If you can’t see that your own culture has its own set of interests, emotions, and biases, how can you expect to deal successfully with someone else’s culture? (p. 261).
Looking Outward
Several models have been created to help us operate from a culturally responsive stance (see Adames & Chavez-Dueñas, 2017 CREAR-CE Model; Park-Taylor et al., 2009 Multicultural Competency Training Model). A well-established framework is White and Henderson’s (2008) multicultural competency building model which includes an actionable plan to develop and maintain cultural competency throughout our mental health careers and beyond. This model is divided into four levels including: (1) conceptual/theoretical/intellectual which underscores the importance of learning about our client’s culture at the deep structural level obtained by reading textbooks and journals, attending lectures and courses, and watching movies/documentaries; (2) engaging in challenging cross-cultural dialogues that provide the opportunity for emotional grow through active participation in difficult dialogues around individual differences; (3) behavioral engagement which emphasizes the importance of immersing ourselves in the context/community of the people we serve; and (4) building practical skills that enhance the therapeutic relationship which focuses on developing healing approaches that are tailored to the unique and complex needs of our clients (also see Adames et al., 2016; Henderson et al., 2014). According to White and Henderson, when we engage in activities at each of the four levels, we end up developing and deepening our cultural competency and improving the psychological services we provide.
SCENARIOS FOR DISCUSSION
You share a suite of offices with several other therapists. The name of each therapist is on the door to that therapist’s office. One morning you find that the door to one of the offices has been broken in and the office vandalized. The name on the door was Jewish. Swastikas along with epithets have been spray-painted on the walls, desk, floor, and bookshelves. You have no evidence but believe the vandal may have been one of your patients—someone who has expressed strong anti-Semitic views during therapy sessions, embraces the view that the Holocaust is fiction, and has described fantasies of vandalizing synagogues. But if you were to ask him during the next therapy session whether he had anything to do with vandalizing your colleague’s office, he would deny it.
How do you feel?
What would you like to do?
What do you think you would actually do?
Would you mention your suspicion that your client may have vandalized your colleague’s office to the colleague, the police, or anyone else? If so, how do you address issues of client privacy and confidentiality?
Would you mention your suspicion to your client? If so, how?
How, if at all, would you address your client’s anti-Semitism in therapy?
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You are a Latino psychotherapist who speaks Spanish only moderately well. Your policy is to try to refer all those who speak only Spanish to fluent Spanish speakers, but you will see Spanish speakers who also speak English if they wish. A South American client who speaks fluent English and Spanish sees you because you are the only Latino available on her HMO list. At the first session, she insists that you should be ashamed for not speaking better Spanish and that you therefore have no culture.
How do you feel?
What are your thoughts and feelings about this client?
How would you respond to this client?
Under what conditions would you continue to see or decline to see this client?
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You have been leading a therapy group at a large mental health facility. As one of the sessions begins, a group member interrupts you and says, “I want to ask you about something. Have you noticed how none of the doctors here are People of Color but almost all the cleaning crew are? Why do you work in a system like that? Don’t you think that has any effects on us patients?”
How do you feel?
What are the possible replies you consider?
What do you think you would say?
What effects, if any, might such a system have on clients?
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You work in a large office building. As your therapy client, a person of the Sikh faith, is getting ready to leave your office, the police show up at the door, handcuff him, and say they are taking him to the station for questioning. When they leave, the accountant across the hall comes over and says that someone saw your client in the lobby, thought he was acting suspiciously, and called the police to report someone who seemed up to no good.
How do you feel?
What do you consider doing?
What would you like to do?
What do you think you would do?
How, if at all, might this affect the therapy?
How, if at all, would you chart this?
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A married couple comes to you for counseling. Both believe that men are the natural leaders in a marriage and that a woman’s rightful place is to be obedient to her husband. However, they often have what they describe as “slips,” when he seems to look to her for guidance or when she finds it hard to accept his decisions. They are seeking marital counseling to help them eliminate these “slips.”
How do you feel?
What are your thoughts and feelings about the wife?
What are your thoughts and feelings about the husband?
What are your thoughts and feelings about the marital relationship that they value and have chosen for themselves?
How do you think you would respond?
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You work as a counselor in a high school where the majority students are African American and Latinx. You see clients in a small space right next to the principal’s office. Most of your clients have been referred to you for “acting out” behaviors—they are often described by their White teachers as “lazy, unmotivated, and trouble-makers.” In therapy your clients often talk about how the school is “not for them.” They often discuss feeling not smart and that the teachers don’t like them. During one of your sessions with a client who is crying while sharing a traumatic event, a teacher barges into your office and blurts out, “gosh, why do these kids have to be so loud, can you keep them quiet for once?”
How do you feel?
How would you respond to the teacher in that moment?
What would you do when the teacher leaves?
What
