World View for Multicultural Issues in Mental Health Counseling - Research Paper Example

? World View Paper for Multicultural Issues in Mental Health Counseling New York Institute of Technology School of Health Professions In partialfulfillment of the requirements for MCHO 710 Prof. Oren Shtayermman, PhD April 10, 2012 Introduction One of the best approaches for counseling is to incorporate culture to enhance understanding and empathy especially for multicultural clients. This practice is widely implemented with the intensification of cultural diversity of culture in almost all countries in the world. To cope up with the increasing assortment of race, gender, sexual orientations, social class and ethnicity, multicultural counseling has taken its place. One idea of multicultural counseling has been driven maybe by the lack of counselors and therapists who can communicate and understand cross-cultural clients. The development of multicultural concept is also relevant to mental health counseling. However, issues are associated with the competencies and approach when it comes to multicultural approach in mental health counseling (Patterson, 2004). It can be viewed that the idea of “multicultural” is not a form of counseling, but an integral nature of counseling. With this, several barriers can definitely arise when dealing with diversity in culture. However, to be an effective counselor, one must first understand its world views. It is natural to say that we are products of our cultural conditioning and can have a significant impact on our counseling and work with cross-cultural individuals. It goes to say that we must also endeavor to respectfully understand and appreciate the world views of our clients. The development of intervention strategies and skills to continuously adjust with the changes in prevailing cultures can become handy for counselors. But to top it all, major challenge is always faced by counselors to discount their biases and values. Thus, prevention of ethnocentrism is a key ingredient to effective cross-cultural counseling (Sue, et. al. 1992). This paper presents the author’s perception of its cultural identity and tries to have a world view of some underlying factors that revolves on the concept of multicultural issues on mental health counseling. Review of Related Literatures There are several components of the issue of cross culture approach in mental health counseling. However, to fully appreciate the developments on multicultural counseling, some foundational principles and concepts on this section will be presented. Culture and Worldview The definition of culture and worldview might be obvious to some; however, it encompasses such enormity of concepts that it has taken different meanings through time. The meaning of culture as defined by the American Psychological Association or known as APA (2003) is the “belief systems and value orientations that influence customs, norms, practices, and social institutions” which is indicative that all individuals are cultural beings and they posses inherent cultural, ethnic, and racial heritage. Furthermore, the APA (2003) extends the definition of culture as the “embodiment of a worldview through learned and transmitted beliefs, values, and practices…” Over-all, it suggests that indeed culture is fluid and dynamic and that there are both cultural universal phenomena. The most common understanding of culture is one that imagines a high level of internal uniformity within a social system which is often experience in ethnicity or nationality. However, the homogeneity of shared values in society is now contested with multi-cultural approach which is aimed at the protection and the recognition of cultural differences by the state (Rathje, 2009). However, in the same study made by Rathje (2009), reworking of the general understanding of culture was done to broaden of the cultural perspective of human coexistence to include a multi-collective perspective which can definitely improve the dynamics of society. A worldview (or "world view") is a set of assumptions about physical and social reality that may have significant effects on cognition and behavior. Lacking a comprehensive model, the construct has been underused (Koltko-Rivera, 2004). In an article by Hart (2010), he believed that worldviews affect our systems of beliefs, ability to decide and solve problems as well make assumptions. Furthermore, Bishop, et al. (2002, as cited by Hart 2010) stated that, “understanding worldviews of both the targeted community and ourselves is imperative if we are going to do more good than harm”. In an article on cultural competence, D. W. Sue (2001) as cited by Snyder (2008) describes the term "worldview" as something that one "espouses as reality". "Each cultural/racial group" Sue explains, "may have its own different interpretation of reality and offer a different perspective on the nature of people, origin of disorders, standards of judging normality and abnormality ... " (p.795). Her definitions further proves that cultural worldviews cease to be seen as views (as in a point of view), and instead become synonymous with "reality". Ethnocentric monoculture From an abstract by Sue (2004), ethnocentric monoculturalism and whiteness are powerful and well-established determinants of worldview. As opposed to racism which is conscious, it is considered rather invisible and unconscious. This makes it detrimental to people especially the marginalized groups in society. Both define a reality that gives advantages to White Euro American males while disadvantaging others. Although most Americans believe in equality and fairness, the inability to deconstruct these 2 concepts allows society to continue unjust actions and arrangements toward minority groups. Bennett (2004) used the term “ethnocentrism” to refer to the experience of one’s own culture as “central to reality.” To elaborate, the beliefs and behaviors that people receive in their early interaction with society are not objected and seen not an issue; they are experienced as “just the way things are.” The way things are experienced in this kind of view revolves normally on certain defining features which were enumerated by Sue (2004) as cited by Snyder (2008). The defining features involve the (a) belief in the superiority of one group's cultural heritage (history, values, language, traditions, arts and crafts, etc.); (b) belief in the inferiority of other groups' heritage; (c) the dominant group's ability (power) to define and impose reality on less powerful groups; (d) the manifestation of these ethnocentric values and beliefs in institutions (programs, policies, practices, structures, etc.); (e) its ability to operate outside of conscious awareness. An interesting proposition by Bennett (2004) shows the transition from ethnocentrism to ethnorelativism. The figure below presents the six distinct kinds of experience with respect to cultural differences. In general, this only implies that the more ethnocentric orientations can be seen as ways of avoiding cultural difference, either by denying its existence, by raising defenses against it, or by minimizing its importance. The more ethnorelative worldviews are ways of seeking cultural difference, either by accepting its importance, by adapting perspective to take it into account, or by integrating the whole concept into a definition of identity (Bennett, 2004). The ethnocentric stages of development by Bennett (2004). Multicultural competence In a study conducted by Capell, Dean and Veenstra (2008) on ethnocentrism and cultural competence among health care professionals, suggests that cultural competence has significantly intertwined relationship with ethnocentrism. The construct of cultural competence warrants further study vis-a-vis its correlates and its impact on clinical outcomes. Sue (2001) has assumed as a fact that psychologists themselves represent a major barrier to cultural competence because many are unconsciously trapped within their own Eurocentric worldview, a phenomenon that Sue refers to as ethnocentric monoculturalism. The National Association of Social Workers or NASW (2001) provided a good definition of cultural competence. They refer to is as a process of response of individuals and systems. It is a respectful and effective approach to people of all “cultures, languages, classes, races, ethnic backgrounds, religions, and other diversity factors in a manner that recognizes, affirms, and values the worth of individuals, families, and communities and protects and preserves the dignity of each.” (p. 8). In another publication by NASW during 2000, it mentioned that cultural competence is a “set of congruent behaviors, attitudes, and policies that come together in a system or agency or among professionals and enable the system, agency, or professionals to work effectively in cross-cultural situations” as cited by NASW (2001). There are five essential elements that contribute to a system’s ability to become more culturally competent. It is expected that these elements must be reflected in attitudes, structures, policies, and services, in every level of the service delivery system. The system should (1) value diversity, (2) have the capacity for cultural self-assessment, (3) be conscious of the dynamics inherent when cultures interact, (4) institutionalize cultural knowledge, and (5) develop programs and services that reflect an understanding of diversity between and within cultures (NASW, 2001). Discussion When working in a multicultural context, it is imperative to be aware of one’s own frame of reference and worldview (Riker and Kokotovic, 2004). Our reference start’s with our own cultural identity and how we understand and analyze our position within our cultural or ethnic group. Our self and own cultural heritage is an essential ingredient before we proceed on understanding and assisting other people. This requires us to acknowledge our own basic tendencies, comprehend other cultures and identify the limits our culture places on our comprehension (Bolton-Brownlee, 1987). The quest for cultural identity The author believed that our cultural identity is closely linked in the formation of our perception of self. However, one must take the journey of a lifetime to develop its own identity, and it can be really tough at times. Being of African-American descent, the immediate idea was to associate the identity recognition with one of the Black identity development models, specifically the model developed by W.E. Cross in the early 1970’s (Cross, 1971). As a follow-up with the Cross Model of “negroscience”, Downing and Rush (1985) as cited by Fraser (2009) also developed a process of feminist identity which will be applied in this paper. The first stage of Cross’ (1971) model is the pre-encounter stage which is probably relevant during the author’s childhood years. In these years, the awareness of negative stereotyping is not yet pronounced. As a young child, the author did not have a concept of color associated with race. The relationship built between other people is doesn’t necessarily reflect ethnicity or culture. This can be a passive acceptance stage, the first stage of the feminist identity model. During this stage individuals are unaware of discriminatory practices committed against them (Eurchull, Liss, Wilson, Bateman, Peterson, & Sanchez, 2009). Upon reaching kindergarten, the realization of being the only African American child in the classroom dawned to the author. Before kindergarten, schooling was first experienced in a day care which was located in the inner city of Albany, New York. At age of three years old after her father passed away, the author moved to the suburbs with her grandmother and mother which was predominately white area. Most African-American children struggle to mature in an environment in which they are a racial minority (McNeil, Capage, and Bennett 2001). The author remembers instances from its experience in kindergarten. The school had 7 Black children from Kindergarten through 8th grade. During this encounter stage – the second stage of Cross’ Model, the impact of color with the disparity of treatment within the class was evidently experienced. The longing to be lighter skinned was intensified mainly because of peer pressure. Growing up with impression that “if you were not of lighter tone skin, you were not classified as being beautiful” developed within. In a study conducted by Cooper and Jordan (2003), the average African American children do experience views of disparity and neglect from color differences. This event marked the second stage of feminist identity model – revelation. This stage occurs on events with the inconsistence of one’s perception with society with the reality of gender and race issues. This stage has highlighted the differences between “us” and “them” and affected the interpersonal relationship of the author to some extent. However, Sue and Sue (2008) stated the fact that being black can also grow positive attitudes in an individual, especially as an African-American. During the latter years of childhood, the bad impression of color started to change. This range of attitudes is experienced until 8th grade. During the early years, the denial stage as an ethnocentric experience is predominant. As Bennett (2004) described in his model of ethnocentric stages of development, denial of cultural differences is the default monocultural primary socialization. This is best observed during childhood years when color doesn’t really matter to but at the same time the author’s classmates doesn’t really took notice of those in the minority of the class. This type of worldview can be best observed in US Americans like their disinterest on cultural differences or apathy with the existing non-dominant culture. The main issue of denial stage is the tendency to avoid noticing cultural difference. However, in the author’s family, race or cultural difference was never a problem. In fact, instead of rejecting the African American culture, the family always wanted to embrace it. As a young child, the author remembered the instance that she would be taken to the African American cultural festival that occurred once a year. The mother would buy black baby dolls. The family never denied their own African American culture or ethnicity. This significant experience provided identity enrichment and helped strengthen the connection with African American culture. This event is considered as enculturation and is defined to be the degree to which persons retain the norms of their culture or origin (Wang and Kim, 2011). This became the start of the immersion (third stage) of development for the Cross’ Model and further developed during the later years. The immersion stage of the racial/cultural identity development model took the positive route for the author during its adolescent and college years. Discrimination was not entirely experienced because of the predominant black population. The perception of color bias has positively faded and sense of pride and identification with culture was enhanced. This helped the author to explore more aspects of her culture and affirm her identity with the support of peers from the same racial background. The college years represented a time when the author’s beliefs regarding locus of control and locus of responsibility began to take shape. The freedom to express one’s own identity has been achieved since the environment in the college consists of mixed culture and races. This became a perfect place to practice simultaneously the fourth and fifth stage of Cross’ Model, the Internalization followed by Commitment. The feeling of pride in being African American intensified and the sense of participation and protection of own cultural identity became one of the worthy causes that was promoted. In the feminist model, this marked the synthesis stage wherein the sense of self began to authenticate incorporating sexism and feminism (Fraserm, 2009). Following this stage, is the final stage of “active commitment”, together with the Cross Model’s internalization-commitment stage, the author has been committed to actively bring social change and reach out to other cultural groups through effective counseling. Towards a culturally effective counselor The stages that the author experienced may give her an advantage during her endeavor towards a culturally effective counselor. The author has been surrounded with a multicultural environment, from its family and friends up to the job and travel activities she has done. The positive confidence to approach people with an open-mind, genuine motives, flexibility and without prejudice on their cultural origins are some of the attitudes that the author can offer as a counselor. After passing through the internalization-commitment stage of Cross’ model, the author is secure with her identity and will continue to find opportunity to reach-out to to other cultures in order to gain understanding. This includes practicing to create a knowledge base of client’s cultures with demonstration of competent provision of service that are sensitive to client’s biases and differences. However, the society still provides pressure to the non-dominant groups like African Americans when it comes to racial oppression. This can be a very challenging task for the author as an aspiring effective counselor. As the NASW (2001) suggest, counselors must be aware of the dynamics inherent when cultures interact. The negative perception of possible clients on the author’s ethnicity can become a communication barrier during counseling. The career of an American African counselor might traverse along a rough road especially amongst the dominating White culture at present. The society seems to offer lack of correspondence and priveleges in favor to White people. This western notion has brought negative impacts especially on the minority culture. There is this prevailing idea that in order to be taken seriously and achieve success, African Americans have to work twice as hard as those from the dominant culture. This provide weight on the bias that western races are generally superior. This view has been tackled by Bennett (2004) and described this as a defense experience under the ethnocentric monoculture. It follows that most dominant culture has the view that the world is organized into “us” and “them”, providing credence with coming up with superior and inferior cultures. In addition, “white privileges” continuously place barriers for opporutnities to most racial groups in society. Blum (2008) describes these privileges as having the tendency to downplay differences and recognize the experiences of racial groups. Furthermore, it can be observed that it minimizes the role of White people in the contribution to a meaningful cause of racial justice. This bias if tolerated to propagate will pose a negative effect on counseling career and may develop into author’s negative drive to prove itself especially to the dominant groups. Conclusion Being a culturally sensitive counselor is deemed to be personally and professionally demanding. It is the responsibility of the author as a counselor to seek self-knowledge and the recognition and minimization of their own biases and assumptions regarding the nature of human behavior and change while giving attention to the cultural diversity and personal racial background of clients. Learning from other culture is necessary but one must preserve and enrich its own cultural identity. Finally, it is best to recognize that cultural competence is never fully realized but rather an ongoing learning process wherein one can always encounter diverse clients and new situations as she grows in the profession. References American Psychological Association. (2003). Guidelines on multicultural education, training, research, practice, and organizational change for psychologists. Vol. 58, No. 5, 377–402 DOI: 10.1037/0003-066X.58.5.377 Bennett, M.J. (2004). Toward multiculturalism: A reader in multicultural education - Becoming interculturally competent. Newton, MA: Int’l Res. 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Therapist multicultural competence, Asian American participants’ cultural values, and counseling process. Journal of Counseling Psychology. Vol. 57 (4): pp. 394-401. DOI:  10.1037/a0020359 Read More