8. Psychotherapy with Members of Diverse Populations
7 guidelines for working the Asians
- emphasize formalism in therapy (e.g., by addressing family members in a way that reflects their status and respecting conversational distances) - be aware that the functions of shame and obligation in Asian cultures is to reinforce adherence to prescribed roles and responsibilities - recognize that modesty and self-deprecation are not necessarily signs of low self-esteem - establish credibility and competence early in therapy (e.g., by disclosing information about your educational background and experience) - prevent premature termination by providing the client with an immediate and meaningful benefit - be aware that Asian clients may express their mental health problems as somatic complaints - focus behaviors > emotions
what is an important issue for LGBT indiviuals?
"coming out" and disclosing one's sexual orientation to family members, friends, and others
ho'oponopono
- "setting it right" - a traditional Hawaiian spiritual healing ritual for restoring harmony among family members be resolving a current conflict or other interpersonal problem
American Indian/Alaskan Native orientation to life
- exhibit a spiritual and holistic orientation to life that emphasizes harmony with nature - regards illness as the result of disharmony
indigenous healing practices
- culture-specific ways of dealing with human problems and distress - may be involved in the therapeutic interventions for clients from culturally diverse groups
3 examples of indigenous healing practices
- curanderismo - ho'oponopono - sweat lodge ceremony
guidelines for working with Hispanics/Latinos
- emphasize "personalismo" (except during initial contacts when "formalismo" is preferred) - be aware that Hispanic/Latino families are basically patriarchal, that sex roles tend to be relatively inflexible, and that the parent-child bond is often stronger than the husband-wife and other family relationships - recognize that differences in degree of acculturation within a family are often a source of individual and family problems - consider the impact of religious and spiritual factors - be aware the Hispanic/Latino clients may express their mental health problems as somatic complaints
Hispanic/Latino view of individual vs family
- emphasize family welfare over individual welfare - stress allegiance to family over other concerns
White Racial Identity Development Model: immersion-emersion status
- explores what is means to be White, confronts his/her own biases, and begins to understand they ways he/she benefits from White privilege - this status is characterized by increased experiential and affective understanding of racism and oppression
Black Racial (Nigrescence) Identity Development Model - stage 2: encounter
- exposure to a single significant race-related event or series of events - leads to greater racial/cultural awareness and an interest in developing a Black identity
how do Blacks view family?
- family is often an extended kinship network that includes both nuclear and extended family members as well as individuals outside the biological family - for many, the church is an important part of the extended family
Savin-Williams and Diamond (2000) compared the sexual identity trajectories of male and female sexual minority youth in terms of four milestones. what were the milestones?
- first same-sex attraction - self-labeling - first same-sex sexual contact - first disclosure
therapy guidelines for working with Native Americans
- focus on building trust and credibility during initial sessions by demonstrating familiarity with and respect for the client's culture and admitting any lack of knowledge - adopt a collaborative, problem-solving, client-centered approach that avoids highly directive or confrontational techniques - incorporate elders, medicine people, and other traditional healers into the treatment process
high-context communication
- grounded in the situation - depends on group understanding - relies heavily on nonverbal cues - helps unify a culture - slow to change
White Racial Identity Development Model: contact status
- has little awareness of racism and of his/her racial identity - may exhibit unsophisticated behaviors that reflect racist attitudes and beliefs (e.g., may consistently base judgements of members of minority groups on White society's standards)
3 substage orientations of internalization in the Black Racial (Nigrescence) Identity Development Model
- pro-Black, non-racist (Afrocentric) - biculturist - multiculturalist
Black Racial (Nigrescence) Identity Development Model - stage 4: immersion-emersion
- race and racial identity have high salience during this stage - split into 2 substage attitudes
Black Racial (Nigrescence) Identity Development Model - stage 1: pre-encounter
- race and racial identity have low salience during this stage - split into 3 substage identities
Black Racial (Nigrescence) Identity Development Model - stage 5: internalization
- race continues to have high salience - split into 3 orientations
low-context communication
- relies primarily on the explicit, verbal part of a message - less unifying - can change rapidly and easily
3 characteristics shared by non-Western indigenous practices according to Lee, Oh, and Mountcastle (1992)
- rely on community and family networks to care for the disturbed individual - the religious and spiritual practices of the community are integrated into the healing process - the healing process is often conducted by a traditional healer or other respected member of the community
how do Blacks view family roles?
- roles within Black families are flexible - relationships between men and women tend to be egalitarian - adults and children may adopt multiple roles
Herek (2004) argues that the term homophobia is ambiguous and imprecise. what 3 terms does he propose it should be replaced with?
- sexual stigma - heterosexism - sexual prejudice
there is evidence that the increased prevalence of psychological disturbances is not due to sexual orientation itself but to the prejudice and discrimination that LGBT individuals encounter because of their sexual orientation. what supports this stance?
- social withdrawal and isolation are common response to stigmatization - internalized homophobia
Homosexual Identity Development Model - stage 3: identity assumption
- the individual becomes more certain of his/her homosexuality - may deal with this realization in a variety of ways (e.g., by trying to "pass" as heterosexual, by aligning him/herself with the homosexual community, or by acting in ways consistent with society's stereotypes about homosexuality)
Asian view of family structure and gender roles
adhere to a hierarchical family structure and traditional gender roles
Hispanic/Latino approach to life
adopt a concrete, tangible approach to life (rather than an abstract, long-term perspective)
there is evidence that lesbian, gay, bisexual, and transgender (LGBT) individuals have higher rates of certain psychological problems. what might these be?
as a group, youth who identify as nonheterosexual are more likely than their heterosexual peers to experience: - depression - anxiety - substance sue - higher risk of suicidality
internalized oppression
can involve: - system beating (acting out against the system), - system blaming, - total avoidance of Whites, and/or - denial of the political significance of race
split-self syndrome
characterized by polarizing oneself into "good" and "bad" components, with the bad components representing one's Black identity
a client in stage 5 (integrative awareness) of the Racial/Cultural Identity Development Model is likely to prefer what kind of therapist?
clients in this stage place greater emphasis on similarity in worldview, attitudes, and beliefs than on ethnic, racial, or cultural similarity
a client in this category is nondisclosing to Black and White therapists, with nondisclosure being due to a combination of pathology and the effects of racism
confluent paranoiac
American Indian/Alaskan Native perception of talking vs listening
consider listening more important than talking
how does communication style (high- vs low-context) affect therapy?
differences in communication style can lead to misunderstandings in cross-cultural therapy ex. an Anglo therapist may misinterpret a Black client's reliance on nonverbal communication as an unwillingness to communication or a lack of verbal ability
what is the IPS for the autonomy status?
flexibility and complexity
a client in stage 2 (dissonance) of the Racial/Cultural Identity Development Model is likely to prefer what kind of therapist and perceive this issues how?
from a racial/cultural minority group personal problems as being related to racial/cultural identity problems
a client in stage 3 (resistance and immersion) of the Racial/Cultural Identity Development Model is likely to prefer what kind of therapist and perceive this issues how?
from the same racial/cultural group as them personal problems are the result of oppression
a client in stage 4 (introspection) of the Racial/Cultural Identity Development Model is likely to prefer what kind of therapist?
from their own group but are more open to therapists who are a similar worldview
clients in this category are nondisclosive to both Black and White therapists
functional paranoiac
what is the goal when working with the healthy cultural paranoiac?
goals of treatment are to: - confront the meaning of the client's paranoia (ie., to help the client bring into conscious awareness his/her antipathy toward Whites) - correct the presenting problem - an important part of treatment is helping the client develop disclosure flexibility - combining disclosure flexibility with appropriate therapist self-disclosure may increase the client's willingness to self-disclose to a White therapist
clients in this category self-disclose to a Black therapist but are reluctant to disclose to a White therapist due to past experiences with racism and/or to the White therapist's attitudes and beliefs
healthy cultural paranoiac
confluent paranoiac
high functional paranoia high cultural paranoia nondisclosure due to both pathology and previous experiences with racism
functional paranoiac
high functional paranoia low cultural paranoia nondisclosure is due primarily to pathology
what type of communication (high- or low-context) is characteristic of many culturally diverse groups in the United States?
high-context communication
what is the IPS for the immersion-emersion status?
hypervigilance and reshaping
Homosexual Identity Development Model - stage 4: commitment/identity integration
individuals have adopted a homosexual way of life and publicly disclose their homosexuality
self-hatred substage of pre-encounter
individuals in the anti-Black substage have accepted negative beliefs about Blacks and, as a result, are likely to have low self-esteem
assimilation substage of pre-encounter
individuals in this substage have adopted a mainstream identity
biculturist orientation of the internalization stage
integrates a Black identity with a White or other salient cultural identity
multiculturist orientation of the internalization stage
integrates a Black identity with two or more other salient cultural identities
a client in this category is willing to self-disclose to a Black or White therapist
intercultural nonparanoiac discloser
conceptual incarceration
involves adopting a White, Anglo-Saxon Protestant worldview and lifestyle
Uncle Tome syndrome
involves adopting a passive or "happy-go-lucky" demeanor
playing it cool
involves concealing anger or other unacceptable feelings by acting composed and calm
etic approach
involves viewing people from different cultures as essentially the same
how does sexual prejudice affect behavior?
like other attitudes, it does not always accurately predict specific behaviors. however, heterosexual individuals with high levels of sexual prejudice against homosexuals are more likely than those with low levels to: - respond negatively to gay individuals, - support antigay political candidates and policies, and - discriminate against gay people
healthy cultural paranoiac
low functional paranoia high cultural paranoia disclose to Black therapist; nondisclosure/reluctance towards White therapist is due to past experiences with racism
intercultural nonparanoiac discloser
low functional paranoia low cultural paranoia willingly disclose to all types of therapists
what type of communication (high- or low-context) is characteristic of Euro-American cultures?
low-context communication
sexual prejudice
negative attitudes that are based on sexual orientation, whether the target is homosexual, bisexual, or heterosexual
what type of therapy does LaFromboise et al. (1990) recommend when working with Native Americans?
network therapy
therapist-client matching with Black clients
not necessary however, when a therapist is not Black, it is often useful to discuss the client's reaction to having a therapist of a different racial/ethnic background during the initial session
what is the IPS for the contact status?
obliviousness and denial
Hispanic/Latino view of locus of control
often attribute the control of life events to luck, supernatural forces, acts of God, or other external factors
a client in stage 1 (conformity) of the Racial/Cultural Identity Development Model is likely to prefer what kind of therapist?
one from the majority group
assimilation
person accepts the majority culture while relinquishing his/her own culture
marginalization
person does not identify with his/her own culture or with the dominant culture
integration
person maintains his/her own (minority) culture but also incorporates many aspects of the dominant culture ** some refer to this as biculturalism
separation
person withdraws from the dominant culture and accepts his/her own culture
etic
phenomena that reflect a universal (culture-general) orientation
Asian view of individual vs group
place greater emphasis on the group (family, community) than on the individual
Helm's White Racial Identity Development Model
proposes that identity development involves two phases: - abandoning racism (statuses 1-3) - developing a nonracist White identity (statuses 4-6) each status is characterized by a different information processing strategy (IPS)
according to Helm, what is a central part of being White in American?
racism
what is the IPS for the reintegration status?
selective perception and negative out-group distortion
what is the IPS for the pseudo-independence status?
selective perception and reshaping reality
what does the research suggest about generalizations and stereotypes about certain groups?
some generalizations can be made about the characteristics or preferences of individuals belonging to a particular groups however, it is important not to stereotype therapy clients on the basis of their race/ethnicity, sexual orientation, or other characteristics
what is the IPS for the disintegration status?
suppression of information and ambivalence
what assumption is the sweat lodge based upon?
sweating combined with prayers and chanting, storytelling, and other rituals cleanses the body, mind, and spirit of impurities
what are the differences between a Euro-American (Western) worldview and non-Western indigenous treatments according to Sue and Sue (2003)?
the Western worldview emphasizes separation, isolation, and individualism non-Western indigenous treatments adopt a holistic perspective and stress interconnectedness and harmony
disclosure flexibility
the ability to recognize when it is appropriate or inappropriate to self-disclose
what is curanderismo based on?
the assumption that illness can arise from either natural or supernatural forces that affect physical, emotional, and/or spiritual functioning
giving
the client's perception that he/she has received something from therapy ex. anxiety reduction, normalization of the client's problems, skill acquisition, goal setting
credibility
the client's perception that the therapist is an expert and is trustworthy
acculturation
the degree to which a member of a culturally diverse group accepts and adheres to the values, attitudes, behaviors, etc., of his/her own group and the dominant (majority) group
what does Ridley (1984) note distrust of White mental health professional by members of ethnic minority groups is related to?
the fact that professionals often misinterpret a healthy, adaptive response to racism (cultural paranoia) as pathology (functional paranoia)
what is important for therapists to be familiar with when working with American Indian clients?
the historical events that have affected their lives and their relationships with Whites one consequence of their history is that American Indian clients may prefer a therapist who helps them reaffirm the values of their own culture and may be distrustful of a therapist's attempts to provide therapy in a "value-free" environment
information processing strategy (IPS)
the methods the individual uses in each stage to reduce discomfort related to racial issues
sexual stigma
the shared knowledge of society's negative regard for any nonheterosexual status differential between heterosexuals and homosexuals in which homosexuality is viewed as inferior to heterosexuality
to be culturally competent, what must therapists be aware of?
their assumptions, values, and beliefs (e.g., they are aware of their own cultural heritage and of values, attitudes, and beliefs that may be detrimental to members of culturally diverse groups
to be culturally competent, what skills must therapists use?
therapeutic modalities and interventions that are appropriate for culturally different clients (e.g., they do not automatically use the same techniques for all clients and recognize their limitations with regard to helping clients from diverse groups)
network therapy
therapy that incorporates family and community members into the treatment process and situates an individual's psychological problems within the context of his/her family, workplace, community, and other social systems
when working with an Asian American client, why is it important to be aware of his/her country of origin and acculturation status?
these factors will influence the client's language and customs, social relationships, and attitudes toward mental illness and psychotherapy Asian Americans include people of Chinese and Japanese heritage, Pacific Islanders, and Southeast Asians
Racial/Cultural Identity Development Model - stage 4: introspection
this stage is characterized by - uncertainty about the rigidity of beliefs held in Stage 3 and - conflicts between loyalty and responsibility toward one's group and feelings of personal autonomy
Racial/Cultural Identity Development Model - stage 1: conformity
this stage is characterized by: - positive attitudes toward and a preference for dominant culture values - deprecating attitudes toward one's own culture
Racial/Cultural Identity Development Model - stage 2: dissonance
this stage is marked by confusion and conflict over the contradictory appreciating and depreciating attitudes that one has toward the self and toward others of the same and different groups
heterosexism
- cultural ideologies, which are systems that provide the rationale and operating instructions that promote and perpetrate antipathy, hostility, and violence against homosexuals - includes beliefs about gender, morality, and sexuality that define sexual minorities as deviant or threatening - inherent in language, laws, and other cultural institutions
what is the optimal treatment when working with the confluent paranoiac?
- a combination of the approaches for functional and healthy cultural paranoiacs - therapist characteristics are VERY important for this type of client; therapist should probably be from the same racial/ethnic group
what type of approach is preferred when working with Asian clients?
- a directive, structured, goal-oriented, problem-solving approach that focuses on alleviating specific symptoms - cognitive-behavioral, solution-focused, and other brief therapies are often effective but may need to be modified so they focus more on the family than on an individual and take into account cultural and social factors
cultural paranoia
- a healthy reaction to racism - when client does not disclose to a White therapist due to a fear of being hurt or misunderstood
White Racial Identity Development Model: pseudo-independence status
- a personally jarring event or series of events causes the person to question his/her racist views and acknowledge the role that Whites have had in perpetrating racism - interested in understanding racial/cultural differences but does so only on an intellectual level
what does the ho'oponopono ritual entail?
- a structured process that is conducted by a senior family member or other respected elder - begins with identifying the problem, followed by discussions that lead to confession, restitution, and forgiveness - family members often share a meal as part of a termination ritual that completes the process
sweat lodge ceremony
- a traditional Native American healing practice - takes place in a domed structure (the sweat lodge) built around a pit containing stones that are heated several hours before the ceremony begins - participants sit in a circle around the pit and water is poured on the stones to create steam and intensify the heat
Savin-Williams and Diamond (2000) compared the sexual identity trajectories of male and female sexual minority youth in terms of four milestones. what were the gender differences?
- adolescent males have an earlier onset of all milestones except first disclosure of sexual orientation to another person - age at fist disclosure not significantly different for males and females
what approaches do several authorities recommend when working with Blacks?
- an ecostructural or ecological systemic approach (e.g., Boyd-Franklin's (1989) multisystems model for African American families) - time-limited, directive, goal-oriented, and problem-solving approach - foster empowerment - promote egalitarianism in the therapeutic relationship
functional paranoia
- an unhealthy condition that itself is an illness -when client is unwilling to disclose to any therapist, regardless of race or ethnicity, due to general mistrust and suspicion
what is a therapist credibility affected by?
- ascribed status (the therapist's assigned position or role) - achieved status (influenced by the therapist's ability to demonstrate adequate cultural knowledge)
3 identities in the pre-encounter stage of the Black Racial (Nigrescence) Identity Development Model
- assimilation - miseducation - self-hatred
Homosexual Identity Development Model - stage 2: self-recognition/identify confusion
- at the onset of puberty - the individual realizes that he/she is attracted to people of the same sex - attributes those feelings to homosexuality, which leads to turmoil and confusion
how is denial of the political significance of race due to internalized oppression manifested?
- attempting to earn acceptance by the conspicuous consumption of material goods, - using status and educational degrees to elevate one's self-worth, and/or - escaping through the use of drugs, food, etc.
White Racial Identity Development Model: reintegration status
- attempts to resolve the moral dilemmas associated with the disintegration status by idealizing White society and denigrating members of minority groups - may blame minority group members for their problems and view Whites as the victims of reverse discrimination
3 components of cultural competence
- awareness - knowledge - skills
what did Grove, Bimbi, Nanin, and Parsons (2006) find about age of coming out and gender and age differences?
- confirmed no gender-related differences in coming out to others - found that women and men ages 18-24 reported coming out to others at a significantly younger age than did older women and men
Hispanic/Latino view of disclosure
- consider discussing intimate personal details with strangers (e.g., a therapist) as highly unacceptable - believe that problems should be handled within the family or other natural support system
6 statuses of the White Racial Identity Development Model
- contact status - disintegration status - reintegration status - pseudo-independence status - immersion-emersion status - autonomy status
2 critical processes when working with culturally diverse clients
- credibility - giving
Ridley (1984) places nondisclosure by Black therapy clients in the context of two types of paranoia:
- cultural - functional
Herek (2000) notes that research on the correlates of sexual prejudice has generally found higher levels of prejudice among who?
- heterosexual men (vs heterosexual women) - individuals who are older - have lower levels of education - live in Southern and Midwestern states or in rural areas - have limited personal contact with homosexuals other studies have linked it to: - authoritarianism - affiliation with a fundamentalist religious denomination - conservative political views
worldview
- how a person perceives his/her relationship to nature, other people, institutions, and so on - impacted by the person's cultural background and experiences
immersion substage of the immersion-emersion stage
- idealizes Blacks and Black culture - feels a great deal of rage toward Whites - as well as guilt and anxiety about his/her own previous lack of awareness of race - Cross refers to the attitudes associated with this substage as intense Black involvement
2 substages in the immersion-emersion stage of the Black Racial (Nigrescence) Identity Development Model
- immersion - emersion
White Racial Identity Development Model: disintegration status
- increasing awareness of race and racism leads to confusion and emotional conflict - to reduce internal dissonance, the person may over-identify with members of minority groups, act in paternalistic ways toward them, or retreat into White society
4 categories of acculturation status described by Berry and his colleagues (1987)
- integration - assimilation - separation - marginalization
emersion substage of the immersion-emersion stage
- intense emotions subside - the individual rejects all aspects of the White culture - begins to internalize a Black identity - Cross refers to the attitudes associated with this substage as anti-White
Ridley's four disclosure modes based on type and level of paranoia
- intercultural nonparanoiac discloser - functional paranoiac - healthy cultural paranoiac - confluent paranoiac
Landrum and Batts (1985) address the effects of racial oppression on the mental health of Blacks and propose that the consequences may take several forms:
- internalized oppression - conceptual incarceration - split-self syndrome
White Racial Identity Development Model: autonomy status
- internalizes a nonracist White identity that includes an appreciation of and respect for racial/cultural differences and similarities - actively seeks out interactions with members of diverse groups
what do curanderismo healing sessions look like?
- led by a male or female healer (curandero or curandera) - combine religious and spiritual rituals with herbal medicine, massage, and traditional methods of healing
what two factors determine one's worldview?
- locus of control - locus of responsibility
consequences of internalized homophobia
- low self-esteem - self-doubt or self-hatred - a sense of powerlessness - denial of one's sexual orientation - self-destructive behavior
how are individuals in the internalization stage with a pro-Black, non-racist (Afrocentric) orientation characterized?
- may actively work to eradicate racism - in therapy, may exhibit healthy cultural paranoia
how do individuals progress through the stages of the Racial/Cultural Identity Development Model?
- may progress in a linear way - because of changes in cross-ethnic/cultural interactions and relationships, may remain at one stage or move forward or backward
Boyd-Franklin's (1989) multisystems model for African American families
- model that addresses multiple systems, intervenes at multiple levels, and empowers the family by utilizing strengths - systems that may be incorporated into treatment include the extended family and nonblood kin, the church and other community resources, and social service agencies
regressive interaction
- occurs when the client's level of racial identity development is at least one level more advanced than the level of the therapist - associated with conflict and early termination from therapy by the client
crossed interaction
- occurs when the statuses of the therapist and client represent opposite attitudes toward race (e.g., when a Black client is in the immersion-emersion stage and the therapist has predominantly contact status attitudes) - tend to be highly confrontational and contentious
parallel interaction
- occurs when the therapist and client have the same or similar levels of racial/cultural identity - although these interactions can produce mutual understanding and respect, they can also lead to inertia, especially when the therapist and client are at less advanced stages of identity development
progressive interaction
- occurs when the therapist's level of racial identity development is at least one level more advanced than the level of the client - according to Helms, this is the most effective interaction in therapy
Helms contends that a White therapist's identity status has an impact on the process and outcomes of therapy. her interactions model of counseling distinguishes between four types of interactions
- parallel interaction - progressive interaction - regressive interaction - crossed interaction
Racial/Cultural Identity Development Model - stage 3: resistance and immersion
- people in this stage actively reject the dominant society and - exhibit appreciating attitudes toward the self and toward members of their own group
American Indian/Alaskan Native perception of time
- perceive time in terms of personal and seasonal rhythms rather than in terms of the clock or calendar - more present- than future-oriented
how do American Indians/Alaskan Natives view the individual vs the whole?
- place greater emphasis on the extended family and tribe than on the individual - adhere to a consensual collateral form of social organization and decision-making
Sue and Sue (2003) describe 2 behaviors that Black individuals may adopt to disguise negative feelings that may be unacceptable to Whites and to protect themselves from being harmed or exploited. what are these survival mechanisms against oppression?
- playing it cool - Uncle Tom syndrome
what approach should be used with working with Hispanics/Latinos?
- therapist is best advised to be active and directive - adopt a multimodal approach that focuses on the client's behavior, affect, cognitions, interpersonal relationships, biological functioning, etc. - family therapy is recommended because it reinforces their view of 'familisomo' and the extended family
what is the best approach for working with the functional paranoiac?
- use interventions that are most effective for alleviating the client's pathology - the choice of a therapist should be based on competence rather than on race or culture
Homosexual Identity Development Model - stage 1: sensitization/feeling different
- usually characteristic of middle childhood - the individual feels different from his/her peers ex. the individual may realize that his/her interests differ from those of same-gender classmates
Asian view of the therapist
- view the therapist as a knowledgeable expert and authority figure - expect therapists to give concrete advice however, the therapist should also foster the participation of these clients by encouraging them to take part in identifying goals and solutions
Hispanic/Latino view of interdependence
- viewed as both healthy and necessary - highly value connectedness and sharing
when working with Blacks, what are 4 things a therapist should consider?
- worldview - family - roles in family - due to their history in the US, may exhibit signs of "healthy cultural paranoia"
5 stages of the Racial/Cultural Identity Development Model
1. conformity 2. dissonance 3. resistance and immersion 4. introspection 5. integrative awareness
4 stages of Cross's (2001) Black Racial (Nigrescence) Identity Development Model
1. pre-encounter 2. encounter 3. immersion-emersion 4. internalization
Troiden's 4 stages of Homosexual Identity Development Model
1. sensitization/feeling different 2. self-recognition/identity confusion 3. identity assumption 4. commitment/identity integration
differences in Cross's (1971, 1991, 2001) Black Racial (Nigrescence) Identity Development Model
1971: described identity development as involving a shift from Black self-hatred to Black self-acceptance and consisted of five stages (pre-encounter, encounter, immersion-emersion, internalization, and internalization-commitment) 1991: introduced the idea of race salience and reduced the number of stages to four 2001: expanded as part of the Cross Racial Identity Scale (CRIS) and included the same four stages as the 1991 model but expanded the pre-encounter stage to include 3 substage identities and the internalization stage to include 2 multiculturalist orientations
individuals in the second stage (encounter) of the Black Racial (Nigrescence) Identity Development Model usually prefer what kind of therapist?
Black
although coming out may result in rejection and other negative consequences, it also has beneficial effects. what are these?
Jordan and Deluty (1998) found that the more widely lesbians disclosed their sexual orientation to others, the more likely they were to report: - higher levels of self-esteem and positive affectivity, - lower levels of anxiety, and - a reduced likelihood of engaging in anonymous socializing (going to gay/lesbian bars to spend time with people they do not know)
individuals in the first stage (pre-encounter) of the Black Racial (Nigrescence) Identity Development Model usually prefer what kind of therapist?
White
White therapists' attitudes should be reflected in what status when working with minority groups?
White therapists whose attitudes and beliefs are consistent with the autonomy status are most effective with clients form racial/cultural minority groups
what did Morris, Waldo, and Rothblum (2001) find was associated with lower levels of psychological distress in lesbian and bisexual women?
a higher degree of "outness" (as measured by years self-identified as lesbian or bisexual and frequency of participation in community or social activities for lesbian and bisexual women)
curanderismo
a holistic system of healing that is practiced in some Latin American countries and Hispanic American communities in the United States
Racial/Cultural Identity Development Model - stage 5: integrative awareness
at this stage: - people experience a sense of self-fulfillment with regard to their cultural identity and - have a strong desire to eliminate all forms of oppression - also adopt a multicultural perspective - objectively examine the values, beliefs, etc. of their own group and other groups before accepting or rejecting them
to be culturally competent, what must therapists be knowledgeable of?
attempt to understand the worldviews of culturally diverse clients (e.g., they have an understanding of the history, experiences, and values of various groups including knowledge about the impact of oppression)
emic approach
attempts to see things through the eyes of the members of a culture in order to understand that culture
what healthcare situations may be impacted by cultural paranoia?
cultural mistrust might limit the effectiveness of suicide prevention programs for Black, Latino, and Native American youth the unwillingness of many older Blacks to: - participate in hospice programs, - accept DNR status, and - complete advance care directives is due not only to a lack of information but also to distrust that a White-dominated healthcare system will provide fair or adequate treatment or will carry out their wishes
emic
culture-specific theories, concepts, and research strategies
Atkinson, Morten, and Sue's (1993) Racial/Cultural Identity Development Model
distinguishes between five stages that people experiences as they attempt to understand themselves in terms of: - their own culture, - the dominant culture, and - the oppressive relationship between the two cultures each stage reflects changes in how the person views the self, others of the same racial/cultural group, members of other racial/cultural groups, and members of the dominant group
what do Asians emphasize in interpersonal relationships?
emphasize harmony, interdependence, and mutual loyalty and obligation
Black worldview
emphasizes the interconnectedness of all things and, as a result, Blacks tend to emphasize group welfare of individual needs
what type of approach do traditional psychological theories and practices usually reflect, emi or etic?
etic perspective
Asian view of emotions
value restraint of strong emotions that might otherwise disrupt peace and harmony and/or bring shame to the family
cultural encapsulation
when a therapist: - defines everyone's reality according to their own cultural assumptions and stereotypes, - disregards cultural differences, - ignores evidence that disconfirms their beliefs, - relies on techniques and strategies to solve problems, and - disregards their own cultural biases
