Concerns about Counseling Racial Minority Clients Scale

The authors discuss the complexities of working with clients with dual minority status (i.e., sexual orientation and ethnicity). The authors explore the multiple contexts that influence ethnic and sexual minority clients' self‐concept. A case illustration of a Puerto Rican lesbian college student is presented, and suggestions for implementing multiple lenses in counseling dual minority clients are offered.

Chapter sixteen - Addiction Treatment Disparities: Ethnic and Sexual Minority Populations

Psychotherapy is a culturally encapsulated healing practice that is created from and dedicated to specific cultural contexts (Frank & Frank, 1993; Wampold, 2007; Wrenn, 1962). Consequently, conventional psychotherapy is a practice most suitable for dominant cultural groups within North America and Western Europe but may be culturally incongruent with the values and worldviews of ethnic and racial minority groups (e.g., D. W. Sue, Arredondo, & McDavis, 1992). Culturally adapted psychotherapy has been reported in a previous meta-analysis as more effective for ethnic and racial minorities than a set of heterogeneous control conditions (Griner & Smith, 2006), but the relative efficacy of culturally adapted psychotherapy versus unadapted, bona fide psychotherapy remains unestablished. Furthermore, one particular form of adaptation involving the explanation of illness-known in an anthropological context as the illness myth of universal healing practices (Frank & Frank, 1993)-may be responsible for the differences in outcomes between adapted and unadapted treatments for ethnic and racial minority clients. The present multilevel-model, direct-comparison meta-analysis of published and unpublished studies confirms that culturally adapted psychotherapy is more effective than unadapted, bona fide psychotherapy by d = 0.32 for primary measures of psychological functioning. Adaptation of the illness myth was the sole moderator of superior outcomes via culturally adapted psychotherapy (d = 0.21). Implications of myth adaptation in culturally adapted psychotherapy for future research, training, and practice are discussed.

The purposes of this study were to (a) investigate whether psychotherapists differ in their effectiveness with clients, (b) determine whether disparities exist within therapists' caseloads in their outcomes with White and racial and ethnic minority (REM) clients, (c) explore therapist factors that might contribute to observed therapist effects, and (d) identify whether treatment outcomes varied for REM and White clients. A sample of 3,825 clients seen by 251 therapists at 45 college counseling centers completed the Counseling Center Assessment of Psychological Symptoms at the beginning and end of individual psychotherapy. Therapists differed in their effectiveness at reducing general distress across clients, and evidence was found for disparities within therapists' caseloads in their effectiveness with REM and White clients. Effect sizes were small. Disparities within therapists' caseloads were not a function of any therapist variable that was studied. Therapy outcomes were similar for White and REM clients. Therapist multicultural competence can, and should, be considered in terms of measurable outcomes across client racial/ethnic groups. It is possible to identify multiculturally expert therapists who evidence competence with both REM and White clients and who might serve as models from whom the field could learn.

Racial minority clients’ experiences of sociocultural issues in psychotherapy.

One hundred five counselor trainees were surveyed to determine their attitudes toward ethnic and non-ethnic minorities. The findings suggested that these counseling students hold positive attitudes toward ethnic minorities, somewhat negative attitudes toward gays and lesbians, and moral development levels typical of college populations. Multiple regression analyses found that the level of moral development was positively related to attitudes toward gays and lesbians, but not toward ethnics. As compared to counselor trainees surveyed one decade earlier (McDermott & Stadler, 1988), these trainees exhibited less homophobia. The relationship of moral development and attitudes toward ethnic minorities was also found to have diminished.

One hundred and twenty counseling students representing 10 programs across the United States were administered the Purdue Master Attitude Scale, the Defining Issues Test, the Index of Homophobia and a demographic questionnaire in an effort to identify attitudes of students to ward minority groups. A demographic profile of these counselors in traning presents a picture of the ‘typical’ American. They are fairly young, mostly caucasian, middle class and were raised in traditional two-parent families. The results of the instruments administered indicate that counseling students appear to reflect the dominant culture attitude with respect to homophobia by demonstrating average to high homophobia, while the Purdue Master Attitude Scale reflects a somewhat overall positive attitude toward ethnic minorities. In terms of statistical analyses, level of moral judgment, as measured by the Defining Issues Test, was significantly related to attitude to ward ethnic and sexual preference minorities. Individuals with more favorable attitudes demonstrated higher levels of moral reasoning and vice versa. Higher frequency of experience with minorities was significantly related to lower homophobia scores and demonstrated a trend in the direction of better attitude scores. Quality of experience, while not achieving significance, showed a trend with better quality ratings being related to better attitude toward ethnic minorities and lower homophobia scores.

[Clin Psychol Sci Prac 18: 242–245, 2011] Hall, Hong, Zane, and Meyer present mindfulness and acceptance psychotherapies as promising treatment modalities for Asian Americans, address possible cultural discrepancies, and propose to adapt the diverging elements into culturally syntonic ones. In this commentary, we discuss how the heterogeneity among Asian Americans suggests the existence of a wide variation of individual differences despite group similarities. We point out the importance of cultural accommodation in psychotherapy, where the therapist accommodates for differences in beliefs, values, and norms implied in the existing theory. Finally, we propose that the underlying principle of effective psychotherapy with ethnic and racial minority clients is cultural congruence, or identifying and selecting culturally congruent processes and therapeutic elements by incorporating both cultural and individual variations.

A now well-established link exists between passive representation of racial and gender minorities in certain bureaucracies and substantive benefits for the represented groups. However, few quantitative studies have distinguished between the multiple possible mechanisms by which passive representation might produce such effects. We conduct a novel set of empirical analyses aimed at determining whether or not passive representation produces effects only for those clients who directly interact with bureaucrats who share their demographic characteristics or if passive representation produces broader organizational-level effects. We find strong evidence that minority clients’ outcomes are positively associated with representation in portions of the bureaucracy with which they do not directly interact. This suggests that either passive representation produces substantial bottom-up, organizational-level effects or that managers who recruit minority personnel also adopt policies that are favorable toward minority clients.

How child welfare workers view their work with racial and ethnic minority families: The United States in contrast to England and Norway

The authors focus on the significance of the counselor's cultural contexts in effective career interventions vis‐à‐vis the incorporation of multicultural metacognition. They briefly summarize and critique extant career counseling models for racial/ethnic minority clients and then describe an expanded model for career counseling that incorporates metacognition processes for addressing counselor‐related cultural factors.

I Norge har det siden 1990-årene vært vanlig å tilby kurs og videreutdanninger som skal gjøre profesjonsutøvere bedre i stand til å møte mennesker med en minoritetsetnisk bakgrunn. Fokus på og forståelse for minoriteters kultur blir her tillagt stor betydning og behovet for «kulturkompetanse» etterspørres stadig i profesjonell yrkesutøvelse. Det er imidlertid ikke tydelig hva denne kompetansen skal bygge på. Vårt empiriske utgangspunkt for å diskutere kulturkompetanse i profesjonell yrkesutøvelse er videreutdanningen «Barnevern i et minoritetsperspektiv». Barnevernsarbeidernes uttalte behov for kunnskap, slik dette kommer til uttrykk i en evaluering av videreutdanningen, ligger til grunn for vår diskusjon i artikkelen. Vi diskuterer hva en kulturkompetansetilnærming innebærer i praksis og noen konsekvenser en slik tilnærming kan gi for profesjonell yrkesutøvelse overfor barn og deres foreldre. Vi er spesielt opptatt av hvordan fokus på kulturkompetanse kan bidra til annengjøring og essensialisering, og på denne måten skyggelegge forhold som marginalisering og diskriminering. English abstract Beginning in the 1990s, a number of nations including Norway established various courses and programs of further education focused on helping professionals to become better equipped to meet and to work with ethnic minorities. Many of these programs were launched and initiated by the state as part of major initiatives aimed at facilitating the integration of minorities into society. In Norway, much attention has been focused on the need for welfare professionals to understand the cultures of ethnic minorities. Demands for increasing cultural understanding and cultural competence among professionals working with minority clients have been central in many programs. One key question left unanswered, however, about these and related programs involves determining what is actually meant by cultural competence. Making use of experiential knowledge acquired during many years of teaching about child welfare work with ethnic minorities, we critically explore culture-related notions expressed both as key goals in many programs and as concepts eagerly sought for by social workers in the field. In examining the concepts of cultural competence, central to many of today’s programs for social work education, we wish to focus especially on how these notions impact in various ways on the practices of professionals with minority parents and their children. In so doing, we wish especially to examine whether well-intended culture-related concepts work at cross-purposes to contribute to essentialist, stereotyped and other harmful understandings minimalizing and obscuring racism and related processes marginalizing ethnic minorities in Norwegian society.

US demographic and sociopolitical shifts have resulted in a rapidly growing need for culturally competent neuropsychological services. However, clinical neuropsychology as a field has not kept pace with the needs of ethnic minority clients. In this discussion we review: historical precedents and the limits of universalism in neuropsychology; ethical/professional guidelines pertinent to neuropsychological practice with ethnic minority clients; critical cultural considerations in neuropsychology; current disparities germane to practice; and challenges to the provision of services to racial/ethnic minority clients. We provide a call to action for neuropsychologists and related organizations to advance multiculturalism and diversity within the field by increasing multicultural awareness and knowledge, multicultural education and training, multicultural neuropsychological research, and the provision of culturally competent neuropsychological services to racial/ethnic minority clients. Lastly, we discuss strategies for increasing the provision of culturally competent neuropsychological services, and offer several resources to meet these goals.

Boundaries are a practice of separating one thing from the other; to make clear where I end and where you begin. Establishing and enforcing clinical boundaries is taken for granted as a necessary foundation of therapeutic work by social work’s governing and administrative bodies. Upon interrogation, normative standards of ethical practice tend to serve broader populations and institutions by deputizing social workers to self-police, even as such boundary norms may fail to serve the individuals and relationships at the heart of clinical practice. As a collective of early-career clinical social workers, we have at times felt certain obligatory boundaries force us to choose between serving an institution and caring for an individual. We explore moments where tension between boundaries and care is felt in vignettes from our clinical work with queer, trans, and racial minority clients, and through our analysis of boundary-setting texts. Seeking to queer norms of boundary-making discourse, we explore the possibilities of resistance that empower clients and prioritize relationships.

Vocational rehabilitation (VR) services are designed to help individuals with disabilities achieve gainful employment. This study examines VR’s effectiveness in assisting minorities achieve gainful employment. The study uses case management data from 617,149 cases closed by VR in 2006 in all states. It examines differences in access, employment, and earnings for White and ethnic minority clients. Multivariate techniques are used to assess factors that influence competitive employment outcomes, hourly earnings, and hours worked. Findings show significant differences in employment and earnings outcomes for minority and majority clients, with minorities faring worse. VR intervention length and per capita expenditures for services significantly influence employment and earnings outcomes. VR is more effective with White than with minority clients. There is a need to implement policies or practices that ensure equity in access to services that might translate into more equitable employment and earnings outcomes.