Acculturation

The process by which individuals with cultures different than the majority culture integrate aspects of the majority culture into their culture of origin.

Ideally, individuals will carefully and gradually pick and choose what they accept from the mainstream culture.

Acculturation can lead to conflicts within families, as children are more likely to acculturate faster than adults.

This quick acculturation is necessary for children who are in school and must learn quickly how to cope in a new culture.

Ex: The school counselor is asked to speak with the Martinez family because they have some acculturation concerns. They have recently immigrated to the U.S. and they feel that their children are abandoning their culture by embracing the American culture so quickly. The school counselor helps the family deal with this conflict.

Assimilation

The process by which individuals with cultures different than the majority culture are absorbed into the mainstream culture. 

The individual loses aspects of their culture of origin, such as language, customs, and ethnicity. 

Assimilation is typically viewed as a negative process, whereas acculturation is a more positive process.

Individuals may feel pressure from members of the majority culture to assimilate quickly.

Ex: Maria came to therapy feeling very depressed. She immigrated to the United States 20 years ago, when she was 25, and learned English very slowly. Though she speaks English now, it is with an accent and she is most comfortable with Spanish. She has been a victim of many anti-immigrant sentiments lately, and blames her depression on them. American friends have encouraged her to assimilate completely, letting of her native language and customs, but she feels it is a part of her self-identity and is reluctant to do so.

Bicultural 

A term used to describe individuals who identify with one or more cultural or ethnic backgrounds. 

An individual who is bicultural is conversant with both sets of values and customs, typically those of the majority culture and of a minority culture.

Maintaining a bicultural identity is often difficult in the United States, as there is pressure from the mainstream culture to assimilate completely.

Ex: Aiyanna came to a therapist known for her work in multiculturalism because she is having trouble reconciling her Native American culture, inherited from her mother, with the Western United States’ culture in which she feels much pressure to assimilate with, due to societal pressures. Her spiritual values are not recognized or respected by many in the majority culture, however, she is bicultural, in her ability to adapt and understand the norms of both cultures.

Collectivism

A way of life in some other cultures in which the group is the primary unit, not the individual.

The needs and interests of individuals are sacrificed in order to meet the needs of the group as a whole. 

This philosophy is prominent in Eastern cultures.

It is in contrast to the prevailing sentiment in the United States, which is individualism.

When counseling someone from a collectivist background, the therapist must be careful not to force their own individualistic viewpoint. 

Ex: Aya comes to therapy because she is having a significant amount of anxiety about her parents, who are Asian-American. They are aging and wish to move in with her, something Aya would like for them to do, but she is experiencing pressure form her American friends who claim that having her parents live with her is weird. The therapist understands that Aya comes from a collectivist culture in which the good of the whole is more important than that of the individual, and tries to help Aya within that context to resolve this conflict.

Coming Out Process

For individuals who identify as gay or lesbian, this is the process in which they reveal to their family and friends that they are gay or lesbian.

Due to many holding unfavorable views of gays and lesbians in society, even currently, the coming out process is emotional and frequently painful.

The individual may lose a great deal of social support form the most important people in their lives, and may need help from a therapist in finding new social support systems. 

A therapist must be very careful in counseling someone who is thinking about coming out, and should make certain that they have considered all the possible consequences.

Ex: An identical twin male, from a Catholic family, knew from a young age he was not attracted to females and was gay, while his twin brother was not. He had such anxiety about coming out to his family and friends, that he tried to not be gay by turning to the Church, and leading a youth group. When this was not working, he came to see a therapist who went over the possible consequences of revealing himself this way, including his family pushing him away, which they did. However, he was able to find a great support system in the gay community and continued to work through difficulties with his therapist.

Cross’s Model of Racial Identity

5 stage model of how African-American individuals move from a White frame of reference to a positive Black frame of reference.

In the pre-encounter stage, the African American individual devalues their own “blackness” and favors White values and ways.

In the encounter stage, the individual experiences a crisis or event that leads them to challenge some of their beliefs about society, and to feel angry for being brainwashed into trying to lead a “White” life. 

The third stage, immersion-emersion, sees the Black person withdrawing completely from the dominant culture and withdrawing completely from the dominant culture and embracing African American culture wholeheartedly.

In the fourth and fifth stages, internalization and internalization-commitment, the individual has accepted positive aspects of both the dominant culture and their African American culture, and is committed to social change and civil rights.

Ex: Byron was court-ordered to therapy after vandalizing a widen-known racist statue in his hometown. The therapist recognized that Marshall was experiencing the immersion-emersion stage of Cross’ nigrescence model, and encouraged Marshall towards less destructive ways of expressing his passion or his African American heritage.

Cultural Competence

The ability of a therapist to be aware of their own cultural assumptions, values, and biases, to understand the worldview of their culturally diverse clients, and to develop culturally appropriate intervention strategies and techniques for their culturally diverse clients.

In addition, therapists have a responsibility to attempt to change any institutional, organizational, and societal policies that are discriminatory.

Cultural competence is not something that can be learned one time, but is instead a lifelong process in which therapists must remain continually engaged.

Ex: Eva is a therapist who is practicing on a Native American reservation with the Blackfoot tribe and attends ceremonies and meetings with the elders of the tribe, in order to better understand how to help her clients in the context of their culture and culture-specific issues, thereby increasing her cultural competence.

Cultural Relativism

The view that cultural values and worldview influence the expression and determination of deviant behavior. 

In some cultures, it is more acceptable to express psychological complaints in physical terms.

In other cultures, it is not considered abnormal to experience hallucinations. 

Some psychologists focus on an individual’s culture and how the disorder they have is manifested and treated within it.

Ex: Hung, a Vietnamese immigrant, comes to therapy complaining of headaches and stomachaches. In the course of treatment, the therapist discerned that these frequent aches, with no apparent physical cause, were manifestations of his anxiety about his family’s financial well-being back in Vietnam. The therapist came from a perspective of cultural relativism and understood that this was a valid way of expressing that anxiety, and crafted a plan to address it.

Cultural Racism

In the context of multicultural psychology, cultural racism is a term used in scientific research to describe a specific type of racism which developed from the generally known form of racism, in which the majority group decides what is culturally valuable. It is a mental and emotional connection of the majority group with cultural superiority and connecting minority cultures to cultural inferiority.

Characterized by: 1) belief in the superiority of one group’s cultural heritage, 2) belief in the inferiority of all other groups’ heritage, 3) a manifestation of these ethnocentric values and beliefs in the governing structure and practices of the society, and 4) its ability to operate outside the level of conscious awareness.

Prejudiced attitudes can be found in many cultural elements, including language, education, religion, norms of morality, economics and aesthetics. 

Cultural racism occurs when a race’s achievements are ignored in education and when white Western-European cultural attributes are considered to be without question the best in the world.

Cultural Universality

(In contrast to cultural relativism), this is the view that the concepts of normality and abnormality can universally be applied, regardless of culture.

Proponents of this view believe that culturally diverse individuals do not need treatments to be adjusted for them, but can be treated just the same as an individual from a Western culture.

Most of the standards of practice currently in use assume cultural universality.

Ex: Briam, who comes from a hispanic and indigenous culture, comes to therapy for help with depression. The therpist, who came form a culturally universal perspective, used traditional treatments for depression without taking into account Briam’s non-Western cultural heritage and how that may impact his symptoms and his treatment.

Culture

This is a set of shared customs, beliefs, and practices that are common to a specific group. 

Those who share culture frequently also have a shared history and a shared ethnicity.

Frequently culture has a significant influence on one’s sense of identity, and to understand the client’s internal frame of reference, the counselor must understand their culture.

Ex: The therapist felt frustrated because his client, Raiden, a Japanese immigrant, would not make eye contact during therapy. He did not understand that, in Raiden’s culture, avoiding eye contact is a show of respect. The therapist must understand the culture from which Raiden is coming from in order to understand how to best treat his condition.

Culture-Bound

Tied to a specific group of people and their values and beliefs.

Certain syndromes and disorders may be culture-bound, as well as certain treatments.

A counselor must be careful not to diagnose something that is considered normal in a culture as a disorder, and also must be sure to be aware of disorders that occur only in specific cultures.

Values can be culture bound as well, such as emotional expressiveness, insight, and self-disclosure (which are not valued as often in cultures outside of the Western culture).

Ex: Dai, an Asian-American, came into therapy because he was having severe anxiety that his penis may recede into his body and kill him. The therapist recognized that this is a culture bound syndrome known as Koro and referred Dai to a therapist specializing in disorders specific to certain cultures, outside of the Western paradigm.

Emic refers to a type of field research which comes from within a social group, or from the perspective of the subject.

The emic approach investigates how local people think–how they perceive and categorize the world, their rules for behavior, what has meaning for them, and how they imagine and explain things.

The emic approach is important to understanding personality because problems can arise when concepts, measures, and methods are carelessly transferred to other cultures in attempts to make cross-cultural generalizations about personality. 

It is hard to apply certain generalizations of behavior to people who are so diverse and culturally different.

Contrasts with etic; both approaches combined are thought to provide the richest view of how a culture or society might be understood.

Ethnicity

A social construct, rather than a biological concept, that refers to an individual’s unique cultural heritage and social characteristics.

Ethnicity may include values, language, cultural symbols, and behavior patterns.

A therapist should consider a client’s ethnicity when counseling them, as they may have different cultural values and beliefs than the therapist as a result of their ethnicity.

Ex: The Salazar family came to therapy because the father was hearing voices and sounds no one else heard. The therapist talked about the father’s problems in front of the entire family, using the son to translate, without realizing that the family’s Hispanic ethnicity would prohibit the son from taking on such a role.

Ethnocentrism

In the context of multiculturalism, this is the belief that one’s culture or ethnicity is superior to everyone else’s culture or ethnicity.

Ethnocentrism becomes a problem when the dominant culture is ethnocentric and attempts to assimilate all other cultures into it, as has been the case in the Western, colonialist world.

The therapist must be careful not to perpetuate any ethnocentrism in their practice.

Ex: A clinician has a client referred to them by a doctor for refusing to undergo a surgery the doctor said was necessary. The client, Rogelio, an indigenous Native from the Amazon, acknowledges he has a medical issue, but does not believe in Western medical practices, having grown up with stories of doctors harming his people, and believing the medicine men in his village were wiser and more skilled in treating disorders. The therapist considers this idea as ignorant and encourages him to go through with the surgery, irrespective of his personal, culture bound beliefs.

Etic refers to a type of field research which comes from outside the social group being studied, or from the perspective of the observer.

Etic knowledge refers to generalizations about human behavior that are considered universally true, and commonly links cultural practices to factors of interest to the researcher, such as economic or ecological conditions, that cultural insiders may not consider very relevant.

An etic account is a description of a behavior or belief by a social analyst or scientific observer, in terms that can be applied across cultures. 

An etic account attempts to be culturally neutral, limiting any ethnocentric, political, and/or cultural bias or alienation by the observer.

Contrasts with emic; both approaches combined are thought to provide the richest view of how a culture or society might be understood.

Eurocentric Monoculturalism

Refers to a worldview centered on Western civilization, as it had developed during the height of the European colonial empires since the Early Modern period and is widely reflected throughout popular literature and adventure literature in general (think: Western ‘heroes’ who conquered ‘savages’).

Eurocentrism has perpetuated intellectual dependence on a restricted group of prestigious Western academic institutions that determine the subject matter and methods of research, including teaching what might be a mostly biased narrative of world history, and especially in the humanities.

Inherent problems arise with the ongoing exchange of ideas and opinions in clinical practice, because psychology has been traditionally defined by and based upon the following worldview: Western, Eurocentric, and biological perspectives and assumptions.

Eurocentric models may not be effective in working with other populations and may do harm by mislabeling or misdiagnosing problems and treatments.

Filial Piety

A prominent virtue in Asian society put forth by Confucius, this is the belief that the children should submit to and take care of their parents, even after they become adults.

Children are expected to strive for family goals and to not engage in behaviors that would bring dishonor to the family.

Therapists must take this into consideration when counseling Asian Americans, who are more likely to put their parents’ needs and wishes above their own in a way that would be considered dysfunctional in a Western family.

Ex: Shu went into medical school because her Asian parents really wanted her to and also needed the money. The therapist understood that this was Shu’s way of expressing filial piety and did not reflect dysfunction.

Generational Poverty

Families who have lived in poverty for at least two generations, meaning children of parents in poverty grow up to live in poverty themselves. 

The idea that someone who came from a poor family, and who grew up poor, will most likely will be poor their whole life.

Families in generational poverty form their own culture with different values, habits and lifestyles that keep them trapped within that cycle generation to generation (i.e., hidden rules/expectations). 

(By contrast, families in situational poverty have fallen into poverty because of a traumatic event such as illness or divorce)

Individualism

Individualistic cultures, such as the mainstream European and North American cultures, place a high value on individuals being independent and self-sufficient. 

Individualism and collectivism vary in four main areas: (1) self (independent vs. interdependent), (2) goals (goal priority based on self vs. group), (3) relationships (rationality vs. relatedness), and (4) social behaviors (determined by attitudes vs. norms). 

In these cultures, there is value placed on the development of the self and on individuals’ abilities and skills. 

Internal attributes, including thoughts and emotions, help organize persons’ behaviors and meaning making. 

In these cultures, individuals’ goals are prioritized over those of the group, and their behavior is guided based on individual attitudes rather than on the norms of the ingroup.

Generally, the more individualistic the culture is, the stronger the emphasis on the independent self.

Mental Health: individual maturity and mental health are associated with competence, ego strength, responsibility, and autonomy. Mental illness and failures are also seen as due to a lack of ability of the individual. 

Institutional Racism

Occurs when policies, priorities and accepted normative patterns designed to subjugate, oppress, and force dependence of individuals and groups on a larger society by sanctioning unequal goals, unequal status, and unequal access to goods and services.

Institutional racism may include police practices, unemployment, housing and education issues, discriminatory practices and inadequate welfare programs.

Prejudiced attitudes can be found in many cultural elements, including language, education, religion, norms of morality, economics and aesthetics. 

Policies, procedures, and laws favor one race over the other or unfairly advantage one group of people.

This is the hardest racism to recognize and works to disempower entire minority groups within the society.

Microagression

Commonplace daily verbal or behavioral indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative racial slights and insults that potentially have a harmful or unpleasant psychological impact on the target person or group.

It has also been defined as rooted in racism, sexism, or discrimination based on nationality or sexual orientation.

It can be delivered casually or even unconsciously.

Recipients of microaggressions may feel anger, frustration, or exhaustion.

Over time, the cumulative effect of microaggressions is thought to lead to diminished self-confidence and a poor self-image, and potentially also to mental health problems such as depression, anxiety, and trauma.

Microaggressions are actually thought more damaging than overt expressions of bigotry precisely because they are small and therefore often ignored or downplayed, leading the victim to feel self-doubt rather than justifiably angry, and isolated rather than supported.

Minority

A group of individuals who differ from the dominant and majority culture in one or more ways, including but not limited to: culture, race, sexual orientation, or country of origin.

Being a member of a minority in a monocultural society often puts one at a significant disadvantage.

Therapists must recognize that they may not understand a minority group member’s unique experiences and must be open to learning about it from that member.

Ex: Tim, a social worker, came to treatment after a challenging experience attempting to treat social anxiety through the use of a powerful shamanic medicine and psychedelic. He needed someone to talk to who would understand, and only hoped the therapist would be able to help, not knowing where else to go, as the practice is still stigmatized in Western culture. The therapist, who had never had any psychedelic or shamanic experience, realized he was lacking competency in treating someone of such a minority, without projecting their own views, someone who believed in the power of the medicine and that he just needed help integrating the experience in order to heal. The therapist referred Tim to someone better able to treat this less-understood aspect of psychedelic therapy–someone with some experience with psychedelics in the past who could better help him continue on his healing journey, without any judgement.

Multicultural Competency

The main features of cultural competence are counselor self-awareness, imperative to have cultural knowledge, and multicultural counseling skills.

Recognizing and being sensitive to cultural differences is essential for establishing the trust necessary to conduct effective counseling sessions.

It is vital to have cultural skills in order to serve multicultural populations in the most productive way to facilitate rapport.

Multicultural Counseling

This is a type of counseling in which the therapist defines goals and uses treatments that are consistent with an individual’s cultural values.

The therapist must recognize that their values may not be the same as that of their culturally diverse client, but that does not give them the right to pressure their client to accept their values.

The therapist must also recognize some behaviors considered deviant in Western society are not considered deviant in the culture of their clients. 

Ex: When Howard was treating his Asian American client, he was careful when they were defining goals that he did not impose his individualistic values on his client, who had more of a collectivist perspective. This was consistent with Howard’s practice of multicultural counseling.

Multicultural Perspective in Counseling

This perspective recognizes the differences among and within clients and how their cultures may impact their values.

According to this perspective, a counselor must maintain awareness of their own cultural biases and values in order to prevent them from interfering with interactions with culturally diverse clients. 

Counselors are also responsible for cultivating knowledge about different cultures and skills that are useful with culturally diverse clients.

Ex: Josie, a therapist, was raised in an impoverished environment, in which the family constantly struggled to put together any meal for the family and could not provide many things. In her experience, she felt many who are wealthy are wasteful and do not have the same values as those who come from very little. She is aware that she must be very careful to work on fixing this biased perspective in her daily life, as well as not judging clients. If she becomes aware of any sort of resentment or negativity towards a client, she will refer them out.

Oppression

When one culture attempts to force one or more other cultures to adopt their values and standards.

The dominant culture frequently will use its power to marginalize, silence, and otherwise subordinate other culture.

Cultural oppression may occur without the oppressor realizing it; in light of this, the therapist must take steps to be very aware of any ways they may be oppressive to culturally diverse clients.

Ex: Koko, a Blackfoot Native, lives on a Native American reservation in which there is a resident counselor. The counselor is American, most aligned with the White culture. Koko sees the counselor to tell her that she is uncomfortable with….

Pluralism

The existence of two or more groups in a society with different cultures, beliefs, or religions who show mutual respect and tolerance for one another. 

These groups may interact with each other without conflict or assimilation.

In order for this to occur, the dominant culture must recognize the importance of other cultures.

Ex:

Poverty and Mental Illness**

Studies show that there is a direct correlation between poverty and mental illness

Impoverished people are actually 2 to 3 times more likely to develop mental illness than those of a higher economic class. 

These families must deal with economic stressors like unemployment and lack of affordable housing, which can lead to mental health disorders. 

There is a strong association between poverty and substance abuse. Substance abuse only perpetuates a continuous cycle. It can make it extremely difficult for individuals to find and keep jobs. 

Both financial problems and substance abuse can cause mental illnesses to develop.

Mental health: increased risk of schizophrenia and involuntary hospitalization; more likely referred for commitment; less access to services; huge stigma; negative orientation.

Race

A biological and social classification of humans into groups based on various factors, such as culture, language, social practices, and common phenotypic and genotypic traits.

Members of different races all belong to the same species, homo sapiens, with no race being inherently superior to another race.

Counselors should be aware that race is a factor when counseling someone of a different race, and not try to ignore it or brush it off.

Ex:

Racial Identity Development Model

Based on the Minority Identity Development (MID) model, this is Sue and Sue’s elaboration and adjustment of the previous model.

In the conformity stage, the individual is depreciating of their self and their culture and appreciating of the dominant culture.

The second stage, dissonance, is marked by a questioning of the individual’s belief that racism is no longer a problem and that the dominant culture is superior.

Resistance and immersion is the third stage, where the individual completely rejects the dominant culture and completely accepts their own culture.

The fourth stage, introspection, is when the individual begins to negotiate a positive self-identity to separate from both the majority and minority cultures.

The final stage, integrative awareness, marks a positive attitude toward their own culture, appreciation of other minorities, and selective acceptance of the dominant culture.

Ex: An Asian-American client came in to see Julia. It became apparent that being a member of a minority was highly salient to the client, so Julia began to assess the client to see what stage of the minority identity development model the client might be in and how the therapist could help her in that stage. Julia determined that the client was just moving out of the resistance/immersion stage and was beginning to question her previous wholehearted acceptance of all her culture’s values. Julia assisted the client in determining what aspects of her culture she wanted to adhere to and which aspects of the dominant culture she might find more helpful.

White Privilege

A system of invisible advantages that White people inherit and that non-White people in the same circumstances do not inherit.

White privilege is not the same as racism; frequently the people who benefit from white privilege are unaware and do not identify as racist or prejudiced.

People who are White do not have to worry that their race may be a factor when they apply for a job, credit card, or a loan.

Ex:

White Racial Identity Development

White racial identity development (WRID) theory describes how White individuals develop a sense of themselves as racial beings, acknowledge the realities of structural racism and White privilege, and come to accept race as a healthy aspect of themselves and others. 

WRID is a specific derivation of the more general cultural/racial identity development theory. 

It is consistent with cultural/racial identity development theory in that it assumes that (a) people have varying levels of awareness about their group identity, (b) the level of awareness is influenced by sociopolitical factors, and (c) the level of awareness has important implications for counseling practice and training.

Worldview

A set of assumptions about reality that have powerful influences on one’s thoughts and behavior.

A person uses their worldview to interpret and interact with the world around them. 

Worldviews encompass views on many different issues, including death, the meaning of life, and the purpose of the individual.

Different cultures frequently have different worldview, which can influence the interaction between the therapist and the client.

Ex:

Counseling-Relevant Cultural Issues for*

African-American clients

Hispanic/Latino clients

Native American clients

LGBT clients

Asian clients

Arab clients

Physically Disabled clients

Female clients

**On printed paper :)**

Afro-Amer: High poverty rate; high incarceration rate; gentrification; foster care (abuse & neglect) & welfare system

Particularly concerned about stigma, including from mental health diagnoses.

Believe mild depression or anxiety would be considered “crazy” in their social circles. Furthermore, many believe that discussions about mental illness would not be appropriate even among family.

An honest discussion of ethnic and racial factors in the therapeutic relationship can increase trust and mutual understanding, leading to a more rapid unfolding of core issues.

His-Amer: 

High poverty rate

Latinos generally have strongly defined sex roles based on cultural values. These values are particularly salient in the family counseling process. They are as follows:

Machismo – men are expected to be strong, dominant, and provide for the family

Marianismo- women are expected to be nurturing, submissive to male and have selfless devotion to children

Latinos with low levels of acculturation will tend to hold these values more strongly. Thus, when doing family counseling, it is important to assess the level of acculturation. It may be beneficial to address the father first in families with low acculturation.

Families with differing levels of acculturation may have conflict.

Have the client state in his or her own words the problem or problems

as he or she sees it—determine the possible influence of religious or

spiritual beliefs. May prefer traditional healers & come from all different latin american/diverse cultures.

Nat-Amer:

Strengths and protective factors: 

‐ A strong identification with culture  

‐ Connection with the past    

‐ Family                      

‐ Traditional health practices (e.g., ceremonies)               

‐ Adaptability           

‐ Wisdom of elders       

Challenges to health and well-being:

‐ Alcohol misuse

‐ Enduring spirit (stubborn, hard to accept change)

‐ trauma is communal

‐ Long memories

‐ Clashes between Native and non-Native views of mental health

Eye contact, and using open-ended questions are typically experienced as invasive. 

Gentle handshake shows respect, not weakness.

May communicate through storytelling.

May not volunteer information, including requests or disapproval.

Silence is valued, not awkward.

Child sexual abuse is common on reservation