the time the socalled baby boomers retire,
  the majority of people contributing to the social
  security and pension plans will be racial/ethnic
  minorities so if people of color continue to be
  the underemployed and underpaid, the economic
  security of retiring White workers looks grim
• The economic viability of businesses will depend
  on their ability to manage a diverse workforce
  effectively

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Mental Health Implications

• Counselors must be prepared to become culturally
  competent through (a) revamping our training
  programs, (b) developing multicultural
  competencies as core standards for our
  profession, and (c) providing continuing
  education for our current service providers

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CHAPTER 4SOCIOPOLITICAL IMPLICATIONS OF
OPPRESSION TRUST AND MISTRUST IN COUNSELING/
PSYCHOTHERAPY
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The Case of Malachi

• The therapist felt he was in danger but could
  it be that the White counselor is not used to
  passionate expression of feelings?
• The counselor imposed White, Western values of
  individualism and self-exploration onto the
  client suggesting Malachis problems lie within
  himself
• The counselor went into the session wanting to
  treat Malachi like every human being thereby
  negating his unique racial-cultural perspective

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ETHNOCENTRIC MONOCULTURALISM

• Ethnocentric monoculturalism is the individual,
  institutional and societal expression of the
  superiority of one groups cultural heritage over
  anothers. In all cases, the dominant group or
  society has the ultimate power to impose their
  beliefs and standards upon the less powerful
  group.

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ETHNOCENTRIC MONOCULTURALISM

• 1. BELIEF IN SUPERIORITY.
• There is a strong belief in the superiority of
  one groups cultural heritage (history, values,
  language, traditions, arts/crafts, etc.). The
  group norms and values are seen positively and
  descriptors may include such terms as more
  advanced and more civilized
• Members of the society may possess conscious and
  unconscious feelings of superiority and that
  their way of doing things is the best way

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ETHNOCENTRIC MONOCULTURALISM

• 2. BELIEF IN INFERIORITY.
• There is a belief in the inferiority of all other
  groups cultural heritage which extends to their
  customs, values, traditions and language.
• Other societies or groups may be perceived as
  less developed, uncivilized, or primitive.
  The life style or ways of doing things by the
  group are considered inferior.

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ETHNOCENTRIC MONOCULTURALISM

• 3. POWER TO IMPOSE.
• The dominant group has the power to impose their
  standards and beliefs upon the less powerful
  group. All groups are to some extent
  ethnocentric that is they feel positively about
  their cultural heritage and way of life. Yet, if
  they do not possess the power to impose their
  values on others, they hypothetically cannot
  oppress.
• It is power or the unequal status relationship
  between groups which defines ethnocentric
  monoculturalism.

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ETHNOCENTRIC MONOCULTURALISM

• 4. EMBEDDED IN INSTITUTIONS.
• The ethnocentric values and beliefs are
  manifested in the programs, policies, practices,
  structures and institutions of the society. For
  example, chain-of-command systems, training and
  educational systems, communication systems,
  management systems, performance appraisal systems
  often dictate and control our lives. They attain
  untouchable and godfather-like status in an
  organization.
• Because most systems are monocultural in nature
  and demand compliance, racial/ethnic minorities
  and women may be oppressed.

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ETHNOCENTRIC MONOCULTURALISM

• 5. INVISIBLE VEIL.
• Since people are all products of cultural
  conditioning, their values and beliefs
  (worldview) represent an invisible veil which
  operates outside the level of conscious
  awareness.
• As a result, people assume universality that the
  nature of reality and truth are shared by
  everyone regardless of race, culture, ethnicity
  or gender.
• This assumption is erroneous, but seldom
  questioned because it is firmly ingrained in our
  world view.

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Therapeutic Impact of Ethnocentric Monoculturalism

• Dissociate the true self
• Playing it cool
• Uncle Tom syndrome
• Increased their vigilance and sensitivity

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Therapist Credibility Expertness and
Trustworthiness

• Credibility may be defined as the constellation
  of characteristics that makes certain individuals
  appear worthy of belief, capable, entitled to
  confidence, reliable, and trustworthy
• Expertness depends on how well-informed, capable
  or intelligent others perceive the communicator
• Trustworthiness is dependent on the degree to
  which people perceive the communicator (therapist
  to make valid assertions)

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Psychological Sets of Clients

• Problem-solving Setclient is concerned about
  obtaining correct information
• Consistency SetIf inconsistent information is
  presented, cognitive dissonance will take place
• Identity SetStrong identification with a group
• Economic Setbeliefs and behaviors are influenced
  by rewards and punishments
• Authority SetPeople in authority positions are
  seen to have rights to prescribe attitudes or
  behaviors

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CHAPTER 5RACIAL, GENDER, SEXUAL ORIENTATION
MICROAGGRESSIONS                                
         
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Microaggressions 

• Microaggressions are brief, everyday exchanges
  that send denigrating messages to a target group
  like people of color, women and Gays
• These microaggressions are often subtle in nature
  and can be manifested in the verbal, nonverbal,
  visual, or behavioral realm and are often enacted
  automatically and unconsciously (Solorzano, Ceja,
  Yosso, 2000)

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Overt vs. Covert Oppression

• Overt Racism, Sexism, and Heterosexism
• vs.
• Covert Racism, Sexism, and Heterosexism

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Microassault

• Blatant verbal, nonverbal or environmental attack
  intended to convey discriminatory and biased
  sentiments (e.g. epithets like spic or
  faggot)

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Microinsult

• Unintentional behaviors or verbal comments that
  convey rudeness, insensitivity or demean a
  persons racial heritage/identity, gender
  identity, or sexual orientation identity (e.g.
  Arnold Schwartzenegger calling Democrats, girly
  men)

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Microinvalidation

• Verbal comments or behaviors that exclude,
  negate, or dismiss the psychological thoughts,
  feelings, or experiential reality of the target
  group (e.g. the most qualified person should
  get the job)

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Categories and Relationship of Racial
Microaggressions

Racial Microaggressions Commonplace verbal or
behavioral indignities, whether intentional or
unintentional, which communicate hostile,
derogatory, or negative racial slights and
insults.
Microinsult (Often Unconscious) Behavioral/verba
l remarks or comments that convey rudeness,
insensitivity and demean a persons racial
heritage or identity.
Microassault (Often Conscious) Explicit racial
derogations characterized primarily by a violent
verbal or nonverbal attack meant to hurt the
intended victim through name-calling, avoidant
behavior or purposeful discriminatory actions
Microinvalidation (Often Unconscious) Verbal
comments or behaviors that exclude, negate, or
nullify the psychological thoughts, feelings, or
experiential reality of a person of color.
Environmental Microaggressions
(Macro-level) Racial assaults, insults and
invalidations which are manifested on systemic
and environmental levels.

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Therapeutic Implications of Microaggressions

• Clients of color tend to terminate prematurely
• Microaggresions my lie at the core of the problem
• Therapist must be credible
• Effective counseling is likely to occur when
  there is a strong working alliance

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CHAPTER 6 BARRIERS TO MULTICULTURAL COUNSELING
AND THERAPY
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Marginal Person

• The marginal person, coined by Stonequist (1937)
  refers to ones ability to form a dual ethnic
  identification due to a bicultural membership

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GENERIC CHARACTERISTICS OF COUNSELING/THERAPY

• 1. Culture-bound values individual centered,
  verbal/emotional/behavioral expressiveness,
  communication patterns from client to counselor,
  openness and intimacy, analytic/linear/verbal
  (cause-effect) approach, and clear distinctions
  between mental and physical well-being.
• 2. Class-bound values strict adherence to time
  schedules (50-minute, once-or-twice-a-week
  meeting), ambiguous or unstructured approach to
  problems, and seeking long-range goals or
  solutions.
• 3. Language variables use of Standard English
  and emphasis on verbal communication.

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CULTURE BOUND VALUES OF COUNSELING/THERAPY

• 1. Focus on the individual.
• Most forms of counseling and psychotherapy tend
  to be individual centered that is, they
  emphasize the I-thou relationship.

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CULTURE BOUND VALUES OF COUNSELING/THERAPY

• 2. Verbal/Emotional/Behavioral Expressiveness.
• Many counselors and therapists tend to emphasize
  the fact that verbal/emotional/behavioral
  expressiveness is important in individuals.
• We like our clients to be verbal, articulate, and
  to be able to express their thoughts and feelings
  clearly.

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CULTURE BOUND VALUES OF COUNSELING/THERAPY

• 3. Insight.
• This characteristic assumes that it is mentally
  beneficial for individuals to obtain insight or
  understanding into their deep underlying dynamics
  and causes.
• Born from the tradition of psychoanalytic theory,
  many theorists tend to believe that clients who
  obtain insight into themselves will be better
  adjusted.

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CULTURE BOUND VALUES OF COUNSELING/THERAPY

• 4. Self-Disclosure (Openness and Intimacy).
• Most forms of counseling and psychotherapy tend
  to value ones ability to self-disclose and to
  talk about the most intimate aspects of ones
  life.
• Self-disclosure has often been discussed as a
  primary characteristic of the healthy
  personality.
• People who do not self-disclose readily in
  counseling and psychotherapy are seen as
  possessing negative traits such as being guarded,
  mistrustful, and/or paranoid.

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CULTURE BOUND VALUES OF COUNSELING/THERAPY

• 5. Scientific Empiricism.
• Counseling and psychotherapy in Western culture
  and society has been described as being highly
  linear, analytic, and verbal in their attempt to
  mimic the physical sciences.
• It emphasizes the scientific method - objective
  rational linear thinking. The therapist is
  objective and neutral, rational and logical in
  thinking. Quantitative evaluation that includes
  psychodiagnostic tests, intelligence tests, and
  personality inventories are used.
• This cause-effect orientation emphasizes
  left-brain functioning.

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CULTURE BOUND VALUES OF COUNSELING/THERAPY

• 6. Distinctions between Mental and Physical
  Functioning.
• Many American Indians, Asian Americans, Blacks,
  and Hispanics hold a different concept of what
  constitutes mental health, mental illness, and
  adjustment.
• Among the Chinese, the concept of mental health
  or psychological wellbeing is not understood in
  the same way as it is in the Western context.
• Latino/Hispanic Americans do not make the same
  Western distinction between mental and physical
  health as their White counterparts.
• Thus, nonphysical health problems are most likely
  to be referred to a physician, priest, or
  minister.

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CULTURE BOUND VALUES OF COUNSELING/THERAPY

• 7. Ambiguity.
• The ambiguous and unstructured aspect of the
  therapy situation may create discomfort in
  clients of color. Culturally diverse clients may
  not be familiar with therapy and perceive it as
  an unknown and mystifying process.
• Some groups, like Hispanics, may have been reared
  in an environment that actively structures social
  relationships and patterns of interaction.
• Anxiety and confusion may be the outcome in an
  unstructured counseling setting.

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CULTURE BOUND VALUES OF COUNSELING/THERAPY

• 8. Patterns of Communication.
• The cultural upbringing of many minorities
  dictates different patterns of communication that
  may place them at a disadvantage in therapy.
• Counseling demands that communication move from
  client to counselor. The client is expected to
  take the major responsibility for initiating
  conversation in the session, while the counselor
  plays a less active role.

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Implications for Practice

• Become aware of the generic characteristics of
  counseling
• Advocate for multilingual services
• Provide community counseling services in the
  clients natural environments (schools, churches,
  etc.)
• Help clients deal with forces such as poverty,
  discrimination, prejudice, immigration stress in
  contrast to developing personal insight through
  self-exploration

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Implications for Practice

• Focus on action orientation and expand your
  repertoire
• Do not overgeneralize or stereotype
• Do not become arrogant and think that clinical
  work is superior to other forms of helping

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CHAPTER 7CULTURALLY APPROPRIATE INTERVENTIONS
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Communication Styles

• It is important that the therapist and client
  send and receive both verbal and nonverbal
  messages accurately and appropriately

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Nonverbal Communication

• Generally occurs outside the level of conscious
  awareness
• Varies from culture to culture
• Important within the counseling context

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Context in Communication

• Directness of a conversation or the degree of
  frankness also varies considerably among various
  cultures
• High Context Communicationanchored in the
  physical contextless reliant on explicit code
  (e.g. many Asian cultures)
• Low Context Communicationgreater reliance on
  verbal parts of the message (e.g. Western)

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Proxemics

• Refers to perception and use of personal and
  interpersonal space
• Violation may cause one to withdrawal, become
  angry, or create conflict
• Some cultures are OK with being very close
• If counselor backs away, may be seen as aloofness
  or coldness
• Counselor may misinterpret clients closeness

69
Kinesics

• Refers to bodily movements (e.g. facial
  expression, posture, gestures, eye contact)
• Japanese smile may mean discomfort
• Latin Americans shake hands with vigor
• Eye contact varies according to culture

70
Paralanguage

• Refers to vocal cues other than words (i.e.
  loudness of voice, pauses, silences, etc.)
• Caseworker may misinterpret silences or speaking
  in a soft tone
• Speaking loudly may not indicate anger but a
  cultural style

71
Communication Styles

• Black styles of communication are often animated,
  interpersonal and confrontational whereas White
  middle-class styles of communication tend to be
  more objective, impersonal and nonchallenging

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Counseling and Therapy as Communication Style

• Different forms of psychotherapy possess varied
  communication styles (e.g. Rogers emphasizes
  attending skills Shostrom relied on direct
  guidance Lazarus took an active reeducative
  style)
• In general, people of color prefer more active,
  directive forms of helping than nondirective ones

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Implications for Practice

• Recognize that no one style of counseling will be
  appropriate for all situations
• Become knowledgeable about how race, culture, and
  gender affect communication styles
• Become aware of your own style
• Obtain additional training and education on a
  variety of theoretical orientations and
  approaches
• Think holistically rather than in a reductionist
  manner when conceptualizing the human condition
• Training programs need to use an approach that
  calls for openness and flexibility in
  conceptualizing issues and skill building

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CHAPTER 8MULTICULTURAL FAMILY COUNSELING AND
THERAPY
75
Family Systems Approaches and Assumptions

• Communications Approach Family problems are
  communication difficulties
• Structural Approach Emphasizes interlocking
  roles
• Assumptions
• Separation/individuation is healthy
• Egalitarian spousal relations
• Be your own person

76
Issues in Working with Ethnic Minority Families

• Many Black families are poor and suffer from
  racism and more Black males are single
• Latinos emphasize the extended family
• Biculturalism stressors
• Strength through slavery
• Native Americansalcohol abuse
• Language structures vary
• Social class issues

77
Machismo vs. Marianismo

• Machismo is a term used in many Latino cultures
  to indicate maleness, virility, and the mans
  role as provider and protector
• Marianismo derived from the cult of the Virgin
  Mary in that women are seen as morally and
  spiritually superior and capable of enduring
  greater suffering

78
Value Preference Considerations

• Time Dimension
• Relational Dimension
• Activity Dimension
• People-Nature Relationship
• Nature of people Dimension

79
Implications for Practice

• Different cultural conceptions of family
• Families cannot be understood apart from the
  culture
• Learn the definition of family for specific
  groups
• Extended ties may be very important
• Do not prejudge patriarchal relations
• Mother role may be most important
• Helping can take many formsbe creative

80
CHAPTER 9NONWESTERN IDIGENOUS METHODS OF
HEALING IMPLICATIONS FOR COUNSELING AND THERAPY
81
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, since these
  beliefs are central to their world view and
  reflect their cultural identity.

82
INDIGENOUS HEALING GUIDELINES

• 2. BECOME KNOWLEDGEABLE ABOUT INDIGENOUS BELIEFS
  AND HEALING PRACTICES.
• 
  
  Counselors/therapists have a professional
  responsibility to become knowledgeable 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!

83
INDIGENOUS HEALING GUIDELINES

• 3. LEARNING ABOUT INDIGENOUS HEALING AND BELIEFS
  ENTAIL EXPERIENTIAL OR LIVED REALITIES.
• While reading books about nonwestern
  forms of healing and attending seminars and
  lectures on the topic is 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 which are
  unfamiliar because it evokes discomfort, anxiety
  and a feeling of differentness.

84
INDIGENOUS HEALING GUIDELINES

• 4. AVOID OVERPATHOLOGIZING AND
  UNDERPATHOLOGIZING A CULTURALLY DIFFERENT
  CLIENTS PROBLEMS.
• A therapist or counselor who is culturally
  unaware and who believes 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 it as more severe and
  pathological than it 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.

85
INDIGENOUS HEALING GUIDELINES

• 5. BE WILLING TO SEEK THE CONSULTATION OF
  TRADITIONAL HEALERS AND/OR UTILIZE 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 clients populations which 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.

86
INDIGENOUS HEALING GUIDELINES

• 6. SPIRITUALITY MUST BE SEEN AS AN INTIMATE
  ASPECT OF THE HUMAN CONDITION AND A LEGITIMATE
  ASPECT OF MENTAL HEALTH WORK.
• Spirituality is a belief in a higher
  power which 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.

87
INDIGENOUS HEALING GUIDELINES

• 7. HAVING THE ABILITY TO EXPAND OUR 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, visiting
  places of worship and 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.

88
INDIGENOUS HEALING IMPLICATIONS

• It is clear that we live in a monocultural
  society a society that invalidates and separates
  us from one another, from our spirituality and
  from the cosmos.
• There is much wisdom in ancient forms of healing
  which stress that the road to mental health is
  through becoming united and in harmony with the
  universe.
• Activities that promote these attributes involve
  community work. They include client advocacy and
  consultation, preventive education, developing
  outreach programs, becoming involved in systemic
  change and aiding in the formation of public
  policy that allows for equal access and
  opportunities for all.

89
CHAPTER 10 RACIAL/CULTURAL IDENTITY
DEVELOPMENT THERAPEUTIC IMPLICATIONS
90
Importance

• 1. Understanding Within Group Differences
• 2. Influence of Racism and Oppression on
  Identity Formation
• 3. Assessment Tool
• 4. Intervention Implications

91
RACIAL IDENTITY ASSUMPTIONS

• 1. Racism is a basic and integral part of U.S.
  life and permeates all aspects of our culture and
  institutions.
• 2. Persons of color are socialized into U.S.
  society and, therefore, are exposed to the
  biases, stereotypes, and racist attitudes,
  beliefs, and behaviors of the society.
• 3. The level of racial identity development
  consciousness affects the process and outcome of
  interracial interactions.

92
RACIAL IDENTITY ASSUMPTIONS

• 4. How people of color perceive themselves as
  racial beings seems to be strongly correlated
  with how they perceive and respond to racial
  stimuli. Consequently, race-related reality
  represent major differences in how they view the
  world.
• 5. It seems to follow an identifiable sequence.
  There is an assumption that people of color who
  are born and raised in the United States, may
  move through levels of consciousness regarding
  their own identity as racial beings.
• 6. The most desirable development is a
  multicultural identity that does not deny or
  negate ones integrity.

93
Levels of Consciousness

• 1. Conformity
• 2. Dissonance
• 3. Resistance and Immersion
• 4. Introspection
• 5. Integrative Awareness

94
Self/Other Perceptions

• 1. Attitude and Beliefs toward Self.
• 2. Attitudes and Beliefs toward Members of the
  Same Minority.
• 3. Attitudes and Beliefs toward Members of
  Different Minorities.
• 4. Attitude and Beliefs toward Members of the
  Dominant Group.

95
PHASE 1 - CONFORMITY

• Marked by desire to assimilate and acculturate
  buys in to the melting pot analogy.
• Accepts belief in White superiority and minority
  inferiority.
• Unconscious and conscious desire to escape ones
  own racial heritage.
• Validation comes from a White perspective.
• Role models, lifestyles, and value systems all
  follow the dominant group.

96
CONFORMITY

• Physical and cultural characteristics identified
  with ones own racial/cultural group are
  perceived negatively, something to be avoided,
  denied, or changed.
• Physical characteristics (black skin color,
  slant-shaped eyes of Asians), traditional modes
  of dress and appearance, and behavioral
  characteristics associated with the minority
  group are a source of shame.
• There may be attempts to mimic what is perceived
  as White mannerisms, speech patterns, dress,
  and goals.
• Low internal self-esteem is characteristic of the
  person.

97
CONFORMITY

• These individuals may have internalized the
  majority of White stereotypes about their group.
  In the case of Hispanics, for example, the person
  may believe that members of his or her own group
  have high rates of unemployment because they are
  lazy, uneducated, and unintelligent.
• The denial mechanism most commonly used is Im
  not like them Ive made it on my own Im the
  exception.

98
CONFORMITY

• Belief that White cultural, social, institutional
  standards are superior. Members of the dominant
  group are admired, respected, and emulated. White
  people are believed to possess superior
  intelligence.
• Some individuals may go to great lengths to
  appear White. In the Autobiography of Malcolm X,
  the main character would straighten his hair and
  primarily date White women.
• Reports that Asian women have undergone surgery
  to reshape their eyes to conform to White female
  standards of beauty may (but not in all cases)
  typify this dynamic.

99
PHASE 2 - DISSONANCE

• Breakdown of denial system.
• Encounters information discordant with previous
  beliefs in the conformity stage.
• Dominant-held views of minority strengths and
  weaknesses begin to be questioned.
• Begins to realize that attempts to assimilate or
  acculturate may not be fully allowed by larger
  society.

100
DISSONANCE

• There is now a growing sense of personal
  awareness that racism does exist, that not all
  aspects of the minority or majority culture are
  good or bad, and that one cannot escape ones
  cultural heritage.
• Feelings of shame and pride are mixed in the
  individual and a sense of conflict develops.

101
PHASE 3 RESISTANCE AND IMMERSION

• Why should I feel ashamed of who and what I am?
• Begins to understand social-psychological forces
  associated with prejudice and discrimination.
• Extreme anger at perceived cultural oppression.
• May be an active rejection of the dominant
  society and culture.
• Members of the dominant group viewed with
  suspicion.

102
RESISTANCE AND IMMERSION

• The minority individual at this stage is oriented
  toward self-discovery of ones own history and
  culture. There is an active seeking out of
  information and artifacts that enhance that
  persons sense of identity and worth.
• Cultural and racial characteristics that once
  elicited feelings of shame and disgust become
  symbols of pride and honor. The individual moves
  into this stage primarily because he or she asks
  the question, Why should I be ashamed of who and
  what I am?
• Phrases such as Black is beautiful, represent a
  symbolic relabeling of identity for many Blacks.
  Racial self-hatred becomes something actively
  rejected in favor of the other extreme, which is
  unbridled racial pride.

103
RESISTANCE AND IMMERSION

• There is a feeling of connectedness with other
  members of the racial and cultural group and a
  strengthening of new identity begins to occur.
  Members of ones group are admired, respected,
  and often viewed now as the new reference group
  or ideal. Cultural values of the minority group
  are accepted without question.
• As indicated, the pendulum swings drastically
  from original identification with White ways to
  identification in an unquestioning manner with
  the minority-groups ways. Persons in this stage,
  are likely to restrict their interactions as much
  as possible to members of their own group.

104
RESISTANCE AND IMMERSION

• There is also considerable anger and hostility
  directed toward White society. There is a feeling
  of distrust and dislike for all members of the
  dominant group in an almost global anti-White
  demonstration and feeling.
• White people, for example, are not to be trusted
  for they are the oppressors or enemies. In
  extreme form, members may advocate complete
  destruction of the institutions and structures
  that have been characteristic of White society.

105
PHASE 4 - INTROSPECTION

• Increased discomfort with rigidly help group
  views (i.e., all Whites are bad).
• Too much energies directed at White society and
  diverted from more positive exploration of
  identity questions.
• Conflict ensures between notions of
  responsibility and allegiance to ones minority
  group, and notions of personal autonomy.
• Attempts to understand ones cultural heritage
  and to develop an integrated identity.

106
INTROSPECTION

• The conflict now becomes quite great in terms of
  responsibility and allegiance to ones own
  minority group versus notions of personal
  independence and autonomy.
• The person begins to spend greater and greater
  time and energy trying to sort out these aspects
  of self-identity and begins to increasingly
  demand individual autonomy.

107
PHASE 5 INTEGRATIVE AWARENESS

• Develop inner sense of security as conflicts
  between new and old identities are resolved.
• Global anti-White feelings subside as person
  becomes more flexible, tolerant and
  multicultural.
• White and minority cultures are not seen as
  necessarily conflictual.
• Able to own and accept those aspects of U.S.
  culture (seen as healthy) and oppose those that
  are toxic (racism and oppression).

108
INTEGRATIVE AWARENESS

• Develops a positive self-image and experiences a
  strong sense of self-worth and confidence.
• Not only is there an integrated self-concept that
  involves racial pride in identity and culture,
  but the person develops a high sense of autonomy.
  
• Becomes bicultural or multicultural without a
  sense of having sold out ones integrity.
• In other words, the person begins to perceive his
  or her self as an autonomous individual who is
  unique (individual level of identity), a member
  of ones own racial-cultural group (group level
  of identity), a member of a larger society, and a
  member of the human race (universal level of
  identity).

109
Implications for Clinical Practice

• Be aware that the R/CID model should be viewed as
  dynamic, not static.
• Do not fall victim to stereotyping in using these
  models
• Know that minority development models are
  conceptual aids and that human development is
  much more complex
• Know that identity development models begin at a
  point that involves interaction with an
  oppressive society

110
Implications for Clinical Practice

• Be careful of the implied value judgment given in
  almost all development models
• Be aware that racial/cultural identity
  development models seriously lack an adequate
  integration of gender, class, sexual orientation,
  and other sociodemographic group identities
• Know that racial/cultural identity is not a
  simple, global concept
• Begin to look more closely at the possible
  therapist and client stage combinations

111
CHAPTER 11WHITE RACIAL IDENTITY DEVELOPMENT
112
WHITE RACIAL IDENTITY DEVELOPMENT - Assumptions

• 1. Racism is a basic and integral part of U.S.
  life and permeates all aspects of our culture and
  institutions.
• 2. White Americans are socialized into U.S.
  society and, therefore, inherit the biases,
  stereotypes, racist attitudes, beliefs, and
  behaviors of the society.

113
WHITE RACIAL IDENTITY DEVELOPMENT - Assumptions

• 3. The level of White racial identity
  development in an interracial encounter affects
  the process and outcome of our relationships.
• 4. How Whites perceive themselves as racial
  beings seems to be strongly correlated with how
  they perceive and respond to racial stimuli.
  Consequently, race-related reality of Whites
  represent major differences in how they view the
  world.

114
WHITE RACIAL IDENTITY DEVELOPMENT - Assumptions

• 5. It seems to follow an identifiable sequence.
  There is an assumption that White Americans who
  are born and raised in the United States, may
  move through levels of consciousness regarding
  their own identity as racial beings.
• 6. The most desirable development is not only
  the acceptance of whiteness, but also defining it
  in a nondefensive and nonracist manner. There is
  an understanding that to deny the humanity of any
  one person is to deny the humanity of all.

115
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase One Naiveté
• Early childhood marked by naïve curiosity about
  race.
• Tendency to be innocent, open, and spontaneous
  regarding racial differences.
• May notice differences, but awareness of social
  meaning are absent or minimal.
• Racial awareness and the burgeoning social
  meanings occur between the ages of 3-5 years.

116
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Two Conformity
• Characteristics of naiveté may be maintained.
• Minimal awareness of self as a racial/cultural
  being.
• Strong belief in the universality of values and
  norms governing behavior.
• Unlikely to recognize the polarities of
  democratic principles of equality and the unequal
  treatment of minority groups.

117
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Two Conformity
• Compartmentalization of contradictory attitudes,
  beliefs and behaviors (i.e., can believe people
  are people, but treat minorities differently).
• Because of naiveté and encapsulation, it is
  possible for two diametrically opposed belief
  systems to coexist in your mind.

118
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Two Conformity
• (a) Uncritical acceptance of White supremacist
  notions which relegates minorities into the
  inferior category with all the racial
  stereotypes.
• (b) Belief that racial and cultural differences
  are considered unimportant. This allows Whites
  to avoid perceiving themselves as dominant
  group members, or of having biases and
  prejudices.

119
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Two Conformity
• The primary mechanism used in encapsulation is
  denial denial that people are different, denial
  that discrimination exists, and denial of your
  own prejudices. Instead, the locus of the
  problem is seen to reside in the minority
  individual or group.
• In her own White racial awakening, Peggy McIntosh
  (1989) stated

120
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Two Conformity
• My schooling gave me no training in seeing
  myself as an oppressor, as an unfairly advantaged
  person, or as a participant in a damaged culture.
  I was taught to see myself as an individual
  whose moral state depended on her individual
  moral will....Whites are taught to think of their
  lives as morally neutral, normative, and average,
  and also ideal, so that when we work to benefit
  others, this is seen as work which will allow
  them to be more like us.
• While the Naiveté stage is brief in duration, the
  Conformity stage can last a lifetime.

121
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Three Dissonance
• Obliviousness breaks down when Whites become
  aware of inconsistencies.
• Becomes conflicted over irresolvable racial moral
  dilemmas that are frequently perceived as polar
  opposites believing they are nonracist, yet not
  wanting their son or daughter to marry a minority
  group member
• Belief that all men are created equal, yet
  seeing society treat people of color as second
  class citizens and not acknowledging that
  oppression exists to witnessing it (beating of
  Rodney King and the unwarranted persecution of
  Wen Ho Lee).

122
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Three Dissonance
• Become increasingly conscious of whiteness and
  may experience dissonance, resulting in feelings
  of guilt, depression, helplessness or anxiety.
• Movement into the Dissonance phase occurs when
  Whites are forced to deal with the
  inconsistencies that have been compartmentalized
  or encounter information/experiences at odds with
  their denial.

123
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Three - Dissonance
• Dissonance may make Whites feel guilty, shameful,
  angry, and depressed. Rationalizations may become
  the manner used to exonerate their inactivity in
  combating perceived injustice or personal
  feelings of prejudice Im only one person, what
  can I do or Everyone is prejudiced, even
  minorities.
• As these conflicts ensue, Whites may retreat into
  the protective confines of White culture
  (encapsulation of the previous stage) or move
  progressively toward insight and revelation
  (resistance and immersion stage).

124
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Four - Resistance and Immersion
• Whites begin to question and challenge their
  racism. For the first time, they begin to realize
  what racism is all about, and their eyes are
  suddenly opened.
• Racism becomes noticeable in all facets of their
  daily lives (advertising, television, educational
  materials, interpersonal interactions, etc.). A
  major questioning of their racism and that of
  others mark this phase of development. In
  addition, increasing awareness of how racism
  operates and its pervasiveness in U.S. culture
  and institutions are the major hallmark at this
  level of development.

125
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Four Resistance and Immersion
• Likely to experience considerable anger at family
  and friends, institutions, and larger societal
  values, that are seen as having sold them a false
  bill of goods (democratic ideals) that were never
  practiced.
• Guilt is also felt for having been a part of the
  oppressive system.

126
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Four Resistance and Immersion
• The "White liberal" syndrome may develop and be
  manifested in two complementary styles (a) the
  paternalistic protector role or (b) an over
  identification with the minority group. In the
  former, Whites may devote energies in an almost
  paternalistic attempt to protect minorities from
  abuse.
• May actually even want to identify with a
  particular minority group (Asian, Black, etc.) in
  order to escape their Whiteness.

127
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Four Resistance and Immersion
• May resolve this dilemma by moving back into the
  protective confines of White culture (Conformity
  stage), again experience conflict (dissonance),
  or move directly to the Introspective stage. In
  many cases, they may develop a negative reaction
  toward their group or culture. While they may
  romanticize People of Color, Whites cannot
  interact confidently with them because you fear
  making racist mistakes.
• The discomfort in realizing that they are White
  and that their group has engaged in oppression of
  racial/ethnic minorities may propel them into the
  next stage.

128
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Five Introspection
• This phase is most likely a compromise of
  swinging from an extreme of unconditional
  acceptance of White identity to a rejection of
  Whiteness. It is a state of relative quiescence,
  introspection and reformulation of what it means
  to be White.
• Realize and no longer deny that they have
  participated in oppression, that they benefit
  from White privilege, and that racism is an
  integral part of U.S. society. Less motivated by
  guilt and defensiveness, accept Whiteness, and
  seek to define own identity and that of ones
  social group.

129
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Five Introspection
• May ask questions What does it mean to be
  White? Who am I in relation to my whiteness?
  Who am I as a racial/cultural being?
• Feelings or affective elements may be existential
  in nature and involve feelings of lack of
  connectedness, isolation, confusion and loss.

130
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Five Introspection
• Asking the painful question of who you are in
  relation to your racial heritage honestly
  confronting your biases and prejudices and
  accepting responsibility for your Whiteness is
  the culminating outcome of the introspective
  stage.
• New ways of defining your White EuroAmerican
  social group and membership in that group become
  important.
• No longer deny being White, honestly confront
  your racism, understand the concept of White
  privilege, and feel increased comfort in relating
  to persons of color.

131
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Six - Integrative Awareness
• Reaching this level of development is most
  characterized as
• (a) Understanding self as a racial/cultural
  being.
• (b) Awareness of sociopolitical influences with
  respect to racism,
• (c) Appreciation of racial/cultural diversity,
• (d) Rooting out buried and nested racial fears
  and emotions.

132
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Six Integrative Awareness
• Formation of a nonracist White EuroAmerican
  identity emerges and becomes internalized. Begin
  to value multiculturalism, comfortable around
  members of culturally different groups, and feel
  a strong connectedness with members of many
  groups.
• Inner sense of security and strength to function
  in a society that is only marginally accepting of
  integratively aware White persons.

133
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Six Integrative Awareness
• This status is different from the previous one in
  two major ways (a) It is marked by a shift in
  focus from trying to change people of color to
  changing the self and other Whites, and (b) it is
  marked with increasing experiential and affective
  understanding that were lacking in the previous
  status.
• Successful resolution of this stage requires an
  emotional catharsis or release that forces you to
  relive or reexperience previous emotions that
  were denied or distorted. The ability to achieve
  this affective upheaval leads to a euphoria or
  even a feeling of rebirth and is a necessary
  condition to developing a new nonracist White
  identity.

134
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Seven Commitment To Antiracist Action
• Most characterized by social action. There is
  likely to be a consequent change in behavior, and
  an increased commitment toward eradicating
  oppression as well.
• Seeing wrong and actively working to right it
  require moral fortitude and direct action.
  Objecting to racist jokes, trying to educate
  family, friends, neighbors, and co-workers about
  racial issues, taking direct action to eradicate
  racism in the schools, workplace, and in social
  policy often in direct conflict with other
  Whites.

135
WHITE RACIAL IDENTITY DEVELOPMENT Process

• Phase Seven Commitment to Antiracist Action
• Become increasingly immunized to social pressures
  for conformance because reference group begins to
  change.
• In addition to family and friends, will begin to
  actively form alliances with persons of color and
  other liberated Whites. They will become a
  second family giving validation, and encouraging
  continuance to the struggle against individual,
  institutional and societal racism.

136
WHITE RACIAL IDENTITY DEVELOPMENT Summary

• First, you must actively place yourself in new
  and oftentimes uncomfortable situations that
  impel you to question yourself as a
  racial/cultural being, and to increase awareness
  of racial issues, especially racism.
• Second, change must occur in the form of new
  insights, attitudes and behaviors that lead to a
  realization of your role in the perpetuation of
  racism.
• Third, considerable and continuing energies must
  be devoted to the maintenance of a healthy White
  racial identity. In other words, change is not
  enough in the face of societal forces that serve
  to squelch or punish dissent.
• Fourth, you must take action to eradicate racism.
  

137
CHAPTER 12SOCIAL JUSTICE COUNSELING/THERAPY
138
Multicultural Counseling

• Multicultural counseling and therapy must be
  about
• social justice
• providing equal access and opportunity to all
  groups
• being inclusive
• removing individual and syste