Clinical Psychology- Diversity Issues

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Therapist-Client Matching

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Matching based on race, ethnicity or culture. INCREASES the DURATION of therapy, but DOES NOT have consisten EFFECTS on other THERAPY OUTCOMES. More specifically increased tx length for all groups except AA; had clear benefits for tx outcomes ONLY for hispanic-americans

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Cultural Encapsulation

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1)s/o who defines e.o's reality accoreding to his own cultural assumptions and stereotypes 2)DISREGARDS cultural differences 3) IGNORES evidence that disconfirms his beliefs 4) relys on techniques and strategies to solve problems 5) DISREGARDS their OWN cultural biases

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EMIC

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refers to CULTURE-SPECIFIC theories, concepts and research strategies

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ETIC

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refers to phenomena that refect a UNIVERSAL (or CULTURE-GENERAL) orientation

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High vs. Low Context Communication

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HIGH= grounded in the siutation, depends on group understanding, relies on nonverbal cues, helps unify a culture, and is slow to change.

LOW=relies primarily on the EXPLICIT, verbal part of the message. Less unifying. Can change rapidly and easily.

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Cultural Paranoia

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Assoc. with Ridley. Nondisclosure by blacks can be viewed in terms of cultural and functional paranoia. CULTURAL=a healthy reaction to racism, client d.n. disclores to a white therapist due to a fear of being hurnt or misunderstood

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Functional (vs. Cultural) Paranoia

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Assoc. with Ridley. Nondisclosure by blacks can be viewed in terms of cultural and functional paranoia. FUNCTIONAL= unelath condition that itself is an illness, where the client is unwilling to disclose to ANY therpaist (regardliess of race) due to general mistrust and suspcian.

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Intercultural Nonparanoiac Discloser

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Low Functional Paranoia, Low Cultural Paranoia. A client in this categor is willing to disclose to an AA or Anglo therapist

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Functional Paranoiac

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High Functional, Low Cultural. Nondisclosive to both AA and Anglo therapists, their nondisclosure is primarily due to pathology. TX should focus on alleviating pathology. CHOICE of THERAPIST should be based on COMPETENCE rather than race or culture.

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Healthy Cultural Paranoiac

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Low Functional, High Cultural. Self-disclose to AA but reluctant to disclose to anglo therapist due to past experiences with racism and/or the white therapist's attitudes and beliefs. TX should confront the meaning of the client's paranoia and help the client dev'p disclosure flexibility.

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Confluent Paranoiac

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High Functional, High Cultural. Nondisclosing to all therapists, with nondisclosure due to pathology AND the effects of racism. Therapist should probably be of the same racial group.

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4 Categories of Acculturation (Berry et al.)

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1) Integration=maintains minority culture but incorporates many aspects of the dominant culture, aka "biculturalism" 2) Assimilation=person accepts the majority culture while relinquishing his (minority) culture 3)Separation= withdraws fromt he dominant culture and accepts his (minority) culture 4)marginalization= does not identify with his own culture NOR the dominant culture

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Five Stages of the Racial/Culture Identity Model (Atkinson, Morten and Sue)

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Stage 1) Conformity
Stage 2) Dissonance
Stage 3) Resistance and Immersion
Stage 4) Introspection
Stage 5) Integrative Awareness

"cultural development really is interesting"

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Racial/Culture Identity Model: Stage 1

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Stage 1=Conformity. Positive attitudes toward and preference for the dominant culture; depreciating attitudes towards one's own culture. PREFERS=MAJORITY THERAPIST

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Racial/Culture Identity Model: Stage 2

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Stage 2=Dissonance. Confusion and conflict over the contradictory appreciating and depreciating attitudes tha one has toward the self and toward others of the same and dif groups. PREFERS=THERAPIST from a RACIAL/CULTURAL minority; PERCEIVES problems as being related to racial/cultural issues

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Racial/Culture Identity Model: Stage 3

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Stage 3= Resistance and Immersion.

Actively rejects the dominant society and exhibits + attitudes toward the self and members of OWN group. PREF=Therapist from OWN group, likely to perceive problems as result of oppresion

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Racial/Culture Identity Model: Stage 4

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Stage 4=Introspection

uncertainty about the rigidity of beliefs held in stage 3, conflicts between loyalty and responsibility to own group and personal autonomy. PREF=therapists from OWN group, but OPEN to therapists who share a similar WORLDVIEW

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Racial/Culture Identity Model: Stage 5

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Stage 5= Integrative Awareness

Sense of self-fulfillment regarding their cultural identity, wish to eliminate all forms of oppression, adop a multicultural perspective. PREF=therapist with SIMILAR WORLDVIEW

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Black Racial (Nigrescence) Identity Dev't Model (Cross, 1991)--four stages

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Black identity dev't is directly linked to racial oppression and consist of 4 stages: 1) Preencounter 2)Encounter 3) Immersion/Emersion 4) Internalization/Commitment

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Black Racial (Nigrescence) Identity Dev't Model (Cross, 1991) STAGE 1

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Stage 1=Preencounter.

whites seen as ideal, AAs are dengrated.

PREFERS a WHITE counselor

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Black Racial (Nigrescence) Identity Dev't Model (Cross, 1991) STAGE 2

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Stage 2=Encounter

exposure to a single significant race related event or multiple events leads to greater racial/cultural awareness and interest in dev'p an AA identity

PREFERS an AA counselor

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Black Racial (Nigrescence) Identity Dev't Model (Cross, 1991) STAGE 3

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Stage 3=Immersion/Emersion

Struggle b/t old and emerging ideas about race. Initially idealizes AAs, immerses in AA culture, and denigrates whites. Near the END, less emotionally immersed and begins to move toward internalization of a new identity.

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Black Racial (Nigrescence) Identity Dev't Model (Cross, 1991)

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STAGE 4= Internalization/Committment

adopts an AA wordview, and in SECOND HALF, works to eradicate racism. May exhibity (HEALTHY) cultural paranoia

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White Racial Identity Development Model (Helms)--

SIX STAGES

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1) Contact
2) Disintegration
3) Reintegration
4) Pseudo-Independence
5)Immersion-Emersion
6) Autonomy

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White Racial Identity Development Model (Helms)

STAGE 1

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= CONTACT

little awareness of racial identity and may exhibit unsophisticated bxs that reflect racist attitudes and beliefs

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White Racial Identity Development Model (Helms)

STAGE 2

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=DISINTEGRATION

increasing contact with minorities increases the person's awareness of being white, leads to CONFUSION and AMBIVALENCE, may OVERIDENTIFY with AA, act in paternalistic ways, or retreat into white society

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White Racial Identity Development Model (Helms)

STAGE 3

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attempts to resolve the conflicts of the disintegration stage (stage 2) by accepting racist views of white superiority or AA inferiority

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White Racial Identity Development Model (Helms)

Stage 4

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=PSEUDO-INDEPENDENCE

a "personally jarring" event causes the person to question his racist views and recognize that whites have a responsiblity for racisim

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White Racial Identity Development Model (Helms)

STAGE 5

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=IMMERSION-EMERSION

explores what it means to be white

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White Racial Identity Development Model (Helms)

STAGE 6

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=AUTONOMY

internalizes a positive, nonracist white identity that includes an appreciation of and respect for racial/cultural differences and similarities

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Homosexual (Gay/Lesbian) Identity Dev't Model (Troiden)

FOUR STAGES

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1)Sensitization: Feeling Different (middle childhood)

2) Self-Recogntition: Identity Confusion (onset of puberty, realizes attraction to same sex, turmoil & confusion)
3)Identity Assumption (more certain of homosexuality but may deal with the realization in different ways--passing or acting is ways consistent with homosexual stereotypes)
4)Commitment: Identity Integration (homosexual WOL, publicly disclose)