Glenn M. Callaghan, Ph.D.
[PSYC 160]
Trull: p. 76-77
Sue: Psychotherapeutic Services for Ethnic
Minorities (article)
Davidson: Conceptual and Ethical Issues for
GLB (article)
Kupers & Ross: chapter)
Gender bias (”Issue 2” –
Questions?
Comments?
How does this fit in?
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Psychotherapy with Racial/Ethnic
Minorities, Disabilities, and those with
Disenfranchised Status
The importance of contextual variables and the sensitivity to diversity
Abilities and disabilities
Gender, minority and disenfranchised status
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What is the culture of …
the US?
California?
Northern California?
San Jose?
San Jose State University?
students in the Department of Psychology at SJSU?
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Last two decades - more interest in this area
Argument is made that “interest” or “intention” hasn’t made a difference in terms of competencies
Equivocal data on whether there are differential outcomes for different minority groups (Sue, Zane,
& Young, 1994)
Social class appears not to be a variable that predicts outcome (Garfield, 1994)
Big question on matching therapist to patient on variables
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Making assumptions about individuals based on group membership
Are there important cultural influences that we might miss because of our own cultural values?
Are there other groups that also should be addressed (e.g., obese people, older adults, people from rural communities)?
Where do we draw the line?
Who is not disenfranchised?
Is the assumption of differences a discriminatory or racist practice in itself?
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Race : “A biological classification system determined by physical characteristics (e.g., skin pigmentation, head form, nasal index, color distribution and texture of body hair) that are of genetic origin, the combination of which helps to distinguish one human subgroup from other subgroups” (Krogman,
1945)
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Ethnicity : “a group classification of individuals who share a unique social and cultural heritage (e.g., language, religion, customs) that is passed on from generation to generation” (Rose, 1964).
Within any race, there can be many ethnicities
(Caucasian) and within any ethnicities, there can be many races (American)
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Culture : “the configuration of learned behavior whose components and elements are shared and transmitted by the members of a particular society”
(Linton, 1945)
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Minority : “a group of people who, because of physical or cultural characteristics, are singled out from others in society in which they live for differential and unequal treatment, and who therefore regard themselves as objects of collective discrimination…Minority status carried with it the exclusion from full participation in the life of society” (Wirth,
1945)
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Majority : “In the United States, the group that holds the balance of economic and political power. Also, the group whose cultural value system is deemed by its members to be the model value system, the one to be emulated.” (Bongar & Beutler, 1995)
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Acculturation : “a process of attitudinal and behavioral change undergone, willingly or unwillingly, by individuals who reside in multicultural societies or who come in contact with a new culture due to colonization, invasion, or other political changes” (Marin, 1992)
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Factors that limit applicability of theories to racial/ethnic minority groups
Belief that problems are mostly intrapsychic
As opposed to just social
Ignoring social, political, and economic conditions and addressing “the problem”
The fact that our science historically is a science of educated white males
both research subjects and the researchers
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Factors that limit applicability of theories to racial/ethnic minority groups
That the goal has historically been to get people to adjust to white values and norms
That we start from the assumption that counseling is the solution for everybody
That we evaluate, treat and experience people with our own biases and stereotypes
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Native Americans/American Indians
Diverse and heterogeneous group
511 distinct federally-recognized native entities
365 state-recognized native tribes
200 different languages
About 1.9 million in 1990 (probably low estimate)
Increasingly urbanized - only about 24% live on reservations
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Native Americans/American Indians
Serious mistreatment ever since whites got here
High levels of unemployment, malnutrition, inadequate health care, shortened life expectancy, high levels of substance abuse and suicide
Very little research on what works
Much more likely to use natural helpers and spiritual guidance than mental health services
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African Americans
U.S.’s second largest racial/ethnic minority at about 12.3%
Tremendous diversity within the group, but discrimination reported throughout
Racial identity potentially very important to therapy
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Hispanics/Latinos
Fastest-growing racial/ethnic group in the U.S.
Currently 12.5% of the pop (9% growth from 1990) annual growth rate is 6.1% (probably underestimates)
Diversity within group both inter-cultural (Mexican versus Puerto Rican) and generational (firstgeneration versus third generation)
Within U.S., they tend to be younger, less educated, poorer, and more likely to live in an inner-city neighborhood
Often a language barrier that may make living here even more difficult
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Asian-Americans/Pacific Islanders
3.6% of US pop in 2000
Umbrella term used to describe Japanese,
Chinese, Filipinos, Koreans, Guamians,
Malays, Samoans, and Southeast Asians
Third-largest racial/ethnic minority group
Very diverse group
Portrayed as “model minorities” in terms of educational and economic success
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White
79.1% of US pop in 2000
Umbrella term used to varied backgrounds and cultural histories
Very diverse group
New census category
2.4% respondents are multiracial
2 or more races
What will this mean/allow us to do with these “profiles”?
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Advantages
Sensitivity to issues
Cultural Sensitivity - ability to recognize issues and how different cultures bring different sets of issues to therapy
Potentially can be competent
Cultural Competence - ability to know these issues for one or more groups and be fluid in provision of services to that group
Help develop guidelines
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Problems
Beware the new stereotypes, new racism
New heuristic, new prejudice
Proxy variables (stand ins)
Tend to be non-manipulable
Tend to be vague, not behaviorally specific
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Problems
Examples
“Racial identity”
Acculturation
Religiosity
Geography (urban or rural)
Socio economic status (SES)
How could one manipulate these to bring about change?
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Kupers & Ross articles
Biases in diagnosing genders
Arguments for and against the DSM being biased
Not biased
should see differences, these are traits, genders are different
Biased
look at who is diagnosed more often
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How many for and against?
Does it matter?
How does history of development of
DSM play in?
What could the worries be?
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Counting the Base Rates
Men
ASPD 5.8% males vs. 1.2% females
Also OCPD, soc phob, Nar PD, Intermittent Explosive,
Paraphilias
Women
Maj Dep, HistrionicPD, BPD, Eating, Dependent PD,
PMDD
What do these have in common?
What about Penis Envy as a trait?
What about PMS as a disorder
Late Luteal Phase Dysphoric Disorder now
Premenstrual Dysphoric Disorder
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How about for men?
Homophobia disorder
Sexual conquistador disorder
Emotionally avoidant disorder
Dependency phobia
Workaholism
Lack of parental involvement disorder
Anti-collaborative disorder, anti-collectivist disorder
Mid-life wife-drop disorder
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Need to ask
What do we want to know?
What will most help the client?
Who is making these summaries and providing this information?
Will I be participating in a new prejudice?
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Do not be satisfied with census categories
Do not buy into cultural sensitivity or cultural competency blindly
Try to appreciate the the complexities of the individual and the situation he or she comes from
Try to look at individual histories
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The “ Paul question ”:
"What treatment, by whom, is most effective for this individual with that specific problem, under which set of circumstances, and how does it come about?" (Paul, 1969, p. 44)
The “Follette re-phrase”:
“What principles, requiring what resources, applied in what context, produce the most meaningful change for a particular person?”
(Follette, 2002)
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Individual histories
How does this person experience their context?
What is it like to be this person with this background having this problem ?
How will I affect the interaction and ability to bring about change with my background and my way of viewing the world?
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