Culturally Competent Therapy

Working with Children and Young People

Steven Walker

• Publisher: Bloomsbury Academic
• Year: 2005
• Print ISBN: 9781403933089
• eBook ISBN: 9781350306011
• Edition: 1
• Topic: Psychology
• Subtopic: Clinical Psychology
• Index: Psychology

This book seeks to liberate and empower practitioners seeking to meet the needs of all the troubled children and young people who come to them for help. Walker fills a gap in the available literature by addressing the needs of the changing demographic and ethnic tapestry of contemporary multi-cultural societies. This book extends classical concepts embodied in psychodynamic and systemic theory and provides practitioners with contemporary resources that reflect the changing external characteristics of society.

1

CULTURAL COMPETENCE

The men of culture are the true apostles of equality.

– Sohrab and Rustum

Introduction

The importance of counsellors and psychotherapists developing a culturally competent practice for working with children and young people cannot be overstated. If we are to truly reach them therapeutically and create the crucial relationship within which they can begin to understand themselves better then we need to work hard at knowing them fully. This means adapting and developing our methods and models of practice to fit the child – not the other way round. It means resisting offering a monotherapeutic experience to every child or young person regardless of their unique characteristics. In so doing we can engage them and enable their needs to permeate our working practices more comprehensively. It means ensuring that we do not make generalisable assumptions about a child or young person’s home life, customs or beliefs from a cursory question or relying solely on information about religion, ethnic origin or family background (Parekh 2000, Hartley 2003, Kehily and Swann 2003).

Children and young people are developing psychologically in an external world in which information, and the power it has to influence and shape their beliefs and feelings have never been greater. Control and manipulation of that information is being concentrated in a few hands themselves closely identified with a narrow ideological doctrine that legitimates certain forms of behaviour, attitude and culture. Western developed countries led by America dominate the production, marketing and distribution of products representing brand names and iconic images aimed at maximising profit in the global marketplace (Hall 1993). Children and young people are viewed as consumers and in this context the nature of their indigenous culture is seen as another part of their identity to be moulded in order to maintain cultural conformity. Young people’s desperate need to fit in, be included and be the same as other children is exploited relentlessly by corporations propagating certain values that reinforce the consumerist culture of the early 21st century.

Children and young people face considerable challenges in maintaining their cultural integrity in the face of institutional racism, homophobia, economic activity or migration patterns. The consequences may lead to significant emotional and psychological problems expressed, for example, by high rates of school exclusion among African-Caribbean children (Otikikpi 1999), suicide and para-suicide of gay and lesbian young people (Trotter 2000) or unemployment among Bangladeshi youth (Jones 1996). The cultural assets of minority children regularly go unrecognised, denied or devalued within the wider community (Newman 2002). It is crucial therefore that support offered by counsellors or psychotherapists includes opportunities to celebrate their heritage and creates links with other members of their cultural or social group. Children from migrant cultures are especially vulnerable to feelings of inferiority resulting in frustration, anxiety and poor school attainment (Spencer 1996). In the USA the promotion of resilience in black communities is an important strategy aimed at developing cultural confidence and enhancing problem-solving capacities (Reynolds 1998).

‘Culture’ is a word that appears in everyday discourse – so much so that as with much common parlance it ceases to require any great effort at understanding what it means. We all seem to know what we are talking about when we mention ‘culture’. Yet the variety of definitions and interpretations of the word allow it an elasticity that is more a hindrance to clarity than a help. The increasing need to improve our therapeutic work with children and young people requires us to examine their changing cultural environment for evidence of how we might harness new ways of understanding them and their troubles. At a general level, culture is associated with high art, refinement, superior taste and so on, or there is popular culture which is associated with the masses, low taste, tabloid media and TV soap operas.

We can also acknowledge that there is a ‘therapy culture’ – that is, something associated with Western methods of responding to individual human psychological difficulties. Depending on the context, it can be used as a term of criticism implying that the problems of society are caused by the culture of therapy which posits people as victims and weak-willed (Masson 1988, Furedi 2003). Or it can be used in a benign sense illustrative of how advanced societies are becoming in attending to the stresses and pressures of modern life. What is certain is that those of us seeking to help troubled children and adolescents need to develop our understanding of how cultural influences affect, maintain and ultimately provide solutions to the psychological difficulties of young people.

‘Culture’ in the anthropological sense has come to mean the way of life followed by a people. This concept developed as the history of Western expansionism and colonialism encountered manifestations of difference around the world. These encounters prompted a reaction at several levels of consciousness. Politically there was a need to justify the appropriation of native land and resources, economically the imperial explorers required raw materials to service industrialisation, but psychologically there was a fear of difference that had to be rationalised – hence the early attempts at racial categorisation and efforts to construct order from diversity and chaos in human lifeways. ‘Culture’ can also be defined in opposition to nature – the product and achievement of human beings representing a rising-above of their natural instincts. In this sense human nature is typically understood as the opposite of culture. ‘Culture’ can also mean the difference between humans and animals – the capacity to use language and complex communication to symbolise that which is not present (Jenkins 2002).

Thus the bearers of a culture are understood to be a collectivity of individuals such as a society or community. However, the cultural patterns that shape the behaviour of children and young people in groups should not be confused with the structure of institutions or social systems, even though there is a link between them. We can think of culture in one sense as the organisation of experience shared by members of a community, including their standards for perceiving, predicting, judging and acting. This means that culture includes all socially standardised ways of seeing and thinking about the world; of understanding relationships among people, things and events; of establishing preferences and purposes; and of carrying out actions and pursuing goals (Valentine 1976, Haralambos 1988, Jenkins 2002). As the history of the past three centuries demonstrates, the impact of Western imperialism has reproduced its economic and political structures worldwide, resulting in the development of industrial societies in former agrarian countries that have disrupted cultural patterns.

Inequalities in the distribution of wealth among these newly developing countries have created expectations and increasing demands for fairer trade relationships. Globalisation combined with instant international communications has brought the consequences of these unequal relationships and the needs of poor nations closer to our attention than ever before. Thus, developed nations are confronted with a variety of cultures with a common experience of exploitation and a need to reconcile conflicting feelings, guilt, confusion and responses. There is still a requirement for systematic knowledge about groups or categories of humanity who are more mobile and are attracted to Western lifestyles of wealth, materialism and welfare. In the early part of this 21st century the recent history of ethnic conflicts, population changes and poverty has prompted the emigration of refugee and asylum seekers towards the West.

The more privileged and comfortable strata of Western societies, as well as new urban communities in former agricultural economies, are facing the reality of desperately poor people who feel more and more marginalised and neglected. Resentment is a feature of the reaction of wealthier nations to inflows of dependent people and the realisation among refugees that they are not universally welcome. There is a need therefore to render knowledge about difference and cultural diversity coherent in order to inform public attitudes and social policy, as well as enhance therapeutic practice. One way of doing this is to attribute a culture or sub-culture to a broad variety of social categories. Hence we encounter relatively meaningless terms such as the ‘culture of poverty’, ‘youth culture’, ‘pop culture’, ‘black culture’ or ‘drug culture’. There is even a ‘refugee culture’ that apparently explains the motivation of families from troubled or impoverished regions to take incredible risks to seek refuge and safety.

Conceptualising culture

Cultural competence can initially be understood in the context of a desire to improve our practice in order to meet the needs of the growing multicultural and ethnically diverse society developing around us. It assumes that historical and orthodox assumptions about human growth and behaviour have served their purpose in meeting the needs of troubled children and young people in particular circumstances and at particular points in time. Now in the early stages of the 21st century changes are required to address and respond to the psychological and emotional problems of a modern generation of families and offspring who cannot be easily fitted into existing theoretical paradigms. There is increasing evidence for the need to refine and develop our methods and models of assessment and intervention so that they are more relevant and accessible to children and young people from a much wider range of backgrounds than was the case in the not-too-distant past (Madge 2001).

This is not to say that children and young people in the majority ethnic communities do not require improved methods of help and support. They are being socialised and exposed to a quite different society than former generations. The pace of life, enhanced stressors, individualism and consumerism are blamed for producing heightened states of arousal and stimulation. Evidence has begun to emerge of genetic changes, the development of new illnesses and of course a range of new risk factors to their mental health – especially the availability of cheap psychoactive drugs and greater access to alcohol. Depictions of family life, for example, in children’s literature has changed dramatically in the past 40 years from misleading idyllic paternalistic havens of safety and security to the grim reality of poverty, child abuse, divorce, mentally ill parents and personal and institutional racism (Tucker and Gamble 2001).

‘Ethnicity’ requires some clarification as another term that can be used in a variety of contexts but without much thought as to its meaning. Its use alongside the term ‘culture’ causes confusion especially when the two become almost synonymous. This is because there is no easy definition, but we at least need to know the complexities of the use of the term ‘ethnicity’ because it perhaps reflects something deeper and more ambivalent about the way we internally manage difference and otherness. Part of the problem lies in mixing up birthplace with ethnic identity. A white person born in Africa and a black person born in Britain can be defined by their ethnic grouping and place of birth. Further confusion has historically prevailed due to the way the official census data have been collated. In the UK, the methods of data collection since 1951 upto 1981 have altered from just recording the country of birth and the birthplace of parents, when there was no question on ethnicity. In 1991 a question on ethnicity offered a range of categories and in 2001 there were further changes to account for citizens with dual or mixed heritage.

The term ‘race’ is now generally accepted to be redundant as a meaningful scientific category; however, the idea of race as a general descriptor of assumed national, cultural or physical difference persists in society (Amin et al. 1997). The concept is embraced at the policy level with legislation such as the Race Relations Act in the UK and institutions such as the Commission for Racial Equality. Legislation such as the 1989 Children Act, the 2005 Children Act and Children’s National Service Framework, which contextualise work with children and young people, expects practitioners to take account of a child’s religious persuasion, racial origin, and cultural and linguistic background, without adequate guidance as to what is meant by ‘race’ or ‘culture’. The issue becomes more complex when we consider census data that show the increase in numbers of children from dual and mixed heritage backgrounds and consider the particularly complex set of problems they can encounter.

Ethnicity and culture

The linkage between race, ethnic identity and inequality has been repeatedly established in terms of its effect on wealth, status and power. These socio-economic and ...

Table of contents

• Cover
• Title Page
• Copyright
• Dedication
• Contents
• Introduction
• 1. Cultural Competence
• 2. Similarities and Differences
• 3. Integrating Theory, Skills and Values
• 4. Socially Inclusive Practice
• 5. Assessment and Intervention
• 6. Religion and Spirituality
• 7. Fairy Stories, Myths and Legends
• 8. Evaluating Practice and the Evidence Base
• Bibliography
• Index