Culturally Competent Assessment
“Cultural competence is the ability to engage in actions or create conditions that maximize the optimal development of client and client systems” (Sue & Sue, 2013, p. 49). Multicultural competence includes a counselor to be aware of his or her biases, knowledge of the culture they are evaluating, and skills to evaluate a client with various backgrounds (Sue & Sue, 2013). Client assessment involves gathering information pertaining to the client’s condition. Making a culturally responsive diagnosis involves using the DSM-IV-TR axis (Hays, 2008). Following the axis backwards is ideal to discovering the client’s diagnosis, understanding the client’s ADDRESSING outline will help to come to a closer resolution for a diagnosis.
Assessment of Symptoms
Axis I: Clinical disorders:
300.1 Panic Disorder without Agoraphobia
307.80 Pain Disorder Associated With Psychological Factors
V62.89 Religious or Spiritual Problem
V61.20 Parent-Child Relational Problem
Axis II: Personality/ developmental disorders:
V71.09 No Diagnosis on Axis II
Axis III: Relevant physical disorders
Recurrent heart racing, shortness of breath, sweating palms, tightness in chest
Axis IV: Psychosocial and Environmental problems
Problems with acceptance from father, church faith rejection, occupational issues, other problems (daughter diagnosed with a severe heart condition)
Axis V: Global Assessment of Functioning
I would believe her GAF would be around 71-80
Axis VI: ADDRESSING
Age and generational influences: 37-year-old, born in Haiti in 1966 living with paternal grandmother until age of seven. Oldest of four children.
Developmental disabilities: None reported
Disabilities acquired later in life: None reported
Religion ...
... middle of paper ...
... the helpfulness and accuracy of one’s diagnosis” (Hays, 2008, p. 160). Using the ADDRESSING framework helps organize the information pertaining to the client’s influences culturally (Hays, 2008). Unless the counselor fully understands the client’s culture, making a diagnostic diagnosis may not be as straightforward as with a client with the same culture as the counselor.
Works Cited
Hays, P. A. (2008). Addressing cultural complexities in practice: Assessment, diagnosis, and therapy (2nd ed.). Washington, DC: American Psychological Association.
Sue, D. W., & Sue, D. (2013). Counseling the culturally diverse: Theory and practice (6th ed.). Hoboken, NJ: John Wiley & Sons
Tip sheet on Haitian culture. (n.d.). New Paltz, NY: Institute for Disaster Mental Health. Retrieved December 6, 2012, from www.newpaltz.edu/idmh/IDMH%20Haiti%20Culture%20Tip%20Sheet.pdf
Counselors today face the task of how to appropriately counsel multicultural clients. Being sensitive to cultural variables can be conceptualized as holding a cultural lens to human behavior and making allowances for the possibility of cultural influence. However, to avoid stereotyping, it is important that the clinician recognize the existence of within-group differences as well as the influence of the client’s own personal culture and values (Furman, Negi, Iwamoto, Shukraft, & Gragg, 2009). One’s background is not always black or white and a counselor needs to be able to discern and adjust one’s treatment plan according to their client.
Cook, D. & Helms, J. (1999). Using race and culture in counseling and psychotherapy. Needham Heights, Massachusetts: A Viacom Company.
Kim, B. S. K., Ng, G. S., & Ahn, A. J. (2005). Effects of client expectation for counseling success, client-counselor worldview match, and client adherence to asian and european american cultural values on counseling process with asian americans. Journal of Counseling Psychology, 52, 67-76.
Haiti is located in the Caribbean with Cuba to the northwest, Jamaica to the southwest, and Puerto Rico to the east. Ninety five percent of Haitian people are of African descent (Holcomb, Parsons, Giger, & Davidhizar, 1996). The language spoken by the vast majority of Haitians is Creole. The pronunciation and vocabulary are derived largely from French but the syntax is similar to that of other creoles (Brown, 2010). Haiti is one of the most densely populated countries in the world. In 2010 the population was approximately 9.6 million and is expected to increase to 13.4 million in 2050 (Edwards, 2010). It is also projected that some Haitians may try to flee fro...
Cultural competence has to do with one’s culture. Culture affects among other factors, how children are raised, how families communicate, what is considered normal or abnormal, ways of coping with issues, the way we dress, when and where we seek medical treatment, and so forth. I should know because I come from a very cultural home where it is considered bad to talk to a male doctor about anything gynecological.
Hays, P. A. (2008). Addressing cultural complexities in practice: Assessment, diagnosis, and therapy (2nd ed.). Washington, DC: American Psychological Association.
After reading the many articles on the notion of diagnosis and counseling with multicultural/ethnic patients, it has come to my attention that this focus is solely based on stereotypical attitudes. Sure, it can be said that it is important for a therapist to have a background of the patient’s heritage and culture, but doesn’t this necessarily mean that the outlook of the therapist will be put in a box by doing so? I think multicultural competency is a ridiculous way to improve patient-therapist relationships because of several reasons. First off, generalities and race-centralisms only hinder, not improve, the inner workings of a therapy session. Second, there is no real way to test for competency of multicultural issues. So the question of competency cannot be tested and thus should be removed from the criteria of abilities of a therapist. Third, these types of attachments in the learning of diagnosis and therapy only add to stereotypical and racist behavior.
Remember, self-reflection is vital to becoming a culturally-competent counselor. The counselor should consistently re-examine their worldview and personal beliefs about diverse individuals and other cultures. The idea is for the counselor to explore their own prejudices, emotions, and preconceived notions of those that differ from themselves. Remaining curious and willing to learn about culturally distinct groups is a practical way of working effectively with varied clients in counseling and understanding what barriers and prejudices are typical in their
There are different perspectives, however, which put stress on various aspects of culture and try to identify its boundaries and its substitutes. Some regard culture as separate entity from demographic factors, some point out acculturation as one of the obstacles, which makes culture difficult to identify, some show how an intimate and meaningful relationship between a counsellor and a culturally different client to be established. In this essay I will be discussing what the different concepts of understanding of culture in Counselling are, by examining different authors and perspectives and evaluating their strengths and weaknesses.
As the most basic indicator of health, the life expectancy from birth in Haiti based on estimates by the World Health Organization is reported to be approximately fifty-five (55) years (although there are a variety of competing numbers provided by other sources). The infant mortality rate is approximately eight percent (8%) and the less than 5 years old mortality rate is over eleven percent (11.7%) (Population Reference Bureau, 2009).
It is important for a counselor to be culturally competent. This is not always an easy task because there are a lot of different cultures with different values. The Racial/ Cultural Identity Development Model was created to help counselors understand their culturally diverse clients more. This model has five levels: conformity, dissonance, resistance and immersion, introspection, and integrative awareness. In this essay I am going to describe these levels and how it can impact the counseling process.
Culture can be defined as behaviors exhibited by certain racial, religious, social or ethnic groups. Some factors in which culture may vary include: family structure, education, and socioeconomic status (Kodjo, 2009). Some may think cultural competence is something that has an end point, however, when the big picture is seen, it is a learning process and journey. From the writer’s perspective, the client-therapist relationship can be challenging. Culturally competent therapists must realize that behaviors are shaped by an individual’s culture. Many changes are taking place within the United States cultural makeup. Therapists and healthcare professionals are being challenged to provide effective and sensitive care for patients and their families. This type of culturally sensitive care requires the professional to be open and seek understanding in the patients diverse belief systems (Kodjo, 2009).
Firstly, beliefs and attitudes infer the counselor’s ability to move beyond cultural unawareness for safeguarding that their personal biases, values or problems will not affect their ability to work with culturally diverse clients (Corey, 2013). In the same way, culturally skilled counselors are cognizant of the fact that “cultural self-awareness and sensitivity to one’s own cultural heritage” plays an integral role in the helping process (Corey, 2013, p.
According to delval.edu “multicultural counseling is defined as what occurs when the professional counselor works with a client from a different cultural group and how that might affect interactions that take place within the counseling relationship. This definition is expanded to include dissimilarities in religion and spirituality, sexual orientation, gender, age and maturity, socioeconomic class, family history, and even geographic location. The first step in effective multicultural counseling is to identify and acknowledge these differences between the counselor and client”
Insofar as therapists and patients have different reference groups, all encounters may be considered cross-cultural. If this perspective is endorsed, then one may indeed consider cultural competence to be essential to overall clinical competence. Therapists should strive for cultural competency by acquiring both generic and specific cultural knowledge and skill sets. Various generic cultural issues may occur at each phase of psychotherapy, and specific cultural knowledge guides their resolution.