Positive Multiculturalism
as Aspirational Ethical
Practice: Therapeutic
Applications
Molly Haas Cowan, PsyD
Jeanne M. Slattery, PhD
John A. “Jay” Mills, PhD, ABPP
Ground Rules (Ervin, 2014)
1. Be respectful/mindful of others
2. Self-reflect and become aware of your
personal reactions
3. Know your limits and boundaries, disclosing
only what is okay for you
4. Sit with tough emotions
• How do you know when you are feeling defensive?
• It’s not the emotional response but what you do with
it that matters.
Ground Rules (Ervin, 2014)
5. Listen to others' perspectives and ideas even
when you disagree
6. Be open to giving and receiving corrective
feedback
7. Don't shut others down—and be aware when
you feel shut down
8. Remember:
• You have the right to “screw up” in an attempt to
understand yourself, your reactions, and the
larger world
• You have the right to "let it be"
We promise to… (Ervin, 2014)
• Challenge you
• Encourage critical thinking
• Push buttons and play “devil's advocate” to
encourage multicultural competence
• Provide a safe place to do these things
Our overriding assumptions:
• We've all internalized “isms.” To work effectively in
this field we need to explore, deconstruct, and
challenge our personal “isms”
• There are many ways to learn about “isms”
Our Goals
1. Use General Ethical Principles and guild-specific
Code of Ethics to guide a multicultural practice;
2. Describe a positive multicultural approach, as well
as reasons for paying attention to multicultural
issues;
3. Recognize barriers to developing multicultural
competency; and
4. Identify strategies for teaching and supervising
therapy trainees to apply accepted professional
principles in determining how multiculturalism is a
part of practice and/or an impediment to optimal
practice.
Good Practice
Ethical Practice
Positive
Multiculturalism
Aspirational principles of ethics code
(APA, 2010)
•
•
•
•
•
Beneficence and nonmaleficence
Fidelity and responsibility
Integrity
Justice
Respect for people's rights and dignity
Guidelines on multicultural education, training, research,
practice, and organizational change (APA, 2002)
Guideline #1: Psychologists are encouraged to recognize that, as
cultural beings, they may hold attitudes and beliefs that can
detrimentally influence their perceptions of and interactions
with individuals who are ethnically and racially different from
themselves.
Guideline #2: Psychologists are encouraged to recognize the
importance of multicultural sensitivity/responsiveness,
knowledge, and understanding about ethnically and racially
different individuals.
Guideline #5: Psychologists strive to apply culturally-appropriate
skills in clinical and other applied psychological practices.
Today the nation is no longer divided along [racial]
lines, yet the Voting Rights Act continues to treat
it as if it were. –John Roberts (6/2013) www.nydailynews.c
om
Perceived racism (Norton & Sommers,
2011)
Blacks continue to indicate drastically poorer outcomes for Black
than White Americans: "from employment to police treatment, loan
rates to education," yet…
Perhaps this reflects perception as a zero sum
game (Norton & Sommers, 2011)
Seeing multicultural ideas can be difficult
Some definitions: Role of culture
Race/ethnicity/gender/class/religion/sexual
orientation, etc. influence:
• preferences, values, habits, goals, etc.
• how we are seen
• how we see others
• experiences of oppression and privilege
Some definitions: Multiple identities
(Slattery & Park, 2011)
What do we see as racism? (Sommers &
Norton, 2006)
1. Discomfort/unfamiliarity (e.g., is uncomfortable
around Blacks; doesn't socialize regularly with Blacks)
2. Overt racism (e.g., discourages kids from playing with
Blacks; thinks Blacks are not suited for certain
professions)
3. Denial of problem (e.g., thinks slavery was so long ago
it is unimportant to talk about; doesn't speak up or act
when someone else is racist)
• People of Color are more likely to identify subtle forms
of bias as racism
• White observers often respond to allegations of subtle
bias with skepticism or questions about ulterior motives
Microaggressions (Sue et al., 2007)
• Using racist epithets and offensive language, making
racist jokes
• Making unwarranted assumptions about a person’s
behavior or background because of skin color
• Silencing racial minorities by dominating work or
classroom discussions or frequently interrupting them
• Treating a person as a representative of an entire group
solely because of skin color
• Dismissing claims of racism
• Giving subtle preference to people who share your
racial background or skin color
Barriers to acknowledging racism?
• Attitudes are the result of personal
experience
• Perceive self as an expert
• Expect a favorable outcome from status quo
• Attitudes are repeatedly expressed
• Stand to win—or lose—something due to
the issue
Barriers to change?
•
•
•
•
•
Anger/discomfort
Shame about making mistakes
May need to acknowledge/give up privilege
Lack of knowledge and self-assessed expertise
Questions about what should be addressed
(and how)
White racial identity (Slattery & Park, 2011)
1.
2.
3.
4.
5.
Contact
Disintegration
Reintegration
Pseudo-independence
Independence
What would you do?
Problem with self-reports (Banaji &
Greenwald, 2013)
1. White lies
• How are you?
• Do I look fat in these?
2. Gray lies
• Can you spare a dollar?
• Is Ms. X at home?
3. Colorless lies
• How may cigarettes do you smoke a day?
4. Red lies
• I love you.
4. Blue lies
• Did you go to church this week?
www.financefox.ca
Implicit Association Test
Shoot or no shoot? (Watt & Sherbourne, in
progress)
Reactions to taking Implicit Attitude
Test (Casad, Flores, & Didway, 2012)
Accurate Inaccurate
After
taking IAT
33%
46%
Unsure
21%
Why? (Casad et al., 2012)
Reasons given for IAT's invalidity
Structure of test is problematic
In-group preference
Explicit and implicit attitude
incongruence
Measures cultural stereotypes
Measures associations, not
prejudice
Measures snap judgments
25%
15%
13%
8%
6%
6%
Reactions to taking Implicit Attitude
Test (Casad et al., 2012)
Accurate Inaccurate
After
taking IAT
After
lecture/
reading
Unsure
33%
46%
21%
45%
33%
22%
What happens when we are
colorblind? (Plaut, Thomas, & Goren, 2009)
Whites' color
blindness
Whites'
multiculturalis
m
Whites' color
blindness
Minorities'
psychological
engagement
Minorities'
Minorities'
psychological perception of
engagement bias
-.66 ***
.57*
-.70 **
--
-.54*
.54*
--
--
-.76***
* p < .05, ** p < .01, *** p < .001
What changes are desirable?
Knowledge
Attitude
Self-reflection
Behavior
What changes? (Pope, 1993; Reynolds, 1997)
• First-order changes (assimilation)
• Increased awareness, knowledge, skills
• Second-order change (accommodation)
• Cognitive restructuring
• Worldview and paradigm shifts
Stages of change (Prochaska, 1999)
•
•
•
•
Precontemplation
Contemplation
Action
Maintenance
Ethical acculturation model
(Handelsman, Gottlieb, & Knapp, 2005)
Personal Ethics
High
Low
Professional High Assimilation
Integration
Ethics
Low Marginalization Separation
Our modification
Personal Commitment to
Multicultural Competence
High
Low
Professional High Assimilation
Integration
Commitment
Low Marginalization Separation
Recommendations from our
experience
• Start where you are
• Foster sensitivity to signs of own biases
• Engage in empathy-inducing activities
• Exploration of aesthetic traditions from other
countries
• Direct engagement in perspective-broadening
activities
• Contact with situations causing cognitive dissonance
• Perform psychosocial histories of clients (seeing
beyond symptoms)
Goals for effective therapists-incontext
• Acknowledge that all helping occurs in a context
• Attend to one’s own context, assumptions, and biases
on ongoing basis
• Recognize that different people may draw different
conclusions under “similar” circumstances due to
different cultures/contexts
• Remain attentive to attitudes and actions related to
therapist’s ongoing multicultural development
• Consider how multiculturalism modifies/enhances
theoretical and practical dimensions of therapy
• Read professional literature with an eye to multicultural
issues
• Read the news, stay current with cultural issues to be
able to perceive culture-influenced issues readily
Questions to consider with client
• What is the client’s unique cultural perspective about
the world and self?
• How does culture/context influence the symptoms or
problems?
• How does culture factor in the client’s decision to seek
treatment?
• How might this client might perceive therapist as a
result of multicultural factors?
•
•
What opportunities?
What barriers?
• How does culture influence the therapeutic alliance?
• What parts of the client’s unique cultural perspective
pose difficulties for the therapist?
Multiculturally-informed issues for
treatment
• Identify and explore microaggressions, oppression,
and privilege
• Assist clients in understanding implications of their
worldview
• Promote consideration of costs and benefits of
culture-related choices
• Empower clients in making conscious choices that
are valid from their own context and culture
The Color of Fear
Resnick: And so you thought that your children,
all five of your children, somehow because of
what you saw as your defective mothering,
were not on the path of righteousness and were
stumbling. [Hmm] And did you feel then that it
was good for them or bad for them, if you in fact
threw them into the sea—or in a bathtub—in a
very real sense? What were you trying to
accomplish then when you did take your
children’s lives?
Andrea Yates
Yates: Maybe in their innocent years … God
would take them up.
Resnick: It would be their innocent years and
God would take them up? Is that what you
said?
Yates: Be with him. Uh huh.
Resnick: God would take them up to be with Him
in heaven? Is that what you mean? [Uh huh.] All
right. And if you had not taken their lives, what
did you think would happen to them?
Yates: Guess they would have continued
stumbling.
Resnick: And where would they end up?
www.nytimes.com
Lia Lee and her mother
Henry Louis Gates Jr.
news.harvard.edu
References
American Psychological Association. (2002). Guidelines on multicultural
education, training, research, practice, and organizational change for
psychologists. Retrieved from
http://www.apa.org/pi/oema/resources/policy/multicultural-guidelines.aspx
American Psychological Association. (2010).Ethical principles of psychologists and
code of conduct. Retrieved from
http://www.apa.org/ethics/code/index.aspx?item=3
Banaji, M. R., & Greenwald, A. G. (2013). Blindspot: Hidden biases of good people.
New York, NY: Delacorte.
Casad, B. J., Flores, A. J., & Didway, J. D. (2012). Using the Implicit Attitude Test
as an unconsciousness raising tool in psychology. Teaching of Psychology, 40,
118-123.
Handelsman, M. M., Gottlieb, M. C., & Knapp, S. (2005). Training ethical
psychologists: An acculturation model. Professional Psychology: Research and
Practice, 36, 59–65.
References (cont.)
Norton, M. I, & Sommers, S. R. (2011). Whites see racism as a zero-sum game that
they are losing. Perspectives on Psychological Science, 6(3), 215–218.
Plaut, V. C., Thomas, K. M., & Goren, M. J. (2009). Is multiculturalism or color
blindness better for minorities? Psychological Science, 20(4), 444-446.
Prochaska, J. O. (1999). How do people change, and how can we change to help
many more people? In M. A. Hubble, B. L. Duncan, & S. D. Miller (Eds.). The heart
and soul of change: What works in therapy (pp. 227–255). Washington, DC:
American Psychological Association.
Slattery, J. M., & Park, C. L. (2011). Empathic counseling: Meaning, context, ethics, and
skill. Pacific Grove, CA: Brooks/Cole.
Sommers, S. R., & Norton, M. I. (2006). Lay theories about white racists: What
constitutes racism (and what doesn't). Group Processes and Intergroup Relations,
9, 117-138.
Sue, D. W., Capodilupo, C. M., Torino, G. C., Bucceri, J. M., Holder, A. M. B., Nadal, K.
L., & Esquilin, M. (2007). Racial microaggressions in everyday life: Implications
for clinical practice. American Psychologist, 62, 271-286.
Watt, J., & Sherburne, C. L. (2011). Implicit attitudes as viewed through a shoot-no
shoot simulation. (Unpublished manuscript).