Clinical: Diverse Populations

Multisystems Model

This model, pioneered by Boyd-Franklin, is an example of an ecostructural/ ecological systemic approach to working with Black clients; it addresses multiple systems, intervenes at multiple levels, and empowers the family by utilizing its strengths

Network Therapy

This therapy, pioneered by LaFromboise and colleagues, situates psychological problems in the context of family, workplace, community, and other social systems; it incorporates family and community members into treatment and is often used with Native American clients

Internalized Homophobia

This occurs when a person accepts heterosexual society’s negative evaluations of them and incorporates these into their self-concepts

Coming Out

This occurs when a person accepts heterosexual society’s negative evaluations of them and incorporates these into their self-concepts

African American

In this group, family is often an extended kinship network, including the nuclear family, extended family, and non-family members

African American

In this group, gender roles are often egalitarian and flexible between men and women, and family members may take on multiple roles

African American

This group may display “healthy cultural paranoia”

Native American

This group often exhibits a spiritual and holistic orientation to life that emphasizes harmony with nature and regards illness as the result of disharmony

Native American

This group often places greater emphasis on the extended family and tribe than on the individual

Native American

This group often adheres to a consensual collateral (collaborative) form of social organization and decision-making

Native American

This group may perceive time in terms of personal and seasonal rhythms rather than in terms of the clock and calendar; they may be more present- than future-oriented

Native American

This group often considers listening more important than talking (i.e., direct questions and direct eye contact may be disrespectful)

African American

Important aspects of work with this group is using cultural sensitivity (not colorblindness), incorporating the extended kinship network, and considering a time-limited/ directive/ goal-oriented/ problem-solving approach

Native American

Important aspects of work with this group include becoming familiar with the client’s history, avoiding “values-free” therapy, admitting to lack of knowledge, avoiding directive or confrontational approaches, incorporating elders and traditional healers, and identifying environmental contributors to dysfunction (e.g., poverty)

Asian American

This group often places greater emphasis on the group than the individual, and there is often a hierarchical family structure with traditional gender roles

Asian American

This group often values restraint of strong emotions that might otherwise disrupt peace and harmony and/or bring shame to the family

Asian American

This group often utilizes a parenting style that is more authoritarian and directive; there is also an emphasize harmony, interdependence, and mutual loyalty and obligation in interpersonal relationships

Asian American

This group may view the therapist as expert and authority figure; they may prefer directive, structured, goal-oriented, and problem-solving approach; they may want concrete advice from the therapist

Asian American

Therapists working with this group should be aware that the function of shame and obligation is to reinforce adherence to prescribed roles and responsibilities; emphasize formalism (e.g., addressing family members in a way that reflects their status and conversational distances); and recognize that modesty and self-deprecation are not always signs of low self-esteem

Asian American

Therapists working with this group should be aware of country of origin and acculturation status, both of which influence language, customs, social relationships, and attitudes toward mental health and therapy; establish credibility and competence early in treatment; provide immediate and meaningful benefit to prevent premature termination of therapy; and focus more on behavior than emotion

Diagnostic Overshadowing

A therapist assuming that an Asian American client’s somatic symptoms are a manifestation of mental rather than physical problems is an example of…

Asian American and Latinx American

Members of these two groups may be more likely to experience and present psychological problems as somatic symptoms

African American and Native American

Work with these two groups should incorporate supports and systems outside of the immediate nuclear family

Latinx American

This group often emphasizes family welfare over individual welfare and stresses allegiance to family over other concerns; they may view interdependence as both healthy and necessary and value high connectedness and sharing

Latinx American

This group may consider discussing intimate personal details with strangers as highly unacceptable; they may believe that problems should be handled within the family

Latinx American

This group may adopt a concrete, tangible approach to life (rather than abstract or long-term); they often attribute control of life events to luck, supernatural forces, acts of God, or other external factors

Latinx American

Therapists working with this group should be active and directive, multimodal (e.g., use thoughts, behavior, relationships, biological functioning, etc.), and consider family therapy; they may also want to emphasize a personable style (except for initial contact, where formality is often preferred)

Latinx American

Therapists working with this group should be aware that families may be patriarchal with inflexible gender roles; that parent-child bonds may be stronger than other familial relationships; that religious and spiritual factors may come into play; and that differences in acculturation may cause tension in family and other relationships

Latinx American and Native American

Therapists working with these two groups should consider incorporating traditional healing practices

True

True or False: LGB+ youth have higher rates of depression, anxiety, substance use, and suicidality

True

True or False: Social and emotional isolation is often a main presenting concern for gay and lesbian adolescents

Internalized Homophobia

Among LGB+ individuals, this can be addressed by correcting cognitive distortions, providing training in assertiveness and coping skills, and activating social support systems

Coming Out

Among LGBTQ+ people, this has been shown to increase levels of self-esteem and positive affect, lower anxiety, and reduce anonymous socializing (e.g., going to a gay bar alone)

False

True or False: Gay men tend to reach all milestones before lesbian women (e.g., first same-sex attraction, self-labeling, first same-sex sexual contact, and first disclosure)

First Disclosure

Gay men tend to reach all milestones before lesbian women, except for __, which occurs around the same time

True

True or False: Younger generations of LGB+ people are coming out and reaching milestones sooner than older generations

Multiracial Americans

This group increased 279% between 2010 and 2020

Racial/ Ethnic Ambiguity

This occurs when other people are not able to easily identify a monoracial category of a mixed-race individual from phenotypic characteristics; may lead to the question “What are you?”

Multiracial Americans

This group often experiences racial identity invalidation, forced-choice choice, difficulty integrating all aspects of identity, and prejudice

Multiracial Americans

According to Root (1998), this group may cope with prejudice in four ways: Accepting the identity assigned by society, choosing to identify with both, choosing a single racial identity, or choosing a mixed-race identity

Multiracial Americans

Therapists working with this group should allow clients to self-define and be aware of possible history of racial identity invalidation; identify strengths associated with multiracial identity/ experiences; realize that clients may have resolved identity issues, and it may not be a factor in their presenting concerns; remember that identity may be fluid and evolve over time; and explore personal biases around interracial relationships

Intersectionality

This is a paradigm that addresses the multiple dimensions of identity and social systems as they intersect with one another and relate to inequality”

Awareness, Knowledge, and Skills

According to Sue and Sue (2003), cultural competence includes these three components

Awareness

According to Sue and Sue (2003), this aspect of cultural competence involves knowing one’s own assumptions, values, beliefs, and cultural heritage—as well as values, attitudes, and beliefs that may be detrimental to members of culturally diverse groups

Knowledge

According to Sue and Sue (2003), this aspect of cultural competence involves attempting to understand the worldviews of clients and understanding the history, experiences, values, and experiences of oppression of various groups

Skills

According to Sue and Sue (2003), this aspect of cultural competence involves using therapeutic modalities and interventions that are appropriate for specific client backgrounds, as well as recognizing limitations with helping clients from diverse backgrounds

Credibility

This is the client’s perception that the therapist is an expert and is trustworthy; it is affected by the therapist’s ascribed status (assigned position or role) and achieved status (influenced by factors like therapist’s ability to demonstrate cultural knowledge)

Giving

This is the client’s perception that they have received something from therapy

Credibility and Giving

Sue and Zane (1987) describe these two processes as important

Indigenous Healing Practices

These are culture-specific ways of dealing with human problems and distress

Curanderismo

This indigenous healing practice occurs in Latin America or Latinx communities in U.S.; it is based on the assumption that illness can arise from either natural or supernatural forces that affect physical, emotional, and/or spiritual functioning; it is led by a male or female healer, combining religious or spiritual rituals, herbal medicine, massage, etc.

Ho’oponopono

Also known as “setting it right,” this is a traditional Hawaiian ritual for harmony and resolving conflict; it involves a senior family member or respected elder helping to identify the problem, followed by discussions that lead to confession, restitution, and forgiveness; often ended by sharing a meal together

Sweat Lodge Ceremony

This is a Native American healing practice that occurs in a domed structure, around a pit with heated stones that are wetted to produce steam; it is based on the idea that perspiration, combined with prayers, chanting, storytelling, and other rituals, cleanses the body, mind, and spirit

Acculturation

This is the degree to which a member of a culturally diverse group accepts and adheres to the values, attitudes, behaviors, etc. of their own group and the dominant group

Integration

This category in Berry’s (1987) acculturation model involves the person maintaining their own culture but also incorporating aspects of the dominant culture (sometimes called biculturalism)

Assimilation

This category in Berry’s (1987) acculturation model involves the person accepting the majority culture while relinquishing their own culture

Separation

This category in Berry’s (1987) acculturation model involves the person withdrawing from the dominant culture and accepting their own culture

Marginalization

This category in Berry’s (1987) acculturation model involves the person not identifying with either their culture or the dominant culture

Integration

This category in Berry’s (1987) acculturation model is associated with the best mental health outcomes

Marginalization

This category in Berry’s (1987) acculturation model is associated with the worst mental health outcomes

Asian American

Kitano’s (1989) model of acculturation for this group has four orientations

Acculturation

Phinney and Devich-Navarro (1997) model for this included six categories for Black and Mexican adolescents: Assimilated, fused, blended bicultural, alternating bicultural, separated, and marginal

True

True or False: Phinney and Devich-Navarro (1997) found that most Black and Mexican adolescents were blended bicultural (ethnic American identity), alternating bicultural (distinct ethnic and American identities), or separated (only ethnic identity)

Worldview

This is how a person perceives their relationship to nature, other people, institutions, and so on

Control and Responsibility

Worldview is determined by locus of __ and locus of __

Internal and Internal

White middle class therapists are most likely to have a worldview characterized by __ locus of control and __ locus of responsibility

External

A person with a __ locus of control is likely to look to collective (rather than individual) effort to make changes

Internal

A person with a __ locus of control is likely to look to individual (rather than collective) effort to make changes

Internal

A person with a __ locus of responsibility is likely to blame the individual (rather than the group) when things go wrong

External

A person with a __ locus of responsibility is likely to blame the group (rather than the individual) when things go wrong

Cultural Encapsulation

According to Wrenn (1985), this occurs when a person defines everyone’s reality by their own assumptions and stereotypes, disregards cultural differences, ignores evidence that disconfirms their beliefs, relies on techniques and strategies to solve problems, and disregards their own cultural biases

Emic

This refers to culture-specific theories, concepts, and research strategies; attempts to see things through the eyes of people in that culture

Etic

This refers to culture-general approaches that involve viewing all people as essentially the same; most psychological theories and practices are this

High-Context

According to Hall (1969), this type of communication is grounded in the situation, depends on group understanding, relies on nonverbal cues, helps unify a culture, and is slow to change; it is characteristic of many culturally diverse groups in U.S.

Low-Context

According to Hall (1969), this type of communication relies primarily on the explicit, verbal part of a message; it is characteristic of White, European cultures in U.S.

Internalized Oppression

According to Landrum and Batts (1985), this may involve system beating (acting out against the system), system blaming, avoidance of white people, and/or denial of the political significance of race

Conceptual Incarceration

According to Landrum and Batts (1985), this involves Black Americans adopting a white, Anglo-Saxon Protestant worldview and lifestyle

Split-Self Syndrome

According to Landrum and Batts (1985), this involves polarizing oneself into “good” and “bad” components, with the bad representing one’s Black identity

Playing It Cool

According to Sue and Sue (2003), this involves Black Americans concealing anger or other unacceptable feelings by acting calm and composed

Uncle Tom Syndrome

According to Sue and Sue (2003), this involves Black Americans adopting a happy-go-lucky or passive demeanor

Cultural Paranoia

According to Ridley (1984), this is a healthy reaction to racism that involves Black clients not disclosing to a white therapist due to a fear of being hurt or misunderstood

Functional Paranoia

According to Ridley (1984), this is an unhealthy condition that involves an unwillingness to disclose to any therapist, regardless of race or ethnicity, due to general mistrust and suspicion

False

True or False: According to Ridley (1984), an Intercultural Non-Paranoiac Discloser (LF-LC) would only be willing to disclose to a Black therapist

True

True or False: According to Ridley (1984), the choice of therapist for a Functional Paranoiac (HF-LC) should be based on competence to treat paranoia

True

True or False: According to Ridley (1984), a Healthy Cultural Paranoiac (LF-HC) the therapist should help the client to develop “disclosure flexibility” (i.e., determining when disclosure is appropriate/ not appropriate)

True

True or False: According to Ridley (1984), the therapist for a Confluent Paranoiac (HF-HC) should be of the same race

Sexual Stigma

This is the shared knowledge of society’s negative regard for any non-heterosexual behavior, identity, relationship, or community; it creates a power and status differential between heterosexual and non-heterosexual

Heterosexism

This refers to cultural ideologies and systems that provide the rationale and operating instructions that promote and perpetuate antipathy, hostility, and violence against LGB+ people; it includes beliefs about gender, morality, and sexuality that are inherent in language, law, and other institutions

Sexual Prejudice

This refers to negative attitudes that are based on sexual orientation; it is highest among older, low education, rural, Southern/ Midwestern, conservative, fundamental religious, authoritarian, males with limited LGBTQIA+ contact

True

True or False: In their study of lesbian and bisexual women, Morris, Waldo, and Rothblum (2001) found that a higher degree of "outness" was associated with lower levels of psychological distress.

Conformity

This is the first stage of Atkinson, Morten, and Sue’s (1998) Racial/ Cultural Identity Model; it involves positive attitudes towards the dominant group and deprecating attitudes towards one’s own group; the preference is for a therapist from the dominant culture

Dissonance

This is the second stage of Atkinson, Morten, and Sue’s (1998) Racial/ Cultural Identity Model; it involves confusion and conflict over contradictory attitudes towards different groups; the preference for therapist of color and attribution of problems to racial and cultural identity issues

Resistance and Immersion

This is the third stage of Atkinson, Morten, and Sue’s (1998) Racial/ Cultural Identity Model; it involves active rejection of the dominant group and appreciation of one’s own group; the preference for same-culture therapist and attribution of problems to oppression

Introspection

This is the first stage of Atkinson, Morten, and Sue’s (1998) Racial/ Cultural Identity Model; it involves uncertainty about the rigidity of beliefs in previous stage, as well as conflicts between loyalty and autonomy; the preference for same-culture therapist but more open to others who share the same worldview

Integrative Awareness

This is the fifth and final stage of Atkinson, Morten, and Sue’s (1998) Racial/ Cultural Identity Model; it involves self-fulfillment with identity and a desire to eliminate all forms of oppression, as well as exploration of values before accepting/ rejecting them; the preference for same-worldview therapist, regardless of race or culture

True

True or False: Different stages of identity development within a family can cause tension and conflict

False

True or False: All people progress linearly through the stages of Atkinson, Morten, and Sue’s (1998) Racial/ Cultural Identity Model

Pre-Encounter

In this phase of Cross’ Black Racial (Nigrescence) Identity Development Model, race has low salience, and the person adopts a mainstream identity (Assimilation) and negative attitudes that contribute to low self-esteem (Anti-Black); the preference is for a white therapist

Encounter

In this phase of Cross’ Black Racial (Nigrescence) Identity Development Model, exposure to a significant event or series of events leads to greater racial awareness and interest in Black identity; there is a preference for therapist of the same race

Immersion-Emersion

In this phase of Cross’ Black Racial (Nigrescence) Identity Development Model, race has high salience, there is increased Black involvement and guilt/ anxiety about past ignorance, as well as anti-white sentiments/ rejection of white culture