The world of the Counselor An introduction to the counseling profession 5e chapter 15

 Hispanics: People of Central American, South American, and Caribbean Origin  48 million Americans 16%  Many from Mexico, Puerto Rico, and Cuba  Each has unique history and culture 

Knowledge & Skills of Multicultural

Counseling

 Over 33% of Americans are racial and ethnic minorities

 Midway through this century minorities will constitute over

50% of the American population

 See Figure 15.1, p 501

 Today, vast majority of immigrants are Latin American and

Asian

 Changing religious demographics

 Changes in sex-role identity

 Increased sensitivity to people from different groups

 A Disclaimer: As you read about the various cultural groups, particularly about behaviors unique to those groups,

remember that some may embrace the unique behaviors and values of their culture of origin but others may not

Don’t ever forget the “individual.”

 African Americans

 42 million Americans (14%)

 90% descendants of slaves

 6-10 million died in route from Africa

 Laws restricting education, work, etc well into 1970s

 37% of all hate crimes against African Americans

 Recently rediscovered their heritage (symbolized by Kwanza)

 Group oriented, value cooperation and interdependence

 Hispanics: People of Central American, South American, and

Caribbean Origin

 48 million Americans (16%)

 Many from Mexico, Puerto Rico, and Cuba

 Each has unique history and culture

 Best to have knowledge of client’s country of origin

 Extended family is emphasized

 Interdependence over independence

 Respect based on age, SES, gender, and perceived importance

 Patriarchal

 Many embrace Catholic values while at the same time believe

in “cultural fatalism”

 People of Asian and Pacific Island Origin

 Includes people from 25 countries

 Many from: China, Philippines, Korea, India, Vietnam, Hawaii

 Unique histories why they sought refuge in U.S.

 Some similar values:

▪ Children tend to be obligated to parents

▪ Family members highly interdependent

▪ Generally patriarchal

▪ Guilt and shame to control behavior of family members

▪ Pride themselves in controlling feelings

▪ Formality in social relationships

▪ Mind and body seen as one

▪ Physical complaints way of expressing psychological problems



 Native Americans

 5 million Americans are Native American and one other race

 3.2 million (1.0%) only Native American

 120,000 are Alaskan Native

 Many different Native Americans with unique histories

 Millions killed by disease or war brought over from Europe

 1.5% of Americans are American Indian heritage

▪ Six tribes = 40%, 252 languages, 22% on reservations

 Many social problems on reservations

 Mental health viewed from a spiritual/holistic perspective.

 Sense of Sense of shared cultural and common core values

1. Have the right attitudes and beliefs, gain knowledge, and

learn skills

2. Encourage clients to speak their own language

3. Assess the cultural identity of the client

4. Check the accuracy of your interpretation of the client’s

nonverbals

5. Make use of alternate modes of communication

6. Assess the impact of sociopolitical issues on the client

7. Encourage clients to bring in culturally significant and

personally relevant items

8. Vary the helping environment

 79 religious groups each having over 60,000 members in U.S.

 Great variety of religions in U.S (see Table 14.1, p 471)

 83% claim a religious affiliation and 88% say religion is fairly

or very important

 Different histories and cultures

 Difference between religion and spirituality:

 Religion is “the organized set of beliefs that encode a person or group’s attitudes toward, and understanding of, the nature of reality” (Ericksen, 2008, pp 510-511)

 Spirituality is: “mindfulness about the existential qualities

of life, especially the relationship between self, other, and the world” (Ericksen, 2008, pp 510–511)

 Brief Descriptions of Some Religions

 Buddhism:

 6th century B.C.E in India

 Based on the Tripaka teachings of Gautama Siddhartha;

after becoming enlightened, became known as the Buddha

 6% of world population

 Four truths:

1. the truth of suffering

2. the cause of suffering, which is desire

3. the cessation of suffering, which is the renunciation of desire

4. the way that leads to the cessation of suffering

 We are born and reborn based on our separation from the divine

 Reincarnation is the road to unity with the divine

1 profess their faith to Allah

2 pray five times a day

3 give regularly a portion of their material wealth to charity

4 fast daily until sundown during the month of Ramadan

5 attempt to make at least one pilgrimage to Mecca

 Judaism

 1300 B.C.E

 0.2 percent of world population

 Particularly long history of oppression

 Largely assimilated into American culture while holding onto Jewish heritage

 Based on Hebrew Bible which includes the five books of Moses (called the Torah)

 12% of all hate crimes committed against Jews Jews make

up 2% of U.S population

 See ASERVIC Fourteen Competencies, pp 512-513

 Six Core Values

 Culture and World View

 Counselor Self-Awareness

 Human and Spiritual Development

 Communication

 Assessment

 Diagnosis and Treatment

 See Box 15.1, p 512: Religion as Projection of Self

 Today, many differences exist between men and women (see Table 15.1, p 514)

 Gender-Aware Therapy

 makes gender central to the therapeutic process

 views problems within a societal context

 encourages counselors to actively address gender injustices

 encourages the development of collaborative and equal relationships

 respects the client’s right to choose the gender roles appropriate for himself or herself

 Women have unique concerns

 Division 17 of APA developed 11 guiding principles for

working with girls and women (see Box 15.2, p 516)

 Twelve steps:

1 Have right attitudes and beliefs, gain knowledge, and learn skills

2 Ensure that the counseling approach has been adapted for women

3 Establish relationship, give up power, demystify the process

4 Identify social/political issues and use them to set goals

5 Use a wellness model and avoid the use of diagnosis and labels.

6 Validate a woman’s angry feelings toward her predicament.

7 Actively promote healing through learning about women’s issues

8 Provide a safe environment to express feelings

9 Provide a safe environment to understand their anger toward men

10 Help with conflicting feelings between traditional and new values

11 Facilitate integration of client’s new identity

 Thirteen Steps:

1 Have the right attitudes and beliefs, gain knowledge, and learn skills

2 Accept men where they are, as this will help build trust

3 Don’t push men to express what may be considered “softer feelings”

4 Early on in therapy, validate the man’s feelings

5 Validate his view of constraints by male sex-role stereotypes

6 Have a plan for therapy

7 Begin to discuss developmental issues

8 Slowly encourage the expression of new feelings (see Box 15.2, p 518)

9 Explore underlying issues and reinforce new ways of understanding

10 Explore behavioral change

11 Encourage integration of new feelings, thoughts, and actions

12 Encourage new male relationships

 Kinsey studies found much variability in sexuality

 Many Americans sill hold heterosexist attitudes which probably

reflect unconscious fear of the “other”

 48% of American continue to believe that being gay, bi, or lesbian is morally wrong (see Box 15.3, p 520

 However, has been gains in Americans support of gays, lesbians, and bisexuals

 18% of hate crimes against individuals due to sexual orientation

 APA has normalized homosexuality in the 1970s

 Transgenderism: person who does not identify with his or her birth

sex and lives in congruence with the sex to which he or she identifies

 Transsexual: Disidentifies with his or her sex and uses hormones

and/or surgery to realign his or her sex with gender identity

 Eleven Steps:

1 Have the right attitudes and beliefs, gain knowledge, and learn skills

2 Have a gay, lesbian, bisexual-friendly office

3 Help gays, lesbians, and bisexuals understand and combat oppression

4 Adopt an affirmative and nonheterosexist attitude

5 Don’t jump to conclusions about lifestyle

6 Understand differences among gays, lesbians, and bisexuals

7 Know community resources for gay men and lesbian women

8 Know identity issues

9 Understand the complexity of sexuality

10 Understand idiosyncrasies of religious views of homosexuality

11 Recognize the importance of addressing unique issues that some gays, lesbians, and bisexuals may face

 Individuals Who Are HIV Positive

 Over 1 million people in U.S are HIV positive

 56,000 new cases of HIV arise each year

 18,0000 individuals die of the disease each year

 600,000 Americans have died of AIDS since disease was identified

 33 million children and adults are living with HIV

 67% of world’s cases in sub-Saharan Africa

 Counseling Individuals Who Are HIV-Positive

1. Have the right attitudes and beliefs, gain knowledge, and learn skills

2. Know the cultural background of the client

3. Know about the disease and combat myths

4. Be prepared to take on uncommon counselor roles

5. Be prepared to deal with unique treatment issues

6. Deal with your own feelings about mortality

7. Understand legal and ethical implications relative to end-of-life decisions

8. Offer a “strength-based” approach to treatment

 The Hungry, Homeless, and the Poor

 700,000 Americans homeless on any particular day

 3.5 million homeless in one year

 Increasingly include women, children, and families

 Many are mentally ill

 37% of homeless have chronic substance abuse

 Counseling the Hungry, the Homeless, and the Poor

1. Have the right attitudes and beliefs, gain knowledge, and

learn skills

2. Focus on social issues

3. Know the client’s racial/ethnic/cultural background

4. Be knowledgeable about health risks

5. Be prepared to deal with multiple issues

6. Know about developmental delays and be prepared to refer

7. Know psychological effects

8. Know resources

9. Be an advocate and stay committed

 Older Persons

 In 1900 4% of population was over 65

 By 2030, 20% of U.S will be over 65

 Older persons have become increasingly diverse

 Older persons have a high percentage of mental health needs but attend counseling at lower rates

 There has been an increase in day-treatment programs and long-term facilities

 Counseling Older Persons

1. Have the right attitudes and beliefs, gain knowledge, and

learn skills

2. Adapt your counseling style

3. Build a trusting relationship

4. Be knowledgeable about issues many older persons face

5. Know about possible and probable health changes

6. Have empathy for changes in interpersonal relationships

7. Know about physical and psychological causes of sexual

dysfunction

8. Involve the client’s family and friends

 The Chronically Mentally Ill

 1955:over ½ million hospitalized for mental illness

 Today, few than 100,000 hospitalized Due to:

▪ New and better drugs

▪ Community Mental Health Centers Act

▪ Deinstitutionalization (Donaldson v O’Connor)

 Today, 4000 psychiatric facilities in U.S

 26% of Americans diagnosed with a mental disorder every year (see Figure 15.3, p 527)

 26% of homeless may have severe psychiatric problems

 Counseling the Chronically Mentally Ill

1 Have the right attitudes and beliefs, gain knowledge, and learn skills

2 Help the client understand his or her mental illness

3 Help the client work through feelings concerning his or her mental illness

4 Ensure attendance in counseling

5 Ensure compliance with medication

6 Ensure accurate diagnosis

7 Reevaluate the client’s treatment plan and do not give up

8 Involve the client’s family

9 Know resources

 Almost 50 million people 5 and older have a disability

 Often discriminated against

 More likely to have a disability if you are in the South, are

poor, and are a minority

 Number of federal laws had an impact on the ability of

individuals with disabilities to receive services:

 Education for All Handicapped Children Act of 1975 (PL 142)

94- Individuals with Disabilities Education Act (IDEA)

 Rehabilitation Act of 1973

 Americans with Disabilities Act of 1992

 Counseling People with Disabilities

1. Have the right attitudes and beliefs, gain knowledge and learn skills

2. Have knowledge of the many disabling conditions

3. Help clients know their disabilities

4. Assist the client through the grieving process

5. Know referral resources

6. Know the law and inform your client of the law

7. Be prepared to do, or refer for, vocational/career counseling

8. Include the family

9. Be an advocate

 Is all Counseling Multicultural? Where do you stand? (see below)

 First counselor asserts: “All counseling is multicultural, for

everyone is different and just because you’re African American, Asian, or Hispanic or whatever, doesn’t mean you’re more

different than the person I counsel who comes from the same background as me but still has some different values than I have.”

 Second counselor retorts: “You do not understand what it’s like to

be culturally different To assert that all counseling is multicultural just shows your ignorance” Clearly, some individuals have roots in their unique culture, are dramatically different from you, and you best learn about their unique culture if you are to work with them effectively.

 Client-Counselor Match vs Cultural Competence?

 Ethical codes may hold some bias

 Some suggest using the “moral underpinnings of the code

instead of the code”

 However, these “moral models” may also be biased

 Make wise ethical decisions when dealing with multicultural issues

 The Ongoing Process of Counseling the Culturally Different

 Counseling methods are not fixed—be open to new methods

 “Not ours, not theirs; no one way of counseling surpasses another As cultures differ, so must counseling.”

(Romano, 1992, p 1)