In my experience, however, I have not seen as much in the way of specific skills training in how to engage, learn from and respectfully challenge culturally different clients. I think there is real value in knowing how to open a dialogue with a culturally different client such that you are able to explore and learn from their own unique worldview, rather than drawing from learned generalizations of their culture.
I have sought to address this through my own work in nonverbal intervention skills training but think that is only a small part of what could be accomplished. I believe the greatest challenge is learning how to step outside of your own worldview. Because of this, believing that everyone else sees and experiences reality the same way you do is a very easy habit to fall into.
Stepping outside of this habit is difficult, and learning how and why to do so is a large part of what I believe multicultural awareness training seeks to do. In my own experience, addressing the habit has involved focusing on developing my own mindfulness and curiosity. When engaging with others, I try to stay mindful of my own emotional experience, reactions and attitudes.
In doing so, I hope to catch myself when this habit is occurring so that I can attempt to limit its impact. He has authored or coauthored a number of books on the topics of multiculturalism, diversity and social justice in counseling. How would you describe the current state of multicultural competency within the field of counseling? It is very obvious that we have made great strides in establishing the idea of multicultural competency as a cornerstone of professional counseling practice.
For example, there has been a proliferation of documents and research articles on various aspects of multicultural competency. Significantly, the concept of multicultural competency is now firmly embedded in the ACA ethical standards. What is needed as the profession moves forward are ways to objectively assess the behaviors associated with multicultural competency. We need procedures that allow counselor educators and supervisors to observe the behaviors of students and practitioners in cross-cultural contexts and then assess the extent to which these exhibited behaviors reflect multicultural competency.
The true nature of the process by which one develops multicultural counseling competency is indeed challenging because it entails first developing global literacy. Indeed, while these are important aspects of ongoing professional development, they should be seen as small components of a lifelong personal journey. Global literacy, therefore, cannot be learned in a classroom.
What challenges did you face personally? I have taught multicultural counseling to graduate students for over 30 years, and in that time, my views on multicultural competency have evolved significantly. The curriculum in the course my first few years consisted of theories and strategies for counseling African American clients.
Over time, I expanded the curriculum to include counseling other client groups of color in the United States.
Gradually, as my conception of multicultural counseling grew, I began to include ideas on how to counsel people from other disenfranchised groups, such as gay and lesbian clients and people with disabilities. My biggest challenge was moving from viewing groups of people in often stereotypical ways when addressing counseling challenges to considering concepts of culture in a broader fashion that transcended both groups and geopolitical boundaries.
Today, I teach my multicultural counseling course from a conceptual approach, as opposed to studying specific groups of people. Given this, students learn about important concepts that must be understood in a cultural context anywhere in the world.
Clemmont Vontress is professor emeritus of counseling at George Washington University. He has been researching, teaching and practicing in the area of cross-cultural counseling for more than 50 years.
Becoming a multiculturally competent counselor is important because problems that clients present [with] emerge from various cultures that impact them. There is not just one culture that influences our existence.
There are at least five. First, the universal culture is our way of being dictated by the fact that we are members of the human species. Therefore, we are like all other human beings in the world. Second, there is the ecological culture or the way of life dictated by the geographical environment in which humans live in a particular environment. Third, people reside in different countries.
They must abide by the rules, regulations, customs and laws of their country. Failure to do so usually leads to social and psychological problems. Fourth, there are regional differences in each country. They, too, impact our well-being. Fifth, most people in the United States and other countries are born into a racio-ethnic culture.
If this understanding of culture is accepted, then we are all multicultural. To be therapeutic, counselors need to understand the many cultural environments or forces that envelop and affect our well-being. Where is counseling as a profession in terms of multicultural competence?
The profession has done a fair job in terms of getting its members to recognize that people are culturally different. However, it has confused and perhaps misled people in making us believe that we can make counselors culturally competent by way of the classroom.
It is hard to live in our safe, clean and well-ordered community and understand people in opposite situations. There is no one way. However, a couple or so come to mind. First, cultural internships might be tried. Counselors-in-training might be required to live in a home or community that they or someone else perceives [as being] culturally different from them. Community involvement might enable the counselor to know that the person or persons first thought to be culturally different are just like them.
I think that we must think outside the box when training effective counselors. Classroom activities may not accomplish the task at hand. Unfortunately, counselor educators appear to be training cross-cultural counselors the same way they did when we did not talk about culture and counseling.
Perhaps our certification groups should focus more on this very important area in counseling. Erford, the second edition of which Pearson published earlier this year. When a counselor is lacking in multicultural competency, how can it hinder the counseling process with clients? When counselors lack the knowledge, awareness and skills to work with diverse clients, there is a domino effect: Clients do not come to counseling or they terminate prematurely, leading to one less resource for them.
This affects their psychological and, often, physical well-being. Part of facilitating multicultural competency is knowing what you do not know and growing with your client — learning together in some cases. It involves asking questions to best meet client needs. What advice would you give to counselors to address some of those challenges? Acquiring multicultural competence can occur in small steps [such as] identifying a social issue or cultural factor we feel passionate about or seeking community resources to begin building a list for clients.
Once we get into the intricacies of one cultural or social justice issue, we can then look for commonalities with other issues — or how one issue impacts a variety of people. Part of stepping out of our comfort zone involves establishing peer networks to discuss client and professional issues in a safe way. In addition, we need to start thinking about the notions that all counseling is multicultural, [that] attention to intersecting identities is important and [that] approaching a client case conceptualization or treatment plan from a multicultural and social justice lens is a must.
Also, be an active consumer of research and develop methods for collecting data with your clients to inform practice; share with a professional audience as well as your community. Part of dealing with discomfort and knowing where to start is the realization that you are not alone and that the profession has only fairly recently started operationalizing multicultural competence. First, the goals surrounding multicultural competency require counselors to have knowledge, skills and awareness to serve in a culturally relevant and affirmative manner.
We have a great distance to go in terms of understanding what skills foster multicultural competency while promoting client and student welfare. In addition, most of what we know in terms of changes in counselor multicultural competency is self-report from counselor trainees. It is important that we involve supervisors, school administrators, clients, parents and other stakeholders to contribute to our understanding of counselor multicultural competency.
Degree of economic security within families and communities has a far-reaching impact on academic, social, occupational and physical well-being. While privilege and oppression related to other cultural group memberships certainly matters, socioeconomic status often has a moderating effect that perpetuates social injustice. Finally, we need to constantly attend to diversifying our profession and expanding our experiences, whether this involves recruiting students of color and males into our counseling programs or practicing in settings that might challenge us culturally.
The type of counselors and experiences they have as trainees ultimately provide a model for the public that counseling could be useful to them, no matter their background or concern.
Kevin Feisthamel is the director of counseling, health and disability services at Hiram College in Ohio. Talk about the importance of multicultural supervision. What does it mean to be a multiculturally competent supervisor, and what will that mean for the counselor being supervised? Multicultural supervision is crucial to the advancement of the counseling profession in producing future mental health counselors who have gained the knowledge, awareness, values, beliefs and practical skills to become competent multicultural counselors.
What it means for me in becoming a multiculturally competent supervisor is being aware of diversity, race, ethnicity and LGBTIQQ concerns as they relate to the supervision process. Being a multiculturally competent supervisor also includes being culturally sensitive in assigning DSM diagnoses to certain races.
Euro-Americans are often diagnosed with more mood disorders. Supervisors also have so many roles, including monitoring client welfare, professional development [and] being a teacher, mentor, advocate and facilitator of self-awareness and self-exploration, that we need to integrate multicultural competencies in all of these roles for our supervisees.
How would you describe the current state of multicultural supervision within the field of counseling? More clinical research and practical techniques need to be implemented within the educational and field placement settings.
I think supervisors lag behind supervisees in multicultural awareness and knowledge. For example, the Council for Accreditation of Counseling and Related Educational Programs requires only one multiculturalism course that is basically an overview of the various types of cultures and what future counselors should particularly pay attention to.
Thus, as graduates become licensed and obtain their supervisory credentials, there is usually no requirement of obtaining CEUs related to multicultural understanding.
If a supervisor has been in the field for 15 to 20 years, only their clinical experience may help with understanding multicultural issues, but more formal training may be needed. She has been studying multiculturalism since the late s and is a founding member of the National Institute for Multicultural Competence.
Why is being multiculturally competent as a counselor so important? Ethics in a Multicultural Context provides strategies for critical decision making in multicultural settings. Utilizing extensive case studies, authors Sherlon P. Pack-Brown and Carmen Braun Williams present a comprehensive exploration of counseling ethics in a cultural context. Examining the implications and consequences of competent multicultural counseling, they present ethical dilemmas arising in face-to-face counseling interactions, supervisory relationships, and educational situations.
By placing ethical issues in a cultural context, this inclusive volume provides readers with the practical tools to address complex questions such as. Ethics in a Multicultural Context encourages critical thinking rather than passive acceptance. The authors identify culturally troublesome issues, encourage culturally appropriate interpretations of existing ethical guidelines, and promote ethical behavior in multicultural contexts.
Designed for students and educators in counselor education and counseling psychology programs, this book is also an essential guide for social workers, psychologists, and health professionals who work in multicultural environments. Should you need additional information or have questions regarding the HEOA information provided for this title, including what is new to this edition, please email sageheoa sagepub.
Please include your name, contact information, and the name of the title for which you would like more information. For assistance with your order: Please email us at textsales sagepub. Skip to main content. Download flyer. Description Contents Features Multicultural counselors often face a moral dilemma: should they follow the ethical guidelines of their professional counseling organization at the expense of a client or take the appropriate action while bending official standards?
By placing ethical issues in a cultural context, this inclusive volume provides readers with the practical tools to address complex questions such as Are dual relationships ethical? How do you handle unintentional cultural bias? Can you barter for counseling services? How do you manage a client's welfare? The skills required for ethical sensitivity, as described earlier, namely controlling social bias, taking the perception of others, relating to others, understanding emotional expression, perceiving and responding to diversity, interpreting ethics in situations and effective verbal and non-verbal communication, see the Ref.
The interrelatedness of the two constructs is unequivocal. There is a close relationship between the level of competence of health care professionals and their ability to provide culturally responsive health care services, which is deemed to be sound ethical practice. Health care professionals need to be trained to develop skill sets for serving diverse populations in a variety of settings and both on pre-professional and professional levels. Cultural competence is also viewed to be a graduate attribute, an outcome of internationalization of the curriculum, a requirement for effective global citizenship and a professional competency, see the Ref.
Programs in higher education have an ethical responsibility to train future health care professionals to develop cultural competency in order to empower them to provide appropriate services to diverse populations and to function efficiently in the diversifying health service professional workforce.
Training programs for the various health care professions are committed to facilitating the development of cultural competence of their students, as required by their professional Code of Ethics. Professional associations support this endeavor and provide resources and policy documents for this purpose.
Training programs are required to include cultural competence in both the classroom and clinical experiences. They need to provide opportunities for students to develop clinical skills with multicultural populations. Working with interpreters and translators is a key in providing cultural competent care, see the Ref.
Attention also should be paid to resolving ethical issues which may occur during these collaborations. A plethora of approaches to the training of cultural competence for health care professionals are available in the literature. For example P.
Rose, Cf. Others are discipline specific e. Lubinski and M. Matteliano, Cf. Educational approaches addressing cultural competence have evolved from the additive teaching model teaching content includes global concepts , to the integrated teaching model some elements of global concepts are embedded within teaching to the transformative model in which teaching and learning experiences are embedded throughout teaching within a dynamic and interactive approach, see e. The transformative model is widely supported as evidence-based education.
Irrespective of the approach followed, all training should be evaluated regularly to ensure that training modules, courses and programs on cultural competence are of a high standard. This model is ideally suited to curricula as it views cultural competence as a developmental process, and not a onetime event. Their educational approach is one of integration of cultural competency into existing courses, rather than the creation of new courses.
They developed a series of exercises, Cf. Specific strategies to facilitate the development of cultural competence have been proposed in the literature such as engaging in open dialogue with students to discuss culture and biases and personal perspectives; self-exploration of own values and biases and how that may influence their behaviors; respect and effective listening; service learning activities critical reflection of their development of cultural competence, Cf.
Formal cultural competence training can prevent health care professionals from engaging in discriminatory practices and providing services which are not culturally and linguistically appropriate and sensitive, Cf. The explicit role that ethics plays in cultural competence curricula has been lacking, see the Ref. Donate-Bartfield and L, Lausten, Cf. The integrated approach, Cf.
Minkoff, Cf. When teaching cultural competence, integrating an understanding of ethical issues is crucial. For example respecting differences is not only important to establishing rapport with clients and patients, and promotes compliance, but it is consistent with the core ethical principles of intervention, see the Ref. Integrating the teaching of ethical principles and cultural competence will better prepare health care professionals to deal with conflicts that may arise in clinical practice.
According to M. Cultural competence involves understanding of the importance of cultural differences, respect for those differences and minimization of the consequences of such differences, Cf. Health care professionals may perceive a conflict between ethical practice and cultural sensitivity to the mores of other cultures.
In developing cultural competence health care professionals need to understand and appreciate that in some cultures other moral domains such as community emphasizing importance of family roles and sanctity emphasizing sacred and spiritual side of human nature hold equal value.
In order to be able to reconcile such differences, students require practice in ethical reasoning through e. This will enable them to fully understand the complexity and interrelatedness of cultural competence and ethical decision making.
The skills required for ethical decision are similar to those of cultural competency e. These skills can all be trained, Cf. Recognizing this relationship will facilitate training in an integrated manner. Disparities between diverse populations exist in terms of access to and quality of care due to social, economic and other factors. Training in cultural competence makes health care professionals aware of these disparities and equips them to meet the diverse needs of such populations, see the Ref.
Finally, health care professional boards require their members to participate in continuing education. Continuing education programs address cultural competence in innumerable ways.
However, such offerings also need to integrate ethical principles and decision making to ensure that health care professionals are supported in their cultural desire to provide the best services to the populations they serve, Cf. Assessment of the Development of Cultural Competence. Cultural competence is viewed to be an outcome of the curriculum which needs to be assessed as such in training programs. However, the assessment of the development of cultural competence is a controversial topic and poses a challenge, especially as cultural competence is an ongoing process.
A panel of internationally known intercultural scholars discussed the assessment of cultural competence, see the Ref. Their conclusion was a recommendation to use a mix of quantitative and qualitative methods to assess [inter]cultural competence, including objective measures, interviews, observation, and judgment by self and others.
There is an abundance of qualitative assessment tools for health care professionals in the literature, which range from informal to formally researched surveys. For example J. The ASKED mnemonic model assists health care professionals with informally assessing their level of cultural competence. Seibert, P. Stridh-Igo and C. Zimmerman, Cf. In the development of their checklist a primary theme that emerged was the significance of verbal and non-verbal communication.
This finding resonates with the communication skills required to develop ethical sensitivity. This tool consists of three surveys, namely the Executive Team and Management survey; Staff survey and Health Professionals survey. Research results established the reliability and validity of the tool which can be used to determine the level of cultural competence preparedness of health care professionals.
Bennett, see Ref. The IDI measures cognitive structure rather than attitudes, which makes it a more stable and generalizable test that is less susceptible to situational factors. It has 50 items that can be taken on-line or in a paper and pencil form. It has been translated into fifteen languages and is widely used in higher education. In conclusion assessment of cultural competence should be an integral part of both training and clinical practice in order to assist health care professionals in the continued process of developing cultural competence.
Results can be used to address weaknesses and strengthen the development of cultural competency. Internationalization of Higher Education. According to Figure 1, the context of higher education is important when reviewing cultural competence and ethical decision making within a broader framework. Two aspects of higher education are addressed in this section: the internationalization of the curriculum and the integrated training of cultural competence and ethical skills.
Internationalization of higher education is viewed to be a response to globalization. It has gained momentum and cultural competence is viewed as one of the outcomes of internationalization, Cf. It has become a powerful and persistent driver in education around the world during the past two decades, Cf. Reference to internationalization can be found in e. The concept has been debated extensively and different terms and definitions have been used to describe this phenomenon in higher education over the past 50 plus years.
According to Knight. There are a plethora of definitions and descriptions which reflect debates and different perspectives on the topic, but all add in different manners to the application of the concept to higher education. Knight, Cf. Hudzik, cf. It shares institutional ethos and values and touches the entire higher education.
It shapes institutional ethos and values and touches the entire higher education enterprise. Various authors have identified key aspects of the internationalization of higher education, which include e.
Political and economic rationales for national policies on internationalization appear to be increasing at the cost of academic and cultural motivations, which could be detrimental to the process, Cf. In spite of internationalization being debated around the world and being implemented in different ways, it is viewed as a positive response to globalization as international connections are enriching and offer a fresh cultural insights, Cf. Cultural competence is central to internationalization in higher education since it is one of the desired outcomes.
Internationalization of the Curriculum IoC. A new focus has emerged within the broader institutional approach to internationalization, namely the internationalization of the curriculum IoC which emphasizes the implementation of internationalization for teaching and learning. Different approaches have been described to the IoC e. However, according to B. Leask, Cf. IoC requires that academics think outside of these traditional restrictive, boundaries and recognize that disciplinary knowledge is not culture-free, Cf.
IoC is based on an understanding of the cultural foundations of knowledge and practice within disciplines and related professions which frequently requires members to challenge commonly held beliefs. Encouragement of and support for students to engage productively with difference, including different ways of thinking, both within and beyond the classroom. It situates the disciplinary teams who construct the curriculum as the center of the process. The framework contains layers of context namely institutional, local, national, and g global.
The interaction of these layers determines how internationalization is conceptualized and enacted in the curriculum. The framework includes curriculum design.
The foundation of knowledge remains within the context of the discipline, but the complexity of the problems must be understood from a broader perspective that acknowledges cultural, social, and linguistic diversity, as well as an international viewpoint of the field of study, Cf. Internationalization of curricula for health care professionals aims to facilitate the acquisition of broader international perspectives through an awareness of culture and intercultural communication skills.
Topics such as equity, access to healthcare, public health and the burden of disease address a global perspective. Development of cultural competence, as mentioned earlier, is a key outcome, and together with professional skills, will allow graduates to be empowered to serve communities in the best way possible, Cf.
Two frameworks for internationalization were proposed by J. She identifies categories of each, provides descriptions of activities and stipulates forms or conditions of mobility for these frameworks.
It is clear that cultural competence plays a central role within both of these frameworks. On a personal level, students would be required to evidence cultural competence to e. Cultural competence could be facilitated by students participating in extracurricular activities e. Faculty would require cultural competence to e. Williams, B. Louw, M. Keske-Soares, K. Bleile, I. Trindade, T. Kessler, L. Maximino, and A. Fukushiro, Cf. They adopted the concept of scientific multiculturalism as the core of their international curriculum.
Scientific multiculturalism refers to the differences in research cultures across countries with regard to student training models, interactions between faculty and students, and interactions among students, Cf.
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