Motivational Enhancement Therapy

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Motivational Enhancement Therapy Culturally
Competent Techniques Results
By Teris Robinson Eldrick Robinson Dr. Irvin J.
Williams
BUILDING A CULTURALLY COMPETENT PROFESSION
THROUGH MULTICULTURAL KNOWLEDGE, SKILL, AND
ATTITUDE BY IMPLEMENTING EVIDENCE and
STRENGTH-BASED PRACTICES Rain Does Not Fall On
One Roof Alone --African Proverb
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WORKSHOP OBJECTIVES
Think outside the box
1 Expose clinicians to ethno-cultures,
subgroups and individual variations to enhance
service delivery
Think outside the box
2 Teach Clinicians to identify the phenomenon of
cultural remission that invalidates the
treatment process
Think outside the box
3 To encourage participants to share in the
journey of the clients experience and gain self
awareness of prejudices to systematize a more
culturally competent facility.
The views expressed in written conference
materials or publications and by speakers and
moderators at HHS-sponsored conferences, do not
necessarily reflect the official policies of the
Department of Health and Human Services nor does
mention of trade names, commercial practices, or
organizations imply endorsement by the U.S.
Government.
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MET Culturally Competent Techniques
ResultsOutline

• Introduction of Cultural Competence
• A. Participants
• B. SAMHSA, NIDA, FADAA
• II. Reasons Solutions for Racial Ethnic
  Disparities
• III. Use of Cultural Competence
• A. Identify associated terms
• B. Form working definition
• C. Ethnicity as a example
• D. Effects of ethno-cultural identity
• Application of RID to MET
• Impact of Drug Use on Black America,
• VI. Q A discussion
• VII. Evaluation

The buck stops here!
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Introduction to Cultural Competence
What is it?
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Cultural Competence
A Matter of Urgent Concern!

• National Institute On Drug Abuse
• Substance Abuse and Mental Health Services
  Administration
• Florida Alcohol and Drug Abuse Association
• Countless Substance Abuse Professionals

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Reasons and Solutions For Racial/Ethnic
Disparities

• differences in access, clinical appropriations,
  client preferences, features of family,
  conditions of child abuse, neglect, sexual abuse,
  societal stigma, fragmented organization of
  services, clinicians lack of awareness, bias,
  inability to speak client language, client fear
  or mistrust of treatment, cultural association
  with substance abuse
• Prejudice of Counselor Client
• Systematic Bias
• 3. Social Economic Inequality
• 4.Lack of Behavioral Health

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Is it relevant to treatment ?
Cultural Competence

• Identify the role of associated terms
• Solidify a working definition
• Cultural competency is a set of congruent
  attitudes, behaviors, and policies that align the
  systematic goals accepted by an agency and among
  professionals to promote effective cross-cultural
  progress.
• Ethnicity- a Facet of Multiculturalism
• African American Culture

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Through Worldview Comparison
Building Cultural Competence

• Euro-American
• Conquering Nature
• Progress
• Rationalism
• Individualism
• Achievement
• Assertiveness
• Freedom
• Rigid Time Orientation
• Self-improvement

• African-American
• Consenting to Nature
• Spirituality
• Oral Tradition
• Extended Familism
• Cooperation Sharing
• Deference to Elders
• Extended Time Orientation
• Selflessness

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Cultural Competence
Is it relevant to the treatment session?
The Effects of Ethno-culture (meanings of
ambivalence)
Perception and Receptiveness
Black Identity Development
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Motivational Enhancement Therapy
Competence in Action
Reflection
Shifting Focus
Rolling with Resistance
Reframing
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Racial Identity DevelopmentA Key Component of
Ethnic Perception
By Dr. William Edward Cross
Pre- Encounter
Encounter
Immersion-Emersion
Internalization
Internalization-Committment
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The Concurrence of Racial Identity Development,
Sub-culture, and the Stages of Change
By Eldrick Teris Robinson
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Racial Identity DevelopmentA Key Component of
Ethnic Perception
Pre- Encounter

• The world is and should be guided by American
  European concepts
• To be Black is to be low-down and dirty
• Black people came from a strange uncivilized and
  the historical relevance began in 1865
• That the white man is inherently superior and
  the white esthetic is superior to the black one.
  (European-based concepts of beauty)
• Incorporation, Integration, or Assimilation is
  an African-Americans most effective means for
  solving problems

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The Concurrence of Racial Identity Development,
Sub-culture, and Pre-Contemplation

• Stays high ALL the time (poly-substance abuse)
• Has estranged children
• Housing and/or legal issues are of paramount
  concern
• No transportation or Drivers License

Zombie
Be open to discuss social factors related to the
need to numb pain of reality Acknowledge
positive traits required to live without
stability Incorporate statistics about drug use
for African-Americans Solicit client to envision
his ideal life, (family, community circumstance)
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Racial Identity DevelopmentA Key Component of
Ethnic Perception
Encounter

• Is somehow shocked into recognition that
  African-Americans cannot solely rely on others
  for support or protection
• Has an anxiety about the consequence of newly
  formed consciousness
• Displays a desperate need for security or
  pre-occupied with the display or illusion of
  security
• Seeks to counter feelings of failure

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The Concurrence of Racial Identity Development,
Sub-culture, and Contemplation

• Sells drugs to support his habit and immediate
  needs
• Has children with 2 or more different Mothers
  occasional involvement
• Legal issues of paramount concern
• Has transportation, rims, paint job with no
  insurance

Dope Boy
Tilt the scale by weighing the odds Benefits-
physical, moral obligation, see impact in
historical context as a temporary recurrence
Detriment- physical, legal, financial, family
relationships, historical context
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Racial Identity DevelopmentA Key Component of
Ethnic Perception
Immersion-Emersion

• Believes that the world should be interpreted
  from a Black-only perspective
• The only liberation from racism is to find a
  world outside of systematic control (job,
  housing, friends..)
• Has an agenda to strategize the appearance of
  assimilation and maintain his ethno-centristic
  viewpoint

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The Concurrence of Racial Identity Development,
Sub-culture, and Preparation

• Sells and uses drugs holds hierarchy of use as
  motivation to cease
• Lives with girlfriend or childrens mother
  illegally (HUD, food stamps) at fault of the
  system
• Legal issues and social support as motivation

Prep Thug
Strategizing on how to further his plight without
systematic involvement Normalize ambivalence of
being caught between two avenues of escape Be
informed about the life of historical figures who
have greatly accomplished and discontinued drug
use
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Racial Identity DevelopmentA Key Component of
Ethnic Perception
Internalization

• This person feels affirmed by continuous
  confrontation of the system and the man
• This person behaves in such a way that indicates
  no fear of control nor oppressive techniques, for
  betterment of others
• Seriously seeking inner-security in blackness
  while accepting factors of oppression
• Has something to prove (Im just as good as you
  are)

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The Concurrence of Racial Identity Development,
Sub-culture, and Action

• Seeks treatment from DUI or friends advice
  (distorted view of talented 10th )
• Continuous gripe about confidentiality
• Skilled in appearance of assimilation

Stunna
Use language that affirms clients leadership
ability Address clients expectation of treatment
and avoid romanticizing treatment setting (void
of racism, bias, areas for systematic
improvement Consider practical barriers and
prompt client to think through plans from a
proactive standpoint
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Racial Identity DevelopmentA Key Component of
Ethnic Perception
Internalization-Committment

• Recognition of interdependence between all types
  of people without a hidden agenda to prove ones
  self
• Realizes the need for all cultures to be
  celebrated and not just the underdog
• Has adopted traditional African principles of
  extended self
• Service oriented, multi-cultural minded

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The Concurrence of Racial Identity Development,
Sub-culture, and Maintenance Recycling

• Seeks treatment as a recharge to cope with
  recent lapse
• Utilizes black vernacular or slang as a tool to
  bridge communication between cultures
• Embarrassed by his revisit, sponsors other
  individuals

Picture Perfect
Be conversant of African-American struggle and
help develop a fire escape plan in the case
that urges continue Compare realistic small
changes to ways of the wise and
exceptional Consider practical barriers and
prompt client to think through plans from a
proactive standpoint
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The Concurrence of Racial Identity Development,
Sub-culture, and the Stages of Change
By Eldrick Teris Robinson
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Watch OutFor divergence ensued by other
cross-identification counseling
White Identification
Gender Sexual Orientation Identification
By Janet Helms
By Kinsey, Pomeroy, Martin
Racial/Cultural Identity
Biracial Identity Development
By Derald Wing Sue
By Tim Poston
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Is this drug induced behavior?
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References

• Adams, R.J., Gallon, S.L. (1997) Entry level
  addiction counselor competency survey National
  results. Portland OR Northwest Regional
  Laboratory Program Report.
• Aker R. (1992). Drugs, alcohol and society
  Social structure, process, and policy. Monterey,
  CA Brooks/Cole.
• Bell, P. (2002) Chemical dependency and the
  African American Counseling strategies and
  community issues. Center City, MN Hazelden.
• Burchum, J., Cultural Competence An
  Evolutionary Perspective Nursing Forum, Vol. 37,
  No. 4, 2002
• Center for Disease Control and National Center
  for Health Statistic Interview Survey and
  National Hospital Discharge Survey. 2006
• Cross, W. E. The Negro-to-Black conversion
  experience. Black World, 1971, July 12-27.
• Dizard, J. E. Black identity, social-class, and
  black power. Psychiatry, 1970, 33, 2, 196-207
• Jackson, J., Tucker B., Bowman, P.
  Culturally-Competent Research Methods in
  Advances in African American Psychology
• Substance Abuse and Mental Health Services
  Administration Treatment Improvement Protocol
  Series 35 Enhancing Motivation For Substance
  Abuse Treatment 2004.

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Thank you for joining us today. We sincerely
hope that you have received invaluable
information for your clients. Please take a
moment to complete the evaluation. Your feedback
is most important to us to assure we always
deliver the absolute best in counselor
strengthening training. Heres to a drug free
America and the part you play in making it
happen! Evaluation