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Cultural Diversity

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Abstract:

In this chapter we present the theoretical and practical underpinnings of our culturally competent practice in psychology model. This contextually based model complements traditional clinical interventions by providing psychotherapists with a conceptual frame to guide culturally sensitive psychotherapy practice. To accomplish this goal we begin the chapter by providing an overview of the literature on cultural competence and describe several prominent cultural competency definitions, models, and guidelines. Second, we review individualistic, relational, and contextual interventions, and propose an integrative multidimensional approach in which we address strengths and weaknesses of these interventions vis-à-vis cultural competence guidelines. Third, we outline a three stage model with specific interventions that clinicians can use to enhance their cultural sensitivity in working with diverse clients. Derived from an integrative multidimensional approach, these three stages are: 1) addressing chief complaints and reducing symptoms, 2) understanding narratives, and 3) fostering empowerment. Fourth, we illustrate this approach with a clinical example and conclude with a discussion of the possibilities and challenges posed by these ideas as well as areas for future research.

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References

  • Abreu, J. M., & Gabarain, G. (2000). Social desirability and Mexican American counselor preferences: Statistical control for a potential confound. Journal of Counseling Psychology, 47, 165–176.

    Article  Google Scholar 

  • Alvidrez, J., Azocar, F., & Miranda, J. (1996). Demystifying the concept of ethnicity for psychotherapy research. Journal of Consulting and Clinical Psychology, 64, 903–908.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • American Psychological Association. (2002). Ethical principles of psychologists and code of conduct. American Psychologist, 57, 1060–1073.

    Google Scholar 

  • American Psychological Association. (2003). Guidelines on multicultural education, training, research, practice, and organizational change for psychologists. American Psychologist, 58, 377–402.

    Google Scholar 

  • American Psychological Association. (2006). Evidence-based practice in psychology: APA presidential task force on evidence-based practice. American Psychologist, 61, 271–285.

    Google Scholar 

  • Anchin, J. C. (2008). Contextualizing discourse on a philosophy of science for psychotherapy integration. Journal of Psychotherapy Integration, 18, 1–24.

    Article  Google Scholar 

  • Angus, L. E., & Mcleod, J. (Eds.). (2004). Handbook of narrative and psychotherapy. London: Sage.

    Google Scholar 

  • Arredondo, P., & Toporek, R. L. (2004). Multicultural counseling competencies: Ethical practice. Journal of Mental Health Counseling, 26, 44–55.

    Google Scholar 

  • Arredondo, P., Toporek, R. L., Brown, S., Jones, J., Locke, D. C., Sanchez, J., et al. (1996). Operationalization of the multicultural counseling competencies. Alexandria, VA: Association for Multicultural Counseling and Development.

    Google Scholar 

  • Arredondo, P., Toporek, R., Brown, S. P., Sanchez, J., & Stadler, H. (1996). Operationalization of the multicultural counseling competencies. Journal of Multicultural Counseling and Development, 24, 42–78.

    Article  Google Scholar 

  • Ballou, M., Matsumoto, A., & Wagner, M. (1992). Toward a feminist ecological theory of human nature: Theory building in response to real-world dynamics. In Ballou, M., & Brown, L. (Eds.), Rethinking mental health and disorder: Feminists perspectives. New York: Guilford.

    Google Scholar 

  • Beck, A. T. (1967). Depression: Causes and treatment. Philadelphia: University of Pennsylvania Press.

    Google Scholar 

  • Beck, A. T. (1991). Cognitive therapy: A 30-year retrospective. American Psychologist, 46, 368–375.

    Article  PubMed  Google Scholar 

  • Berry, J. W., & Kim, U. (1988). Acculturation and mental health. In Dansen, P. R., Berry, J. W., & Sartorius, N. (Eds.), Health and cross-cultural psychology (pp. 207–236). Newbury Park, CA: Sage.

    Google Scholar 

  • Betancourt, H., & López, S. (1993). The study of culture, ethnicity and race in American psychology. American Psychologist, 48, 629–637.

    Article  Google Scholar 

  • Breuer, J., & Freud, S. (1895). Studies on hysteria. London: Hogarth Press.

    Google Scholar 

  • Brown, L. S. (1994). Subversive dialogues: Theory in feminist therapy. New York: Basic Books.

    Google Scholar 

  • Bruner, J. (1990). Acts of meaning. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Bonham, V. L., Warshauer-Baker, E., & Collins, F. S. (2005). Race and ethnicity in the genome era: The complexity of the constructs. American Psychologist, 60, 9–15.

    Article  PubMed  Google Scholar 

  • Carter, R. T., & Qureshi, A. (1995). A typology of philosophical assumptions in multicultural counseling and training. In Ponterotto, J. G., Casas, J. M., Suzuki, L. A., & Alexander, C. M. (Eds.), Handbook of multicultural counseling (pp. 239–262). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Christopher, M. S., & Skillman, G. D. (2009). Exploring the link between self-construal and distress among African American and Asian American college students. Journal of College Counseling, 12, 44–56.

    Article  Google Scholar 

  • Comas-Diaz, (2006). Cultural variation in the therapeutic relationship. In Goodheart, C. D., Kazdin, A. E., & Sternberg, R. J. (Eds.), Evidence-based psychotherapy: Where practice and research meet. Washington, DC: American Psychological Association.

    Google Scholar 

  • Constantine, M. G., & Ladany, N. (2001). New visions for defining and assessing multicultural counseling competence. In Ponterotto, J. G., Casas, J. M., Suzuki, L. A., & Alexander, C. M. (Eds.), Handbook of multicultural counseling (pp. 482–498). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Constantine, M. G., & Sue, D. W. (Eds.). (2005). Strategies for Building Multicultural Competence in Mental Health and Educational Settings. Hoboken, NJ: Wiley & Sons.

    Google Scholar 

  • Cushman, P. (1995). Constructing the self, constructing America: Studies in the cultural history of psychotherapy. New York: Addison-Wesley.

    Google Scholar 

  • D’Andrade, R. (1990). Some propositions about the relationship between culture and human cognition. In Stigler, J., Shweder, R., & Herdt, G. (Eds.), Cultural psychology: Essays on comparative human development (pp. 88–120). New York: Cambridge University Press.

    Google Scholar 

  • Davis, P., & Donald, B. (1997). Multicultural counseling competencies: Assessment, evaluation, education and training, and supervision. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Epston, D., & White, M. (1992). Consulting your consultants: The documentation of alternative knowledges. In Epston, D., & White, M. (Eds.), Experience, contradiction, narrative and imagination. Adelaide, Australia: Dulwich Centre.

    Google Scholar 

  • Fowers, B. J., & Davidov, B. J. (2006). The virtue of multiculturalism: Personal transformation, character, and openness to the other. American Psychologist, 61, 581–594.

    Article  PubMed  Google Scholar 

  • Fowers, B. J., & Richardson, F. (1996). Why is multiculturalism good? American Psychologist, 51, 609–621.

    Article  Google Scholar 

  • Freud, S. (1933). New introductory lectures on psychoanalysis. Standard Edition. London: Hogarth.

    Google Scholar 

  • Garro, L. C. (2003). Narrating troubling experiences. Transcultural Psychiatry, 40, 5–44.

    Article  PubMed  Google Scholar 

  • Garro, L. C. (2005). “Effort after meaning” in everyday life. In Casey, C., & Edgerton, R. B. (Eds.), A companion to psychological anthropology: Modernity and psychocultural change (pp. 48–71). Oxford: Blackwell.

    Google Scholar 

  • Geertz, C. (1973). Interpretation of cultures. New York: Basic Books.

    Google Scholar 

  • Gelso, C., & Mohr, J. (2001). The working alliance and the transference-countertransference relationship: Their manifestation with racial/ethnic and sexual orientation minority clients and therapists. Applied and Preventive Psychology, 10, 51–66.

    Article  Google Scholar 

  • Gergen, K. (1991). The saturated self: Dilemmas of identity in contemporary life. New York: Basic Books.

    Google Scholar 

  • Gold, J., & Watchel, P. (1993). Cyclical psychodynamics. In Stricker, G., & Gold, J. (Eds.), Comprehensive handbook of psychotherapy integration. New York: Plenum.

    Google Scholar 

  • Guarnaccia, P. J., & Rodriguez, O. (1996). Concepts of culture and their role in the development of culturally competent mental health services. Hispanic Journal of Behavioral Sciences, 18, 419–443.

    Article  Google Scholar 

  • Hall, C. C. I. (1997). Cultural malpractice: The growing obsolescence of psychology with the changing U.S. population. American Psychologist, 52, 642–651.

    Article  PubMed  Google Scholar 

  • Haynes, R. B., Devereaux, P. J., & Guyatt, G. H. (2002). Physicians’ and patients’ choices in evidence based practice: Evidence does not make decisions, people do. British Medical Journal, 324, 1350–1414.

    Article  PubMed  Google Scholar 

  • Herman, J. L. (1992). Trauma and recovery: The aftermath of violence from domestic abuse to political terror. New York: Basic Books.

    Google Scholar 

  • Helms, J., & Cook, D. (1999). Using race and culture in counseling and psychotherapy. Boston: Allyn & Bacon.

    Google Scholar 

  • Helms, J. E., Jernigan, M., & Macher, J. (2005). The meaning of race in psychology and how to change it: A methodological perspective. American Psychologist, 60, 27–36.

    Article  PubMed  Google Scholar 

  • Horowitz, M. J. (1986). The stress response syndromes. Northvale, NJ: Jason Aronson.

    Google Scholar 

  • Jordan, J. V., & Surrey, J. L. (1983). Women and empathy: Implications for psychological development and psychotherapy. Wellesley, MA: Stone Center for Developmental Services and Studies.

    Google Scholar 

  • Jordan, J. V., Walker, M., & Hartling, L. M. (2004). The complexity of connection: Writings from the Stone Center’s Jean Baker Miller Training Institute. New York: Guilford.

    Google Scholar 

  • Kazarian, S., & Evans, D. (1998). Cultural clinical psychology: Theory, research and practice. New York: Oxford University Press.

    Google Scholar 

  • Kazdin, A. E. (2008). Evidence-based treatment and practice: New opportunities to bridge clinical research and practice, enhance the knowledge base, and improve patient care. American Psychologist, 63, 146–159.

    Article  PubMed  Google Scholar 

  • Kohut, (1984). How does analysis cure? Chicago: University of Chicago Press.

    Google Scholar 

  • Klein, M. (1955). New directions in psycho-analysis; the significance of infant conflict in the pattern of adult behaviour. New York: Basic Books.

    Google Scholar 

  • Kleinman, A. (1988). The illness narratives: Suffering, healing, and the human condition. New York: Basic Books.

    Google Scholar 

  • Kleinman, A. (2001). A psychiatric perspective on global change. Harvard Review of Psychiatry, 9, 46–47.

    Article  PubMed  Google Scholar 

  • Klerman, G. L., Weissman, M. M., Rounsaville, B. J., & Chevron, E. S. (1984). Interpersonal psychotherapy for depression. New York: Basic Books.

    Google Scholar 

  • Lakes, K., López, S. R., & Garro, L. C. (2006). Cultural competence and psychotherapy: Applying anthropologically informed conceptions of culture. Psychotherapy: Theory, Research, Practice, & Training, 43, 380–396.

    Article  Google Scholar 

  • Landrine, H., & Klonoff, E. A. (1996). African American acculturation. Thousand Oaks, CA: Sage.

    Google Scholar 

  • La Roche, M. (1999). Culture, transference, and countertransference among Latinos. Psychotherapy, 36, 389–397.

    Article  Google Scholar 

  • La Roche, M. (2002). Psychotherapeutic Considerations in treating Latinos. Harvard Review of Psychiatry, 10, 115–122.

    Article  PubMed  Google Scholar 

  • La Roche, M. (2005). The cultural context and the psychotherapeutic process: Towards a culturally sensitive psychotherapy. Journal of Psychotherapy Integration, 15, 169–185.

    Article  Google Scholar 

  • La Roche, M., & Christopher, M. S. (2008). Culture and empirically supported treatments: On the road to a collision? Culture and Psychology, 14, 333–356.

    Article  Google Scholar 

  • La Roche, M., & Maxie, A. (2003). Ten considerations in addressing cultural differences in psychotherapy. Professional Psychology: Research and Practice, 34, 180–186.

    Article  Google Scholar 

  • Lehrman, S. (2006). The implicit prejudice. Scientific American, 294, 32–34.

    Article  PubMed  Google Scholar 

  • López, S. R. (1997). Cultural competence in psychotherapy: A guide for clinicians and their supervisors. In Watkins, C. E. (Ed.), Handbook of psychotherapy supervision (pp. 570–588). New York: Wiley.

    Google Scholar 

  • López, S. R., & Guarnaccia, P. (2000). Cultural psychopathology: Uncovering the social world of mental illness. Annual Review of Psychology, 51, 571–598.

    Article  PubMed  Google Scholar 

  • López, S. R., Kopelowicz, A., & Canive, J. M. (2002). Strategies in developing culturally congruent family interventions for schizophrenia: The case of Hispanics. In Lefley, H. P., & Johnson, D. L. (Eds.), Family interventions in mental illness: International perspectives (pp. 61–90). Westport, CT: Praeger.

    Google Scholar 

  • Marsella, A. J. (1998). Toward a “global-community psychology”: Meeting the needs of a changing world. American Psychologist, 53, 1282–1291.

    Article  Google Scholar 

  • Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50, 370–396.

    Article  Google Scholar 

  • Maslow, A. H. (1969). Toward a psychology of being. Princeton, NJ: Van Nostrand.

    Google Scholar 

  • Mattingly, C. (2008). Reading minds and telling tales in a cultural borderland. Ethos, 36, 136–154.

    Article  PubMed  Google Scholar 

  • McIntosh, P. (1988). White privilege: Unpacking the invisible knapsack (Working Paper 189). Wellesley, MA: Wellesley College Center for Research on Women.

    Google Scholar 

  • Miller, J. B., & Stiver, I. P. (1997). The healing connection: How women form relationships in therapy and in life. Boston: Beacon.

    Google Scholar 

  • Mitchell, S. (1988). Relational concepts in psychoanalysis: An integration. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Moghaddam, F. M., & Studer, C. (1999). Cross-cultural psychology: The frustrated gadfly’s promises, potentialities, and failures. In Fox, D., & Prilleltensky, I. (Eds.), Critical psychology: An introduction. New York: Sage.

    Google Scholar 

  • Muñoz, R. F., & Mendelson, T. (2005). Toward evidence-based interventions for diverse populations: The San Francisco General Hospital prevention and treatment manuals. Journal of Consulting and Clinical Psychology, 73, 790–799.

    Article  PubMed  Google Scholar 

  • National Council of Schools and Programs in Professional Psychology (NCSPP). (2002). Diversity competency statement. Retrieved July 9, 2008, from http://www.ncspp.info/div.htm.

  • National Council of Schools and Programs in Professional Psychology (NCSPP). (2007). Competency developmental achievement levels (DALS). Retrieved July 13, 2008, from http://www.ncspp.info/DALof%20NCSPP%209-21-07.pdf.

  • Norasakkunkit, V., & Kalick, S. M. (2002). Culture, ethnicity, and emotional distress measures: The role of self-construals and self-enhancement. Journal of Cross-Cultural Psychology, 33, 56–70.

    Article  Google Scholar 

  • Norcross, J. C., & Goldfried, M. R. (Eds.). (2005). Handbook of psychotherapy integration. New York: Oxford University Press.

    Google Scholar 

  • Peterson, F., Coleman, F., Dobbins, J., & Boyce, J. (2002). Understanding the importance of cultural competency in consultation, psychotherapy and supervision. In VandeCreek, L., & Jackson, T. (Eds.), Innovations in clinical practice: A source book (pp. 343–354). Sarasota, FL: Professional Press.

    Google Scholar 

  • Phinney, J. S. (1996). When we talk about American ethnic groups, what do we mean? American Psychologist, 51, 918–927.

    Article  Google Scholar 

  • Pope-Davis, D. P., & Dings, J. G. (1995). The assessment of multicultural counseling competencies. In Ponterotto, J. G., Casas, J. M., Suzuki, L. A., & Alexander, C. M. (Eds.), Handbook of Multicultural Counseling (pp. 287–311). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Prilleltensky, I. (1999). Values, assumption and practice: Assessing the moral implications of psychological discourse and action. American Psychologist, 53, 202–213.

    Google Scholar 

  • Ridley, C. (2001). Building self-esteem in racially diverse populations. Christian Counseling Today, 9, 46–49.

    Google Scholar 

  • Rogers, C. (1961). On becoming a person. Boston: Houghton Mifflin.

    Google Scholar 

  • Rowe, D. C. (2002). IQ, birth weight, and number of sexual partners in White, African American, and mixed race adolescents. Populations, 23, 513–524.

    Article  Google Scholar 

  • Ryder, A. G., Yang, J., Zhu, X., Yao, S., Yi, J., Heine, S. J., et al. (2008). The cultural shaping of depression: Somatic symptoms in China, psychological symptoms in North America? Journal of Abnormal Psychology, 117, 300–313.

    Article  PubMed  Google Scholar 

  • Saldaña, D. H. (2001), Cultural competency: A practical guide for mental health service providers. San Antonio, TX: Foundation for Mental Health.

    Google Scholar 

  • Samuda, R. J., Feuerstein, R., Kaufman, A. S., Lewis, J. E., & Sternberg, R. J. (1998). Advances in cross-cultural assessment. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Shweder R. J. (1995). Cultural psychology: What is it? In Rule-Goldberger, N., Bennet, J., & Veroff, M. (Eds.), The culture and psychology reader (pp. 41–86). New York: New York University Press.

    Google Scholar 

  • Sternberg, (2006). Evidence-based practice: Gold standard, gold plated, or fool’s gold? In Goodheart, C. D., Kazdin, A. E., & Sternberg, R. J. (Eds.), Evidence-based psychotherapy: Where practice and research meet. Washington, DC: American Psychological Association.

    Google Scholar 

  • Stricker, G., & Gold, J. R. (Eds.). (1993). Comprehensive handbook of psychotherapy integration. New York: Plenum.

    Google Scholar 

  • Sue, D. W. (2001). Multidimensional facets of cultural competence. Counseling Psychologist, 29, 790–821.

    Article  Google Scholar 

  • Sue, D. W., Arredondo, P., & Mc Davis, R. J. (1992). Multicultural counseling competencies and standards: A call to the profession. Journal of Counseling and Development, 70, 477–483.

    Article  Google Scholar 

  • Sue, D. W., Bernier, J., Durran, M., Feinberg, L., Pedersen, P., Smith, E., et al. (1982). Position paper: Cross-cultural counseling competencies. Counseling Psychologist, 10, 45–52.

    Article  Google Scholar 

  • Sue, D. W., Carter, R. T., Casas, J. M., Fouad, N. A., Ivey, A. E., Jensen, M., LaFromboise, T., Manese, J. E., Ponterotto, J. G., & Vazquez–Nutall, E. (1998). Multicultural counseling competencies: Individual and organizational development. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Sue, D. W. & Sue, D. (2007). Foundations of counseling and psychotherapy: Evidence-based practices for a diverse society. New York: Wiley.

    Google Scholar 

  • Sue, D. W., & Torino, G. (2005). Racial cultural competence: Awareness, knowledge and skills. In Carter, R. T. (Ed.), Handbook of multicultural psychology and counseling (pp. 3–18). New York: Wiley.

    Google Scholar 

  • Sue, S. (1998). In search of cultural competence in psychotherapy and counseling. American Psychologist, 53, 440–448.

    Article  PubMed  Google Scholar 

  • Sue, S. (1999). Science, ethnicity and bias: Where have we gone wrong? American Psychologist, 54, 1070–1077.

    Article  PubMed  Google Scholar 

  • Sue, S. (2003). In defense of cultural competency in psychotherapy and treatment. American Psychologist, 58, 964–970.

    Article  PubMed  Google Scholar 

  • Sullivan, H. S. (1953). The interpersonal theory of psychiatry: A systematic presentation of the later thinking of one of the great leaders in modern psychiatry. New York: W.W. Norton.

    Google Scholar 

  • Task Force on the Promotion and Dissemination of Psychological Procedures. (1995). Training in dissemination of empirically-validated psychological treatments. The Clinical Psychologist, 48, 3–23.

    Google Scholar 

  • Tseng, W. S., & Streltzer, J. (2001). Culture and psychotherapy. New York: American Psychiatric.

    Google Scholar 

  • U.S. Department of Health and Human Services. (1999). Mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.

    Google Scholar 

  • U.S. Department of Health and Human Services. (2001). Mental health: Culture, race and ethnicity – A supplement to mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Public Health Services, Offices of the Surgeon General.

    Google Scholar 

  • Wampold, B. E. (2007). Psychotherapy: The humanistic (and effective) treatment. American Psychologist, 62, 855–873.

    Article  PubMed  Google Scholar 

  • Whaley, A. L., & Davis, K. E. (2007). Cultural competence and evidence-based practice in mental health services: A complementary perspective. American Psychologist, 62, 563–574.

    Article  PubMed  Google Scholar 

  • Winnicot, D. W. (1969). Playing and reality. New York: Routledge.

    Google Scholar 

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La Roche, M.J., Christopher, M.S. (2010). Cultural Diversity. In: Thomas, J.C., Hersen, M. (eds) Handbook of Clinical Psychology Competencies. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09757-2_4

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