Sue and Zane (1987).

 

 Technique Oriented Suggestions for Minority Groups (EX. Asian-Americans are more culturally used to counseling, direction and structure--so are Hispanics, who are comfortable with a present time orientation and Filipino‑Americans, with whom one should avoid introspection and touchy‑feely techniques) are helpful, but should not be used blindly because of a wide range of differences in minorities.

 

Knowledge of the degree of enculturation is important so ethnic matches don’t become cultural mismatches. An ethnic match may produce ascribed credibility, but this is secondary to achieved credibility. Sue advocates “gift giving” to help achieved credibility, for example, Normalization: “Your feelings are not crazy. They are what anyone would feel in your situation.” Other gifts include: Relief from anxiety and depression, Cognitive clarity, Reassurance, Hope and faith, and Skills acquisition. Within 2 or 3 sessions therapists should: (A) Convey a conceptualization of the problem congruent with the client’s belief structure, (B) Provide an outline of treatment that is culturally acceptable, and C) Establish culturally reasonable goals. Therapists should assess their own credibility on a case by case basis.

 

 

Sue, Zane, & Young---Therapy with culturally diverse populations. (Handbook Chapter from 1994).

 

Sue et al., emphasize within-culture heterogeneity.

 

African-Americans and Anerican-Indians overutilize mental health (MH) services; Asian-Americans and Latino-Americans (who are more likely to have English as a second language) underutilize services.

 

In general, African-Americans and Asian-Americans improve as much as whites; Latinos (esp. Mexican Americans) may improve more. Not enough data on American Indians.

 

There is a general preference for ethnic matches by clients.

 

 

PROCESS

 

            African-Americans often function from an interpersonal orientation; which may differ from white therapists; who frequently may have an instrumental or goal orientation.

 

American-Indians value:

                        1.         Sharing and redistribution VS. Acquisition

                        2.         Cooperation VS. Competition

                        3.         Noninterference VS. Intervention

                        4.         Harmony with nature VS. Control

                        5.         Present VS. Future planning

                        6.         Extended family VS. Nuclear

 

Asian-Americans:

                        1.         prefer and expect a more directive problem-solving approach.

                        2.         also tend not to make a strong distinction between emotional and physical problems, and attribute both to bodily imbalances.

                        3.         believe that M.H. is enhanced by self-discipline and avoidance of negative thinking.

                        4.         often refrain from verbalizing emotions. Instead, they use gestures, metaphors, and exchange of material as the language of emotions.

                        5.         value extended family arrangements based on structured, hierarchal role, relationships and collectivism.

                        6.         they also value group achievement, “face”, and emotional restraints.

 

-           Latinos:

                        1.         prefer directive therapist style.

                        *Many culturally sensitive treatments developed (Cuento) importance of family.

 

New information from 2004 Handbook Chapter, “Research on psychotherapy with culturally diverse populations” by Zane, Hall, Sue, Young, and Nunez.

 

30% of the population of the U.S. in 2000 were ethnic minorities. Compared to other cultural groups, African-Americans are more likely to prematurely terminate. About half of the 35 million African-Americans in the U.S (2000) are members of the middle or upper classes. Therapist-client ethnic matches show small effects, usually upon continuation in therapy rather than outcomes.

 

The American Indian population is the U.S. (2.4 million) is often economically impoverished, educationally disadvantages, and young. Twenty-six percent had incomes under the poverty line, unemployment ranged from 20-70% depending upon community, and their mean education level (9.6 yrs.) is the lowest of any ethnic group.

 

The 11.2 Asian Americans in the U.S. have a higher median household income (45K) than Whites (40K). Asian Americans tend to have larger households of more wage earners than Whites.

 

Latino/a Americans (32.4 million) are projected to become the largest ethnic minority group by 2005.  There is a strong emphasis on respect for elders and an emphasis on family. Directive counseling continues to be preferred.

 

GARNETS ET AL. 1991

 

EXEMPLARY PRACTICES

 

1.         A therapist (T.) uses the understanding of the societal prejudice experienced by gay men and lesbians (G.M. and L.) to guide therapy, to help G.M. and L. to overcome negative ideas about homosexuality .

 

2.         T. recognizes that his/her own sexual orientation may be relevant and tries to recognize possible limitations.

 

3.         T. does not attempt to change the sexual orientation of a client without strong evidence that this is the appropriate course of action.

 

4.         T. helps client to develop a positive G.M. or L. identity and understands how the client’s negative attitude to homosexuality may complicate this process.

 

5.         T. is knowledgeable about the diverse nature of G.M. and L. relationships and supports and validates their potential for the client.

 

6.         T. recognizes the potential importance of extended and alternate families for G.M. and L.

 

7.         T. recognizes the effects of societal prejudice on G.M. and L. relationships and parenting.

 

8.         T. understands that the family of origin of G.M. and L. may need education and support.

 

9.         T. is familiar with needs and treatment issues of G.M. and L., and uses relevant M.H., education, and G.M. and L. community resources.

 

10.       T. recognizes the importance of educating professionals, students, supervises, and others about G.M. and L. issues and actively counters misinformation or bias about G.M. and L.

 

 

BERGIN 1991

 

VALUES AND RELIGIOUS ISSUES

 

Therapists are more religious than one might expect:

           

                                                Clinical Psychologists                      All Therapists             General Population

Regular church attendees---------------33%------------------------------------41%-------------------------40%

 

“I try hard to live by my

religious beliefs.”------------------------65%-------------------------------------- 77%-------------------------84%

 

“My whole approach to

life is based on my religion.”-----------33%------------------------------------ 46%-------------------------72%

 

 

Only 29% of therapists rated religious/spirituality content as important in treatment behind:

            1.         competent perception and expression of feelings. (87%)

            5.         human relatedness/family commitment. (73%)

            9.         regulated sexual fulfillment. (49%)

 

 

Religious values:

            intrinsic-         person internalizes religious beliefs and is responsible and socially conscious. A positive correlation with mental health and tolerant attitudes

 

            extrinsic-        person uses religion as a means of attaining security and status; becomes less flexible, dogmatic, and authoritarian