Section I The Multiple Dimensions of Multicultural Counseling and Therapy

Preface

x i x

Section I

The Multiple Dimensions of Multicultural

Counseling and Therapy

P a r t I

T h e A f f e c t i v e a n d C o n c e p t u a l D i m e n s i o n s o f

M u l t i c u l t u r a l C o u n s e l i n g / T h e r a p y 3

Chapter 1

T h e M u l t i c u l t u r a l J o u r n e y t o Cultural C o m p e t e n c e :

P e r s o n a l N a r r a t i v e s 5

Diverse: Theory and Practice—Mark S. K i s e l i c a 6

M y P e r s o n a l a n d P r o f e s s i o n a l J o u r n e y a s a P e r s o n of Color: T h e Heart a n d S o u l of Counseling the

Culturally Diverse—Derald W i n g S u e 16

Being Chinese American in a Monocultural Society 18 The College a n d Graduate School Years 20

First Job—A Counseling Psychologist 21 Going into Academia 22

Work on Multicultural Counseling a n d Therapy 23 Expanding Social Justice Horizons 24

I m p l i c a t i o n s for C l i n i c a l Practice 2 6

Chapter 2

T h e S u p e r o r d i n a t e N a t u r e o f M u l t i c u l t u r a l

C o u n s e l i n g a n d T h e r a p y 2 9

Derald Wing Sue, David Sue

vi Contents T h e m e Three: T h e I n c l u s i v e o r E x c l u s i v e N a t u r e o f M u l t i c u l t u r a l i s m 3 3 T h e m e Four: T h e S o c i o p o l i t i c a l Nature o f C o u n s e l i n g / T h e r a p y 3 4 T h e m e Five: T h e N a t u r e o f M u l t i c u l t u r a l C o u n s e l i n g C o m p e t e n c e 3 5 A Tripartite F r a m e w o r k for U n d e r s t a n d i n g t h e M u l t i p l e D i m e n s i o n s of Identity 36 I n d i v i d u a l a n d U n i v e r s a l B i a s e s i n P s y c h o l o g y a n d M e n t a l H e a l t h 4 0 T h e Impact o f Group I d e n t i t i e s o n C o u n s e l i n g a n d P s y c h o t h e r a p y 4 1 What I s M u l t i c u l t u r a l C o u n s e l i n g / T h e r a p y ? 4 2 What Is Cultural C o m p e t e n c e ? 43

Competency One: Therapist Awareness of One's O w n Assumptions, Values, and Biases 44

Competency Two: Understanding the Worldview of Culturally Diverse Clients 44

Competency Three: Developing Appropriate Intervention Strategies and Techniques 45

M u l t i d i m e n s i o n a l M o d e l o f Cultural C o m p e t e n c e i n C o u n s e l i n g 4 8

I m p l i c a t i o n s for Clinical Practice 51

Part II

T h e Political D i m e n s i o n s of M e n t a l H e a l t h P r a c t i c e 53

Chapter 3

T h e Politics of C o u n s e l i n g a n d P s y c h o t h e r a p y 55

T h e Diversification of t h e U n i t e d States 59

The Graying of the Workforce and Society 59 The Feminization of the Workforce and Society 60

The Changing Complexion of the Workforce a n d Society 61

T h e E d u c a t i o n a n d Training o f M e n t a l H e a l t h P r o f e s s i o n a l s 6 4

Definitions of Mental Health 66

Curriculum and Training Deficiencies 70

C o u n s e l i n g a n d M e n t a l H e a l t h Literature 7 1

Minorities and Pathology 71

R e l e v a n c e o f Research 7 5 I m p l i c a t i o n s for Clinical Practice 76

Chapter 4

Chapter 5

Racial, G e n d e r , a n d S e x u a l O r i e n t a t i o n Microaggressions:

I m p l i c a t i o n s for C o u n s e l i n g a n d P s y c h o t h e r a p y 105

By Derald Wing Sue & Christina M. Capodilupo

R a c i s m , S e x i s m , a n d H e t e r o s e x i s m 107

The Evolution of Racism, Sexism, and Heterosexism: Microaggressions 110 The Dynamics and Dilemmas of Microaggressions 112

Therapeutic Implications 121 I m p l i c a t i o n s for C l i n i c a l Practice 1 2 4

P a r t I I I

T h e Practice D i m e n s i o n s o f M u l t i c u l t u r a l C o u n s e l i n g / T h e r a p y 131

Chapter 6

Barriers t o M u l t i c u l t u r a l C o u n s e l i n g a n d T h e r a p y 133

Focus on the Individual 141

Verbal/Emotional/Behavioral Expressiveness 142

S o c i o p o l i t i c a l I m p l i c a t i o n s o f O p p r e s s i o n : Trust a n d M i s t r u s t

i n C o u n s e l i n g / T h e r a p y 7 9

Effects o f H i s t o r i c a l a n d Current O p p r e s s i o n 8 4

Ethnocentric Monoculturalism 84

Historical Manifestations of Ethnocentric Monoculturalism 88 Therapeutic Impact of Ethnocentric Monoculturalism 91

C r e d i b i l i t y a n d A t t r a c t i v e n e s s i n M u l t i c u l t u r a l C o u n s e l i n g 9 3

Counseling as Interpersonal Influence 94 Psychological Sets of Clients 95

Therapist Credibility 98

I m p l i c a t i o n s for C l i n i c a l Practice 102

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Insight 143

Self-Disclosure (Openness and Intimacy) 145 Scientific Empiricism 146

Distinctions between Mental and Physical Functioning 146 Ambiguity 147

Patterns of Communication 147

C l a s s - B o u n d Values 1 4 8 L a n g u a g e Barriers 1 5 1 G e n e r a l i z a t i o n s a n d S t e r e o t y p e s : S o m e C a u t i o n s 153

I m p l i c a t i o n s for Clinical Practice 154

Chapter 7

Culturally Appropriate Intervention Strategies 157

C o m m u n i c a t i o n S t y l e s 1 6 0

Nonverbal Communication 162

S o c i o p o l i t i c a l Facets o f N o n v e r b a l C o m m u n i c a t i o n 1 6 9

Nonverbals as Reflections of Bias 170

Nonverbals as Triggers to Biases and Fears 172

C o u n s e l i n g a n d T h e r a p y a s C o m m u n i c a t i o n S t y l e 1 7 6

Differential Skills in Multicultural Counseling/Therapy 177 Implications for Multicultural Counseling/Therapy 178

I m p l i c a t i o n s for Clinical Practice 1 8 1

Chapter 8

Multicultural F a m i l y C o u n s e l i n g a n d T h e r a p y 183

F a m i l y S y s t e m s C o u n s e l i n g a n d T h e r a p y 1 8 9 I s s u e s i n W o r k i n g w i t h E t h n i c M i n o r i t y F a m i l i e s 1 9 0

Ethnic Minority Reality 190 Conflicting Value Systems 191 Biculturalism 192

Ethnic Differences in Minority Status 192 Ethnicity and Language 195

M u l t i c u l t u r a l F a m i l y C o u n s e l i n g / T h e r a p y : A C o n c e p t u a l M o d e l 196

People-Nature Relationship 197 Time Dimension 199

Relational Dimension 201 Activity Dimension 203

Nature of People Dimension 204

I m p l i c a t i o n s for C l i n i c a l Practice 2 0 5

Chapter 9

N o n - W e s t e r n I n d i g e n o u s M e t h o d s o f Healing:

I m p l i c a t i o n s for C o u n s e l i n g a n d T h e r a p y 209

Causation a n d Spirit Possession 214

The S h a m a n as Therapist: Commonalities 215 A Case of Child Abuse? 216

The Principles of Indigenous Healing 219

Holistic Outlook, Interconnectedness, a n d Harmony 222 Belief in Metaphysical Levels of Existence 223

Spirituality in Life and the Cosmos 225

I m p l i c a t i o n s for C l i n i c a l Practice 2 2 8

P a r t IV

Racial/Cultural I d e n t i t y D e v e l o p m e n t i n M u l t i c u l t u r a l

C o u n s e l i n g a n d T h e r a p y 231

Chapter 10

Racial/Cultural I d e n t i t y D e v e l o p m e n t i n P e o p l e o f Color:

T h e r a p e u t i c I m p l i c a t i o n s 233

Black Identity Development Models 236 Asian American Development Models 239

Latino/Hispanic American Identity Development Models 240

x Contents

Chapter 11

White Racial I d e n t i t y D e v e l o p m e n t : T h e r a p e u t i c I m p l i c a t i o n s 2 5 9

The Hardiman White Racial Identity Development Model 266 The Helms White Racial Identity Development Model 269

T h e P r o c e s s o f W h i t e Racial I d e n t i t y D e v e l o p m e n t : A D e s c r i p t i v e M o d e l 2 7 6 I m p l i c a t i o n s for C l i n i c a l Practice 2 8 2

Part V

Social J u s t i c e D i m e n s i o n s i n C o u n s e l i n g / T h e r a p y 285

Chapter 12

Social J u s t i c e C o u n s e l i n g / T h e r a p y 287

Understanding Individual a n d Systemic Worldviews 293

L o c u s o f Control 2 9 4 A Racial/Cultural Identity D e v e l o p m e n t M o d e l 2 4 2

Conformity Stage 242 Dissonance Stage 246

Resistance and Immersion Stage 248 Introspection Stage 249

Integrative Awareness Stage 251

Therapeutic I m p l i c a t i o n s o f t h e R / C I D M o d e l 2 5 2

Conformity Stage: Therapeutic Implications 253 Dissonance Stage: Therapeutic Implications 254

Resistance and Immersion Stage: Therapeutic Implications 255 Introspection Stage: Therapeutic Implications 256

Integrative Awareness Stage: Therapeutic Implications 256

Contents xi

L o c u s o f R e s p o n s i b i l i t y 2 9 6 F o r m a t i o n o f W o r l d v i e w s 2 9 7

Internal Locus of Control (IC)-Internal Locus of Responsibility (IR) 298 External Locus of Control (EC)-Internal Locus of Responsibility (IR) 300 External Locus of Control (EC)-External Locus of Responsibility (ER) 302 Internal Locus of Control (IC)-External Locus of Responsibility (ER) 303

M u l t i c u l t u r a l O r g a n i z a t i o n a l D e v e l o p m e n t ( M e s o Level) 3 0 5

Culturally Competent Mental Health Agencies 306

S y s t e m i c C h a n g e ( M a c r o Level) 3 0 9

Antiracism as a Social Justice Agenda 310

Social Justice Requires Counseling Advocacy Roles 311

Section

II

Multicultural Counseling and Specific Populations

P a r t VI

C o u n s e l i n g a n d T h e r a p y I n v o l v i n g M i n o r i t y G r o u p

C o u n s e l o r s / T h e r a p i s t s 315

Chapter 13

M i n o r i t y G r o u p Therapists: Working w i t h Majority a n d O t h e r

M i n o r i t y Clients 317

E t h n i c M i n o r i t y a n d Majority T h e r a p i s t P e r s p e c t i v e s 3 2 6

xii Contents

P a r t VII

C o u n s e l i n g a n d T h e r a p y w i t h R a c i a l / E t h n i c M i n o r i t y G r o u p

P o p u l a t i o n s 329

Chapter 14

C o u n s e l i n g African A m e r i c a n s 331

Kinship Bonds and Extended Family and Friends 334 Educational Orientation 335

Spirituality 336

Ethnic or Racial Identity 337 African American Youth 337 Racism and Discrimination 340

I m p l i c a t i o n s for C l i n i c a l Practice 3 4 1

Chapter 15

C o u n s e l i n g A m e r i c a n I n d i a n s a n d A l a s k a n N a t i v e s 345

Specific P r o b l e m A r e a s for A m e r i c a n I n d i a n s / A l a s k a n N a t i v e s 3 5 1

Education 351

Acculturation Conflicts 352 Domestic Violence 354 Suicide 354

Alcohol and Substance Abuse 355

Contents x i i i

Chapter 16

C o u n s e l i n g A s i a n A m e r i c a n s a n d Pacific Islanders

359

A s i a n A m e r i c a n s : A S u c c e s s Story?

Traditional A s i a n Cultural V a l u e s , B e h a v i o r Patterns, a n d I m p l i c a t i o n s for T h e r a p y 3 6 0 3 6 2 Collectivistic Orientation 362 Hierarchical Relationships 363 Parenting Styles 364 Emotionality 365

Holistic View on Mind and Body 366 Academic and Occupational Goals 367 Racism and Prejudice 367

A c c u l t u r a t i o n Conflicts b e t w e e n P a r e n t s a n d C h i l d r e n 3 6 8

Identity Issues 368

Psychotherapy Is a Foreign Concept to Many Asian Americans 369 Expectations of Counseling 370

Counseling Interventions 370 Family Therapy 371

I m p l i c a t i o n s for C l i n i c a l Practice 3 7 2

Traditional H i s p a n i c V a l u e s , Characteristics, B e h a v i o r Patterns, a n d I m p l i c a t i o n s

Family Values 377 Family Structure 378 Sex Role Expectations 379 Spirituality a n d Religiosity 381 Acculturation Conflicts 382 Educational Characteristics 384

Immigration, Racism, Discrimination, and Other Societal Factors 385 Assessment and Linguistic Issues 386

I m p l i c a t i o n s for C l i n i c a l Practice 3 8 7

Chapter 17

C o u n s e l i n g H i s p a n i c / L a t i n o A m e r i c a n s

375

x i v Contents

Chapter 18

C o u n s e l i n g I n d i v i d u a l s o f Multiracial D e s c e n t 3 8 9

Facts a n d F i g u r e s R e l a t e d t o B i r a c i a l / M u l t i r a c i a l P o p u l a t i o n s 3 9 0

Hypodescent: The "One Drop of Blood" Rule 392

R a c i a l / E t h n i c A m b i g u i t y , o r "What A r e You?" 3 9 3

The Marginal Syndrome, or Existing b e t w e e n the Margins 395

Stereotypes and Myths of Multiracial Individuals and Interracial Couples 397 A Multiracial Bill of Rights 399

I m p l i c a t i o n s for C l i n i c a l Practice 4 0 1

P a r t VIII

C o u n s e l i n g a n d Special C i r c u m s t a n c e s I n v o l v i n g

Racial/Ethnic P o p u l a t i o n s 405

Chapter 19

C o u n s e l i n g Arab A m e r i c a n s 4 0 7

Facts Regarding Arab Americans and Islam 408 Stereotypes, Racism, and Prejudice 409

Religious and Cultural Background 411 Family Structure and Values 412 Acculturation Conflicts 413 I m p l i c a t i o n s for C l i n i c a l Practice 4 1 3

Chapter 20

C o u n s e l i n g J e w i s h A m e r i c a n s 415

Contents xv

Chapter 21

Chapter 22

C o u n s e l i n g R e f u g e e s 431

Effects of Past Persecution, Torture, or Trauma 433 Culture and Health 434

Safety Issues a n d Coping with Loss 435 Gender Issues and Domestic Violence 436 Linguistic and Communication Issues 437

I m p l i c a t i o n s for C l i n i c a l Practice 4 3 8

P a r t IX

C o u n s e l i n g a n d T h e r a p y w i t h O t h e r M u l t i c u l t u r a l P o p u l a t i o n s 441

Chapter 23

C o u n s e l i n g S e x u a l M i n o r i t i e s 443

C o u n s e l i n g I m m i g r a n t s 423

Barriers to Seeking Treatment 428

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Chapter 24

C o u n s e l i n g Older A d u l t Clients 455

P r o b l e m s o f O l d e r A d u l t s 4 5 7

Physical and Economic Health 457 Mental Health 458

Mental Deterioration or Incompetence 458 Family Intervention 459

Elder Abuse and Neglect 461 Substance Abuse 462

Depression and Suicide 462 Sexuality in Old Age 464 Multiple Discrimination 465 I m p l i c a t i o n s for C l i n i c a l Practice 4 6 6

Chapter 25

C o u n s e l i n g W o m e n 4 6 9

Barriers to Career Choices 471 Discrimination and Victimization 472 Gender Issues 473 Affective Disorders 474 Aging 475 F e m i n i s t I d e n t i t y T h e o r y 4 7 7 T h e r a p y for W o m e n 478 I m p l i c a t i o n s for C l i n i c a l Practice 4 7 9

Chapter 26

C o u n s e l i n g I n d i v i d u a l s w i t h D i s a b i l i t i e s 4 8 1

Contents xvii

C o u n s e l i n g I s s u e s w i t h I n d i v i d u a l s w i t h D i s a b i l i t i e s 4 9 0

Models of Disability 491

Life Satisfaction and Depression 492 Sexuality and Reproduction 493 Spirituality and Religiosity 494 Family Counseling 495

I m p l i c a t i o n s for C l i n i c a l Practice 4 9 6

R e f e r e n c e s 497

A u t h o r I n d e x 539

S u b j e c t I n d e x 546