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Multicultural Competency Development

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Title: Multicultural Competency Development


1
  • Multicultural Competency Development
  • Fernando A. Ortiz, Ph.D.

2
CHAPTER 1THE MULTICULTURAL JOURNEY TO CULTURAL
COMPETENCE
3
Emotional Roadblocks to the Path of Cultural
Competence
  • Strong emotions such as
  • anger, sadness, and defensiveness are displayed
    when discussing experiences of race, culture,
    gender, and other sociodemographic variables

4
Emotional Roadblocks to the Path of Cultural
Competence
  • These feelings can enhance or negate a deeper
    understanding of the worldviews of culturally
    diverse clients
  • Disturbing feelings serve to protect us from
    having to examine our own prejudices and biases
    (Winter, 1977)
  • Multiculturalism deals with real human
    experiences and it would behoove the reader to
    understand his/her emotional reactions on the
    journey to cultural competence

5
Common Emotions
  • I FEEL GUILTY, I could be doing more
  • I FEEL ANGRY, I dont like to feel like Im
    wrong
  • I FEEL DEFENSIVE, Why blame me, I do enough
    already

6
Common Emotions
  • I FEEL TRUNED OFF, I have other priorities in
    life
  • I FEEL HELPLESS, The problem is too bigwhat can
    I do?
  • I FEEL AFRAID, I am going to do somethingI
    dont know what will happen

7
Implications for Clinical Practice
  • Do not allow your own emotional reactions negate
    the stories of the most disempowered in society
  • Try to acknowledge your inherited biases openly
    so that you can listen to your clients in a
    non-defensive way
  • Experiences with people of color will enhance
    ones cultural competence
  • Explore yourself as a racial/cultural being
  • Try to understand what your intense emotions mean
    for you when they arise
  • Do not squelch dissent or disagreements
  • Take an active role in exploring yourself

8
CHAPTER 2THE SUPERORDINATE NATURE OF
MULTICULTURAL COUNSELING AND THERAPY
9
Themes from the Difficult Dialogue
  • Cultural Universality (etic) vs. Cultural
    Relativism (emic)
  • Emotional Consequences of Race
  • Inclusive vs. Exclusive nature of
    Multiculturalism
  • Sociopolitical Nature of Counseling/Therapy
  • The Nature of Multicultural Counseling Competence

10
Tripartite Framework
  • Individual Level
  • Group Level
  • Universal Level

11
Tripartite Framework Model
12
What is MCT?
  • 1. MCT broadens the perspective of the helping
    relationship. The individualistic approach is
    balanced with a collectivistic reality that we
    are embedded in our families, significant others,
    our communities and culture.
  • Working with a client is not perceived as solely
    an individual matter, but as an individual who is
    a product of his or her social and cultural
    context. As a result, systemic influences are
    seen as equally important as individual ones.

13
What is MCT?
  • 2. MCT expands the repertoire of helping
    responses. Traditional therapeutic taboos are
    questioned.
  • Five taboos derived from monocultural code of
    ethics/standards of practice are especially
    important as examples

14
Therapeutic Taboos
  • 1. Therapists do not give advice and suggestion
    (it fosters dependency).
  • 2. Therapists do not self disclose their
    thoughts and feelings (it is unprofessional).
  • 3. Therapists do not barter with clients (it
    changes the nature of the therapeutic
    relationship).
  • 4. Therapists do not serve dual role
    relationships with clients (there is a potential
    loss of objectivity).
  • 5. Therapists do not accept gifts from clients
    (it unduly obligates them).

15
BECOMING CULTURALLY COMPETENT
  • Cultural competence is the ability to engage in
    actions or create conditions that maximize the
    optimal development of client and client systems.
    It is the acquisition of awareness, knowledge,
    and skills needed to function effectively in a
    pluralistic democratic society (ability to
    communicate, interact, negotiate, and intervene
    on behalf of clients from diverse backgrounds),
    and on an organizational/societal level,
    advocating effectively to develop new theories,
    practices, policies and organizational structures
    that are more responsive to all groups.

16
BECOMING CULTURALLY COMPETENT
  • l. Having all of us become culturally aware of
    our own values, biases and assumptions about
    human behavior.
  • What stereotypes, perceptions, and beliefs do we
    hold about culturally diverse groups that may
    hinder our ability to form a helpful and
    effective relationship?
  • What are the worldviews they bring to the
    interpersonal encounter? What value systems are
    inherent in the professionals theory of helping,
    educating, administrating, and what values
    underlie the strategies and techniques used in
    these situations?
  • Without such an awareness and understanding, we
    may inadvertently assume that everyone shares our
    world view. When this happens, we may become
    guilty of cultural oppression, imposing values on
    our culturally diverse clients.

17
BECOMING CULTURALLY COMPETENT
  • 2. Having all of us acquire knowledge and
    understanding of the worldview of culturally
    diverse groups and individuals.
  • What biases, values and assumptions about human
    behavior do these groups hold?
  • Is there such a thing as an African American,
    Asian American, Latino(a)/Hispanic American or
    American Indian worldview? Do other culturally
    different groups (women, the physically
    challenged, gays/lesbians, etc.) also have
    different world views?

18
BECOMING CULTURALLY COMPETENT
  • 3. Having each of us begin the process of
    developing appropriate and effective helping,
    teaching, communication and intervention
    strategies in working with culturally diverse
    groups and individuals.
  • This means prevention as well as remediation
    approaches, and systems intervention as well as
    traditional one-to-one relationships.
  • Equally important is the ability to make use of
    existing indigenous-helping/healing approaches
    and structures which may already exist in the
    minority community.

19
BECOMING CULTURALLY COMPETENT
  • 4. Understanding how organizational and
    institutional forces may either enhance or negate
    the development of multicultural competence.
  • It does little good for any of us to be
    culturally competent when the very organization
    that employs us are filled with monocultural
    policies and practices.
  • In many cases, organizational customs do not
    value or allow the use of cultural knowledge or
    skills. Some organizations may even actively
    discourage, negate, or punish multicultural
    expressions. Thus, it is imperative to view
    multicultural competence for organizations as
    well.
  • Developing new rules, regulations, policies,
    practices, and structures within organizations
    which enhance multiculturalism are important.

20
Implications for Counseling
  • Realize that you are a product of cultural
    conditioning and that you are not immune from
    inheriting biases associated with culturally
    diverse groups in our society
  • Be aware that persons of color, gays/lesbians,
    women, and other groups may perceive mental
    illness/health and the healing process
    differently than do Euro-Americans
  • Be aware that Euro-American healing standards
    originate from a cultural context and represent
    only one form of helping that exists on an equal
    plane with others
  • Realize that the concept of cultural competence
    is more inclusive and superordinate than is the
    traditional definition of clinical competence.

21
Implications for Counseling
  • Realize that organizational/societal policies,
    practices, and structures may represent
    oppressive obstacles that prevent equal access
    and opportunity. If that is the case, systems
    intervention is most appropriate
  • Use modalities that are consistent with the
    lifestyles and cultural systems of clients

22
CHAPTER 3THE POLITICS OF COUNSELING AND
PSYCHOTHERAPY
23
Katrina and Counseling?
  • Katrina is a prime example of the clash of racial
    realities and the multitude of political issues
    that are likely to arise in clinical sessions
    between counselors and culturally diverse clients
  • Counseling and psychotherapy do not take place in
    a vacuum isolated from the larger
    social-political influences of our societal
    climate      

24
The Diversification of the United States
  • Nowhere is diversification of society more
    evident than in the workplace where three major
    trends can be observed
  • the graying of the workforce
  • the feminization of the workforce
  • the changing complexion of the workforce

25
Graying of the Workforce
  • As the baby boomers head into old age, the
    elderly population of those 65 and older will
    surge to 53.3 million by 2020
  • In 2005, 70 of workers were in the 25-54 age
    group and workers 55 and older rose 15     

26
Implications
  • Lack of knowledge concerning issues of the
    elderly and the implications of an aging
    population on mental health needs
  • In American society, the elderly suffer from
    beliefs and attitudes of society (stereotypes)
    that diminish their social status
  • The elderly are increasingly at the mercy of
    governmental policies and company changes in
    social security and pension funds
  • Social service agencies are ill prepared to deal
    with the social and mental health needs of the
    elderly

27
Feminization of the Workforce and Society
  • Over a fifteen year period from 1990 to 2005
    women accounted for 62 of the net increase in
    the civilian labor force
  • However, women continue to occupy the lower rungs
    of the occupational ladder but are still
    responsible for most of the domestic
    responsibilities

28
Implications
  • Women are subjected to greater number of
    stressors than their male counterparts due to
    issues related to family life and role strain
  • Family relationships and structures have
    progressively changed as we have moved from a
    traditional single-earner, two-parent family to
    two-wage earners
  • Women continue to be paid less than men, and 25
    of children will be on welfare at some point
    before reaching adulthood

29
The Changing Complexion of the Workforce and
Society
  • From 1990 to 2000, the U.S. population increased
    13 to over 281 million (U.S. Bureau of the
    Census, 2001)
  • Projections indicate that persons of color will
    constitute a numerical majority sometime between
    2030 and 2050 (D. W. Sue et al., 1998)
  • The rapid demographic shift stems from two major
    trends immigration rates and differential
    birthrates

30
Implications
  • By the time the socalled baby boomers retire,
    the majority of people contributing to the social
    security and pension plans will be racial/ethnic
    minorities so if people of color continue to be
    the underemployed and underpaid, the economic
    security of retiring White workers looks grim
  • The economic viability of businesses will depend
    on their ability to manage a diverse workforce
    effectively

31
Mental Health Implications
  • Counselors must be prepared to become culturally
    competent through (a) revamping our training
    programs, (b) developing multicultural
    competencies as core standards for our
    profession, and (c) providing continuing
    education for our current service providers

32
CHAPTER 4SOCIOPOLITICAL IMPLICATIONS OF
OPPRESSION TRUST AND MISTRUST IN COUNSELING/
PSYCHOTHERAPY
33
The Case of Malachi
  • The therapist felt he was in danger but could
    it be that the White counselor is not used to
    passionate expression of feelings?
  • The counselor imposed White, Western values of
    individualism and self-exploration onto the
    client suggesting Malachis problems lie within
    himself
  • The counselor went into the session wanting to
    treat Malachi like every human being thereby
    negating his unique racial-cultural perspective

34
ETHNOCENTRIC MONOCULTURALISM
  • Ethnocentric monoculturalism is the individual,
    institutional and societal expression of the
    superiority of one groups cultural heritage over
    anothers. In all cases, the dominant group or
    society has the ultimate power to impose their
    beliefs and standards upon the less powerful
    group.

35
ETHNOCENTRIC MONOCULTURALISM
  • 1. BELIEF IN SUPERIORITY.
  • There is a strong belief in the superiority of
    one groups cultural heritage (history, values,
    language, traditions, arts/crafts, etc.). The
    group norms and values are seen positively and
    descriptors may include such terms as more
    advanced and more civilized
  • Members of the society may possess conscious and
    unconscious feelings of superiority and that
    their way of doing things is the best way

36
ETHNOCENTRIC MONOCULTURALISM
  • 2. BELIEF IN INFERIORITY.
  • There is a belief in the inferiority of all other
    groups cultural heritage which extends to their
    customs, values, traditions and language.
  • Other societies or groups may be perceived as
    less developed, uncivilized, or primitive.
    The life style or ways of doing things by the
    group are considered inferior.

37
ETHNOCENTRIC MONOCULTURALISM
  • 3. POWER TO IMPOSE.
  • The dominant group has the power to impose their
    standards and beliefs upon the less powerful
    group. All groups are to some extent
    ethnocentric that is they feel positively about
    their cultural heritage and way of life. Yet, if
    they do not possess the power to impose their
    values on others, they hypothetically cannot
    oppress.
  • It is power or the unequal status relationship
    between groups which defines ethnocentric
    monoculturalism.

38
ETHNOCENTRIC MONOCULTURALISM
  • 4. EMBEDDED IN INSTITUTIONS.
  • The ethnocentric values and beliefs are
    manifested in the programs, policies, practices,
    structures and institutions of the society. For
    example, chain-of-command systems, training and
    educational systems, communication systems,
    management systems, performance appraisal systems
    often dictate and control our lives. They attain
    untouchable and godfather-like status in an
    organization.
  • Because most systems are monocultural in nature
    and demand compliance, racial/ethnic minorities
    and women may be oppressed.

39
ETHNOCENTRIC MONOCULTURALISM
  • 5. INVISIBLE VEIL.
  • Since people are all products of cultural
    conditioning, their values and beliefs
    (worldview) represent an invisible veil which
    operates outside the level of conscious
    awareness.
  • As a result, people assume universality that the
    nature of reality and truth are shared by
    everyone regardless of race, culture, ethnicity
    or gender.
  • This assumption is erroneous, but seldom
    questioned because it is firmly ingrained in our
    world view.

40
Therapeutic Impact of Ethnocentric Monoculturalism
  • Dissociate the true self
  • Playing it cool
  • Uncle Tom syndrome
  • Increased their vigilance and sensitivity

41
Therapist Credibility Expertness and
Trustworthiness
  • Credibility may be defined as the constellation
    of characteristics that makes certain individuals
    appear worthy of belief, capable, entitled to
    confidence, reliable, and trustworthy
  • Expertness depends on how well-informed, capable
    or intelligent others perceive the communicator
  • Trustworthiness is dependent on the degree to
    which people perceive the communicator (therapist
    to make valid assertions)

42
Psychological Sets of Clients
  • Problem-solving Setclient is concerned about
    obtaining correct information
  • Consistency SetIf inconsistent information is
    presented, cognitive dissonance will take place
  • Identity SetStrong identification with a group
  • Economic Setbeliefs and behaviors are influenced
    by rewards and punishments
  • Authority SetPeople in authority positions are
    seen to have rights to prescribe attitudes or
    behaviors

43
CHAPTER 5RACIAL, GENDER, SEXUAL ORIENTATION
MICROAGGRESSIONS                                
         
44
Microaggressions 
  • Microaggressions are brief, everyday exchanges
    that send denigrating messages to a target group
    like people of color, women and Gays
  • These microaggressions are often subtle in nature
    and can be manifested in the verbal, nonverbal,
    visual, or behavioral realm and are often enacted
    automatically and unconsciously (Solorzano, Ceja,
    Yosso, 2000)

45
Overt vs. Covert Oppression
  • Overt Racism, Sexism, and Heterosexism
  • vs.
  • Covert Racism, Sexism, and Heterosexism

46
Microassault
  • Blatant verbal, nonverbal or environmental attack
    intended to convey discriminatory and biased
    sentiments (e.g. epithets like spic or
    faggot)

47
Microinsult
  • Unintentional behaviors or verbal comments that
    convey rudeness, insensitivity or demean a
    persons racial heritage/identity, gender
    identity, or sexual orientation identity (e.g.
    Arnold Schwartzenegger calling Democrats, girly
    men)

48
Microinvalidation
  • Verbal comments or behaviors that exclude,
    negate, or dismiss the psychological thoughts,
    feelings, or experiential reality of the target
    group (e.g. the most qualified person should
    get the job)

49
Categories and Relationship of Racial
Microaggressions

Racial Microaggressions Commonplace verbal or
behavioral indignities, whether intentional or
unintentional, which communicate hostile,
derogatory, or negative racial slights and
insults.
Microinsult (Often Unconscious) Behavioral/verba
l remarks or comments that convey rudeness,
insensitivity and demean a persons racial
heritage or identity.
Microassault (Often Conscious) Explicit racial
derogations characterized primarily by a violent
verbal or nonverbal attack meant to hurt the
intended victim through name-calling, avoidant
behavior or purposeful discriminatory actions
Microinvalidation (Often Unconscious) Verbal
comments or behaviors that exclude, negate, or
nullify the psychological thoughts, feelings, or
experiential reality of a person of color.
Environmental Microaggressions
(Macro-level) Racial assaults, insults and
invalidations which are manifested on systemic
and environmental levels.

50
Therapeutic Implications of Microaggressions
  • Clients of color tend to terminate prematurely
  • Microaggresions my lie at the core of the problem
  • Therapist must be credible
  • Effective counseling is likely to occur when
    there is a strong working alliance

51
CHAPTER 6 BARRIERS TO MULTICULTURAL COUNSELING
AND THERAPY
52
Marginal Person
  • The marginal person, coined by Stonequist (1937)
    refers to ones ability to form a dual ethnic
    identification due to a bicultural membership

53
GENERIC CHARACTERISTICS OF COUNSELING/THERAPY
  • 1. Culture-bound values individual centered,
    verbal/emotional/behavioral expressiveness,
    communication patterns from client to counselor,
    openness and intimacy, analytic/linear/verbal
    (cause-effect) approach, and clear distinctions
    between mental and physical well-being.
  • 2. Class-bound values strict adherence to time
    schedules (50-minute, once-or-twice-a-week
    meeting), ambiguous or unstructured approach to
    problems, and seeking long-range goals or
    solutions.
  • 3. Language variables use of Standard English
    and emphasis on verbal communication.

54
CULTURE BOUND VALUES OF COUNSELING/THERAPY
  • 1. Focus on the individual.
  • Most forms of counseling and psychotherapy tend
    to be individual centered that is, they
    emphasize the I-thou relationship.

55
CULTURE BOUND VALUES OF COUNSELING/THERAPY
  • 2. Verbal/Emotional/Behavioral Expressiveness.
  • Many counselors and therapists tend to emphasize
    the fact that verbal/emotional/behavioral
    expressiveness is important in individuals.
  • We like our clients to be verbal, articulate, and
    to be able to express their thoughts and feelings
    clearly.

56
CULTURE BOUND VALUES OF COUNSELING/THERAPY
  • 3. Insight.
  • This characteristic assumes that it is mentally
    beneficial for individuals to obtain insight or
    understanding into their deep underlying dynamics
    and causes.
  • Born from the tradition of psychoanalytic theory,
    many theorists tend to believe that clients who
    obtain insight into themselves will be better
    adjusted.

57
CULTURE BOUND VALUES OF COUNSELING/THERAPY
  • 4. Self-Disclosure (Openness and Intimacy).
  • Most forms of counseling and psychotherapy tend
    to value ones ability to self-disclose and to
    talk about the most intimate aspects of ones
    life.
  • Self-disclosure has often been discussed as a
    primary characteristic of the healthy
    personality.
  • People who do not self-disclose readily in
    counseling and psychotherapy are seen as
    possessing negative traits such as being guarded,
    mistrustful, and/or paranoid.

58
CULTURE BOUND VALUES OF COUNSELING/THERAPY
  • 5. Scientific Empiricism.
  • Counseling and psychotherapy in Western culture
    and society has been described as being highly
    linear, analytic, and verbal in their attempt to
    mimic the physical sciences.
  • It emphasizes the scientific method - objective
    rational linear thinking. The therapist is
    objective and neutral, rational and logical in
    thinking. Quantitative evaluation that includes
    psychodiagnostic tests, intelligence tests, and
    personality inventories are used.
  • This cause-effect orientation emphasizes
    left-brain functioning.

59
CULTURE BOUND VALUES OF COUNSELING/THERAPY
  • 6. Distinctions between Mental and Physical
    Functioning.
  • Many American Indians, Asian Americans, Blacks,
    and Hispanics hold a different concept of what
    constitutes mental health, mental illness, and
    adjustment.
  • Among the Chinese, the concept of mental health
    or psychological wellbeing is not understood in
    the same way as it is in the Western context.
  • Latino/Hispanic Americans do not make the same
    Western distinction between mental and physical
    health as their White counterparts.
  • Thus, nonphysical health problems are most likely
    to be referred to a physician, priest, or
    minister.

60
CULTURE BOUND VALUES OF COUNSELING/THERAPY
  • 7. Ambiguity.
  • The ambiguous and unstructured aspect of the
    therapy situation may create discomfort in
    clients of color. Culturally diverse clients may
    not be familiar with therapy and perceive it as
    an unknown and mystifying process.
  • Some groups, like Hispanics, may have been reared
    in an environment that actively structures social
    relationships and patterns of interaction.
  • Anxiety and confusion may be the outcome in an
    unstructured counseling setting.

61
CULTURE BOUND VALUES OF COUNSELING/THERAPY
  • 8. Patterns of Communication.
  • The cultural upbringing of many minorities
    dictates different patterns of communication that
    may place them at a disadvantage in therapy.
  • Counseling demands that communication move from
    client to counselor. The client is expected to
    take the major responsibility for initiating
    conversation in the session, while the counselor
    plays a less active role.

62
Implications for Practice
  • Become aware of the generic characteristics of
    counseling
  • Advocate for multilingual services
  • Provide community counseling services in the
    clients natural environments (schools, churches,
    etc.)
  • Help clients deal with forces such as poverty,
    discrimination, prejudice, immigration stress in
    contrast to developing personal insight through
    self-exploration

63
Implications for Practice
  • Focus on action orientation and expand your
    repertoire
  • Do not overgeneralize or stereotype
  • Do not become arrogant and think that clinical
    work is superior to other forms of helping

64
CHAPTER 7CULTURALLY APPROPRIATE INTERVENTIONS
65
Communication Styles
  • It is important that the therapist and client
    send and receive both verbal and nonverbal
    messages accurately and appropriately

66
Nonverbal Communication
  • Generally occurs outside the level of conscious
    awareness
  • Varies from culture to culture
  • Important within the counseling context

67
Context in Communication
  • Directness of a conversation or the degree of
    frankness also varies considerably among various
    cultures
  • High Context Communicationanchored in the
    physical contextless reliant on explicit code
    (e.g. many Asian cultures)
  • Low Context Communicationgreater reliance on
    verbal parts of the message (e.g. Western)

68
Proxemics
  • Refers to perception and use of personal and
    interpersonal space
  • Violation may cause one to withdrawal, become
    angry, or create conflict
  • Some cultures are OK with being very close
  • If counselor backs away, may be seen as aloofness
    or coldness
  • Counselor may misinterpret clients closeness

69
Kinesics
  • Refers to bodily movements (e.g. facial
    expression, posture, gestures, eye contact)
  • Japanese smile may mean discomfort
  • Latin Americans shake hands with vigor
  • Eye contact varies according to culture

70
Paralanguage
  • Refers to vocal cues other than words (i.e.
    loudness of voice, pauses, silences, etc.)
  • Caseworker may misinterpret silences or speaking
    in a soft tone
  • Speaking loudly may not indicate anger but a
    cultural style

71
Communication Styles
  • Black styles of communication are often animated,
    interpersonal and confrontational whereas White
    middle-class styles of communication tend to be
    more objective, impersonal and nonchallenging

72
Counseling and Therapy as Communication Style
  • Different forms of psychotherapy possess varied
    communication styles (e.g. Rogers emphasizes
    attending skills Shostrom relied on direct
    guidance Lazarus took an active reeducative
    style)
  • In general, people of color prefer more active,
    directive forms of helping than nondirective ones

73
Implications for Practice
  • Recognize that no one style of counseling will be
    appropriate for all situations
  • Become knowledgeable about how race, culture, and
    gender affect communication styles
  • Become aware of your own style
  • Obtain additional training and education on a
    variety of theoretical orientations and
    approaches
  • Think holistically rather than in a reductionist
    manner when conceptualizing the human condition
  • Training programs need to use an approach that
    calls for openness and flexibility in
    conceptualizing issues and skill building

74
CHAPTER 8MULTICULTURAL FAMILY COUNSELING AND
THERAPY
75
Family Systems Approaches and Assumptions
  • Communications Approach Family problems are
    communication difficulties
  • Structural Approach Emphasizes interlocking
    roles
  • Assumptions
  • Separation/individuation is healthy
  • Egalitarian spousal relations
  • Be your own person

76
Issues in Working with Ethnic Minority Families
  • Many Black families are poor and suffer from
    racism and more Black males are single
  • Latinos emphasize the extended family
  • Biculturalism stressors
  • Strength through slavery
  • Native Americansalcohol abuse
  • Language structures vary
  • Social class issues

77
Machismo vs. Marianismo
  • Machismo is a term used in many Latino cultures
    to indicate maleness, virility, and the mans
    role as provider and protector
  • Marianismo derived from the cult of the Virgin
    Mary in that women are seen as morally and
    spiritually superior and capable of enduring
    greater suffering

78
Value Preference Considerations
  • Time Dimension
  • Relational Dimension
  • Activity Dimension
  • People-Nature Relationship
  • Nature of people Dimension

79
Implications for Practice
  • Different cultural conceptions of family
  • Families cannot be understood apart from the
    culture
  • Learn the definition of family for specific
    groups
  • Extended ties may be very important
  • Do not prejudge patriarchal relations
  • Mother role may be most important
  • Helping can take many formsbe creative

80
CHAPTER 9NONWESTERN IDIGENOUS METHODS OF
HEALING IMPLICATIONS FOR COUNSELING AND THERAPY
81
INDIGENOUS HEALING GUIDELINES
  • 1. DO NOT INVALIDATE THE INDIGENOUS CULTURAL
    BELIEF SYSTEMS OF YOUR CULTURALLY DIVERSE
    CLIENTS.
  • On the surface, the assumptions of indigenous
    healing methods might appear radically different
    from our own. When we encounter them, we are
    often shocked, find such beliefs to be
    unscientific and are likely to negate,
    invalidate or dismiss them.
  • Such an attitude will have the effect of
    invalidating our clients as well, since these
    beliefs are central to their world view and
    reflect their cultural identity.

82
INDIGENOUS HEALING GUIDELINES
  • 2. BECOME KNOWLEDGEABLE ABOUT INDIGENOUS BELIEFS
    AND HEALING PRACTICES.


  • Counselors/therapists have a professional
    responsibility to become knowledgeable and
    conversant with the assumptions and practices of
    indigenous healing so that a desensitization and
    normalization process can occur.
  • By becoming knowledgeable and
    understanding of indigenous helping approaches,
    the therapist will avoid equating differences
    with deviance!

83
INDIGENOUS HEALING GUIDELINES
  • 3. LEARNING ABOUT INDIGENOUS HEALING AND BELIEFS
    ENTAIL EXPERIENTIAL OR LIVED REALITIES.
  • While reading books about nonwestern
    forms of healing and attending seminars and
    lectures on the topic is valuable and helpful,
    understanding culturally different perspectives
    must be supplemented by lived experience.
  • Even when we travel abroad, few of us
    actively place ourselves in situations which are
    unfamiliar because it evokes discomfort, anxiety
    and a feeling of differentness.

84
INDIGENOUS HEALING GUIDELINES
  • 4. AVOID OVERPATHOLOGIZING AND
    UNDERPATHOLOGIZING A CULTURALLY DIFFERENT
    CLIENTS PROBLEMS.
  • A therapist or counselor who is culturally
    unaware and who believes primarily in a universal
    psychology may oftentimes be culturally
    insensitive and inclined to see differences as
    deviance. They may be guilty of
    overpathologizing a culturally different clients
    problems by seeing it as more severe and
    pathological than it truly may be.
  • There is a danger, however, of also
    underpathologizing a culturally different
    clients symptoms as well. While being
    understanding of a clients cultural context,
    having knowledge of culture-bound syndromes and
    being aware of cultural relativism are desirable,
    being oversensitive to these factors may
    predispose the therapist to minimize problems,
    thereby underpathologizing disorders.

85
INDIGENOUS HEALING GUIDELINES
  • 5. BE WILLING TO SEEK THE CONSULTATION OF
    TRADITIONAL HEALERS AND/OR UTILIZE THEIR
    SERVICES.
  • Mental health professionals must be willing and
    able to form partnerships with indigenous healers
    or develop community liaisons.
  • Such an outreach has several advantages (a)
    traditional healers may provide knowledge and
    insights into clients populations which would
    prove of value to the delivery of mental health
    services, (b) such an alliance will ultimately
    enhance the cultural credibility of therapists,
    and (c) it allows for referral to traditional
    healers (shamans, religious leaders, etc.) in
    which treatment is rooted in cultural traditions.

86
INDIGENOUS HEALING GUIDELINES
  • 6. SPIRITUALITY MUST BE SEEN AS AN INTIMATE
    ASPECT OF THE HUMAN CONDITION AND A LEGITIMATE
    ASPECT OF MENTAL HEALTH WORK.
  • Spirituality is a belief in a higher
    power which allows us to make meaning of life and
    the universe. It may or may not be linked to a
    formal religion, but there is little doubt that
    it is a powerful force in the human condition.
  • Many groups accept the prevalence of
    spirituality in nearly all aspects of life thus
    separating it from ones existence is not
    possible.

87
INDIGENOUS HEALING GUIDELINES
  • 7. HAVING THE ABILITY TO EXPAND OUR DEFINITION
    OF THE HELPING ROLE TO COMMUNITY WORK AND
    INVOLVEMENT.
  • More than anything else, indigenous healing is
    community oriented and focused. Culturally
    competent mental health professionals must begin
    to expand their definition of the helping role to
    encompass a greater community involvement.
  • The in-the-office setting is, oftentimes,
    nonfunctional in minority communities.
    Culturally sensitive helping requires making home
    visits, going to community centers, visiting
    places of worship and areas within the community.
    The types of help most likely to prevent mental
    health problems are building and maintaining
    healthy connections, with ones family, ones
    god(s), and ones universe.

88
INDIGENOUS HEALING IMPLICATIONS
  • It is clear that we live in a monocultural
    society a society that invalidates and separates
    us from one another, from our spirituality and
    from the cosmos.
  • There is much wisdom in ancient forms of healing
    which stress that the road to mental health is
    through becoming united and in harmony with the
    universe.
  • Activities that promote these attributes involve
    community work. They include client advocacy and
    consultation, preventive education, developing
    outreach programs, becoming involved in systemic
    change and aiding in the formation of public
    policy that allows for equal access and
    opportunities for all.

89
CHAPTER 10 RACIAL/CULTURAL IDENTITY
DEVELOPMENT THERAPEUTIC IMPLICATIONS
90
Importance
  • 1. Understanding Within Group Differences
  • 2. Influence of Racism and Oppression on
    Identity Formation
  • 3. Assessment Tool
  • 4. Intervention Implications

91
RACIAL IDENTITY ASSUMPTIONS
  • 1. Racism is a basic and integral part of U.S.
    life and permeates all aspects of our culture and
    institutions.
  • 2. Persons of color are socialized into U.S.
    society and, therefore, are exposed to the
    biases, stereotypes, and racist attitudes,
    beliefs, and behaviors of the society.
  • 3. The level of racial identity development
    consciousness affects the process and outcome of
    interracial interactions.

92
RACIAL IDENTITY ASSUMPTIONS
  • 4. How people of color perceive themselves as
    racial beings seems to be strongly correlated
    with how they perceive and respond to racial
    stimuli. Consequently, race-related reality
    represent major differences in how they view the
    world.
  • 5. It seems to follow an identifiable sequence.
    There is an assumption that people of color who
    are born and raised in the United States, may
    move through levels of consciousness regarding
    their own identity as racial beings.
  • 6. The most desirable development is a
    multicultural identity that does not deny or
    negate ones integrity.

93
Levels of Consciousness
  • 1. Conformity
  • 2. Dissonance
  • 3. Resistance and Immersion
  • 4. Introspection
  • 5. Integrative Awareness

94
Self/Other Perceptions
  • 1. Attitude and Beliefs toward Self.
  • 2. Attitudes and Beliefs toward Members of the
    Same Minority.
  • 3. Attitudes and Beliefs toward Members of
    Different Minorities.
  • 4. Attitude and Beliefs toward Members of the
    Dominant Group.

95
PHASE 1 - CONFORMITY
  • Marked by desire to assimilate and acculturate
    buys in to the melting pot analogy.
  • Accepts belief in White superiority and minority
    inferiority.
  • Unconscious and conscious desire to escape ones
    own racial heritage.
  • Validation comes from a White perspective.
  • Role models, lifestyles, and value systems all
    follow the dominant group.

96
CONFORMITY
  • Physical and cultural characteristics identified
    with ones own racial/cultural group are
    perceived negatively, something to be avoided,
    denied, or changed.
  • Physical characteristics (black skin color,
    slant-shaped eyes of Asians), traditional modes
    of dress and appearance, and behavioral
    characteristics associated with the minority
    group are a source of shame.
  • There may be attempts to mimic what is perceived
    as White mannerisms, speech patterns, dress,
    and goals.
  • Low internal self-esteem is characteristic of the
    person.

97
CONFORMITY
  • These individuals may have internalized the
    majority of White stereotypes about their group.
    In the case of Hispanics, for example, the person
    may believe that members of his or her own group
    have high rates of unemployment because they are
    lazy, uneducated, and unintelligent.
  • The denial mechanism most commonly used is Im
    not like them Ive made it on my own Im the
    exception.

98
CONFORMITY
  • Belief that White cultural, social, institutional
    standards are superior. Members of the dominant
    group are admired, respected, and emulated. White
    people are believed to possess superior
    intelligence.
  • Some individuals may go to great lengths to
    appear White. In the Autobiography of Malcolm X,
    the main character would straighten his hair and
    primarily date White women.
  • Reports that Asian women have undergone surgery
    to reshape their eyes to conform to White female
    standards of beauty may (but not in all cases)
    typify this dynamic.

99
PHASE 2 - DISSONANCE
  • Breakdown of denial system.
  • Encounters information discordant with previous
    beliefs in the conformity stage.
  • Dominant-held views of minority strengths and
    weaknesses begin to be questioned.
  • Begins to realize that attempts to assimilate or
    acculturate may not be fully allowed by larger
    society.

100
DISSONANCE
  • There is now a growing sense of personal
    awareness that racism does exist, that not all
    aspects of the minority or majority culture are
    good or bad, and that one cannot escape ones
    cultural heritage.
  • Feelings of shame and pride are mixed in the
    individual and a sense of conflict develops.

101
PHASE 3 RESISTANCE AND IMMERSION
  • Why should I feel ashamed of who and what I am?
  • Begins to understand social-psychological forces
    associated with prejudice and discrimination.
  • Extreme anger at perceived cultural oppression.
  • May be an active rejection of the dominant
    society and culture.
  • Members of the dominant group viewed with
    suspicion.

102
RESISTANCE AND IMMERSION
  • The minority individual at this stage is oriented
    toward self-discovery of ones own history and
    culture. There is an active seeking out of
    information and artifacts that enhance that
    persons sense of identity and worth.
  • Cultural and racial characteristics that once
    elicited feelings of shame and disgust become
    symbols of pride and honor. The individual moves
    into this stage primarily because he or she asks
    the question, Why should I be ashamed of who and
    what I am?
  • Phrases such as Black is beautiful, represent a
    symbolic relabeling of identity for many Blacks.
    Racial self-hatred becomes something actively
    rejected in favor of the other extreme, which is
    unbridled racial pride.

103
RESISTANCE AND IMMERSION
  • There is a feeling of connectedness with other
    members of the racial and cultural group and a
    strengthening of new identity begins to occur.
    Members of ones group are admired, respected,
    and often viewed now as the new reference group
    or ideal. Cultural values of the minority group
    are accepted without question.
  • As indicated, the pendulum swings drastically
    from original identification with White ways to
    identification in an unquestioning manner with
    the minority-groups ways. Persons in this stage,
    are likely to restrict their interactions as much
    as possible to members of their own group.

104
RESISTANCE AND IMMERSION
  • There is also considerable anger and hostility
    directed toward White society. There is a feeling
    of distrust and dislike for all members of the
    dominant group in an almost global anti-White
    demonstration and feeling.
  • White people, for example, are not to be trusted
    for they are the oppressors or enemies. In
    extreme form, members may advocate complete
    destruction of the institutions and structures
    that have been characteristic of White society.

105
PHASE 4 - INTROSPECTION
  • Increased discomfort with rigidly help group
    views (i.e., all Whites are bad).
  • Too much energies directed at White society and
    diverted from more positive exploration of
    identity questions.
  • Conflict ensures between notions of
    responsibility and allegiance to ones minority
    group, and notions of personal autonomy.
  • Attempts to understand ones cultural heritage
    and to develop an integrated identity.

106
INTROSPECTION
  • The conflict now becomes quite great in terms of
    responsibility and allegiance to ones own
    minority group versus notions of personal
    independence and autonomy.
  • The person begins to spend greater and greater
    time and energy trying to sort out these aspects
    of self-identity and begins to increasingly
    demand individual autonomy.

107
PHASE 5 INTEGRATIVE AWARENESS
  • Develop inner sense of security as conflicts
    between new and old identities are resolved.
  • Global anti-White feelings subside as person
    becomes more flexible, tolerant and
    multicultural.
  • White and minority cultures are not seen as
    necessarily conflictual.
  • Able to own and accept those aspects of U.S.
    culture (seen as healthy) and oppose those that
    are toxic (racism and oppression).

108
INTEGRATIVE AWARENESS
  • Develops a positive self-image and experiences a
    strong sense of self-worth and confidence.
  • Not only is there an integrated self-concept that
    involves racial pride in identity and culture,
    but the person develops a high sense of autonomy.
  • Becomes bicultural or multicultural without a
    sense of having sold out ones integrity.
  • In other words, the person begins to perceive his
    or her self as an autonomous individual who is
    unique (individual level of identity), a member
    of ones own racial-cultural group (group level
    of identity), a member of a larger society, and a
    member of the human race (universal level of
    identity).

109
Implications for Clinical Practice
  • Be aware that the R/CID model should be viewed as
    dynamic, not static.
  • Do not fall victim to stereotyping in using these
    models
  • Know that minority development models are
    conceptual aids and that human development is
    much more complex
  • Know that identity development models begin at a
    point that involves interaction with an
    oppressive society

110
Implications for Clinical Practice
  • Be careful of the implied value judgment given in
    almost all development models
  • Be aware that racial/cultural identity
    development models seriously lack an adequate
    integration of gender, class, sexual orientation,
    and other sociodemographic group identities
  • Know that racial/cultural identity is not a
    simple, global concept
  • Begin to look more closely at the possible
    therapist and client stage combinations

111
CHAPTER 11WHITE RACIAL IDENTITY DEVELOPMENT
112
WHITE RACIAL IDENTITY DEVELOPMENT - Assumptions
  • 1. Racism is a basic and integral part of U.S.
    life and permeates all aspects of our culture and
    institutions.
  • 2. White Americans are socialized into U.S.
    society and, therefore, inherit the biases,
    stereotypes, racist attitudes, beliefs, and
    behaviors of the society.

113
WHITE RACIAL IDENTITY DEVELOPMENT - Assumptions
  • 3. The level of White racial identity
    development in an interracial encounter affects
    the process and outcome of our relationships.
  • 4. How Whites perceive themselves as racial
    beings seems to be strongly correlated with how
    they perceive and respond to racial stimuli.
    Consequently, race-related reality of Whites
    represent major differences in how they view the
    world.

114
WHITE RACIAL IDENTITY DEVELOPMENT - Assumptions
  • 5. It seems to follow an identifiable sequence.
    There is an assumption that White Americans who
    are born and raised in the United States, may
    move through levels of consciousness regarding
    their own identity as racial beings.
  • 6. The most desirable development is not only
    the acceptance of whiteness, but also defining it
    in a nondefensive and nonracist manner. There is
    an understanding that to deny the humanity of any
    one person is to deny the humanity of all.

115
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase One Naiveté
  • Early childhood marked by naïve curiosity about
    race.
  • Tendency to be innocent, open, and spontaneous
    regarding racial differences.
  • May notice differences, but awareness of social
    meaning are absent or minimal.
  • Racial awareness and the burgeoning social
    meanings occur between the ages of 3-5 years.

116
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Two Conformity
  • Characteristics of naiveté may be maintained.
  • Minimal awareness of self as a racial/cultural
    being.
  • Strong belief in the universality of values and
    norms governing behavior.
  • Unlikely to recognize the polarities of
    democratic principles of equality and the unequal
    treatment of minority groups.

117
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Two Conformity
  • Compartmentalization of contradictory attitudes,
    beliefs and behaviors (i.e., can believe people
    are people, but treat minorities differently).
  • Because of naiveté and encapsulation, it is
    possible for two diametrically opposed belief
    systems to coexist in your mind.

118
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Two Conformity
  • (a) Uncritical acceptance of White supremacist
    notions which relegates minorities into the
    inferior category with all the racial
    stereotypes.
  • (b) Belief that racial and cultural differences
    are considered unimportant. This allows Whites
    to avoid perceiving themselves as dominant
    group members, or of having biases and
    prejudices.

119
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Two Conformity
  • The primary mechanism used in encapsulation is
    denial denial that people are different, denial
    that discrimination exists, and denial of your
    own prejudices. Instead, the locus of the
    problem is seen to reside in the minority
    individual or group.
  • In her own White racial awakening, Peggy McIntosh
    (1989) stated

120
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Two Conformity
  • My schooling gave me no training in seeing
    myself as an oppressor, as an unfairly advantaged
    person, or as a participant in a damaged culture.
    I was taught to see myself as an individual
    whose moral state depended on her individual
    moral will....Whites are taught to think of their
    lives as morally neutral, normative, and average,
    and also ideal, so that when we work to benefit
    others, this is seen as work which will allow
    them to be more like us.
  • While the Naiveté stage is brief in duration, the
    Conformity stage can last a lifetime.

121
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Three Dissonance
  • Obliviousness breaks down when Whites become
    aware of inconsistencies.
  • Becomes conflicted over irresolvable racial moral
    dilemmas that are frequently perceived as polar
    opposites believing they are nonracist, yet not
    wanting their son or daughter to marry a minority
    group member
  • Belief that all men are created equal, yet
    seeing society treat people of color as second
    class citizens and not acknowledging that
    oppression exists to witnessing it (beating of
    Rodney King and the unwarranted persecution of
    Wen Ho Lee).

122
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Three Dissonance
  • Become increasingly conscious of whiteness and
    may experience dissonance, resulting in feelings
    of guilt, depression, helplessness or anxiety.
  • Movement into the Dissonance phase occurs when
    Whites are forced to deal with the
    inconsistencies that have been compartmentalized
    or encounter information/experiences at odds with
    their denial.

123
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Three - Dissonance
  • Dissonance may make Whites feel guilty, shameful,
    angry, and depressed. Rationalizations may become
    the manner used to exonerate their inactivity in
    combating perceived injustice or personal
    feelings of prejudice Im only one person, what
    can I do or Everyone is prejudiced, even
    minorities.
  • As these conflicts ensue, Whites may retreat into
    the protective confines of White culture
    (encapsulation of the previous stage) or move
    progressively toward insight and revelation
    (resistance and immersion stage).

124
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Four - Resistance and Immersion
  • Whites begin to question and challenge their
    racism. For the first time, they begin to realize
    what racism is all about, and their eyes are
    suddenly opened.
  • Racism becomes noticeable in all facets of their
    daily lives (advertising, television, educational
    materials, interpersonal interactions, etc.). A
    major questioning of their racism and that of
    others mark this phase of development. In
    addition, increasing awareness of how racism
    operates and its pervasiveness in U.S. culture
    and institutions are the major hallmark at this
    level of development.

125
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Four Resistance and Immersion
  • Likely to experience considerable anger at family
    and friends, institutions, and larger societal
    values, that are seen as having sold them a false
    bill of goods (democratic ideals) that were never
    practiced.
  • Guilt is also felt for having been a part of the
    oppressive system.

126
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Four Resistance and Immersion
  • The "White liberal" syndrome may develop and be
    manifested in two complementary styles (a) the
    paternalistic protector role or (b) an over
    identification with the minority group. In the
    former, Whites may devote energies in an almost
    paternalistic attempt to protect minorities from
    abuse.
  • May actually even want to identify with a
    particular minority group (Asian, Black, etc.) in
    order to escape their Whiteness.

127
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Four Resistance and Immersion
  • May resolve this dilemma by moving back into the
    protective confines of White culture (Conformity
    stage), again experience conflict (dissonance),
    or move directly to the Introspective stage. In
    many cases, they may develop a negative reaction
    toward their group or culture. While they may
    romanticize People of Color, Whites cannot
    interact confidently with them because you fear
    making racist mistakes.
  • The discomfort in realizing that they are White
    and that their group has engaged in oppression of
    racial/ethnic minorities may propel them into the
    next stage.

128
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Five Introspection
  • This phase is most likely a compromise of
    swinging from an extreme of unconditional
    acceptance of White identity to a rejection of
    Whiteness. It is a state of relative quiescence,
    introspection and reformulation of what it means
    to be White.
  • Realize and no longer deny that they have
    participated in oppression, that they benefit
    from White privilege, and that racism is an
    integral part of U.S. society. Less motivated by
    guilt and defensiveness, accept Whiteness, and
    seek to define own identity and that of ones
    social group.

129
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Five Introspection
  • May ask questions What does it mean to be
    White? Who am I in relation to my whiteness?
    Who am I as a racial/cultural being?
  • Feelings or affective elements may be existential
    in nature and involve feelings of lack of
    connectedness, isolation, confusion and loss.

130
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Five Introspection
  • Asking the painful question of who you are in
    relation to your racial heritage honestly
    confronting your biases and prejudices and
    accepting responsibility for your Whiteness is
    the culminating outcome of the introspective
    stage.
  • New ways of defining your White EuroAmerican
    social group and membership in that group become
    important.
  • No longer deny being White, honestly confront
    your racism, understand the concept of White
    privilege, and feel increased comfort in relating
    to persons of color.

131
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Six - Integrative Awareness
  • Reaching this level of development is most
    characterized as
  • (a) Understanding self as a racial/cultural
    being.
  • (b) Awareness of sociopolitical influences with
    respect to racism,
  • (c) Appreciation of racial/cultural diversity,
  • (d) Rooting out buried and nested racial fears
    and emotions.

132
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Six Integrative Awareness
  • Formation of a nonracist White EuroAmerican
    identity emerges and becomes internalized. Begin
    to value multiculturalism, comfortable around
    members of culturally different groups, and feel
    a strong connectedness with members of many
    groups.
  • Inner sense of security and strength to function
    in a society that is only marginally accepting of
    integratively aware White persons.

133
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Six Integrative Awareness
  • This status is different from the previous one in
    two major ways (a) It is marked by a shift in
    focus from trying to change people of color to
    changing the self and other Whites, and (b) it is
    marked with increasing experiential and affective
    understanding that were lacking in the previous
    status.
  • Successful resolution of this stage requires an
    emotional catharsis or release that forces you to
    relive or reexperience previous emotions that
    were denied or distorted. The ability to achieve
    this affective upheaval leads to a euphoria or
    even a feeling of rebirth and is a necessary
    condition to developing a new nonracist White
    identity.

134
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Seven Commitment To Antiracist Action
  • Most characterized by social action. There is
    likely to be a consequent change in behavior, and
    an increased commitment toward eradicating
    oppression as well.
  • Seeing wrong and actively working to right it
    require moral fortitude and direct action.
    Objecting to racist jokes, trying to educate
    family, friends, neighbors, and co-workers about
    racial issues, taking direct action to eradicate
    racism in the schools, workplace, and in social
    policy often in direct conflict with other
    Whites.

135
WHITE RACIAL IDENTITY DEVELOPMENT Process
  • Phase Seven Commitment to Antiracist Action
  • Become increasingly immunized to social pressures
    for conformance because reference group begins to
    change.
  • In addition to family and friends, will begin to
    actively form alliances with persons of color and
    other liberated Whites. They will become a
    second family giving validation, and encouraging
    continuance to the struggle against individual,
    institutional and societal racism.

136
WHITE RACIAL IDENTITY DEVELOPMENT Summary
  • First, you must actively place yourself in new
    and oftentimes uncomfortable situations that
    impel you to question yourself as a
    racial/cultural being, and to increase awareness
    of racial issues, especially racism.
  • Second, change must occur in the form of new
    insights, attitudes and behaviors that lead to a
    realization of your role in the perpetuation of
    racism.
  • Third, considerable and continuing energies must
    be devoted to the maintenance of a healthy White
    racial identity. In other words, change is not
    enough in the face of societal forces that serve
    to squelch or punish dissent.
  • Fourth, you must take action to eradicate racism.

137
CHAPTER 12SOCIAL JUSTICE COUNSELING/THERAPY
138
Multicultural Counseling
  • Multicultural counseling and therapy must be
    about
  • social justice
  • providing equal access and opportunity to all
    groups
  • being inclusive
  • removing individual and syste
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