Handbook of Multicultural Counseling Competencies

Jennifer A. Erickson Cornish, Barry A. Schreier, Lavita I. Nadkarni, Lynett Henderson Metzger, Emil R. Rodolfa, Jennifer A. Erickson Cornish, Barry A. Schreier, Lavita I. Nadkarni, Lynett Henderson Metzger, Emil R. Rodolfa

• Publisher: Wiley
• Year: 2010
• Print ISBN: 9780470437469
• eBook ISBN: 9780470609200
• Edition: 1
• Topic: Psychologie
• Subtopic: Sozialpsychologie

A THOROUGH AND CONTEMPORARY EXPLORATION OF ISSUES FUNDAMENTAL TO MULTICULTURAL COMPETENCY

Handbook of Multicultural Counseling Competencies draws together an expert group of contributors who provide a wide range of viewpoints and personal experiences to explore the identification and development of specific competencies necessary to work effectively with an increasingly diverse population. Beginning with a Foreword by Derald Wing Sue, this unique handbook offers a broad, comprehensive view of multiculturalism that is inclusive and reflective. The coverage in this important book lies beyond the scope of traditionally defined multiculturalism, with discussion of historically overlooked groups that have experienced prejudice and bias because of their size, social class, age, language, disability, or sexual orientation.

This book provides readers with:

• Practical cases and examples to enhance skill development, promote critical thinking, and increase awareness
• A cross-section of diversity characteristics and best practice guidelines
• Examination of detailed, developmentally relevant competency categories
• Resources and exercises designed for practitioners at various levels of experience and expertise
• A forum for debate, discussion, and growth

Designed to help readers enhance general multicultural competency and their ability to provide services to the populations specifically described, this thought-provoking text will prove useful in facilitating ongoing dialogues about multicultural competence in all its variations.

Chapter 1

An Overview of Multicultural Counseling Competencies

Lynett L. Henderson Metzger, Lavita I. Nadkarni, and Jennifer A. Erickson Cornish

Introduction

The November 2008 election of the first African American U.S. President signaled for many a “dramatic change in attitudes toward race in America” (Turner, 2009). Others, however, placed significant caveats on the apparent gains made by some traditionally disenfranchised groups in this country:

Throughout this election season, where the 3 strongest candidates—a senior citizen, a woman and an African American—were “non-traditional,” we were reminded that an individual's differences are too often viewed as weakness rather than strength. We were reminded that while diversity is today a fact of life, there is still much work to be done to create a culture of inclusion where a person's age, gender, ability, race, religion or any other defining characteristic—whether physical or cultural—adds to the creativity, innovation and commitment that leads to the kind of breakthrough thinking required to solve the most seemingly intractable problems. (Crider, 2008, p. 2)

Mental health practitioners, researchers, and educators who value inclusivity and social justice likewise walk a fine line between celebrating the laudable strides made by the field in recent decades and acknowledging the enormity of the distance left to go. Much of this work lies within the arenas of race, ethnicity, and culture; much lies beyond the scope of traditionally defined “multiculturalism” and focuses on individuals whose places at the diversity table to date have been limited to folding chairs in the corner of the room. This textbook represents a small gesture of welcome toward a few of these historically overlooked groups.

Multiculturalism in Practice: Much Progress, Much to Be Done

If, as the saying goes, the journey of 1,000 miles begins with a single step, then surely the climb toward a richer definition of multicultural competence rests on the innumerable handholds placed by those with the vision, courage, and eloquence to define a paradigm—and shatter it. The seminal works of Cross, Parham, and Helms (see, e.g., Cross, Parham, & Helms, 1991; Helms, 1990), McIntosh (2008), D. W. Sue and D. Sue (1990, 2008), and so many others form the scaffolding upon which modern American multicultural discourse is built. Early (and continuing) efforts to operationalize White and non-White identity development, understand privilege and combat oppression,¹ and create a shared knowledge base and minimal expectations of multicultural competencies (see, e.g., American Psychological Association [APA], 2003) provide a critical starting point for understanding what it means to be an effective and ethical practitioner in an increasingly diverse world.

Case Vignette 1.1

Mariana Prader, PhD, directs Progressive State College (PSC)'s clinical training program. The Provost has called for across-the-board budget cuts, and all program directors have been asked to submit proposals reducing expenditures by 10 percent. Dr. Prader knows next year's spreadsheet includes two big-ticket proposals from her program. One is the installation of an elevator system connecting the parking garage to the PSC Mental Health Clinic waiting area. Currently, an uncovered ramp winds from a service entrance on the far side of the building to a hallway several doors down from the waiting room entrance. The ramp is steep, ices over in winter, and (Dr. Prader thinks to herself) is a lawsuit waiting to happen. However, as no client in a wheelchair has ever utilized the Clinic, she reasons there must not be much need for disability services in the PSC community. The second item is a 5-day “SafeZone” training colloquium for all PSC personnel. Dr. Prader believes the training would be helpful in educating faculty and staff about issues facing gay, lesbian, and bisexual students, especially in light of some homophobic graffiti found on campus recently. Although she personally values diversity, Dr. Prader is aware that several faculty members have been very vocal in their opposition to the proposed colloquium; politically, the best thing for all concerned might be if the idea died a regrettable—but unavoidable—death from acute budgetitis.

Across town, Etienne Lamont, LCSW, also faces a dilemma: bran muffins, or jelly doughnuts? Eti (as his clients call him) conducts an evening parenting skills group for single fathers. Most of the men come to the two-hour group straight from work—some will return for extra hours or head to second jobs afterward—and Eti likes to offer a few snacks to tide them over. He frowns, tabulating an appropriate ratio of healthy to not-so-healthy items, and mentally runs through a quick checklist of his clients' dietary constraints. Ted and Kyle have heart conditions (bran for them). Roger has diabetes (sugar-free angelfood cake), and Vaughn has some unpronounceable gastrointestinal affliction; he probably won't eat anything, anyway. The 8 men in the group have between them 11 kids, 9 jobs, 6 functional vehicles (if you count Colin's old truck, which runs about half the time), 5 mortgages (including a pending foreclosure and an eviction notice), close to $100k in outstanding debt, and an average blood pressure of 140/90. Eti remembers taking a graduate course on “gender issues,” and his feelings of indignation over the historical and ongoing oppression of women worldwide. He pauses, checks in with himself. He still feels that anger, is still aware of his privilege and that of other men—but there is a story to be told here, too. He struggles to think of a way to speak both truths to the men in his group. Eti sighs. Men may run the world, he thinks, sticking a couple of bananas in the basket, but, man, it runs them, too.

At that exact moment, Dae-sun Yi sits at her computer and thoughtfully compares college Web sites. She is considering majoring in psychology, and would like an intellectually rigorous program with some clinical training opportunities in the community. She hopes to attend graduate school, perhaps earning a PsyD with an emphasis on working with older adults. One program, offered at a nearby school, looks pretty good. There are some interesting electives, the teachers appear to be well-respected, and the program utilizes a nationally recognized competency-based diversity training model. Dae-Sun hesitates, finger poised above the button on the mouse. Diversity—is that important?, she wonders. Is that me?

But what constitutes “effective” and “ethical” may evolve over time and with developmental level. Consider the examples discussed in Case Vignette 1.1.²

The scaffolding is there—but, as the previous vignette illustrates, it is by no means complete. Increasingly nuanced understandings of the interplay between target status and day-to-day reality are emerging from current explorations of racial microaggressions (the insidious and pervasive staccato of invalidating and disempowering messages with which persons of color are almost continually bombarded) (Sue, Capodilupo, & Holder, 2008; Sue et al., 2007), intersectional identity theory (see, e.g., Shuddhabrata Sengupta's 2006 article, “I/Me/Mine,” in which she describes multiple identities as “minefields,” and observes, “it's just that we don't know which mine (as in ‘weapon’ and as in ‘first-person possessive singular personal pronoun’) will claim which part of me,” p. 634), contemporary racism (Smith, Constantine, Graham, & Dize, 2008, for example, note that clinicians risk hitting a “developmental ceiling unless they simultaneously refine their understanding of the operations of racism within their own and their clients' conceptual worlds” [p. 337], including forms of oppression much more subtle than those encountered during the civil rights era), and myriad other issues at the forefront of social justice scholarship.

Nor are racial, ethnic, and cultural themes the only overlooked aspects of diversity. By way of example, a cursory search for the term racism appearing in publication titles over the last 20 years yields 58 results; once racism is excluded, the terms ageism, sexism, ableism, sizeism, and transphobia appear in only 19 journal titles combined over the same period of time, with sexism accounting for all but one of these.³ In decrying the 96 percent failure rate in summary judgment on employment discrimination suits based on multiple claims (cases in which the plaintiff argues that she was discriminated against based on, e.g., her age, gender, and religious affiliation), Kotkin (2009) questions whether “the realities of today's workplace” suggest that “diversity is tolerated or may even be valued up to a point,” but that “too much difference” leads to “disparate treatment” (p. 3). When the provision of psychotherapy services itself risks becoming inherently “disparate” due to a lack of clinical expertise in the core issues that impact hundreds of millions of people (or, if considered in the aggregate, every human being), the time has come for a reconsideration of what the field means by basic “cultural competence.”

Practitioners and researchers alike recognize gaps in therapists' awareness and experience in effectively meeting the needs of clients whose multicultural identities fall outside of the syllabi of most three-credit graduate “diversity” courses. Recent articles question the competency of counseling training program graduates to offer services to differently abled clients (Cornish et al., 2008; Smart & Smart, 2006) and argue that even among those with positive attitudes toward diversity in general, college “faculty members may not consider disability as an aspect of diversity” (Barnard, Stevens, Oginga Siwatu, & Lan, 2008, p. 173). Similarly, Bartoli (2007) argues that training in the areas of religion and spirituality “continues to be scarce and inadequate,” suggesting that “recent, and not so recent, graduates are left on their own to seek further training and develop relevant competencies,” a reality that renders it “dubious whether psychologists currently meet the needs of religious and spiritual clients adequately” (p. 54). In promulgating its “Guidelines for Psychological Practice with Girls and Women,” the American Psychological Association (APA, 2007) acknowledged that “many psychologists and members of the general public may believe that women's issues in psychology were dealt with and resolved in the 1970s and 1980s” (p. 949), while the needs of female clients in today's changing social and economic context remain unmet. In an increasingly pernicious double-bind, older adults chronically underutilize therapy services, while “mental health issues relevant to older individuals continue to be underrepresented in the research literature and underemphasized in psychology, medical, and other health care provider training programs” (Smith, 2007, p. 277). Popular media and the counseling and training literature are full of similar examples of a profound disconnect between the needs of the mental health field's constituent communities and the functional expertise of its providers. The Surgeon General's office, for example, has documented disparities along ethnic and racial lines in both mental health access and service delivery (U.S. Department of Hea...

Table of contents

• Cover
• Title Page
• Copyright
• Foreword
• Acknowledgments
• Chapter 1: An Overview of Multicultural Counseling Competencies
• Chapter 2: The Competent Treatment of the Diverse Older Adult
• Chapter 3: Disability: Multiple and Intersecting Identities–developing Multicultural Competencies
• Chapter 4: Broaching Ethnicity Competently in Therapy
• Chapter 5: Clinical Competencies in Working with Immigrant Communities
• Chapter 6: Competency with Linguistically Diverse Populations
• Chapter 7: Psychotherapy with Men: Building Practice Competencies
• Chapter 8: Developing Multicultural Competency in Clinical Work with People of Mixed Ancestry
• Chapter 9: Becoming a Racially Competent Therapist
• Chapter 10: Competencies for Working with Sexual Orientation and Multiple Cultural Identities
• Chapter 11: Sizeism: An Unrecognized Prejudice
• Chapter 12: Developing Competency in Social Class and Classism in Counseling and Psychotherapy
• Chapter 13: Developing Competency in Spiritual and Religious Aspects of Counseling
• Chapter 14: Counseling Competency with Transgender and Intersex Persons
• Chapter 15: White Identity and Privilege
• Chapter 16: Counseling Competencies with Women: Understanding Gender in the Context of Multiple Dimensions of Identity
• Contributors' Photographs and Brief Biographies
• Author Index
• Subject Index