Title: Ethical Considerations for the Rehabilitation Professional: Serving Culturally Diverse Populations
1Ethical Considerations for the Rehabilitation
Professional Serving Culturally Diverse
Populations
- Maureen McGuire-Kuletz, Ed.D., CRC
- Director/Assistant Research Professor
- George Washington University RRCEP
- 2011 I Street, NW
- Suite 300
- Washington, D.C. 2005
- 202-973-1558/mkuletz_at_gwu.edu
2Learning Objectives
- To discuss diversity in terms of vocational
rehabilitation practices - Develop strategy for exploring cultural diversity
- Explore ethics as related to professional
practice with diverse populations - Analyze case studies for culturally diverse
populations
3What is Culture?
4Culture
- The sum total of ways of living including
values, beliefs, esthetic standards, linguistic
expression, patterns of thinking, behavioral
norms, and styles of communication which a group
of people develop to assure their survival in a
particular physical and human environment.
5Cross Cultural Awareness
6Cross Cultural Awareness
- Refers to the basic ways of learning that
behavior and ways of thinking and perceiving are
cultural conditioned rather than being universal
aspects of human nature. In this learning,
unconscious, culturally-based assumptions and
values held by individuals are brought to the
surface.
7Cultural Competence
8Cultural Competence
- The ability of individuals to see beyond the
boundaries of their own cultural interpretations,
to be able to maintain objectivity when faced
with individuals from cultures different from
their won and to be able to interpret and
understand the behaviors and intentions of people
form other cultures nonjudgmental and without
bias.
9Terms
- INSTITUTIONAL BEHAVIOR (FAMILY POLITICAL
RELIGIOUS ECONOMICAL) ASSOCIATIONS - VALUES THESE ARE DEFINED ASBELIEFS THAT LEAD
TO ACTION (E.G. "WORK IS GOOD FOR YOUR
CHARACTER" "IT IS GOOD TO BE A VEGETARIAN"). - NORMS ARE DEFINED ASIMPLICIT RULES OF BEHAVIOR
(EG., BEING PUNCTUAL GETTING UP EARLY). - ROLES THESE ARE DEFINED AS PERFORMANCE OF
FUNCTIONS (E.G. "LOVING" MOTHER"SUBMISSIVE"
WIFE "EMPATHIC COUNSELOR").
10- STATUS RELATIVE POSITION IN A PRESTIGE
HIERARCHY (EG., ECONOMIC,SOCIAL, PROFESIONAL). - MINORITY A GROUP THAT RANKS AS SUBORDINATE,
BASED ON DIFFERENTIALPOWER OR POPULATION
SIZE.MINORITY MEMBERSHIP IS TRANSMITTED BY RULE
OF DESCENT OF SPECIFIC CULTURAL AND/OR PHYSICAL
TRAITS THAT ARE HELD IN LOWESTEEM BY DOMINANT
SOCIETY.
11- DOMINANT A GROUP WITH COMMON HISTORY, VALUES AND
LANGUAGE SEEKING TO ADVANCE OWN INTERESTS OVER
THOSE OF OTHER GROUPS BASED ON ECONOMIC AND
POLITICAL POWER. - ETHNOCENTRISM THE DOMINANT GROUP ASSUMES THAT
SURVIVAL OF THE GROUP AND SOCIETY DEPENDS ON
PERPETUATION OF OWN VALUES. - RACISM THE BELIEF ON RACE SUPERIORITY
(IDEOLOGICAL) NEED TO DEFINE OTHERS AS INFERIOR
(PSYCHOLOGICAL) STRUCTURED INEQUALITY JOB
BARRIERS LOW EDUCATIONAL OPPORTUNITTIESLOW
POLITICAL PARTICIPATION.
12- DISCRIMINATION DIFFERENTIAL AND UNEQUAL
TREATMENT OF THE MINORITY GROUPS BY THE DOMINANT
GROUP. E.G. WAGEDIFFERENTIALS UNEQUAL ACCESS
TO PROMOTION LOW ADMISSION RATES TO SCHOOLS,
ETC. WHEN DISCRIMINATION IS BASED ON RACE
DIFERENCES THEN IS CALLED RACISM, OR SEXISM WHEN
BASED ON SEX DIFFERENCES. - SEGREGATION ENFORCED PATTERN OF SETTLEMENT/USE
OF FACILITIESE.G., RESIDENTIAL RESTRICTIONS. IT
MAY BE BASED ONRACE, RELIGION, ETC. - PREJUDICE UNFAVORABLE ATTITUDES TOWARD A GROUP
OR INDIVIDUAL BECAUSE OF FALSE PERCEPTIONS OR
STEREOTYPES
13- SEGREGATION ENFORCED PATTERN OF SETTLEMENT/USE
OF FACILITIESE.G., RESIDENTIAL RESTRICTIONS. IT
MAY BE BASED ONRACE, RELIGION, ETC. - PREJUDICE UNFAVORABLE ATTITUDES TOWARD A GROUP
OR INDIVIDUAL BECAUSE OF FALSE PERCEPTIONS OR
STEREOTYPES - RELATIONSHIP PATTERNS BETWEEN DOMINANT AND
MINORITY GROUPSSTABILIZED ACCOMODATION BY WHICH
SUBORDINATION IS TAKEN FOR GRANTED
14- ASSIMILATION THAT THE INDIVIDUAL OR GROUP
ASSUMES THE IDENTITY AND BEHAVIORS OF THE
DOMINANT CULTURE - PLURALISM THE COEXISTENCE OF DIFFERENT GROUPS IN
WHICH EACHGROUP RETAINS ITS IDENTITY AND
BEHAVIORS. INTEGRATION OF DIFFERENT GROUPS BASED
ON INDIVIDUAL EQUALITY. - MELTING POT ALL DIFFERENT GROUPS MERGE INTO ONE
THAT IS THE PRODUCT OF THE MIX OF ALL CULTURES. - (Garcia, 2003)
15Cultural Perceptions (adapted from Collier, 2002)
16Cultural Perceptions
17Difference versus Disability
- The side effects of culture shock can look like
indicators of learning and behavior disabilities.
18Locus of control (LOC)
- Individuals who feel that LOC is external may not
feel that counseling is a credible source of
help. - Individuals with internal LOC more likely to take
action on their own behalf - ( Brown Lent, 1992)
19Ways to Value Diversity(Advancement Strategies,
1992)
B Be aware. Broaden your general knowledge of groups and cultures
I Include others Have a variety of people involved in activities and groups
N Never assume! Ask questions listen carefully check understanding
G Give Respect. Treat all people fairly, honestly, and with positive regard.
O Openly communicate. Share information, expectations and unwritten rules with everyone
20Number of Persons with Disabilities
- Debates continue concerning how many of us are
disabled, however. Depending on the criteria
used, estimates vary from a low of about 36.1
million (LaPlante, 1992) to about 54 million
(National Council on Disability, 1997).
21STAGES OF MULTICULTURAL DEVELOPMENT (Pederson,
1999)
- AWARENESS
- KNOWLEDGE
- SKILLS
22Awareness
-
- ABILITY TO JUDGE A CULTURAL SITUATIONFROM ONE'S
OWN AND THE OTHER'S CULTURAL VIEWPOINT. - AWARENESS REQUIRES
- - RECOGNIZE COMMUNICATION STYLES (E.G.,
VERBAL VS NON VERBAL) - - SENSITIVITY TO NONVERBAL CUES (E.G.,
PROXEMICS OR HOW CLOSE A PERSON GETS TO ANOTHER
WHEN INTERACTING KINETICS OR HOW A PERSON
EXPRESSES HROUGH GESTURES, ETC) -
RECOGNIZE CULTURAL AND LINGUISTIC
DIFFERENCES - SENSITIVITY TO MYTHS AND
STEREOTYPES (E.G., ALL LATINOS ARE MACHISTAS
ALL LATINO WOMEN ARE SUBMISSIVE) OF THE
CULTURE
23Awareness requires.
-
- - CONCERN FOR WELFARE OF
OTHERS - ARTICULATE ELEMENTS OF OWN
CULTURE (E.G., FORMALITY, LINEAR THINKING, FOCUS
ON VERBAL COMMUNICATION, NUCLEAR FAMILY, ETC.)
- APPRECIATE IMPORTANCE OF
MULTICULTURAL TEACHING - AWARENESS OF
RELATIONSHIPS BETWEEN CULTURAL GROUPS (E.G.,
RACISM, SIMILARITIES) - JUDGING
"GOODNESS" AND "BADNESS" IN THE OTHER CULTURE
(FROM THE OTHER CULTURE'S PERSPECTIVE)
24KNOWLEDGE REQUIRES INFORMATION ABOUT
-
- - HISTORICAL EXPERIENCES (E.G.,
INTERNMENT, WARS, ETC.) - TEACHING AND
LEARNING RESOURCES - ROLES OF
EDUCATION - SOCIOECONOMIC
BACKGROUNDS - VALUES, ATTITUDES,
BEHAVIORS - CUSTOMS, SLANG -
LEARNING STYLES AND WAYS OF THINKING -
KNOWLEDGE ABOUT OWN CULTURE IN RELATION TO THE
OTHER - PROFESSIONAL EXPERTISE IN AN
AREA VALUED BY THE OTHER CULTURE
25SKILL DEVELOPMENT
- - APPROPRIATE TEACHING/LEARNING TECHN
IQUES AND STYLE FOR WORK IN THE
OTHER CULTURE - EMPATHY WITH
PERSONS FROM OTHER CULTURE 9E.G., IDENTIFY
FEELINGS CORRECTLY) - ABILITY TO
RECEIVE AND ANALYZE FEEDBACK FROM PERSONS OF
THE OTHER CULTURE -
ABILITY TO DEVELOP NEW METHODS FOR WORK IN THE
OTHER CULTURE (E.G., MORE OR LESS DIRECTIVE, MORE
OR LESS FAMILY ORIENTED MORE OR LESS VERBAL,
ETC).
26- CULTURALLY BIASED ASSUMPTIONS
- THE FOLLOWING IS A LIST OF FALSE ASSUMPTIONS
THAT WE MAKE ABOUT OTHERS
27-
-
- - BELIEVING THAT WE SHARE A COMMON VIEW OF WHAT
"NORMAL" MEANS. - BELIEVING THAT INDIVIDUALS
INSTEAD OF GROUPS ARE THE BASIC BLOCKS OF
SOCIETY - THINKING THAT OTHERS WILL UNDERSTAND
OUR ABSTRACT WORDS THE SAME WAY WE DO. THIS MEANS
THAT WE NEED TO PAY MORE ATTENTION TO CONTEXT SO
OTHERS CAN UNDERSTAND WHAT THE CONCEPT MEANS
(E.G., FAIRNESS, HUMANE, BAD, ETC.) - THE
BELIEF THAT INDEPENDENCEDESIRABLE AND DEPENDENCE
UNDESIRABLE. FOR EXAMPLE IN MANY CULTURES
INTERDEPENDENCE IS MORE IMPORTANT THAN
INDEPENDENCE AS A GOAL FOR A PERSON WITH A
DISABILITY. - BELIEVING THAT FORMAL COUNSELING
IS BETTER THAN NATURAL SUPPORT. IN MANY CULTURES
THIS MAY BE THE OPPOSITE.
28-
- - THE ASSERTION THAT LINEAR THINKING IS THE NORM
(DEPENDENCE ON MEASURES CAUSE AND EFECT)
THINKING OTHER CULTURES MAY VALUE COMPLEMENTARITY
(TWO ASPECTS OF THE SAME REALITY) INSTEAD OF
CAUSE-EFFECT RELATIONSHIPS BETWEEN TWO
EVENTS. - THE BELIEF THAT INDIVIDUALS NEED TO
FIT THE SYSTEM INSTEAD OF THE SYSTEM FITTING THE
INDIVIDUAL..- BELIEVING THAT HISTORICAL CONTEXT
IS NOT RELEVANT AND THAT COUNSELORS NEED TO FOCUS
ON IMMEDIATE EVENTS PRIMARILY. MANY TIMES
UNDERSTANDING THE CLIENT'S PERSPECTIVE
REQUIRES KNOWLEDGE OF HISTORICAL BACKGROUND THAT
THE CLIENT FEELS IS RELEVANT.- THE BELIEF THAT
WE ALREADY KNOW ALL OUR CULTURALLY-BIASED
ASSUMPTIONS. WE NEED TO UNDERSTAND THAT OTHER
GROUPS MAY HAVE DIFFERENT ASSUMPTIONS SO WE CAN
INTEGRATE OR COORDINATE THOSE ASSUMPTIONS WITH
OURS.
29SKILLS RELATED TO RECOGNIZING SPECIFIC CLIENT
RESISTANCE
30- COPING THE CLIENT MAY BE UNABLE TO COPE WITH
THE STRESS OF THE SESSION - VALUES CONFLICT IT MAY BE THAT THE CLIENT
PERCEIVES THE COUNSELOR IS JUST RESPONDING TO HIS
OR HER OWN VALUES. - OPEN VS CLOSED QUESTIONS THE CLIENT MAY BE MORE
COMMUNICATIVE WHEN ASKED OPEN QUESTIONS - DIRECTIONS THE CLIENT MAY NEED SOME SPECIFIC
STEPS THAT HE/SHE MAY AGREE TO TAKE.
31- CONFRONTATION IT MAY BE THAT THE COUNSELOR
NEEDS TO BRING UP THE CONTRADICTION THAT THE
CLIENT IS FACING (E.G., "YOU SAY YOU ARE ANGRY
ABOUT YOUR EMPLOYER BUT YOUR ACTIONS DO NOT
REFLECT THAT"). - INTERPRETATION BE AWARE THAT YOUR
INTERPRETATION OF THE CLIENT'S PROBLEM MAY BE
OFFENSIVE TO HIM (E.G., "WHAT YOU SEEM TO NEED IS
GOING BACK TO YOUR COUNTRY"). - FOCUS ON TOPIC THIS IS WHEN THE COUNSLOR DRIFTS
AWAY FROM WHAT THE CLIENT WANTS TO FOCUS ON
(E.G., FOCUS ON JOB INSTEAD OF RACISM). - FOCUS ON GROUP YOU MAY BE TALKING ABOUT LATINOS
IN GENERAL WHEN THE CLIENT WANTS TO TALK ABOUT
HIS INDIVIDUAL SELF.
32- SELF-AWARENESS THE COUNSELOR MAY NEED TO BECOME
AWARE OF HIS/HER ATTITUDE DURING THE SESSION
(E.G., BEING PATERNALISTIC INSTEAD OF RESPECTING
THE CLIENT).
33- SKILLS RELATED TO DIMINISHING THE COUNSELOR'S
OWN DEFENSIVENESS WHEN WORKING WITH CLIENTS FROM
DIFFERENT CULTURES
34- SENSE OF HUMOR COUNSELORS DO NOT HAVE TO BE
AFRAID OF USING HUMOR WHEN THEY FEEL THEY MADE A
MISTAKE (E.G., MAKING THE WORNG JUDGEMENT ABOUT
THE CLIENT'S CULTURAL IDENTITY). - SELF DISCLOSURE COUNSELORS CAN MAKE
SELF-DISCLOSURES WHICH ARE USUALLY VERY
APPROPRIATE IN MULTICULTUTAL COUNSELING AS LONG
AS THEY DO NOT DOMINATE THE SESSION (E.G., "AS A
CHILEAN I CAN UNDERSTAND HOW YOU FEEL ABOUT HUMAN
RIGHTS VIOLATIONS"). - DESCRIPTIVE THE COUNSELOR NEEDS TO BE
NONJUDGEMENTAL ABOUT THE CLIENT FROM OTHER
CULTURE WHICH REDUCES COUNSELOR DEFENSIVENESS.
35- SPONTANEITY THIS HAS TO DO WITH BEING GENUINE
AS WELL WHICH MAY REDUCE THE COUNSELOR FEARS
ABOUT THE CLIENT'S CULTURE. - RECEPTIVITY BEING OPEN AND RESPONSIVE TO THE
CLIENT'S COMMUNICATIONS ABOUT THE COUNSELOR'
CULTURE. - ADMITTING DEFENSIVENESS THE COUNSELOR IS BETTER
OFF BY COMMUNICATING TO THE CLIENT HIS
DEFENSIVENESS IN AN APPROPRIATE WAY (E.G., " YOU
MUST KNOW THAT I FELT VERY RELUCTANT TO ADDRESS
THAT TOPIC AT THE BEGINNING").
36- APOLOGIZING THE COUNSLOR CAN APOLOGIZE
APPROPRIATELY FOR MAKING A JUDGMENT ABOUT THE
CLIENT (E.G., "EXCUSE ME FOR TAKING YOUR COMMENT
AS OFFENSIVE"). - MANPULATION DO NOT BE AFRAID TO MAKE
SUGGESTIONS AND/OR GUIDE YOUR CLIENT/CUTOMER -
SOMETIMES CLIENTS APPRECIATE SUGGESTIONS WHEN
THEY FEEL IT IS IN THEIR BEST INTEREST.
37- RESPECT CULTURAL DIFFERENCES WHEN COUNSELING
DIFFERENT CULTURAL GROUPS
38ETHICAL PRINCIPLES
- Ethical Principles
- Translation of our beliefs about what we value
- Rules of conduct that are derived from values
39Ethical Principles
- Beneficence
- Autonomy
- Nonmaleficience
- Justice
- Fidelity
40BENEFICENCE
- Definition - (be-nef-e-sens)
- Helping others further their important and
legitimate interests, Do the Right Thing - Justification
- Society has an obligation to provide help
- Society is responsible for the handicap of
individuals - Counselors information re customer/client
situation increases obligation to promote good
41NONMALEFICENCE
- Nonmaleficence
- Definition (non-mal-ef-e-sens)
- Working at and/or ensuring that no harm, no
evil preventing negligence or harm from
happening - Justification
- Civilized societies are responsible for doing no
harm to clients.
42AUTONOMY
- Concept
- Self-governance, liberty, privacy and being
ones own person - Definition
- Counselors are required to recognize and
- honor the client/customer freedom of choice to
control their own lives
43JUSTICE
- Definition
-
- The fair allocation of caseload resources and
monies to clients -
- Fair allocation of the counselors time to
provide services and achieve outcomes
44FIDELITY
- Definition
- Keeping promises or commitments being loyal to
clients/customers, agencies and organizations - Justifications
- Mutual trust based upon commitment and
promises - Unequal relationship between client and
- counselor mandates counselor honesty
45CRC Code of Professional Ethics for
Rehabilitation Counselors
- Adopted in June 2001 by the Commission on
Rehabilitation Counselor Certification - Effective January 1, 2002
46Code of Ethics
- Developed in response to the Rehabilitation Act
of 1973 - Developed, in part, as a response to the
need/desire to professionalize the field
47Section of Code
- A The Counseling Relationship
- B Confidentiality
- C Advocacy and accessibility
- D Professional responsibility
- E Relationships with other professionals
- F. Evaluation, assessment, and interpretation
- G Teaching, training, supervision
48CRC Code of Ethics
- H Research and publication
- I Electronic communications and emerging
applications - J Business practices
- K Resolving ethical issues
49A.2. Respecting diversity
- a. Respecting culture
- b. Interventions
- c. Non-discrimination
50C.1. Advocacy
51D.1. Professional Competence
52DATA
- 45 of Rehabilitation Counselors attempt to
resolve dilemmas without any consideration of
ethical principles - (Wright, Emener, 1996)
- 75 of Counselors believe that ethical dilemmas
are increasing - (Patterson, 1999)
53Data
- The Ethics Resource Center 2000 survey found that
when ethics training and written ethics standards
(Code of Ethics) were in place, employees were
54Data
- Less likely to feel pressured to compromise
ethics standards - Less likely to observe misconduct in peer or
supervisors - More satisfied with their organizations
- More likely to see themselves as valued members
of the organization
55-
- What are the characteristics/criteria of an
ethical dilemma?
56Characteristics/Criteria of an Ethical Dilemma
- A choice must be made between two courses of
action - Significant consequences are present for taking
either course of action - Each course of action can be supported by one or
more of the ethical principles - The ethical principles supporting the unchosen
course of action will be compromised
57Ethical Decision Making Models
- Rational
- Integrative
- Transcultural Integrative
58Rational model
- Identify the Problem
- Apply the CRC Code of Ethics
- Determine the nature and dimensions of the
dilemma. - Generate potential courses of action
- Consider the potential consequences of all
options, choose a course of action.
59Ethical model continued.
- Evaluate the selected course of action
- Implement the course of action
60Transcultural Integrative Model
- Description The transcultural integrative model
for ethical decision-making in counseling
addresses the need for including cultural factors
in the process of ethical dilemma resolution.
This transcultural model incorporates
state-of-the-art concepts from multicultural
theory into an ethical decision making model that
borrows primarily from the integrative model
developed by Tarvydas.
61Outline of Model
62Step 1
- 1.Interpret the situation through awareness and
fact-finding. The goals here are to determine
our sensitivity and awareness about the variables
involved, to reflect about the dilemma involved,
to determine the major stakeholders and to extend
our knowledge about the facts of the case. From
the cultural standpoint it means
63Step 1 continued.
- (a) To examine our own emotions and attitudes
related to this case and analyze to what extent
we are satisfied with our knowledge about the
clients culture and issues of cultural identity,
acculturation, gender role socialization, and the
work skills of the client
64Step 1 continued.
- (b) To reflect about the nature of the dilemma
and see whether different worldviews of the
counselor and client may lead to different
courses of action.
65Step 1 continued
- (c) To determine the parties involved in the
dilemma and examine how close or opposed they are
from clients values.
66Step 1 continued
- (d) To gather as much cultural information as
relevant to the case, such as immigration
history, family composition and community
relationships
67Step 2
- Formulate an ethical decision or course of
action. This step involves basically the same
steps that comprise the rational ethical dilemma
resolution model, but under the transcultural
model the counselor needs to consider the
cultural aspects involved.
68Considerations
- a. To make sure that after compiling new
cultural information about the situation the
counselor still hold the same opinion about he
nature of the dilemma
69Considerations
- (b) To examine the ethics code of the counselors
professional association, laws, and ethical
principles that may apply to the case, in
addition to examining the institutional policies
and procedures that may impact on this case.
70Considerations
- (c) To generate reasonable courses of action
based on an analysis of the case and taking into
account the different worldviews involved.
71Considerations
- (d) To consider all the positive and negative
consequences of each of the courses of action
identified above, including the impact on aspects
valued by the culture of the client
72Considerations
- (e) To consult with colleagues or experts with
knowledge about multicultural counseling to see
whether the courses of action reflect culturally
appropriate analysis.
73Considerations
- (f) To determine which is the best course of
action, based on a review of the information
gathered in step 1 plus the examination of the
courses of action in step 2. At this point, the
counselor may decide that course of action 3 is
the best since it accounts for the client values
and responds to the interests and values of the
other parties involved. The course of action
must also be compatible with the ethical
principles that support it, such as autonomy
defined from the cultural perspective of the
client, or fairness to the parties involved.
74Step 3
- Planning and executing the course of action
selected.
75Considerations
- a. To formulate steps that are consistent with
the general plan of action
76Considerations
- b. To develop strategies (e.g. negotiation,
consensus building) to counter possible barriers
to the implementation of the course of action
chosen, such as their own personal values
collegial, institutional or societal values and
regulations, as well as client doubts, employer
biases, or professional prejudices
77Considerations
- c. To evaluate the plan of action, which entails
collecting valid and reliable information that
has both universal (applicable to all people) and
cultural (applicable to the specific clients
culture) meaning.
78Case Study
79Case Study
- Maria is a Latina from a rural area in El
Salvador who moved to the United States three
years ago and while working as a cook (she has a
work permit) in a restaurant she fell from a high
set of stair and suffered a moderate brain injury
that left her with physical and cognitive
sequelae that has prevented her to work in the
last six months she is married but her husband
is back in El Salvador and very rarely sends her
monetary support. She lives with her three
children and three members of her extended family
(who hold unskilled occupations) in the US. She
has been sent to a VR counselor who is a
Caucasian female with five years of
experience. She is unsure about going back to
work or staying on disability benefits. She has
also sought legal advise from a refugee center
who provides those kind of services and attends a
bilingual support group held at a local
multicultural counseling center. She is unsure
about returning or continuing to work, or just
staying on disability benefits. This is a dilemma
for the VR counselor who has to find the best
solution to this conflict
80Step 1
- (a) To examine our own emotions and attitudes
related to this case and analyze to what extent
we are satisfied with our knowledge about the
clients culture and issues of cultural identity,
acculturation, gender role socialization, and the
work skills of the client for example, the
counselor may have negative attitudes toward
immigrants and experience angry feelings toward
them to the extent that she would like to
recommend Nancy to go back to her own country it
could also mean that the counselor needs to
gather more information about Marias
acculturation which can be done by asking
questions about how she feels toward the dominant
culture, her English language skills, or her
preferences and behavior. The counselor can also
ask Maria about her role as a woman in her family
and with respect to her husband (gender role
socialization).
81Step 1 continued
- (b) To reflect about the nature of the dilemma
and see whether different worldviews of the
counselor and client may lead to different
courses of action for example the counselor may
have strong feelings about work as a central part
of her belief structure whereas Maria may believe
that family is the central value. One belief
could lead to perceive work at any cost as the
only option and the other to consider what would
be the best for the family.
82Step 1 continued..
- (c) To determine the parties involved in the
dilemma and examine how close or opposed they are
from Marias values. For example, Maria can
give more credence to the report presented by a
family member than to the one presented by
somebody who is using her cultural values against
her (e.g. she believes in family values so she
needs to return to El Salvador).
83Step 1 continued
- (d) To gather as much cultural information as
relevant to the case, such as immigration
history, family composition and community
relationships. For example, one of the facts
could be that she is here as a refugee and going
back to her country is not an option.
84Step 2
- (a) To make sure that after compiling new
cultural information about Maria, the counselor
still holds the same opinion about the nature of
the dilemma or whether this has changed (e.g.,
the counselor now believes that she needs to find
options for Maria here in the US).
85Step 2 continued
- (b) To examine the ethics code of the counselors
professional association, laws, and ethical
principles that may apply to the case, in
addition to examining the institutional policies
and procedures that may impact on this case. For
example, the counselor should review the
diversity standards contained in the code, which
could shed some light as to the options the
counselor should consider. The counselor may
also find that the immigration laws favor or
damage Marias aspirations, or that the
institutional policies have strict regulations
about working with bilingual clients. From an
ethical principle perspective, the counselor
needs to examine the cultural interpretation pf
principles such as autonomy, beneficence, and
justice, to name some. For example, autonomy of
the family could mean more to the client than her
own individual autonomy.
86Step 2.
- (c) To generate reasonable courses of action
based on an analysis of the case and taking into
account the different worldviews involved. In
consequence, some potential courses of action
could be to first give priority to an employment
outcome by establishing this as an absolute goal,
second to give priority to the future of the
family by establishing that benefits could be of
most value to Maria and her family, or third, to
find a middle ground that would mean continue
working on an employment option but considering
the input and goals of the family.
87Step 2
- (d) To consider all the positive and negative
consequences of each of the courses of action
identified above, including the impact on aspects
valued by the culture of Maria and her
family. For example, the employment option could
lead to guilt feelings in her family members who
see as their responsibility to take care of her.
88Step 2
- (e) To consult with colleagues or experts with
knowledge about multicultural counseling to see
whether the courses of action reflect culturally
appropriate analysis. For example, a colleague
from a different cultural background may believe
that the counselor may be offending Maria by
stereotyping her as a dependent, submissive
woman, without taking into account her level of
acculturation.
89Step 2.
- (f) To determine which is the best course of
action, based on a review of the information
gathered in step 1 plus the examination of the
courses of action in step 2. At this point, the
counselor may decide that course of action 3 is
the best since it accounts for the client values
and responds to the interests and values of the
other parties involved. The course of action
must also be compatible with the ethical
principles that support it, such as autonomy
defined from the cultural perspective of the
client, or fairness to the parties involved.
90Step 3
- (a) To formulate steps that are consistent with
the general plan of action. Such steps could
include Reaching consensus with the parties
involved through negotiation and consensus
building activities evaluation of the brain
injury sequelae, analysis of transferable skills
(if applicable), and conduct a job analysis that
would all result in appropriate long-term
vocational goals engaging the client in job
development and placement motivating the client
to actively participate and exercise her choice
rights waiting until the client and family
members are ready for placement and until then
continue with disability benefits working with
employers and service providers (including DSS
personnel) toward the plan and evaluate the
implementation of the plan.
91- (b) To develop strategies to counter possible
barriers to the plan such as client doubts,
employer biases, or professional prejudices. For
example, the counselor may set up support
meetings with the client, schedule regular
meetings with employers, or bring the case in
professional meetings on a regular basis.
92- c) To evaluate the plan of action, which entails
collecting valid and reliable information, that
has both universal and cultural meaning. For
example, the counselor may establish bi-weekly
meetings with Maria, the her family and the
employer to obtain information about motivation,
work performance, and overall satisfaction
(universal) but also collect information about
cultural aspects such as potential cultural
prejudice, language difficulties, relationship
with peers, and cultural compatibility of the
job. A relational method that implies keeping
all the parties informed and in agreement should
be the counselors general strategy.
93Counselor, Know ThyselfCulturally Skilled
Counselors Should
- Be aware and sensitive to his/her own cultural
heritage - Be aware of his/her values and biases and how
these biases may affect minority consumers - Be comfortable with cultural/racial differences
that exist between themselves and the consumers
they serve - Be sensitive to circumstances that may dictate
referral of minority consumers to a member of
their own race/suture or to another counselor in
general.
94- Possess specific knowledge and information about
the value systems and work views of the
particular minority group he/she is working with - Have a good understanding of the socio-political
systems that operate in their geographical region
with respect to the treatment and service
delivery for minorities - Have a clear and explicit knowledge and
understanding of generic characteristics of
counseling and theory. - Adapted from Sue Sue (1990)
95Ethical Considerations for the Rehabilitation
Professional Serving Culturally Diverse
Populations
- Maureen McGuire-Kuletz, Ed.D., CRC
- Director/Assistant Research Professor
- George Washington University RRCEP
- 2011 I Street, NW, Suite 300
- Washington, D.C. 2005
- 202-973-1558
- mkuletz_at_gwu.edu
- This information is the intellectual property of
the George Washington University and is to be
used for training purposes only.