CHAPTER 1 The Culturally Competent Counselor Developing Multicultural

CHAPTER 1: The Culturally Competent Counselor Developing Multicultural Counseling Competence: A Systems Approach Second Edition Danica G. Hays and Bradley T. Erford

Historical Shifts • Counseling geared toward white, middleupper class individuals • Forces: Psychodynamic, Behaviorism, Existentialism/Humanism • Increasing diversity in the United States • Forces: multiculturalism, social advocacy Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -2

U. S. Demographics (2010) • Increased diversity • Aging Trends • Vary by racial and ethnic groups • Increasing birth rates • Immigration trends • Historical patterns • Projected patterns Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -3

U. S. Demographics (2010) Cont. • U. S. Population = approximately 309 million • White (72. 4%; 63. 7% non-Hispanic/Latino) • Black/African American (12. 6%) • Asian American (4. 8%) • Other races (e. g. , Native American, Alaska Native, Native Hawaiian = 5. 2%) • 16. 9% identify as Hispanic/Latino • 11% foreign-born (majority from Latin America) Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -4

U. S. Demographics (2010) Cont. • Median household income • Poverty rates • Gender data • Racial and ethnic group data Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -5

What is Multicultural Counseling? • The integration of cultural identities within the counseling process • Cultural Identity • Subgroups (e. g. , race, ethnicity, gender, sexual identify, SES, disability, spirituality, age, etc. ) • Role of “American” culture • Acknowledgement of cultural identity in counseling impacts one’s counseling experience. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -6

Culture • …the totality of the human experience for social contexts. • biological, psychological, historical, political events • behaviors, feelings, attitudes, feelings, and cognitions • organizes a group as a whole • worldview, individualism-collectivism, race, ability status, spirituality • universal, group, and individual cultures • cultural encapsulation/ethnocentrism Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -7

Individualism & Collectivism • Individuals guide their decisions by how they benefit/reflect upon themselves, others, or both. • Individualism defined – competitiveness, self-disclosure, agency, independence, self -promotion • Collectivism defined – cooperation, “saving face, ” interdependence Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -8

Race & Ethnicity • Two of the major classification systems • Race defined – arbitrary, socially constructed classification system based on physical distinctions • Ethnicity defined – shared characteristics of culture, religion, and language • Nationality defined – common component of ethnicity; one’s nation of origin Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -9

Generational Status • Generational status defined – clusters of particular age groups with typical ranges of 15 to 20 years • Living Generations: • • GI (government issue) 1901 -1924 • Silent 1925 -1942 • Baby boomer 1943 -1960 • Generation X 1961 -1981 • Generation Y 1982 -2000 • Generation Z 2000+ The role of age and generational status may vary among cultures. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -10

Gender • Gender defined – expression of social categories • Gender roles defined – social categories that describe behaviors deemed appropriate for males and females • Masculinity • Femininity • Androgyny defined – blending of masculinity and femininity for both males and females • Benefits and challenges of social norms Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -11

Sexual Orientation • Sexual orientation defined – sexual/affectional attraction to the same, or opposite gender, or both • Sexual identity defined – degree of identification with a particular sexual orientation • Heterosexual, gay, lesbian, bisexual, questioning • Continuum of gender and sexual orientation Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -12

Socioeconomic Status • Indicated by: household income, occupational status, education level, use of public assistance, and access to healthcare • Lower SES tend to have negative mental health outcomes. • Intersection of SES, race, ethnicity, & gender is an important multicultural counseling component. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -13

Disability • Disability defined – mental or physical impairment that affects at least one of an individual’s daily activities • Ableism – negative consequences experienced by those with disabilities • Legislation has allowed for increased protection and appropriate treatment: • U. S. Rehabilitation Act (1973), American Disabilities Act (1990), Individuals with Disabilities Education Improvement Act (2004) Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -14

Spirituality • Spirituality defined – connections individuals have with themselves & the universe as a whole • provides direction, meaning, purpose for individuals • Religion – behaviors & practices of faith; organizing construct of spirituality • Buddhism, Christianity, Confucianism, Hinduism, Islam, Judaism, Taoism Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -15

Advocacy, Privilege, & Oppression • Advocacy defined – promoting an idea, policy, or cause that betters the lives of those who have less power, access, advantage, or social status • Sense of responsibility to change the status quo • Individual & systemic interventions to empower individuals • Assumed power differential/privilege Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -16

Advocacy, Privilege, & Oppression Continued • • Privilege defined – often unconscious & unearned power, access to resources, advantage, & social position based on cultural membership • White, male, heterosexual, higher SES, ablebodied, Christian • Privilege creates oppression Oppression defined – lack of power, inaccessibility, disadvantage, minority social status • Racial & ethnic minority groups, females, sexual minorities, less able-bodied, lower SES, religious minorities Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -17

Worldview • Worldview defined – an individual’s conceptualization of their relationship with the world • Locus of responsibility & locus of control guide behavior and motivation • Sue (1978) Combinations – IR-IC – IR-EC – ER-IC – ER-EC Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -18

Worldview • • Klockholn & Strodbeck’s theoretical model (1961) – 5 Components of worldview • Human relationship – good, bad, combination • Relationship to nature – harmony, power over, or power in • Sense of time – past, present, or future oriented • Activity – being, being-in-becoming, doing • Social relationships- Lineal-hierarchical, Collateral-mutual, and Individualistic Impact on counselor/client relationship Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -19

Verbal Communication • Primary tool used in counseling • Power is embedded in language; those who do not speak the majority language are marginalized • Language barriers • Feelings of frustration/invalidation • Use of metaphors from the client’s culture to deepen levels of understanding • Preferences for expression in native languages • Counselors should be aware of resources in the community • Counselors may employ interpreters or learn a second language Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -20

Nonverbal Communication • • 85% of communication is nonverbal Facial expressions Proxemics – use of personal physical distance Kinesics – body movements, positions, postures Paralanguage – verbal cues other than words Often ambiguous and culturally bound Counselors should be aware of own nonverbal behaviors Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -21

Emotional Expression • Universal experiences: anger, sadness, gladness, fright, surprise, disgust • Expression & causes of emotions vary among and within culture • Socialization influences the way emotions are experienced • Use norms from within the client’s culture to determine if expression is pathological • Include the client’s beliefs regarding the origin of emotions in the counseling process Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -22

Communication Patterns • Ideally, communication patterns between counselor & client are characterized by openness & honesty. • Counselor should: • consistently check with the client to ensure accurate interpretation & understanding. • engage in a self-reflective process. • respond based on the client’s frame of reference. • self-disclose appropriately to promote trust. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -23

Culture & Context • Culturally based contextual factors affect the counseling process. • Discrimination, immigration, acculturation, violence, trauma • Incongruence between traditional counseling processes and culturally diverse clients’ mental health needs & general attitudes towards counseling. • Contextual factors may increase diverse clients’ risk of mental health problems due to limited resources & support in U. S. society. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -24

Prejudice & Discrimination • Prejudice defined – prematurely holding a belief/attitude without appropriate examination or consideration of actual data; positive or negative • Discrimination defined – covert & overt behaviors based on generalizations held about individuals based on their cultural group membership. • Both prejudice and discrimination: • Are based on stereotypes • Include racism, sexism, classism, heterosexism • Pervade individual, institutional, & cultural practices • Impart economic, social, political, mental, & physical costs. • Affect social support, occupational status, SES • Encourage maladaptive coping responses, serves as a catalyst for depression, suicide, substance abuse, violence, anxiety, disorders, stress • Can fuel medical complications: hypertension, heart disease, cancer Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -25

Immigration • Immigration defined – process by which foreign-born individuals settle in a new country • Most racial/ethnic groups were immigrants at some point. • • Exceptions: Native Americans, Aleuts, Native Hawaiians Examine reasons for entry to the U. S. , length of time in the U. S. , information about the cultural climate of the country of origin, & the historical and present degrees of prejudice/discrimination faced by client’s family. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -26

Acculturation • Acculturation defined – degree to which immigrants identify with & conform to a new culture of a host society • Can identify with both homeland & host culture, embracing one culture over another, or rejecting both cultures. • Models of Acculturation: Assimilation, Separation, Integration, Biculturalism, and Marginalization • Largely determined by number of years in process, country of origin, age at onset of acculturation process, & ethnic identity • Many stressors attributed to acculturation Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -27

Violence & Trauma • Relate across cultural identities • Linked to mental health problems: PTSD & depression • Often make immigration and acculturation processes more difficult • Often occurs in lower SES communities, among women, and among gay, lesbian, and bisexual individuals. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -28

Culture & the Counseling Process • Culturally diverse clients underuse counseling services & prematurely terminate counseling. • Differences between counseling & cultural values • Stigmatizing process • Mistrustful of counselors, who tend to be predominately White • Counseling services tend to be inaccessible to culturally diverse clients. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -29

Developing Multicultural Counseling Competence • All counselors need to: • become more self-aware of values and biases. • understand how various forms of oppression influence counseling. • appreciate other cultural norms and value systems. • skillfully employ culturally-appropriate assessments & interventions. • Multicultural Counseling Competency Standards & Guidelines (Sue et al. , 1992). Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -30

A Systems Approach • Individual • • Race, ethnicity, gender, SES, spirituality, disability, sexual orientation, acculturation, racial identity development, spiritual identity development Family • Plays a significant role in cultural identity. • Counselors should understand how the family affects the clients’ worldviews and behaviors. • Violence & trauma within families Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -31

A Systems Approach • • Community • Schools, mental health/social services, spiritual institutions, legal & economic resources, within- & between-group cultural diversity • Client & family experiences are embedded within the community values, resources & practices • Counselors are encouraged to increase their knowledge to connect clients to the community Historical • Culturally based events for a community that impact a client • Racist acts, economy of a community, immigration patterns, civil rights events, historic discrimination Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -32

Social Justice and Advocacy • Goal is to promote equal access to resources and to promote environmental changes that result in optimal mental health for all • Counselors must advocate for social justice by empowering clients, advocating for fair and equal treatment of all clients, conducting preventative workshops, working with community organizations, and advocating for policy changes at institutional and societal levels. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -33

Etic vs. Emic Debate • • Within the multicultural counseling literature, a debate over how broadly to conceptualize cultural differences exists: • Etic approach – focuses on universal qualities common to all cultures & aspects of counseling that are generalizable across cultures. • Emic approach – emphasizes “divergent attitudes, values, & behaviors arising out of specific cultures” (Ridley, Li, & Hill, 1998, p. 835) and calls for culturally-specific counseling interventions. Majority of research supports the emic approach Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -34

Within Group & Between Group Differences • There are more within-group differences than between-group differences • Counselors should consider a client’s cultural identity & context, as well as individual attributes • All clients possess multiple levels of cultural identity • Counselors should strive to validate & relate to which identity is most salient for the client at the present time Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -35

Underutilization of Services • Culturally diverse clients underuse & prematurely terminate counseling services • Values inherent in counseling may not be congruent with values in an individual’s culture • Culturally diverse clients may perceive counseling to be stigmatizing • Clients may be mistrustful of counselors Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -36

Conflicting Cultural Values • Counseling values mirror those of the dominant U. S. culture: • • Non-western cultures may have different values: • • Individualism, preference for increased selfawareness, self-disclosure & emotional expression, linear time orientation, & goal directedness Collectivism, interdependence, limited disclosure, & circular time orientation Traditional counseling theories tend to minimize a systems approach Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -37

Social Stigma • Some cultures view mental illness as something to be discussed only within a specific community • The way normality and abnormality are defined in counseling • Western ideas may not be appropriate for conceptualizing clients from culturally diverse backgrounds leading to misdiagnosis Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -38

Mistrust of the Counseling Profession • Culturally diverse clients tend to be mistrustful of counselors, who tend to be predominately White • Historical racist, sexist, classist, heterosexist undertones in counseling • Limited levels of awareness of the roles privilege & oppression play in both the counseling relationship & the clients’ daily lives Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -39

Inaccessibility of Services • Tend towards a lack of mental health services in communities where people of color & lower SES groups reside • Counseling is often unavailable for non. English speaking clients • Traditional counseling may be costprohibitive for certain diverse groups Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -40

Resistance to Multiculturalism • Racism, sexism, classism, heterosexism, ethnocentrism, & ageism exist within the counseling profession and prevent change • Competent multicultural practices require effort and change • Not all treatments look like traditional, empirically supported treatments that counselors may be comfortable using • Some counselors may be unwilling to relinquish the power associated with the expert role Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 1 -41