Implementation of a Broad Diversity Curriculum in Internship Training

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Implementation of a Broad Diversity Curriculum in
Internship Training

• Jeanette Hsu, Ph.D.
• VA Palo Alto Health Care System
• April 5, 2003

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VA Palo Alto Health Care System Internship

• 14 predoctoral interns
• 40 full-time psychologists on staff
• Location highly diverse SF Bay Area
• Weekly required seminar series for 42 weeks
• 3 hours per week
• Diversity training
• Before 2000 6 hours (3-hour overview, one
  special topic)
• Since 2000 now 12-16 hours of specialized
  seminars (7-9 topics) within a more integrated
  curriculum

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Assumptions and Rationale

• Diversity as a core psychological variable
• APA Ethics code - Commitment to social justice
  and respect for differences
• Need for competence in working with diverse
  populations (e.g., client groups, co-workers,
  colleagues, future students/trainees)
• Integration/infusion across the total training
  experience, not marginalization

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Multicultural Competence

• APA multicultural guidelines adopted as policy
  recommending specific professional behavior,
  endeavors, and conduct (August, 2002)
• Represents the most current rationale regarding
  the need for addressing multiculturalism and
  diversity in training and education, as well as
  empirical research and further references
• Entire document available at www.apa.org/pi/multic
  ulturalguidelines.pdf

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Guidelines Relevant to Internship Training

• Recognize that, as cultural beings, we may hold
  attitudes and beliefs that can detrimentally
  affect our perceptions of and interactions with
  individuals who are ethnically and racially
  different from ourselves
• Recognize the importance of multicultural
  sensitivity/responsiveness, knowledge, and
  understanding

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Guidelines Relevant to Internship Training (cont.)

• Apply the constructs of multiculturalism and
  diversity in psychological education
• Promote intern self-awareness
• Provide culture-specific education
• Increase therapeutic competence
• Apply culturally appropriate skills in clinical
  and other applied psychological practices

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Components of Multicultural Training

• Coursework and other didactics
• Exposure to modeling and mentoring
• Multicultural supervision
• Clinical experience

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Issues in Seminar Planning

• Full support of Training Director and Training
  Committee
• Assessing interns level of multicultural
  awareness, knowledge, and skills
• Involvement of interns in seminar planning
• Pool of speakers
• Role models
• Funding for honoraria
• Coordination of multiple presenters and topics
  for coherent diversity seminar series

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Integration of Diversity in Seminar Series

• Addressing diversity issues throughout the
  seminar series (e.g., in every seminar, diversity
  topics spread out)
• Use of vignettes and interactive nature of
  seminars/presentations
• Integration of science and practice
• Emphasis on culturally competent assessment, case
  conceptualization, hypothesis-testing, and
  treatment planning
• Teaching interns to be aware of their limits and
  to seek further education

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Diversity Seminar Series

• Overview seminar with experiential and
  self-awareness components (3 hours)
• Culture- or group-specific topics (e.g., Latino
  populations, GLBT populations, disability issues)
• Cross-cutting topics (e.g., health care
  utilization among Asian Americans,
  ethnogeriatrics)

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Evaluations

• Intern evaluations of seminar
• Each seminar rated on a scale of 1-5
• Two dimensions - Quality and Usefulness
• Diversity seminars among the highest rated of 40
  seminars each year
• Direct application of knowledge and opportunities
  to conceptualize cases most engaging and useful
  to interns
• Evaluation of intern multicultural competence
  included in every section of exit competencies
  (e.g., assessment, treatment planning)

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Recommendations for a More Effective Training
Experience

• Continual assessment of interns level of
  multicultural competence
• At start of internship past education
• At end of internship
• Greater coordination with supervisors to
  integrate with clinical experiences on internship

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Possible Future Directions in Training

• Immersion or field experiences
• Year-long intern discussion/consultation group
• Clinical mini-rotation with specific cultural
  group
• Multicultural supervision consultation group and
  CE workshops for staff