The Changing Face of America

• Changing demographics are a function of a number of factors, including higher birth rates among culturally diverse populations, the fact that most immigrants no longer come from Western countries, a population that is growing older, and immigration rates that are the highest in U.S. history.

• Today’s immigrants have a tendency to want to assert their cultural heritage rather than be swallowed up by the Western-based U.S. culture.

• Changes in the racial, ethnic, and cultural makeup of Americans have also brought changes in the religious composition of the country.

• In addition to the changing ethnic, cultural, and religious diversity in the United States, changes in sex-role identity are occurring.

The Need for Cultural Competence

• Diversity challenges human service professionals to do good work with all clients by embracing cultural competence and cross-cultural sensitivity.

  • Unfortunately, such skills are often lacking, with the result being that clients from diverse cultures are frequently misunderstood, often misdiagnosed, sometimes spoken down to, and other times patronized, have the impact of negative social forces minimized, find the helping relationship less helpful, seek mental health services at lower rates, and terminate helping relationships earlier.

• Many clients from nondominant groups are distrustful of helpers, are confused about the helping process, or feel worlds apart from their helpers.

• The helping relationship is unappealing to so many clients from nondominant groups, often due to helper incompetence because the helper holds on to one or more of the following viewpoints:

  • The melting pot myth.

  • Incongruent expectations about the helping relationship.

  • De-emphasizing social forces.

  • Ethnocentric worldview.

  • Ignorance of one’s own racist attitudes and prejudices.

  • Inability to understand cultural differences in the expression of symptomatology.

  • The unreliability of assessment and research procedures.

  • Institutional racism.

Defining Culturally Competent Helping

• A basic definition offered by McAuliffe, suggests that culturally competent helping is “a consistent readiness to identify the cultural dimensions of clients’ lives and a subsequent integration of culture into counseling work.”

• The helper should consider the three following aspects of the client’s life, also known as client identities:

  • Individual identity

    • The helper should understand that the client has unique issues and concerns.

  • Group identity

    • They propose that all clients have a shared cultural background with others (e.g., sexual orientation, race, gender), which partially defines their problems and concerns

  • Universal identity

    • The helper should recognize that as humans, we all share common experiences.

• The culturally competent helper determines if the client relies more on an individualistic perspective (focuses more on self) or a collective perspective (focuses more on community) and then works to understand the client’s identities so as to set appropriate goals for the helping relationship.

Developing Cultural Competence

• If human service professionals are to work effectively with all clients, then they must graduate from training programs with the desire and the ability to help all people.

  • Human service professionals will have achieved competence in working with clients from nondominant groups when each training program graduate students who have

    • Worked with clients from diverse backgrounds.

    • Identities as human service professionals that include a multicultural perspective.

    • The attitudes, beliefs, knowledge, and skills to be effective with various clients.

• Ways to develop such cultural competence include embracing the multicultural counseling competencies as well as the advocacy competencies, understanding the Tripartite Model, and using the RESPECTFUL model.

Multicultural Counseling Competencies Model

• Multicultural counseling competencies offer a framework within which one can develop the skills necessary to become culturally competent.

  • These competences focus on the importance of helpers having the following:

    • (1) the appropriate attitudes and beliefs in the sense that they are aware of their assumptions, values, and biases.

    • (2) the knowledge about their clients’ culture needed to understand their clients better

    • (3) a repertoire of skills or tools that can be effectively applied to clients from diverse backgrounds.

• These attitudes and beliefs, knowledge, and skills should be applied in three areas:

  • The helper’s awareness of the client’s worldview.

  • The helper’s awareness of the client’s worldview.

  • The helper’s ability to use culturally appropriate intervention strategies.

• Attitudes and Beliefs.

  • The culturally competent helper has an awareness of his or her own cultural background and has actively pursued gaining awareness of his or her own biases, stereotypes, and values.

• Knowledge.

  • Culturally competent helpers have knowledge of their cultural heritage and realize how that might impact their relationship with clients.

  • Culturally competent helpers also have knowledge of the group from which the client comes and do not jump to conclusions about the client’s ways of being.

  • Culturally competent helpers show a willingness to gain a greater depth of knowledge of various cultural groups.

  • Such helpers are aware of how sociopolitical issues such as racism, sexism, and heterosexism can negatively affect clients.

  • They recognize how some theories of counseling assume values that may be detrimental to some clients in the helping relationship.

  • Culturally competent helpers understand how institutional barriers can affect the willingness of clients from nondominant cultures to use mental health services. Unfortunately, lack of knowledge of a cultural group can cause the human service professional and others to jump to incorrect conclusions.

• Skills.

  • The culturally competent helper is able to apply, when appropriate, generic interviewing and helping skills and also has knowledge of and is able to employ specialized skills and interventions that might be effective with clients from specific nondominant groups.

  • Such a helper understands the verbal and nonverbal language of the client and can communicate effectively with the client.

  • In addition, the culturally skilled helper understands the importance of having a systemic perspective, such as an understanding of the impact of family, community, and society on clients.

  • This helper can collaborate with extended family members, individuals in the community, folk healers, and other professionals and knows when to advocate for his or her clients.

  • Finally, the culturally competent helper knows the limit of his or her skills and understands the steps necessary to pick up new skills that will prove vital in working with specific clients.

Advocacy Competencies and Social Justice

• Working for social justice is a critical part of the cross-cultural helping relationship and of the human service professional’s work in general.

• Social justice work broadens culturally competent helping by including a wide range of activities that affect the client’s broader system in some profound manner and ultimately create a better life for the client.

  • One framework within which to view social justice work is advocacy.

• Recent advocacy competencies provide a mechanism for human service professionals to understand their work on social justice issues

• The advocacy competencies encompass the client, the community, and the public. Each of these domains is divided into two levels that include a focus on whether the helper is “acting with” or “acting on behalf” of the domain.

  • Acting with the Client, Community, and Public.

    • Here, the advocacy model focuses on client empowerment, community collaboration, and public information.

  • Acting on Behalf of the Client, Community, and Public.

    • Here, the advocacy model focuses on client advocacy, systems advocacy, and social/political advocacy.

Tripartite Model of Personal Identity

• Sue and Sue suggest that professionals be aware of three spheres of our clients lives which are as follows:

  • (1) the individual level, which represents our clients’ unique genetics and distinctive experiences

  • (2) the group level, which reflects a wide range of factors that a person may have in common with other people (e.g., race, gender, age, culture)

  • (3) the universal level, which comprises those shared experiences that come to define all of us as human, such as “(a) biological and physical similarities, (b) common life experiences (birth, death, love, sadness, etc.), (c) self-awareness, and (d) the ability to use symbols such as language.”

• The Tripartite Model of Personal Identity is helpful because it defines a number of factors that human service professionals can target better to understand their clients (the group level), offers us a model for understanding how the client may be unique, and provides an understanding of how clients may be similar to us.

The Respectful Model

• In gaining cultural competence, professionals should adopt the RESPECTFUL Model of helping, which highlights 10 following factors that helpers should explore in trying to obtain a good understanding of their clients:

  • R: religious/spiritual identity.

  • E: economic class background.

  • S: sexual identity.

  • P: level of psychological development.

  • E: ethnic/racial identity.

  • C: chronological/developmental challenges.

  • T: various forms of trauma and other threats to one’s sense of well-being.

  • F: family background and history.

  • U: unique physical characteristics.

  • L: location of residence and language differences.

• By addressing each of these dimensions with clients, helpers can better understand the varying factors that impact client development, increasingly work in a more holistic fashion with clients, and be able to develop effective strategies when working with clients.

Becoming Culturally Sensitive: Knowledge and Words

• Culturally competent helpers are familiar with a wide range of diversity issues and understand basic definitions of words and terms that give them a common framework within which to communicate.

• Culture.

  • Culture is expressed through common values, habits, norms of behavior, symbols, artifacts, language, and customs.

• Prejudice, Stereotypes, and Racism

  • Prejudice has to do with judging a person or a group based on preconceived notions about the group.

  • Stereotypes are rigidly held beliefs that most or all members of a group share certain characteristics, behaviors, or beliefs.

  • Racism is a specific belief that one race is superior to another.

• Discrimination and Microaggression.

  • Discrimination involves active behaviors, such as unfair hiring practices focused on specific ethnic or cultural groups or gay bashing.

  • Microaggressions comprise brief and often unconscious behaviors that denigrate others.

• Ethnicity.

  • When a group of people shares a common ancestry, which may include specific cultural and social patterns such as a similar language, values, religion, foods, and artistic expressions, they are said to be of the same ethnic group.

• Minority and Nondominant Group.

  • A minority is any person, or group of people, who are being singled out due to their cultural or physical characteristics and are being systematically oppressed by those individuals who are in a position of power.

  • Helping professionals increasingly use the term nondominant group rather than minority because of the latter's negative connotations.

    • The term nondominant group suggests that social causes (the oppression by dominant groups) engender distress in other (nondominant) groups.

• Power Differentials.

  • Power differentials may represent greater disparities between people than culture, ethnic group, race, or social class.

  • Power can be a function of race, class, gender, occupation, socioeconomic status, and a host of other factors.

• Race.

  • Race has traditionally been defined as permanent physical differences as perceived by an external authority.

• Religion and Spirituality.

  • Religion may be seen as an organized or unified set of practices and beliefs that have moral underpinnings and define a group’s way of understanding the world.

  • Spirituality is seen as residing in a person, not in a group, and defines the person’s understanding of self, self in relationship to others, and self in relationship to a self-defined higher power or lack thereof.

• Sexism, Heterosexism, and Sexual Prejudice.

  • When a person discriminates against, denigrates, or stigmatizes another individual due to his or her gender, that person is said to be sexist.

  • When a person discriminates against, denigrates, or stigmatizes an individual for nonheterosexual behaviors, that person is said to be a heterosexist.

    • The word heterosexism has become preferred over homophobia, as homophobia implies there is a “phobia” or “disorder” within a person that makes the person act in a stigmatizing or denigrating fashion. In contrast, heterosexism suggests that such behaviors are more of a conscious choice about the kinds of language and behaviors we exhibit.

  • Sexual prejudice is a more inclusive term that refers to negative attitudes targeted toward homosexual, bisexual, heterosexual, or transgender individuals.

• Sexual Orientation.

  • Sexual orientation (in contrast to sexual preference) is the gender toward which a person consistently has sexual feelings, longings, and attachments.

  • One’s sexual orientation, therefore, can be toward the same sex, the opposite sex, or both sexes.

• Social Class (“Class”).

  • Class is based on a person’s education, income, and wealth and represents the perceived ranking of an individual within society and the amount of power an individual wields.

• Political Correctness

  • Finding the correct term to refer to a person is often difficult and must be approached with a degree of respect.

  • Although there is great variety in how individuals prefer to be addressed, preferences often exist for a specific reason.

  • People vary in how they wish to be addressed, and it is always a good idea to ask a client what he or she likes to be called. In either case, using terms correctly shows our sensitivity to individuals from diverse cultures.

Ethical, Professional, and Legal Issues: The Client’s Right to Culturally Competent Counseling

• A client from a nondominant culture deserves a culturally competent human service professional who is knowledgeable about cultural differences and is sensitive to the needs of clients from nondominant groups.

• All clients deserve the respect and understanding of the professionals with whom they are working.

• Prejudices often exist in a realm beyond our awareness, and our unconscious prejudicial attitudes may seep out during interviews with clients.

• It is because of this that ethical guidelines stress the importance of having the knowledge and skills to work effectively with a wide range of clients and of knowing one’s own beliefs and possible prejudices.

• NOHS Standard to think about:

  • Human service professionals are knowledgeable about their cultures and communities within which they practice. They are aware of multiculturalism in society and its impact on the community as well as individuals within the community. They respect the cultures and beliefs of individuals and groups. (Standard 11).

  • Human service professionals are aware of their own cultural backgrounds, beliefs, values, and biases. They recognize the potential impact of their backgrounds on their relationships with others and work diligently to provide culturally competent service to all of their clients. (Standard 34).

  • Human service professionals seek the training, experience, education and supervision necessary to ensure their effectiveness in working with culturally diverse individuals based on age, ethnicity, culture, race, ability, gender, language preference, religion, sexual orientation, socioeconomic status, nationality, or other historically oppressive groups (Standard 26).

The Effective Human Service Professional: Open to the Continual Development of a Multicultural Perspective

• most professionals will pass through a number of stages, including the following:

  • Affective/ impulsive stage

    • Where professionals may respond impulsively and in a hostile fashion when discussing issues of diversity.

  • The dualistic rational stage

    • where professionals learn to monitor their prejudices but still feel them.

  • Liberal stage

    • where professionals can begin to see different viewpoints when understanding clients from nondominant cultures.

  • Principled activist stage

    • where professionals can understand and accept that all people hold varying values and beliefs and may behave in ways different from their helpers.

• To reach higher levels of development, human service professionals need to be open to new experiences, reflect on their own attitudes and skills, and, of course, gain the appropriate knowledge and skills.

• The culturally competent helper is always eager to learn about new theories and strategies and willing to grow personally in new ways.