Copyright 2016. American Psychological Association.
All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law.
Doing Your Own Cultural
Self-Assessment
S
3
ue was a newly hired clinician at a rural American Indian
counseling center. Although she had several years of experience working in urban clinics with Latino and African
American people, she had never worked with a Native organization or in a rural community. Sue liked her new work
and the people, but over time she became frustrated with
the slowness of change. After a few months, she complained
to an Indian coworker that she couldn’t understand why it
took so long to decide on a solution and implement it. The
coworker explained that in contrast to many non-Native
organizations in which decisions are made by an individual
director, their center placed a high value on consensus and
giving everyone who might be affected a chance to speak,
share concerns, and contribute to the solution. The goal
was to have everyone on board with the change whenever
possible—a process that took longer on the front end but,
once the decision was made, involved less time taken up by
employee distress, resignations, and new hires.
http://dx.doi.org/10.1037/14801-003
Addressing Cultural Complexities in Practice: Assessment, Diagnosis, and Therapy,
Third Edition, by P. A. Hays
Copyright © 2016 by the American Psychological Association. All rights
reserved.
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Before this job, Sue had never worked in a setting that prioritized
consensus over speed, and because she was a member of the dominant
culture herself, there was nothing in her personal experience that challenged this value priority. So not only was she frustrated by the clinic’s
different approach, but she also had a negative bias toward it—that is,
she assumed that her (the dominant culture’s) approach was better.
But after talking with her coworker, she could see the prioritization of
different values as culturally based and began to appreciate the respect
embedded in this slower approach.
In general, our privileged areas are those in which we hold the
least awareness, because privilege tends to cut those with privilege off
from direct knowledge of and experience with minority perspectives.
The challenge for us as therapists is to recognize our particular areas
of privilege and commit to the extra work that is required to fill our
knowledge gaps. Toward this goal, there are a number of practical steps
you can take to increase your self-awareness and knowledge, including,
but not limited to
❚❚
❚❚
❚❚
❚❚
investigating your cultural heritage and how it influences you;
paying attention to the influence of privilege on your understanding of cultural issues, and hence on your work with clients;
educating yourself through diverse sources of information; and
developing relationships with diverse people.
Work in each of these areas can be facilitated through the use of the
ADDRESSING framework.
Investigating Your Own
Cultural Heritage
To start or deepen your cultural self-assessment, it can be helpful to think
about the ways in which the ADDRESSING influences have affected you,
whether you are a member of a dominant or minority group (or both) in
relation to each influence. Table 3.1 shows how a cultural self-assessment
might look using the therapist Olivia as an example. Under Age and
generational influences, Olivia wrote, “55 years old; third-generation
U.S. American; member of politically active generation of Chicanos and
Chicanas in California; first generation affected by post-civil rights academic and employment opportunities in the 1970s.” On the line for
Developmental or other Disability, she wrote, “Chronic knee problems
since early adulthood, including multiple surgeries; sometimes I use
crutches to walk.” She continued through the list, with some overlap
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Doing Your Own Cultural Self-Assessment
TA B L E 3 . 1
Cultural Self-Assessment: Example of Olivia
Cultural influence
Olivia’s self-assessment
*Age and generational
influences
55 years old; third-generation U.S. American; member of politically
active generation of Chicanos and Chicanas in California; first
generation affected by post-civil rights academic and employment
opportunities in the 1970s.
No developmental disability, but chronic knee problems since
early adulthood, including multiple surgeries; sometimes I use
crutches to walk.
Mother is a practicing Catholic, father a nonpracticing Presbyterian;
my current beliefs are a mixture of Catholic and secular; I do not
attend mass.
Mother and father both of mixed Mexican (Spanish and Indian)
heritage, both born in the United States; my own identity is
Chicana; I speak Spanish, but my primary language is English.
Parents urban, working, lower-middle-class members of an ethnic
minority culture; however, my identity is as a university-educated
Chicana; I identify with working-class people, although my
occupation and income are middle class.
Heterosexual; I have one friend who is lesbian.
My maternal grandmother was Indian and immigrated to the
United States from Mexico with my grandfather when they
were young adults; what I know about this part of my heritage
came from her, but she died when I was 10 years old.
United States, but deep understanding of the immigration
experience from my grandparents.
Woman, Chicana, divorced, mother of two children.
Developmental or
other Disability
*Religion and spiritual
orientation
Ethnic and racial
identity
*Socioeconomic status
*Sexual orientation
Indigenous heritage
*National origin
Gender
* connotes dominant cultural identity.
between categories, providing a general sketch of both minority and
dominant cultural influences and identities salient for her.
YOUR CULTURal SELF-ASSESSMENT
Take some time to answer the questions in Exercise 3.1, but don’t feel
limited by the questions; they’re simply a starting point to get you
thinking about the cultural influences on you. If these influences or
your identity has changed over time (e.g., if you grew up identifying
with a religious community and no longer do), note the earliest ones
first, then the later ones. Fill in every category, even those for which
you hold a dominant cultural identity, because this, too, is meaningful information (e.g., even if you have never had a disability, consider
how your physical and intellectual abilities have affected your life and
opportunities). As already noted, some of these influences overlap. For
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EXERCISE 3.1
Your Cultural Self-Assessment
Age and generational influences: When you were born, what were the social expectations for a
person of your identity? What are they now? Do you identify with a particular generation (e.g.,
baby boomers, millennials, Generation X or Y, World War II veterans)? How have your values and
worldview been shaped by the social movements of or influences on your generation (e.g., the
Great Depression, World War II, Vietnam War, women’s movement, Stonewall riots, Americans
With Disabilities Act, civil rights movement, social media, economic downturn, university costs,
climate change, wars in Iraq and Afghanistan)? What generational roles are core to your identity (e.g., aunt, father, adult child, grandparent)? How have these roles influenced your life?
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Developmental or other Disability: Were you born with a disability, or did you acquire one
later in life? If yes, is it a visible or nonvisible disability (e.g., chronic pain, psychiatric illness,
or cognitive impairment)? If no, have you been a caregiver or lived with someone who has a
disability? How has disability affected your life and opportunities?
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Religion and spiritual orientation: Were you brought up in a religious or spiritual tradition? Do
you identify with a religion or have a spiritual practice now? How were your values and goals
shaped by your religious or nonreligious upbringing?
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Ethnic and racial identity: What do you consider your ethnic or racial identity? If you were
adopted, what are the identities of your biological and adoptive parents? How do other people
identify you? Are these the same? Are there ethnic or racial differences within your family? If so,
how are these differences perceived, and how have they affected you?
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Socioeconomic status: What social class did you grow up in, and what do you consider to be your
socioeconomic status now? When you were in high school, what were the educational and work
opportunities available to you? Do you have peer-level relationships with people who differ
from you socioeconomically (i.e., defined by educational, income, and occupational levels)?
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
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Doing Your Own Cultural Self-Assessment
E X E R C I S E 3 . 1 (Continued)
Sexual orientation: Do you identify as gay, lesbian, bisexual, or heterosexual? If you are
heterosexual, do you have a family member or friend who is gay? Is your family accepting
of a gay member? How has your minority or dominant sexual orientation affected your
relationships and educational and work experiences?
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Indigenous heritage: Do you have any Native heritage—for example, Native Hawaiian, First
–ori, or Aboriginal Australian? Did
Nations, Alaska Native, American Indian, New Zealand Ma
you grow up on or near a reservation or Native community? If so, how has this affected you? If
not, how has the lack of such experience affected you? Do you belong to a culture that has a
multigenerational connection to a particular land, water, or place?
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
National origin: Are you a U.S. citizen, an international student, or an immigrant? Were you
born in the United States? Do you (and your parents and grandparents) speak English as a first
language? How has your English-language ability affected your life and opportunities? How
has your nationality affected your life and opportunities?
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Gender: What were and are the gender-related roles and expectations for you in your family of
origin and current family? When you were a teenager, what were the norms, values, and gender
roles supported within your family, by your peers, in your culture, and in the dominant culture?
How have these expectations affected your choices in life?
________________________________________________________________________________________
________________________________________________________________________________________
Note. Adapted from Addressing Cultural Complexities in Practice, Second Edition: Assessment, Diagnosis, and
Therapy (p. 44), by P. A. Hays, 2008, Washington, DC: American Psychological Association. Copyright 2008 by
the American P­ sychological Association.
example, if you are Jewish, you might note your Jewish heritage under
Ethnic and racial identity, or under Religion and spiritual orientation,
depending on how you conceptualize these influences on you.
The degree to which this exercise is helpful depends on how far you
take your exploration. For instance, in the area of Age and generational
influences, simply recognizing your chronological age is not particularly informative. However, exploring generational influences, including
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historical and sociocultural contexts and their developmental impact on
you at particular ages, is a rich source of information. In addition, exploring the meaning of these diverse influences on you can be facilitated by
participation in a group, because hearing the ways in which other people
have experienced culture will bring up ideas you may have overlooked.
HOW PRIVILEGE AND CULTURE
AFFECT YOUR WORK
Taking this exploration a step further, the next exercise will help you
recognize the ways in which identity privileges affect your life and
work. I’ve found it helpful to emphasize privilege (rather than oppression) because most of us are very aware of the areas in which we feel
oppressed but much less aware of the areas in which we hold privilege.
And unrecognized privilege is dangerous for therapists because privilege cuts us off from information and experiences that help us understand our clients.
Now return to your cultural self-assessment (Exercise 3.1). Look
back over each category, and next to the areas in which you hold a dominant cultural identity, put a little star (*). (Look again at Table 3.1 to see
the stars next to Olivia’s dominant cultural influences.) For example, if
you are between 30 and 60 years old (i.e., a young to middle-aged adult),
put a star next to “Age and generational influences.” If you do not have
a disability (i.e., if you are a member of the nondisabled majority), put
a star next to “Developmental or other Disability.” If you grew up in a
secular or Christian home, put a star next to ”Religion and spiritual
orientation.“ Continue on down the list, starring “Ethnic and racial
identity” if you are of European American heritage, “Socioeconomic
status” if you were brought up in a middle- or upper-class family or
are currently of middle- or upper-class status, “Sexual orientation” if
you are heterosexual, “Indigenous heritage” if you have no Indigenous
heritage, “National origin” if you live in the country in which you were
born and grew up, and “Gender” if you are a cisgender male.
Now look at your ADDRESSING self-description with attention to
the stars. Every individual has a different constellation. However, because
a majority of therapists in North America hold membership in dominant
ethnic, educational, and socioeconomic groups (e.g., the composition of
many U.S. mental health disciplines is 90% White; F. F. Duffy et al., 2004),
when I do this exercise in the United States people are often surprised by
how many stars—that is, how much privilege—they have. This is true
even for therapists who hold a minority identity in one area, such as ethnicity, but are privileged in others, such as generational status, educational
level, socioeconomic status, sexual orientation, or physical abilities.
As you may notice, recognizing the areas in which we hold privilege
is not simple. Privilege can change over time—for example, for a person
who grew up in poverty but now lives a middle-class lifestyle. Privilege
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Doing Your Own Cultural Self-Assessment
also varies depending on context. For example, a middle-class older
Chinese man living in British Columbia may experience little privilege in
relation to the dominant Anglo majority. However, within the Chinese
Canadian community in Vancouver, the same man’s age, gender, and
socioeconomic standing may give him significant privilege. In fact, he
may be quite powerful in his particular community.
Perceiving one’s own privileges can be difficult because, as the saying
goes, privilege is like oxygen—you don’t notice it unless it’s not there.
This is particularly true among members of dominant groups, because
there’s a tendency to become defensive, which blocks recognition of
one’s own privilege. For example, I once met a woman who insisted she
had no privilege while teaching in a Yup’ik village in Alaska. She said
that because she was one of the few White people there, she was the
“oppressed one.” But what she didn’t recognize was that despite it being
a Native village, everyone in her workplace had to speak her language
(English); the curriculum she was teaching was developed by people
of her culture; the power structure and values prioritized in the school
were those of her culture; the school authorities (principal and superintendent) and legal authorities (state trooper who flew in and regional
judge) were members of her culture; and the computer, TV, and radio
were dominated by perspectives representing her culture.
The Case of Ned
To give you a better idea of how the process of self-exploration and selfquestioning can work, consider the responses to questions by a therapist named Ned.1 People would generally see Ned as a middle-aged,
middle-class White man; however, his identity is much more complex
when considered via the ADDRESSING framework. His example is a
good one for illustrating the point that cultural influences affect all
people in complex ways, whatever their identities.
Table 3.2 summarizes the ADDRESSING influences in Ned’s life.
The following interview provides the background for understanding
the meaning of Ned’s self-description in Table 3.2:
Interviewer:How have these cultural influences shaped who
you are, how you see yourself, and how clients
see you?
Ned:Well, clearly they’ve all influenced me in a great
way. I think the most significant factor in my life
would probably be having been . . . adopted; I’m
1
Ned chose to use his real name for this interview to be congruent with his beliefs
and his desire to be open about who he is.
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TA B L E 3 . 2
Cultural Self-Assessment: Example of Ned
Cultural influence
Ned’s self-assessment
Age and generational
influences
Post-World War II baby boomer; I identify with the sense of hopefulness of my generation and a shared history of political and social
upheaval in my early adult years (grew up near Berkeley, CA).
No current disability, but I once had cataracts on both eyes that
hindered my work for 1 year; also, I was the primary caregiver for
parents, both of whom had a heart attack or stroke in their 50s.
Grew up in a fairly religious Irish Roman Catholic family; currently
a “recovered” Catholic with a strong sense of spirituality as
well as a belief in reincarnation, Buddhist philosophy, and
earth-based spiritualities.
One-half Irish, one-quarter French Canadian, one-quarter Seneca
Indian; adopted at birth and reared in an Irish American family;
as an adult, reconnected to Native heritage through legal search,
academic study, professional work, and social relationships.
Adopted into a middle-class family that made it into upper middle
class; currently upper middle class.
Gay, with some bisexual leanings; was married to a woman in my
early 20s, had a child with her, then divorced; was married to a
male partner 23 years and politically active in the gay community.
See Ethnic and racial identity.
Born and reared in United States; English is first language.
Male; roles as son, brother, father, and partner.
*Developmental or
other Disability
*Religion and spiritual
orientation
*Ethnic and racial
identity
*Socioeconomic status
Sexual orientation
Indigenous heritage
*National origin
*Gender
* connotes dominant cultural identity.
hesitating, because the word that comes to mind
is abandoned, and I do think that’s a significant
piece, because the abandonment stuff has been
pretty big in my life.
I was adopted by my Irish Catholic family at
the age of 10 months. My sister was also adopted,
but she was 100% Irish. I’ve known my whole
life that I was adopted, but I did not find out
more about my background until high school.
Then, much later, I did a legal search, not to get
in contact with my biological parents, but because
I wanted more of a cultural identity, more of a
sense of who I was. And that’s how I found out
about the French Canadian and Seneca piece.
[As for the meaning of this for me,] it’s a
mixed blessing. Because I found it out as an
adult, with a fair amount of education behind
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Doing Your Own Cultural Self-Assessment
me and an interest already in diversity, the first
thing that it did was that it slapped me in the
face with my own prejudice. What I felt was a
lot of pain because I realized how much I had
bought into stereotypes growing up. I lived in a
family with a father who was pretty bigoted, my
mother less so but still influenced by her culture.
I was raised in a pretty privileged, White, uppermiddle-class environment on the East Coast, in
the Midwest, in the South, and then in California. I went to junior high and high school in
Oakland, California, and that was very diverse;
the schools were about 60% students of color.
That introduced me to a whole lot more. But I
still lived in a White neighborhood.
In finding out more about my ethnic heritage, I had fairly avoidant behaviors, particularly
around Native Americans. One, because growing
up in the East and Midwest, I didn’t see them;
even in California, the Native population was not
very visible. Seattle is the first city I’ve lived in
where there is a much larger Native population
that is urban. I also had a painful awareness of
how I had these internalized stereotypes of people who were lazy, who were drunk, who didn’t
parent very well. And then having to discover
that there was a part of me that fit into that group
was really hard, and it still is.
I’ve never felt a part of my family, so to
some degree I feel more connected now that I
have a sense of my ethnic heritage. But I still
feel pretty isolated from a community. Through
my adoptive family, I can connect to my Celtic
heritage, but there’s still this other half of me.
I’m trying to find ways to connect with that in
more meaningful ways. I battle with feeling like
an outsider because, basically, I am. I have been
putting out feelers to the Seneca tribe, which is
one of the more decimated groups of the Iroquois Nation. They are primarily in upper New
York State, Ontario, and Québec. But they’ve
lost their land and don’t really have a place.
I’ve also made some strong connections in
the Seattle community. I completed the Native
American mental health specialist certification
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and did a lot of work with the Seattle Indian
Health Board, which gave me more of a sense
of how to work. I have also spent a lot of time
in some rural areas of Mexico, particularly with
Zapotec Indians. I did observations with their
healers, studying with a translator, as part of my
dissertation work.
I had these interests even before I knew
the details of my heritage. But it was still pretty
painful for me to see that despite all of that,
there was still part of me that avoided Indian
people. I don’t have this problem when I’m
someplace else. But in my own home community, I really have to push myself to change that.
It’s still a struggle in that I generally want to feel
connected, but I also feel like a fraud, because I
was not raised with the identity. And clearly the
other piece for me is that I look White.
Interviewer:How do these influences affect your comfort
level in certain groups and your feelings about
particular clients?
Ned:There’s a double-edged sword. On one hand,
they allow me to feel fairly comfortable about
being with people I don’t know. I resort back to
being the quiet observer at the beginning before
I move in. The flip side of it is that I can get so
introspective and so conscious about how I can
best connect that I get in the way of opportunities that are available. It’s the fraud thing. I
would hate for any person or group of people to
think that I’m co-opting them or attempting for
all the wrong reasons to be a part of them.
Interviewer:What is the relationship between your visible
identity and your self-identification?
Ned:Today, they are much more congruent. But I
would say historically, I was really good at having
a facade of being personable and present, when
internally I experienced myself differently. I did
a really good job of acting. But I didn’t feel as
confident inside.
Interviewer:
How has your self-identification been influenced by your cultural context?
Ned:A lot. I think there’s a cultural thing with being
an adult adoptee. It comes out in the part of me
that realizes the male White privilege I have
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Doing Your Own Cultural Self-Assessment
and how uncomfortable I can feel about that
sometimes, even though I realize it’s somewhat
uncontrollable. And adding to it is the recognition that I had all of that, and then finding out
that I’m not really that at some level, or not all
of me. I mean, in the purest sense, I’m not this
White middle-class straight male. And that’s a
whole thing that we haven’t even touched on—
the gay aspect.
Interviewer:Was there a parallel between the time you began
to recognize that you were gay and the time you
started to learn about your ethnic identity?
Ned:The gay part happened much earlier. I mean, I
knew, but I didn’t have a word for it. But I knew
that I was attracted to other boys at about age 6
to 8. Certainly, culturally, it was not just my family but also the world around me. I didn’t really
get it—that there were gay people—until I was
in college. And that says something about the
interaction between the social and family system.
I mean, I grew up in the Bay Area, and I had no
clue until I moved here. And I spent lots of time in
San Francisco, and so, like, where was I? I have no
idea. I dated women, and I had these full-blown
attractions to men. And I was comfortable about
it, but I knew I couldn’t talk about it.
I think the hard thing now in my life is that
although I feel so much more congruent, I am
more aware when I act in opposition to this desire
to be authentic. I don’t have to or want to hide
parts of myself. There are certainly places and
situations where I come up against that—hiding
myself—where it feels very clear that I should
keep my mouth shut, for safety. However, I am
no longer willing to consciously lie. Now, I might
find creative ways around it that feel safe. Still,
being more conscious means being aware of my
discomfort.
But that’s contemporary, and it’s been true
for the past 10 to 15 years. Previous to that, it
was a real struggle. I mean, my homophobic
stuff played itself out in terms of finding ways to
avoid having to deal with it. I didn’t want to lie,
but I didn’t want to get in trouble either, and I
could pass as straight really well. To me, it was
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particularly evident not so much in my own life
and how it had an impact on me, but in the sense
that I wouldn’t say anything when other people
were making jokes or cracks. And now I feel
ashamed that I didn’t say something—which
I’m no longer willing to do, about anybody. And
that’s true in terms of my ethnic relations stuff,
too. If I have anything in my life that haunts me
now, that’s it—that for a long chunk of time I
didn’t stand up and say, “This is not OK.”
Interviewer:When clients first meet you, and know nothing
about you, do you have an awareness of how
they perceive you?
Ned:I suspect that they perceive me as this middleaged—oh, I don’t like to say that word—this
youthful, middle-aged, White guy and assume
that I’m straight. I think that once we’ve chatted
for a little while, they have a sense of me that’s
deeper. And it’s not so much about whether
my exterior has changed, but their sense of my
being that’s shifted.
Interviewer:How might your areas of privilege affect your
work (e.g., your clinical judgments, theoretical
preferences, view of clients, beliefs about health
care)?
Ned:The biggest piece for me, and I try to keep really
conscious of this, is the biases that come out of
the givens of my life. It’s something that I always
have to pay attention to in terms of the expectations I have of people. In other words, when
someone is clearly different from me, it’s much
easier for me to step out of my biases, because
I think I’m more conscious of them. I actually
struggle more with people who look like me,
or are more like me, because then it’s easier
to make assumptions that I shouldn’t make
about their experience. On one level, I really do
believe that we all have the capacity to do whatever we want to do. And I think that there are
tremendous obstacles based on history and all
these “isms” we’re talking about.
But underneath that, I still really believe the
idea that we can all transcend ourselves in some
way, even if it’s just our attitude. So sometimes
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Doing Your Own Cultural Self-Assessment
I have to be careful that I’m not leaving things
out, like the obstacles; that has happened, and
I have to catch myself that I don’t make these
assumptions.
The other thing to pay attention to is values with people of particular backgrounds. The
biggest place I get caught is between the value
of the group versus the value of the individual,
to stay conscious of not placing importance on
the individual only. I’ve also been in situations
where there’s so much value placed on the
group that the individual gets lost. It’s not that
it’s right or wrong; it’s just priorities.
Interviewer:
How about in terms of your theoretical
preferences?
Ned:I can’t help but assume that because I was raised in
this Western culture as a White male, that’s influenced me to some degree. I’ve certainly known
that early on, for me, a cognitive–behavioral
training program was attractive because it was
rational. It was about changing thinking, and that
made sense to me—even though that’s not how I
operate very well, but I got caught in it, and I was
good at it.
I also think that my later attraction to existentialism was influenced by Western culture, which
values the individual more than the group. And
I think that I was attracted to Zen Buddhism for
the same reason. Zen Buddhism is a very rational,
individually oriented kind of thing, and I think
it’s also larger than that. It’s about the individual
within a group context. When I talk to people
who were raised in Buddhist cultures, they have
a very different slant on it than I do, yet this
doesn’t diminish the usefulness of this perspective
for me.
I also have a firm belief that both of these
theoretical leanings have lots of room to be widened. I think that there are elements of each
that address societies and groups and not just the
individual. But that has to be conscious, something you do with it, which is most of the work
I’m trying to do now. Clearly, I’m still influenced
by my experience, which I can’t change.
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And that’s the other big thing I’ve come to
realize: I can’t leave behind my context, so how
do I adapt it? I think it’s a trend now to want to
throw it out, because it’s “bad,” but I can’t. We
see this now in how many Westerners attempt
to co-opt Eastern thought without truly understanding the context. In the process, they have
once again done this Western dualistic split—
Eastern is good, Western is not.
I can change what I think about things, but
I can’t change who I am. So I have a hard time
with folks out there throwing everything off of
their Euro/White, Christian culture and trying to
be something they’re not. I think we can learn
from lots of other things, but we’re always going
to interpret it in a Western way. We can live
in another country for years, and there’s still
going to be a way in which we perceive things.
I think that’s one of the reasons why both Zen
Buddhism and existentialism offer me so much,
because the one thing they do similarly and
really well is that they hold the paradox. To me
that’s so essential. It’s not about leaving one
behind and moving to another, or either–or. It’s
about both–and.
Interviewer:Now, at the age of 60, how have your agerelated experiences affected you?
Ned:I’m so much more aware of the aging process
and the way others perceive who I am. It’s
funny, in that we often hear older adults talk
about the almost discordant way in which their
internal experience of themselves and what
they see in the mirror are so different. I intellectually understood that, but it wasn’t until the
past several years that I really got it. I don’t feel
very different than when I was in my thirties
and forties, but I know that others perceive me
as “older.” Certainly I have very real moments
of being aware of aging (yoga is not quite as easy
as it used to be; I have more aches and pains
when I am not staying active), but my internal
frame of reference for life in general still has me
thinking of myself as young.
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Doing Your Own Cultural Self-Assessment
In addition, the loss of my partner of almost
28 years was a significant event in my life. It was
so totally unexpected and sudden. He was 4 years
younger than I and suddenly, at the age of 52,
was diagnosed with cancer. Although initially it
was termed “highly treatable,” it got into his brain
and nervous system, and things went downhill
fast. From diagnosis until death was only a little
over 3 months. Although over the past 15 years
I’ve also lost both parents, theirs were more
expected, and they had lived fuller lifespans. Losing a younger partner is and was so much more
a shock to the system. Believe me, going through
that major life event 4 years ago completely
reshaped my perspective on being in the world.
Although I am immensely grateful for the
amazing community support we both had, and
the fact that we had the time to do closure and say
what was needed, it really made me reevaluate
my life and what I wanted to do from that point
on. I think it has both grounded me in the reality
of time and mortality and truly allowed me to live
even more in the present, which is something I
have been attempting to practice for many years.
Now I’m not willing to just do what is
expected. I’m not willing to waste my life on
things that do not provide meaning and value.
I’ve been able to disengage from administrative work commitments that no longer provide
meaning for me so that I have more time to do
work that I love (teaching, mentoring, writing,
creating). I’ve even reintegrated my first profession (theater) back into my life—with another
former theater professional, I’ve started a theater company focused on theater with a social
conscience and have been producing, acting in,
and directing plays for the past 4 years. It brings
great joy and balance to my life. In addition, it
has really allowed me to see how much my previous theater training and experience contributed to my work as a clinician and how much
of my clinical training and practice deepens my
work as an actor and director.
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Interviewer:Has disability affected you as you’ve aged?
Ned:I’ve fortunately not really had to deal with disability at this point in life. Although I do have
some small peripheral vision loss as a result of
a torn, detached retina and the subsequent surgery several years ago, I have been lucky that
the surgery stabilized my vision, and I have had
no further problems. As my doctor stated, “You
have really healthy eyes; they are just really
old.” Oh, boy!
Interviewer:How have these experiences helped you be a
better therapist?
Ned:I definitely know that going through real and
potential losses has had a great impact. The very
real losses of my parents and my partner and
the awareness of the potential to lose one of my
senses (sight) both offered me the opportunity
to self-reflect and attend to what priorities I had
placed on my day-to-day life and to reevaluate
and make changes in what was and
is important to me. Now, as I work
Think about this:
with clients and students, I feel I
1. How have cultural influences shaped who
have such a different and deeper
compassion for suffering in all forms.
you are, how you see yourself, and how
I feel like it is easier in many ways
clients see you?
to find the places where they and I
2. How do these influences affect your comfort
connect, whether it is similar expelevel in certain groups and feelings about
riences or feelings or beliefs. It has
particular clients?
allowed me to stay more present
3. What is the relationship between your
with those I am working with and to
let go of needing to know so that we
visible identity and your self-identification,
can just engage in where we are so
and how is this relationship influenced by
that knowing emerges as it needs to.
your cultural context?
4. What kinds of assumptions are clients
likely to make about you based on your
visible identity, your sociocultural context,
and the information you choose to share
about yourself?
5. How might your areas of privilege affect
your work (e.g., your clinical judgments,
theoretical preferences, view of clients,
beliefs about health care)?
Ned clearly was a person who had
thought deeply about cultural influences
on himself before this interview. But even
if you are highly experienced in the area of
diversity, there are always areas in which
you can learn more. Now that you have
read Ned’s responses, try answering the
same questions that he was asked, which
are listed below. If you can talk about
your answers with a friend or a culturally
diverse group of people, all the better.
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Doing Your Own Cultural Self-Assessment
Seeking New and Diverse
Sources of Information
Carefully considering the questions and ideas outlined so far, you may
come to recognize key gaps in your experience and knowledge base
regarding particular groups. The next step is to begin to search for
information that will educate you about the groups you have less
experience with. This search can lead to online sources, books, magazines, newspapers, films, theater, workshops, and culture-specific community events. Of course, most people already use these sources of
information; what turns them into culture-specific learning opportunities is how you think about them and the questions you ask—that
is, critical thinking.
Critical thinking about sources of information involves questions
that challenge the information itself and simultaneously expand your
perceptions, beliefs, and attitudes (Brookfield, 1987). For example, when
you read an article about a minority group, do you read between the
lines for information about where it’s coming from (e.g., the organization’ or author’s identity, affiliation, or political orientation)? If an article
was produced by a minority group member, do you assume that this one
person’s opinion represents those of the entire group? Does it occur to
you that many written sources regarding minority cultures were written
or filmed by members of dominant groups, often without input from
members of the minority group?
The views and experiences of people of minority cultures are routinely excluded from the mainstream media. Consider the number of
popular American films that feature two young White able-bodied heterosexual people (most) versus the number that focus on the love story
of an immigrant couple, or an older gay couple, or a couple with disabilities. When minority groups are discussed, it is often from the perspective of members of the dominant culture. For example, despite the
plethora of films about the Vietnam War, have you ever seen one that
was written and directed by a Vietnamese person? Similarly, how many
U.S. newspaper articles about Iraq or Afghanistan or even Muslims in
general are written by an Iraqi, an Afghani, or a Muslim?
To counter such imbalances, it helps to look for information from
media and organizations that originate in and from minority communities themselves. In cities and even in many smaller communities,
minority groups often publish their own newsletters and newspapers.
A few examples of organizations that offer online information directly
from the groups they represent include Mouth Magazine (http://www.
mouthmag.com/) and Able (http://ablenews.com), by people with disabilities; Advocate (http://www.advocate.com), National LGBTQ Task Force
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(http://www.thetaskforce.org), and Parents, Families, and Friends of
Lesbians and Gays (http://www.pflag.org) by lesbian, gay, bisexual, and
transgender (LGBT) groups and their allies; and the National Association
of Women (http://www.now.org) by women.
To learn from—not simply about—
people of diverse minority groups, knowlTry this: Find an article, book, or online
edge of culture-specific organizations is
source you’ve recently read or listened to,
also important. Examples of local resources
therapists should be familiar with include
and answer the following questions.
religious institutions (e.g., mosques, syna1. Who are the authors, producers, or editors
gogues, churches, temples, meetinghouses),
of this information, and what are their idensupport groups, educational institutions,
tities, political orientations, and alignments?
recreational centers for elders and peo2. Are people of minority identities and
ple with disabilities and their families,
views represented?
culture-specific community organizations,
3. Is this information directly from people of
language-specific social services, LGBT
minority groups, or only about them?
counseling services, university and community women’s centers, and community
4. Where might you obtain information from
support groups and activities for parents
more direct or alternative sources?
and children.
Relationships and the Influence
of Sociocultural Contexts
As a field, psychology is oriented toward individualistic work. However,
to increase multicultural competence, individually oriented work (e.g.,
introspection, self-questioning, reading, some forms of research) is not
sufficient. Engagement with people of diverse identities is also important, because if the people around you all hold similar identities and
share the same privileges, the “universal” nature of your beliefs and
worldview will generally be reinforced. It is through relationships with
people who differ from us that awareness of our limitations and biases
becomes evident.
So here is another exercise. Take a minute to consider the people with whom you choose to spend most of your time or those you
consider your closest confidants (e.g., your partner, spouse, friends,
coworkers, fellow students, and individual family members). Write the
names of at least five of these people across the top of the right column in Exercise 3.2. The example of Olivia is provided in Exercise 3.3;
Olivia wrote the names of her best friends Gita and Jan, her coworker
Gilberto, her sister-in-law Alma, and her mother.
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Doing Your Own Cultural Self-Assessment
EXERCISE 3.2
Recognizing the Influence of Your Sociocultural Contexts
For each confidant, place a checkmark next to every ADDRESSING influence that matches yours.
Do my confidants have the same influences as me in:
Confidants’ names
Age and generational influences?
Developmental or other Disability?
Religion and spiritual orientation?
Ethnic and racial identity?
Socioeconomic status?
Sexual orientation?
Indigenous heritage?
National origin?
Gender?
The next step in Exercise 3.2 is to go down the ADDRESSING list
of influences for each person on your list and put a checkmark next
to every ADDRESSING influence that matches yours. As you can see
in Olivia’s example (Exercise 3.3), she checked that she and Gita are
similar with regard to Age and generational influences, Religion and
spiritual orientation, Ethnic and racial identity, Socioeconomic status,
EXERCISE 3.3
Recognizing the Influence of Sociocultural Contexts: Olivia’s Examples
For each confidant, place a checkmark next to every ADDRESSING influence that matches yours.
Confidants’ names
Do my confidants have the same influences as me in:
Gita
Jan
Gilberto
Alma




*Religion and spiritual orientation?


Ethnic and racial identity?

*Socioeconomic status?

*Sexual orientation?

Indigenous heritage?

*National origin?


Gender?


*Age and generational influences?
Developmental or other Disability?
Mom
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








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
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Sexual orientation, Indigenous heritage, National origin, and Gender.
However, because Olivia has chronic knee problems and Gita does not
have a disability, Olivia did not put a checkmark next to Developmental
or other Disability for Gita.
Of course, everyone’s situation is different, but for many people,
this exercise highlights the homogeneity of their social circles, especially
among members of the dominant culture. Social psychology suggests
that people tend to be attracted to those they perceive as similar to themselves (J. T. Jones, Pelham, Carvallo, & Mirenberg, 2004), and because
dominant-culture members are usually a numerical majority, they are
more able to choose similar partners and friends. However, because
minority members are fewer in number, they often have no choice but
to develop relationships with people who are different from themselves.
For example, according to Census data, although 10% of heterosexual
married couples had partners of a different race or Hispanic origin, 21%
of same-sex couples had partners of a different race or Hispanic origin
(U.S. Census Bureau, 2014).
Now look back at the cultural self-assessment you did in Exercise 3.1
and review the cultural influences you starred as your areas of privilege. Think about the five individuals you wrote down in Exercise 3.2,
and ask yourself, “How many in my circle differ from me in these areas
of privilege?” Again, if your closest circle holds the same privileges
you do, it is so much more difficult to perceive these privileges and
recognize how they skew your perspective.
Of course, direct personal experience with people of diverse backgrounds is an important part of multicultural sensitivity and understanding, but it is not enough to simply be around people who differ
from you. Traveling to different countries, eating in ethnic restaurants,
and attending cultural events can set the stage for interaction, but
deeper learning comes from relationships between people that are sustained over time.
In addition, it is important to remember that power differentials
can affect what and how much is shared in a relationship. Relationships
with people who are in a less powerful position than you (e.g., clients,
students, support staff) may involve learning, but power differences
generally mean that one person is in a more vulnerable position and
thus less able to speak freely. You are apt to learn more from peer-level,
intimate relationships in which both parties hold enough power to
honestly and safely share their feelings and thoughts.
The development of such relationships is a natural outgrowth of the
personal work described so far. However, if members of dominant cultural identities are not engaged in this personal work, their attempts to
develop relationships with people of minority identities may backfire.
Choosing to develop a friendship because the person holds a particu-
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Doing Your Own Cultural Self-Assessment
lar identity may be offensive, because it suggests a greater interest in
obtaining cultural information than in knowing the individual.
Conclusion
Culturally responsive practice begins with the therapist’s commitment
to a lifelong process of learning about diverse people across cultures
and lifespans. A first step in this process is to explore the influence
of cultural heritage on your beliefs and worldview, recognizing the
ways in which privilege can limit your experiences and knowledge
base. Equally important is a willingness to seek out new sources of
information that will help you learn from and with (not simply about)
people of diverse cultures. Forming intimate peer-level relationships
with people of diverse identities is an important part of this learning. The reward for these efforts is an appreciation of the richness of
diverse people’s experiences, a deeper understanding of one’s clients,
and an ability to provide more effective and culturally responsive mental health services.
Practice: Watching for Privilege
Throughout this next week, watch for the privileges you experience in relation to your dominant cultural identities for each of the
ADDRESSING influences. Regarding age-related privileges, if you are
a young adult, notice the positive representations of your age group
in the world around you versus those of older adults. If you do not
have a disability, pay attention to your physical environment and the
way it works for you but would not be accessible, convenient, or even
safe if you were living with a visual or intellectual disability, were deaf,
or used a scooter or wheelchair. If you are of European American or
Christian heritage, pay attention to the ways in which the media, your
institution or organization, and your family and friends value, prioritize, and promote perspectives that are similar to yours. These are just
a few examples—yours will depend on your particular identity and
constellation of privileges.
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Key Ideas
1.Recognizing the ADDRESSING influences on your life is a first
step toward understanding the influence of your cultural heritage on your beliefs and worldview.
2.Unrecognized privilege is dangerous for therapists, because
privilege cuts therapists off from information and experiences
that help us understand clients.
3. Privilege is contextual: A privileged identity in one cultural
context may not be privileged in another.
4. The areas in which we hold privilege are usually those in which
we hold the least awareness.
5. Defensiveness tends to block recognition of one’s own privilege.
6. Individually oriented work (e.g., introspection, self-questioning,
reading, some forms of research) is necessary but not sufficient
for increasing multicultural competence.
7. The views and experiences of minority members are routinely
excluded from mainstream media.
8. What turns mainstream sources of information into culturespecific learning opportunities is how you think about them
and the questions you ask—that is, critical thinking.
9.Engagement with people of diverse identities is important for
multicultural learning, because if the people around you hold
similar identities and privileges, the “universal” nature of your
beliefs and worldview will generally be reinforced.
10. Intimate relationships that are peer level provide the best
opportunities for multicultural learning because both parties
hold enough power to honestly and safely share their feelings
and thoughts.
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