The Effectiveness of Multicultural Running head: the effectiveness of multicultural counseling



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The Effectiveness of Multicultural

Running head: THE EFFECTIVENESS OF MULTICULTURAL COUNSELING

The Effectiveness of Multicultural Counseling Competencies vs. Universal Systems of Counseling

CED 5910-Introduction to Counseling and Human Services

Kean University



Dashua U. Hinton

Spring 2010

The Effectiveness of Multicultural Counseling Competencies vs. Universal Systems of Counseling

One major principle for culturally effective counseling and psychotherapy is recognizing one’s own self awareness through examination of cultural values, biases, and a thorough understanding of other cultures. Currently, many upcoming mental health professionals are becoming more cognizant of multicultural issues and recognize the impact of effective treatment for multi-ethnic populations. Many colleges and universities nationwide have incorporated cultural competency and multicultural counseling curriculums into their programs as an effort to build cross-cultural counseling skills and familiarize students with theories, counseling techniques, skill development and a wide range of issues regarding ethical and effective counseling in a world of cultural differences. Such emphasis are also placed on expanding cultural awareness, knowledge, and skill building in order to facilitate an appreciation of cultural, racial, ethnic, age, gender and sexual preference issues.

For present day mental health professionals, it is essential to understand one’s own cultural heritage and awareness before going forward in understanding and assisting individuals in treatment. As a result of the growing need for promoting culturally competent practitioners, multicultural counseling competencies were evolved and developed so that many mental health professionals could provide optimal care to clients of different backgrounds. This is extremely important as counselors incorporate a greater awareness of their clients' culture into their theory and practice. Yet, some professionals in the field argue that the need for such multicultural competencies are irrelevant to the counseling profession and despite the growing microcosm of this present culture, there is no specific form of counseling that is multicultural. Some also argue that all counseling is multicultural which would negate the effectiveness of multicultural competencies within the counseling profession. As a result, this research paper seeks to examine the Effectiveness of Multicultural Counseling Competencies in contrast to universal methods and approaches that are effective and used with all kinds of clients. In addition, this literature review also seeks to examine counseling approaches that will ultimately lead to better outcomes for multi-ethnic clients in counseling, in particular African Americans.

Sue (2003) suggests the following:

Multicultural counseling and therapy in relation to the therapy process and the roles of

the mental health practitioner may be defined as both a helping role process that uses modalities and defines goals consistent with the life experiences and cultural values of clients, recognizes client identities to include individual group, and universal dimensions, advocates the use of universal and culture specific strategies and roles in the healing process, and balances the importance of individualism and collectivism in the assessment, diagnosis, and treatment of client and client systems. (p.16)

One may inquire of the effectiveness of multi-cultural counseling, and how it helps in facilitation of building a therapeutic alliance between counselor and client. In order to understand the importance of multi-cultural counseling, one must also acknowledge the importance of mutli-cultural competence. Sue ( 2003) defines multicultural counseling competence as the “counselor’s acquisition of awareness, knowledge, and skills needed to function effectively in a pluralistic democratic society and on a organizational/societal level advocating effectively to develop new theories, practices, policies, and organizational structures that are more responsive to all groups” Therefore, it is key for any mental health professional to identify and become fully aware of the importance of multicultural counseling and cultural competency in their practice.

However; despite how important multicultural counseling is to the counseling profession, some still argue against it. Patterson (2004) suggests that there is no specific form of counseling that is multicultural. All counseling is multicultural; everyone lives in a multicultural society. But this does not mean that mental health professionals need different counseling theories and practice for all the possible groups in that society. Patterson goes on to state that no mental health counselor however; can be prepared to counsel every possible client. The mental health practitioners prepared under the universal system will have the bases of becoming capable of counseling a wide variety of client. Such mental health counselors will, of course need special preparation to work with clients from particular groups.

Patterson explains the universal system of counseling as what is known as client-centered therapy. There are five basic qualities in this system which includes respect for the client, genuineness, empathic understanding, and communication of empathy, respect, and genuineness to the client and structuring. (Rogers, 1957) These professional qualities are not only essential for effective counseling, however; it also serves as the elements of all facilitative interpersonal relations. They are neither time bound nor culture bound. Patterson also goes on to explore two faulty assumptions which describe multicultural competencies as lacking philosophical foundations. The first faulty assumption is that counseling or psychotherapy is a matter in information, knowledge, practices, skills, or techniques. The second faulty assumptions is that client differences are more important than client similarities that it is useful and desirable to classify clients into a number of discrete groups, each requiring different counseling treatments.
Adherence to a specific counseling theory or method may also limit the success of counseling. Many cultural groups do not share the values implied by the methods and thus do not

share the counselor's expectations for the conduct or outcome of the counseling session. To counter these differences, effective counselors must investigate their clients' cultural background and be open to flexible definitions of "appropriate" or "correct" behavior. (LaFromboise, 1985) Overall Patterson points out that review of recommendations and suggestions for specific methods and techniques or skills for working with multicultural clients indicate that there is no evidence for the appropriateness or effectiveness of these methods. “It follows that we do not need competencies for multicultural clients. We need methods and approaches that are effective with all kinds of clients. These methods would constitute a universal system of counseling.” (Patterson, 2004)

In April 1991, the Association for Multicultural Counseling and Development (AMCD) approved a document outlining the need and rationale for a multicultural perspective in counseling. The work of the Professional Standards committee went much further in proposing 31 multicultural counseling competencies and strongly encouraged the American Association for Counseling and Development (AACD), and the counseling profession to adopt these competencies in accreditation criteria. The hope was to have the competencies eventually become a standard for curriculum reform and training of helping professionals. As a result, The American Association of Multicultural Counseling and Development created the (AMCD)- Multicultural Counseling Competencies in order to promote counselor awareness of their own cultural values and biases, the client’s worldview, and culturally appropriate intervention strategies. This was also a result of many organizations noting the serious lack of training programs in addressing racial, ethnic, and cultural matters.

In the past, society has operated primarily within a monoculture and monolingual perspective reflected in what has been referred to as the “encapsulated counselor” (Wrenn, 1962). Fast forwarding to this present day, multiculturalism is an explosive phenomenon. The American culture is no longer viewed as a diverse melting pot but more closely related to a salad bowl society consisting of hundreds of languages and dialects spoken daily in this country. With mental health issues on the rise, it can be observed that there is a rational and fundamental need for a multicultural perspective and cross cultural counseling approach to meet the needs of various populations. One particular at risk population includes the African American race and disparities in mental health care for this population. The effectiveness of multicultural competencies can have a huge impact on the risk factors associated with the African American race.

One risk factor affecting the African American race is examined by Tucker and Dixon (2009). Their research explored current challenges facing impoverished African American male youth who exhibit symptoms of attention deficit hyperactivity disorder, the need for mental health services, and the barriers to services that they face, and offer recommendations for mental health counselor. Many mental health professionals must be equipped with specific tools and strategies for working with at risk populations who experience barriers to mental health services. Further research suggests that African American males are overrepresented in most categories of learning, emotional, and behavioral disabilities. The Office of Special Education Programs, 2005 includes in their studies that African American children were overrepresented in specific learning disabilities (18%), mental retardation (34%) and emotional disturbance categories (28%).

In addition to the alarming rates of African American children overrepresentation of disabilities, there are also disparities in the mental health care for African Americans. As a result, “Tucker and Dixon (2009) concludes that African American boys have much higher reported rates of problem behaviors that do Euro American boys but are far less likely to receive a diagnosis of ADHD. In conjunction to the disparities faced within the African American race in mental heath are also concerns of cultural stigma surrounding mental health care regarding discrimination and the perception and views that mental health professions have of their multi-ethnic clients. Tucker and Dixon (2009) also suggest that in order to effectively reach African American families, counselors should draw from literature to inform their practices for engaging families, engage families in a mutual sharing model of communication instead of traditional one-way, counselor as expect model. Mental health counselors should also be aware of class bias in their approach and should explain all mental health issues to their clients. Overall, many counselors can improve the effectiveness of counseling African Americans by becoming more conscious of the issues involved in the assessment, diagnosis, and treatment of ADHD by systematically learning and incorporating methods of reaching at risk clients and addressing barriers and injustices of their clients.

The need for culturally responsive treatments has become more urgent as the number of ethnic minority clients increase, as a result, Previous research of a clinically referred sample of substance abusing African American inner city teenagers found that treatment engagement increased when cultural content was incorporated in the therapeutic process. Liddle, Gilfort, and Marvel (2006) suggest that clinical outcomes may be improved by integrating culturally responsive intervention methods within a multisystemic approach to treatment. It is believed that clinical outcomes can be enhanced by responding to the cultural, environmental, relational, and interpersonal contexts of the adolescent’s life. Research has also shown that culturally responsive therapeutic services enhance clinical outcomes for African Americans.

Because of the vital need to enhance the effectiveness of mental health services for racial and ethnic groups, numerous studies have been conducted evaluating culturally adapted interventions. Griner and Smith (2006) conducted a study using metaanalyytic methodology to summarize data. As a result, the study indicated a moderately strong benefit of culturally adapted interventions. Interventions targeted to a specific cultural group were four times more effective than interventions provided to groups consisting of clients from a variety of cultural backgrounds. Overall, the findings were indicative of providing evidence that the benefits of culturally adapting mental health interventions particularly when the interventions are targeted to a specific racial ethnic group and when the interventions are conducted in client’s preferred language.(Griner & Smith, 2006)

Constatine (2007) examined the relationship among African American client’s perceptions of their white counselors with respect to perceived racial microaggressions in cross racial counseling relationships, the counseling working alliance, the counselors’ general and multicultural counseling competence and their counseling satisfaction. As a result, studies indicated that perceived racial microaggressions were negatively associated with African American client’s perceptions of the therapeutic working alliance with the white therapist general and multicultural counseling competence. Results also indicated that African American clients who perceived a less effective therapeutic working alliance with white counselors were more likely to perceive these counselors as having lower levels of both general and multicultural counseling competence. Furthermore, findings reveal that African American clients perceived racial microaggressions had an indirect effect on both general and multicultural counseling through these clients’ perceptions of the therapeutic working alliance. Findings also indicated that African Americans client’s perceptions of white counselors’ general and multicultural counseling competence were not significantly associated with the clients counseling satisfaction ratings nor did they significantly mediate the relationship between the therapeutic working alliance, counseling satisfaction ratings, and perceived racial microaggressions and counseling satisfaction.

Numerous researchers have attempted to generate counseling services to improve therapeutic outcomes for people of color in counseling and psychotherapy. Unfortunately, in some cases, therapeutic approaches do not reflect sensitivity to such populations resulting in ineffective services and negative attitudes towards the profession and those associated with the profession. However; in order for effective strategies to be implemented successfully and improved for Mental health practitioner must be willing to become more aware of multicultural issues and the need to improve the quality of mental health services.

It is a sad occasion that despite the many milestones that this country has made in enforcing equal rights for many, that certain ethnic groups experience inequities in the mental health system. Despite the increase in multi cultural research, African Americans and other clients of color are still not fearing well with counseling services, In addition, there continues to be a need to address how effective multi cultural counseling approaches are for African Americans and other clients of color, it is also important to address multicultural issues in cross counseling relationships. Therefore, multicultural competencies are encouraged for treatment in working with people of color. As a result of this literature review, studies have shown and support that multicultural counseling and therapy provides a framework and a theoretical basis which supports positive outcomes in treatment for people of color. Studies have also shown that cultural competencies are not needed in the profession of counseling and that counseling should take on the universal role. Although counseling can be considered universal, it is firmly supported that the role of clinicians and mental health practitioners from diverse backgrounds despite their similarities and differences in clinical approaches should become more responsive and culturally aware as they provide services to diverse clients. Overall, there is a need for the rationale and need for a multicultural perspective in counseling, and for those in the field, multicultural counseling in the profession should be considered necessary for ethical practice as a counseling profession.

References

(Constatine M G 2007 Racial Microaggression Against African American Clients in Cross- Racial Counseling Relationships)Constatine, M. G. (2007). Racial Microaggression Against African American Clients in Cross- Racial Counseling Relationships. Journal of Counseling Psychology, 54(1), 1-16.

(Griner D Smith T B 2006 Culturally Adapted Mental Health Interventions: A Meta- Analytic Review)Griner, D., & Smith, T. B. (2006). Culturally Adapted Mental Health Interventions: A Meta- Analytic Review. Psychotherapy: Theory, Research, Practice, Training, 43(4), 531-548.

(Lafromboise TD 1985 Role of Cultural Diversity in Counseling Psychology)Lafromboise, T.D. (1985). The Role of Cultural Diversity in Counseling Psychology. The Counseling Psychologist, 13, 649-655.

(Liddle H Gilfort A J Marvel F A 2006 American Journal of Orthopsychiatry)Liddle, H., Gilfort, A. J., & Marvel, F. A. (2006). American Journal of Orthopsychiatry. An Empirically Supported and Culturally Specific Engagement and Intervention Strategy for African American Adolescent Males, 75(2), 215-225.

(Marbley A F et al 2007 Real Cases with African American Clients: Reports of Racially Diverse Practioners)Marbley, A. F., et al. (2007). Real Cases with African American Clients: Reports of Racially Diverse Practitioners. Journal of Humanistic Counseling, Education And Development, 46.

(Office of Special Education 20 Twnty-fifth annual report to Congress on Special Education Programs)Office of Special Education (2005). Twenty-fifth annual report to Congress on Special Education Programs. Retrieved from http://www.ed.gov/about/reports/annual/osep/2003/25th-vol-1sec-2.pdf

(Patterson C H 2004 Do We Need Multicultural Counseling Competencies?)Patterson, C. H. (2004). Do We Need Multicultural Counseling Competencies? Journal of Mental Health Counseling, 26(1), 67-73.

(Rogers C R 1957 necessary and sufficient conditions of theraupeutic personality change)Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21, 95-103.

(Sue D W Arrendondo P McDavis R 1992 Multicultural Counseling Competencies and Standards: A Call to the Profession)Sue, D. W., Arrendondo, P., & McDavis, R. (1992). Multicultural Counseling Competencies and Standards: A Call to the Profession. Journal of Counseling & Development, 70.

(Sue D W Sue D 2003 Counseling the Culturally Diverse)Sue, D. W., & Sue, D. (Eds.). (2003). Counseling the Culturally Diverse (4th ed., Rev.). Canada: John Wiley & Sons.



(Tucker C Dixon A L 2009 Low-income African American Male Youth with ADHD Symptoms in the Unites States: Recommendations for Clinical Mental Health Counselors)Tucker, C., & Dixon, A. L. (2009). Low-income African American Male Youth with ADHD Symptoms in the Unites States: Recommendations for Clinical Mental Health Counselors. Journal of Mental Health Counseling, 31(4), 309-322.

(Wrenn C G 1962 culturally encapsulated counselor)Wrenn, C. G. (1962). The culturally encapsulated counselor. Harvard Education Review, 32, 444-449.


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