Minority Client: A Case Study

Cultural competency aids in closing the “disparities gap” in health care. ("OMH," 2012, para. 2) In doing so, health professionals and their clients are better able to discuss concerns without cultural differences getting in the way of effective communication and problem solving. Being respectful of and sensitive to the client’s health beliefs, culture, values, and diverse needs can bring positive outcomes within treatment and patient care. After all, is it not the main job of the health care provider to ensure patient trust? Open forms of communication when dealing with client issues can only be provided if the patient is comfortable with his provider and believes his

Each client is influenced by race, ethnicity, national origin, life stage, educational level, social class, and sex roles (Ibrahim, 1985). The counsellor must view the identity and development of culturally diverse people in terms of multiple interactive factors rather than a strictly cultural framework (Romero, 1985).

D.D. is a 50-year-old, African American male presenting with a number of anxiety and depressive symptoms. The client reports that he came to counseling for “extra support and someone to talk to.” D.D. has been struggling with mental health issues since he was young. Since the age of 15 he has been hospitalized on and off for “hearing voices.” In the early 1980’s he was diagnosed with schizophrenia and prescribed Risperdal to treat the symptoms. Since then, D.D. has been in a variety of mental health settings, including hospitals, day programs, and outpatient treatment. The client has an extensive alcohol and drug use history that he believes impacted his Schizophrenia. In the early 1980’s the client would use alcohol every day “to avoid the voices,” drinking “anything he could get his hands on.” He was also heavily involved with drugs at that time and regularly used marijuana, PCP, cocaine, and heroine. In 2000, the client was sentenced to eight years in jail for four bank robberies. While in jail, D.D. received mental health treatment and alcohol and drug treatment, which was greatly beneficial. When the client was released from jail in 2008, he was drug and alcohol free and was taken off of Risperdal.

The importance of a cross-cultural understanding in Psychology is imperative to successful care and assistance of mental health. Understanding and acknowledging the complexities of different cultures is the beginning of a more informed approach to mental health. Cultural factors and questions play a fundamental role, however, simply acknowledging cultural differences does not necessarily provide the best individual help. Thus, a combination of cultural, demographic and individual factors are crucial initial steps to specific individual assistance. Treating individuals in context can help discern deviations from cultural factors and norms. Therefore an approach which recognises that both culture and specificity to the client is most effective. Knowing someone’s background can be fundamental to clinical help but could also reinforce cultural stereotypes, this overly simplistic view could be detrimental to treatment. Throughout this essay the impact of culture on mental health will be examined, and how the health care provider and client mediate a relationship to produce the most effective results.

It is important to be aware of one’s limitations, weaknesses and strengths in the delivery of counseling services. Taking into account the cultural values of the client, the support systems and the client’s view of the key parts of his or her makeup (the history of the client) are culture specific (because someone is of the same race does not mean that values will be the same) and does not discount the individual. Sue et al reminds us that multicultural counseling competency looks beyond racial and ethnic minorities and also includes disabilities, sexual orientation, age, and other special populations (Sue, et al, 1992).

In a multicultural counseling perspective there are four key approaches when counseling individuals, (a) multicultural awareness of culturally learned assumptions about self and others leading to accurate assessments of clients, (b) multicultural knowledge of information, (c) multicultural skills and interventions, that are appropriate treating clients, and (d) individuals are from a variety of backgrounds, demographic status, and affiliation of cultures. The three-stage approach, will direct the counselor towards levels of multicultural competence in therapy by providing a successful outcome in the recovery process. When conducting a psychotherapy session with a client the counselor should be able to demonstrate skills, when exploring the client’s cultural background. Counselors should also be able to focus on the essential skills and pattern behaviors, when identifying cultural differences. Counseling a minority from a different culture counselors’ must be able to identify their own personal behaviors. These behaviors are crucial when counseling these individuals. First, a counselor must be able to sense the clients’ viewpoint or issue in some way. Secondly, a counselor should be specific when asking a question rather than being unclear and confusing.

As a result, it is imperative to take a look at current and historical oppressions that a client experience by being part of a minority social group or a group that does not conform to popular culture (Aviera, 2002). These oppressions will offer me a deeper insight into the source of challenges that a client faces. By merely looking at the individual without considering these oppressions, I could fail to determine what drives him to experience life the way that he does. Therefore, in order to build a practice that is useful to a different set of cultures, keeping in mind significant experiences encountered as a collective is fundamental in cultivating effective cross-cultural counseling

Engaging into the importance of multicultural competence, awareness of such competency has become a significant necessity in the area of mental health, and various fields of psychology (Hayes, 2008). It is essential for a counselor to be multicultural competent in order to develop a therapeutic alliance with a client, while understanding their cultural identity. Therefore, culturally competent knowledge, attitudes, and skills of diverse culture, is necessary, in proper treatment and diagnosis. Nonetheless, the complexity of cultural diversity can contribute to challenges in assessment, diagnosis and or treatment. It is further understood; by understanding one’s social history, psychosocial history, presenting problems, along with other pertinent information regarding a cultural responsiveness in a diagnosis, and how it would be beneficial to individuals of various social, ethnic, and other minority groups in order to make a treatment plan based on the findings of a cultural assessment (Sue & Sue, 2013). Nonetheless, cultural influences, often neglected, are needed to incorporate the challenges cultural groups face when seeking treatment. Therefore, I have found it applicable to use “ADDRESSING,” framework in therapy as a resource for developing cultural and relevant assessments in addition to the onset symptoms presented in the client in the case study of Mrs. Hudson. The use of “ADDRESSING” acronym is designed to obtain age, developmental and physical disabilities

Counselors who are unaware of diverse cultural viewpoints are more than likely to do intentional or unintentional damage when working within communities opposite of their own and with those whose cultures and worldviews differ from theirs. If a counselor is unaware of their own cultural identity, biases, and stereotypes, how then will they know if they are unintentionally causing harm to their clients or build rapport? Cultural self-awareness is relevant because counselors need to know their cultural identity and what they must offer their clients in a therapeutic relationship and to help clients become aware their cultural identities.

Being aware of culture in the field has many benefits. The main benefit would be that it would help in providing better therapy for the client in question. Understanding how culture affects a client’s life can help explain the clients various roles and identities in life. Apart from that, understanding socio cultural settings will help the psychologist be more aware of the needs of their clients. For example, Indians are less comfortable in seeing a psychologist and are less liable to tell their family and friends that they are in currently undergoing therapy (Zhang, Snowden, & Sue, 1998). The psychologist should use information about the clients’ culture to personalise the therapy in order to enhance the effectiveness of it as well as to not discourage the client as well as to understand how culture affects the client and the disorder. The involvement of culture would also make the psychologist more aware of their own personal biases and mind-sets that maybe prevent the therapy from being effective. Creation of guidelines to help psychologists in the assessment of clients from varied cultures are important.

Cultural competency is critical in psychology practice. In the United States, the groups, which considered as cultural and ethnic minorities, are growing in the population (APA, 2003). Culture often influences the content and quality of people’s experience, perception, and response. Thus, it is important for psychologists to be aware of cultural influences on client’s presenting experience(s) (Gardiner & Kosmitzki, 2010). Without a regard for cultural influence, there is a significant risk for the psychologist to misunderstand, misinterpret, and misguide his or her client. Such misunderstanding, misinterpretation, and misguidance are not only unhelpful but can be detrimental for the client (Corey, Corey, & Callanan, 2011; Pope, & Vasquez, 2011).

     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

In order to provide culturally appropriate care, an examination of one's personal views, beliefs, and prejudices must be examined. The first portion of this paper will examine my personal values, beliefs, biases, and prejudices. The remaining paper will analyze the African American culture relating to the Ginger and Davidhizar's Transcultural Assessment Model cited in Hood (2010). This model uses six key cultural elements that include communication, space, social organization, time, environment, and biological variations. This model provides a systematic approach for assessing culturally diverse clients. I will also discuss an aspect of care that I would

The relationship of a counselor to his or her client can be troubled when the two come from different cultural backgrounds. "As counselors incorporate a greater awareness of their clients' culture into their theory and practice, they must realize that, historically, cultural differences have been viewed as deficits (Romero, 1985). Adherence to white cultural values has brought about a naive imposition of narrowly defined criteria for normality on culturally diverse people" (Bolton-Brownlee 1987). The challenge for counselors today is to balance multiculturalism and sensitivity for the client with the need to move the client forward and enable him or her to reach productive life goals. Cultural acceptance cannot be synonymous with complacency.

While gender and ethnicity may be the more apparent cultural features other things are important also, which include sexual orientation, spiritual or religious practices, political aspects, and general philosophy of life are all cultural elements that need to be incorporated into interventions and treatment options” (Cummins et al., 2012, p.237). In addition, it is important for the social worker to have cultural knowledge because it is necessary for selecting the appropriate intervention and treatment methods for that client. Furthermore, the appropriate multidimensional assessment provides the social worker with the internal culture of the client such as cognitive abilities or limitations, emotional health, and emotional responses and