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Thursday, April 1, 2010

Working with the Culturally Diverse


With immigration to the United States rapidly on the rise, growing awareness of the importance of integrating cultural values and norms into professional practice has been under evaluation to examine its effectiveness. As a practitioner, one is ethically obligated to provide therapy that is culturally sensitive, respectful, and beneficial based on a client’s background characteristics (Jacob & Hartshorne, 2007).

In an effort to provide culturally competent practice; a school psychologist must attempt to utilize the following “best practices” strategies (Sue & Sue, 2008):

  • develop awareness of their own cultural heritage, gender, class, ethnic-racial identity, sexual orientation, and age and its implications on personal and social development
  • learn about a client’s background, values, and experiences and how they may have influenced individual development and behavior
  • demonstrate understanding and respect for cultural and experiential differences between practitioner and client
  • utilize knowledge of best practices when selecting, designing, and implementing treatment plans for diverse students/clients
  • consider an individual’s cultural/ethnic identity to prevent “over-pathology” or “under-pathology”
  • become conscious of communication style and try to anticipate their impact on culturally diverse clients
  • dispel biases through immersion of culture which requires additional education
    seek professional advice from colleagues

By adhering to the aforementioned strategies, school psychologists will provide, to the best of their ability, a therapeutic climate where progress is likely to occur.

To what extent do personal biases, lack of requisite knowledge, and poor adaptive therapeutic skills influence professional practice when working with a diverse clientele?

This blog was created by: Prattima Kaulessar & Danielle Muhammad

21 comments:

Mark said...

The biases that we bring to the session can have a huge impact on how we create an alliance with our client. If we do not recognize our background and consider the experiences of others it may come out during the session. Many times countertransference issues play out because we react to content that a client discusses which can hurt how we want to effectively with our clients.

Rebeccca said...

I agree with Mark that biases can have a huge impact. I think that is why there does seem to be a large effort at NJCU to counteract this. Through our courses of study I think we are made very aware of our biases.

The only problem is that I find we look at our biases a lot but have not discussed how to correct or at least counteract them. Instead of just making us aware they need to help us change or start the process.

Prattima Kaulessar said...

I agree that making ourselves aware of personal biases is not enough to combat the issue. If a clinician does not attempt to move past personal biases, therapy may not be very successful because bias acts as a wedge and prevents therapeutic progress. I believe, to dispel biases, one must immerse themselves in literature and experiences for knowledge plays a huge part in breaking down the walls of stereotype.

Also, Rebecca made a good point. There should be more emphasis placed on multicultural issues in school psychology to reflect the diversity within the United States.

Ana said...

I must agree with Mark about the fact that our biases can have a huge impact on how well we can work with clients. In our program we had one course that dealt with multicultural issues and what it did was make us more aware of these biases and the fact that they truly do exist, even with those people who believe that they do NOT have any biases.
The area of cultural issues is so relevant in our field, yet we have done very little to combat it! It's something that we cannot escape! Something as small as body language can really deter a relationship! We may not be aware of this but our clients can tell how comfortable we are with them. Culture sensitivity is something that we must spend more time learning about, whether it is through experiences or literature. What are some other ways that may help us with this issue??

Prattima Kaulessar said...

You have made some great points, Ana. Multicultural issues affect interaction between clinicians and clients. It is also true that nonverbal signals, such as body language or facial expressions, give away much of our thought process. It is a very important issue because it may impact effectiveness as clinicians and progress made by clients yet only one course has been dedicated to multicultural issues within counseling.

Cultural biases or lack of knowledge about a group may result in a loss of credibility on the therapist’s part. It could also create inequities and feelings of inferiority on the client’s behalf which may lead to the contribution of oppressive attitudes. For these reasons, it is extremely important to be aware of biases and the harm it could potentially have on the therapeutic process.

In order to combat personal biases as a therapist, one must realize that, although not desirable, biases exist in everyone and is the individual’s responsibility to change the negative or derogatory attitudes. In addition, I feel knowledge, through immersion of experience, is the best way to eradicate stereotypes and biases for therapists have an ethical obligation to provide the best service to clients even if it means additional work. If, after exhausting all options, a therapist feels they cannot provide adequate services and progress is unlikely to occur, they may refer the client to another therapist who may service them more appropriately.

Rebeccca said...

Prattima,

I think you are correct that immersion would be the most beneficial to helping to correct or at least counteract biases.

One way to help correct them is to start to feel more comfortable dealing with people who you are biases against.

Danielle Muhammad said...

I personally think that biases directly correlate with lack of knowledge. I believe that if we admit our biases, and then educate ourselves on our beliefs, we will decrease the amount of biases we have.
We are conditioned to think many false things. But, the concern is that some people don't attempt to find out the truth.
As school psychologist, we will work with people of all sorts. We must see each person individually and want to help them equally. There is really no room for biased school psychologist who are not willing to confront their biases.

Mark said...

Working with a diverse clientele will bring up many challenges, it is important that immersion and knowledge will have its benefits but lets not forget that each client will bring their own experiences and I think we can learn more from the client than from a book.

Rebeccca said...

Mark I agree that we have to remember that each client is an individual. After so much emphasis on how differnt cultures act and think differenlty than the typical "Westerner" we still have to be sure that we don't automatically assume that someone from a different culture does hold non Western views. First you have to assess their views because you never really know before you ask and we don't want to automatically assume that someone is communisitic or avoids eye contact or something like that.

Alaafia said...

Not having requisite knowledge is a huge negative influence when working with clients of diverse cultures. There is no way that any school psychologist can even deal with their own biases and not have poor adaptive therpeutic skills if you lack the knowledge in dealing with cliente with diverse backgrounds.

Having the necessary knowldege goes beyond the four walls of a classroom, i believe we need first-hand experience by really shadowing/working with professionals who have the experince and seeing them work with real clients of diverse population and how they address the various issues that come up will go a long way in helping in preparing us for what we are bound to face in our professional careers.

Prattima Kaulessar said...

All of you have made very valid points!

As Danielle said, lack of knowledge leads to biases and almost all individuals carry some preconceived notion about one group or another; most of which are gravely incorrect. In addition, Alaafia made an excellent point in that learning about diversity should be an interactive and real-world experience for the messages of tolerance and acceptance to be learned in a meaningful way. We can, most certainly, learn a lot from clients but therapists must be willing to learn about ideas that may be very different from their own.

In closing, it is our responsibility to educate ourselves in an effort to be more open and accepting of others even if we, as school psychologists, are not in agreement with their views. I believe it is more than an ethical issue pertaining to the role of school psychologists, it is a human rights issue and clinicians must teach and practice tolerance and acceptance if they expect to be successful therapists working with culturally diverse clients.

Alarys said...

We also have to keep in mind from the beginning intelligence quotient assessments were geared to be biased and utilized for segregation and discrimination. According to Jacob and Hartshorne (2007) IQ tests were at the forefront of justifying racial and gender inferiority. Knowing the history of our assessments and in conjunction with personal stereotypes that we all have against one race or another, a school psychologist walks a fine line between what is ethical and what is biased.
Another aspect we must keep in mind is the need for bilingual school psychologists. Under IDEA a child must be assessed in his or her native language. Before treatment can begin these issues must be addressed. However many schools do not have bilingual individuals on the child study team. What should a school psychologist do when researching a child’s culture is just not enough?

AmandaBish said...

Our influence on our clients is not just a temporary one either. It can have lasting and persistent effects. If the client does not trust us because of our personal biases or poor adaptive therapeutic skills, they are going to terminate therapy. Not only that, but if we make our client feel uncomfortable or even give off a racist/sexist/prejudiced "vibe", we are going to perpetuate the situation. Many times our diverse clients come to us BECAUSE of something that has to do with their cultural identity. Then the client might generalize and assume all therapists are racists or whatever and then never seek therapy again. Problem definitely not solved.

Danielle Allegra said...

I think biases, lack of knowledge, and poor skills allhave a HUGE impact on the relationship that is established with the client. Not only may soem of our biases slip out during a session, but even it doesn't it still affects the relationship because the therapist will still have the biases in their head which may affect the way the client is treated.
i do believe that having biases is inevitable, but there must be strategies or classes one must take in order to stop them from leaking out in session and effecting the session, as Rebecca said. I think that first hand on experience is a great way to learn about multicultural issues, i think as part of the program one must have to intern in schools with all different makeups of students, to get a first hand experience of what it is truly like.

Mike said...

When it comes to personal biases, it is more important to recognize our own stereotypes and address them than to do a complete 180 in our lives. After all, as Sue & Sue indicate, it is perfectly normal and a physiological tool to develop stereotypes. Where practitioners fall short is with their lack of knowledge and lack of resources to help clients of diverse backgrounds. If the psychologist is honest with his or herself in acknowledging their biases, and open with their client as to their position, there can be a very healthy relationship established. It is important to arm all of our colleagues with the knowledge and resources necessary to be an effective practitioner instead of utilizing the referral of these clients to other professionals.

Anel said...

We explored this issue to a great extent in our Multicultural Counseling class, and I must admit that coming into the class, I always thought that biases must somehouw be eradicated. But as Mike has pointed out, it is virtually impossible to do so.

I think that one of the things we really need to focus on, is not only that the bias exists, but to be aware of the need to refer out. If our work with the client ever becomes counter-productive, we have a responsibility to help the client find someone that can be more effective with him/her.

Danielle Muhammad said...

I am glad that we all agree that school psychologist should be aware of their biases. Secondly, we must seek understanding to overcome those biases. Once we do that we will be able to work with clients who we may have made assumptions about initially.

However, one must remember that if you can't overcome biases you can't objectively help clients.

Denise said...

I'd like to disagree with Rebecca's first post. I don't think we have enough multicultural training at NJCU. We are only required to take one course and that's supposed to make us culturally aware and sensitive. We have been very lucky to have Dr. Pastor as a professor more than once, however, so the push towards multiculturalism is evident in the courses we take with her. I'd be surprised if we discuss anything based on cultural issues from here on out in our program starting next semester. I do however agree that through courses taught in a multicultural fashion, we are pushed to explore our biases. I also think this is a very beneficial process to that of career dealing with people... which is pretty much everything.

Rebeccca said...

Denise, you may be correct that NJCU, in general, does not teach it enought but right now I am taking Dr. Pastor for 3 classes, took her once in the past, and am currently in multicultural counseling so at the moment I feel like it is one of the few issues I have really been taught.

What I want to know is: now that I am aware of my biases where do I go.

Prattima Kaulessar said...

Rebecca, I believe you are on your way!

As Mike said, it is normal, even necessary, to have stereotypes because they assist us in categorizing groups according to similarities and differences. Our brain is composed this way and even young children innately categorize objects and people, as learned in Dr. Bailey’s class. In addition, stereotypes are generally neutral because their purposes are the following: 1.guide social interaction by providing rules and generalities; 2. provide a set of expectations; and 3.constrain thinking in an effort to deter brain over-stimulation. It is when stereotypes lead to biases, based on generalities, which the problem occurs.

Honestly, some people may never dispel their personal biases; however, a therapist must learn to overcome them enough to assist a client in therapy. By not attempting to disband stereotypes, a therapist is sending the message (intentional or unintentional) that the client is unimportant, essentially! It may be easier said than done, but there is an ethical obligation to be as unbiased as possible when working in the therapeutic setting.

In closing, we do not have to agree with everyone and assimilate to others’ cultures and belief system but we must respect everyone’s right to their own beliefs without judgment.

Stefanie said...

If we enter a session with a client and we begin to say something that is normal to us as Americans, it may possibly be very offensive to someone else. I agree with Denise that we are lucky to have a professor that teaches us so much. being in the field of teaching for 5 years now I have to say I have never had any formal training on cultural diversity, but I hopefully will learn what I need to here and in Multicultural in the Fall.