Racial minority clients’ experiences of sociocultural issues in psychotherapy.

ABSTRACT 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.

Applying Theater-Based Training Methods to Address Anti-Black Racism in Community-Based Mental Health Services: A Pilot Feasibility Study

Concerns about counseling racial minority clients: Ethnocultural empathy, insight, and multicultural intervention self-efficacy.

The purpose of this study was to develop and validate the Concerns about Counseling Racial Minority Clients (CCRMC) scale among counselor trainees. Sample 1 was used for an exploratory factor analysis and confirmatory factor analysis. Four factors were identified, Managing Cultural Differences (α = .82), Offending or Hurting Clients (α = .87), Biased Thoughts and Behaviors (α = .81), and Client Perceptions (α = .77). The coefficient alpha for the CCRMC was .90. The results support the validity of the scale. The scores on the CCRMC and its subscales have positive associations with fear of negative evaluation from others (r = .19 to .40) and negative associations with general counseling self-efficacy (r = -.30 to -.46) and multicultural intervention self-efficacy (r = -.30 to -.64). The CCRMC significantly predicted fear of negative evaluation, session management self-efficacy, and multicultural intervention self-efficacy over and above multicultural social desirability. The validity evidence was not different between White and minority graduate trainees. In Sample 2, the estimated 1-week test-retest reliabilities ranged from .75 to .96 for the CCRMC and its four subscales.

[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.

Intimate partner violence against women (IPV) affects all populations, but significant variations among these groups have been suggested. However, research results on racial differences in IPV are not only inconclusive, they are also limited-particularly with regard to racial minorities. As a result, it has been challenging for practitioners and service providers in many communities to serve an increasing number of racial minority clients. This study used the Collaborative Psychiatric Epidemiology Surveys (CPES) to examine differences in the prevalence of IPV, and associated factors, among major race groups in the U.S. Included variables were age, race, financial security, employment, education, social network, IPV perpetration and victimization, and severity of IPV. The results showed that Blacks were victimized the most, followed by Whites and Latinos, and Asians were victimized the least. Asians were the least likely to be victimized by IPV, even when controlling for sociodemographic variables. The odds of victimization for Blacks and Latinos were not significantly different from Whites. Financial security and age affected IPV victimization. Those who perceived themselves as financially secure were less likely to be victimized than those who did not. The older were less likely to be victimized than the younger. Employment, education, and social networks did not affect victimization. Race was not a significant predictor of perpetration, when controlling for other variables. Age was the only predictor of perpetration: the older were less likely to perpetrate IPV than the younger.

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.