1 Multicultural TrainingWelcome Training began 1.5 hrs. late. As a result we did not complete the entire set of modules; however we made up to the Toolkit.

2 Logistics Cell phones Meals Bathroom breaks Participant packets etc.

3 Getting Acquainted Name tags Please say name before speaking Exercise:Profession/Job role One expectation in coming to the workshop

4 Workshop Goals Increased awareness of own assumptions, values, and bias Greater knowledge of the world view of the culturally diverse or different client New skill with appropriate counselor interventions, strategies and techniques A personal action plan for applying what you have learned A-3

5 Guided by: Multicultural competencies developed by Sue, Arrendondo and McDavis (1992) - outlined on your handout 3 main areas of development over the next two days: BELIEFS, KNOWLEDGE and SKILLS.

6 Beliefs Culturally self-aware Aware of biases’ influenceCounselor’s Awareness of Own Assumptions, Values and Bias Understanding the Worldview of the Culturally Diverse Client Developing Appropriate Counselor Interventions, Strategies, and Techniques Culturally self-aware Aware of biases’ influence Realize personal limitations Comfortable with client’s racial, ethnic, cultural, and belief differences Contrast own beliefs with client’s in nonjudgmental fashion Aware of stereotypes and preconceived notions about the different ways of racial and ethnic minority groups Respect client’s religious or spiritual beliefs/values Respect indigenous helping practices and networks Value bilingualism

7 Knowledge Counselor’s Awareness of Own Assumptions, Values and BiasUnderstanding the Worldview of the Culturally Diverse Client Developing Appropriate Counselor Interventions, Strategies, and Techniques How counselor heritage affects definition of normality/abnormality How oppression, racism, discrimination, and stereotypes affect on counselor work, allowing counselor to acknowledge individual racism How counselor’s social impact and communication style differences affect on clients and how to anticipate their impact Have information of particular group one is working with (e.g., life experiences, cultural heritage, and historical background of culturally different client) Culture’s affect on personality, choices, and preferences for counseling approaches Sociopolitical influences that impinge on minority life (e.g., poverty, racism, powerlessness) How generic counseling skills may clash with cultural systems How institutional barriers hinder minority usage of mental health services Potential bias in assessment instruments Minority family structure, hierarchies, values, and beliefs Discriminatory practices in society

8 Skills Counselor’s Awareness of Own Assumptions, Values and BiasUnderstanding the Worldview of the Culturally Diverse Client Developing Appropriate Counselor Interventions, Strategies, and Techniques Seek our educational, consultative, and training experiences to enrich understanding of culturally different populations, recognizing the limitations of your competencies Understand self as a racial and cultural being and actively seek a nonracist identity Understand relevant research and latest findings on cross-cultural mental health issues, disorders, and service Become actively involved with minorities outside the counseling setting so one’s perspective is more than an academic or helping exercise Able to engage in a variety of verbal and nonverbal helping responses Able to exercise institutional intervention skills on behalf of client Consult with traditional healers or religious leaders Interact in client’s language Aware of cultural limitations Is assessment and testing instruments Seek to eliminate biases, prejudice, and discriminatory practices Educate clients in goals, expectations rights, and counselor orientation

9 Difficult/Different ClientsIt was so much easier to blame it on Them. It was bleakly depressing to think that They were Us. If it was Them, then nothing was anyone's fault. If it was us, what did that make Me? After all, I'm one of Us. I must be. I've certainly never thought of myself as one of Them. No one ever thinks of themselves as one of Them. We're always one of Us. It's Them that do the bad things.

10 Icebreaker: BINGO Try to find people that fulfill the criteria in the squares and write their names there Can only use each person’s name once on your card Good BINGO’s: Vertical, horizontal or diagonal First person with a correct BINGO wins

11 BINGO Person’s name Category fulfilled for the matchJoseph Q. suggested participants do this activity twice, this time they were to assume he/she fit the same category as another and check out if their assumption was correct.

12 Ground Rules Be Respectful of Others Disagree AgreeablyOuch Oops Respect Confidentiality Speak One at a Time

13 Facilitator’s ExpectationsExpect to experience a range of thoughts and feelings throughout the day Expect to start and finish at your own pace Expect to leave without all the answers Expect to get out of the workshop what you are willing to put into the workshop Expect to take risks Expect to be treated with respect

14 Multicultural Needs AssessmentWe want to help you identify needs related to working with different/difficult clients. Some needs are easy to identify. Let’s identify some Other needs are more difficult to identify. To identify gaps in our training: Multicultural Needs Assessment and Self Awareness Exercise.

15 X: not comfortable O: very comfortableINDEX SCORE Wipe their nose for them. Let take a sip of my soda with my same straw. Go on vacation with. Bring to my Church. Introduce them to my family. Eat cookies that they made. Would go to the movies. Supervisors Zookeepers Workshop Trainers Children under age 5

16 X: not comfortable O: very comfortable7 2 4 5 INDEX SCORE X O Wipe their nose for them. Let take a sip of my soda with my same straw. Go on vacation with. Bring to my Church. Introduce them to my family. Eat cookies that they made. Would go to the movies. Supervisors Zookeepers Workshop Trainers Children under age 5

17 Multicultural Needs Assessment and Self Awareness ActivityDiscuss in groups of three: How did you feel when completing this exercise? When you were finished? What were your thoughts in completing this exercise? Anything surprising or anything that you didn’t expect to see? More Xs that you anticipated? More Os than you anticipated? What were the hardest questions to answer? What was it like to see Xs on your worksheet? What are potential reasons why one or more groups are challenging for you? Are these barriers you must overcome in order to provide effective services to these groups? What resources would you need to address these barriers? What did you learn from this self awareness and self assessment exercise?

18 Self-Awareness Goal of this activityTo develop greater awareness of your own cultural background, values, worldview,etc. Awareness of our own cultural background is a key aspect of being able to work competently with culturally different clients. Lack of awareness might get us into trouble in our work.

19 Would we rather have someone use the “oops” rule or the “ouch” rule?

20 An individual who is unaware of his or her own cultural values is like a cup with a hole. Without knowledge of the hole, the liquid inside leaks out onto the owner, the floor, and anything else it touches. (Sue & Sue, 1990)

21 Activity

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23 Social Events/Holidays Cultural Norms Health Beliefs and Practices Think about your personal, family, or community’s attitudes, beliefs, and practices concerning the following cultural dimensions: Social Events/Holidays Cultural Norms Health Beliefs and Practices Alcohol and Other Drug Use Mental Illness Groups of “others” not like us Education Family Success Work Religion and/or Spirituality Recreation Gender Roles Locus of Control Food Preferences Music Preferences Communication Patterns

24 Questions for Discussion:What did you learn about yourself through this activity? Were there dimensions that were easier to define than others? Were there some dimensions that you did not know the answer to and need more information from family, community, etc.? What did you learn about other participants through this activity? If your parent/sibling were to do this activity, would the pictures be similar to yours? How would they be different? How will your iceberg be different in ten years? How will it be the same?

25 Defining Multicultural Terms and ConceptsGoal: to have a common vocabulary for our dialogue during the training.

26 RACE: GROUPINGS BASED ON PHYSICAL TRAITS BY WHICH PEOPLE CAN BE DISTINGUISHED

27 Ethnicity Referring to group membership often, but not necessarily, specifically linked by race, nationality, religion and/or language. People belonging to the same ethnic group share a common cultural heritage and/or derivation, distinguished by such characteristics as: Geographic origins Family patterns Language Values Cultural norms History Music Gender roles Dietary patterns

28 Culture Shared values, traditions, norms, customs, religion, arts, history, folklore, language and/or institutions of a specific group of people. What are some different cultures?

29 Privelege Right or immunity granted as a peculiar benefit, advantage, or favor. Such as a right or immunity attached specifically to a position or an office.

30 White Privilege I have come to see white privilege as an invisible package of unearned assets which I can count on cashing in each day, but about which I was “meant” to remain oblivious. White privilege is like an invisible weightless knapsack of special provisions, maps, passports, codebooks, visas, clothes, tools, and blank checks. (Peggy McIntosh)

31 Exercise: Counting our PrivilegesCircle each question that applies to you You get one point for every circle

32 Stereotypes: Stereotyping is the process of making generalizations about an entire group based on either accurate or inaccurate information about some of its members. It means “set image.” Exaggerates differences and minimizes commonalities At their worst, it allows people to not recognize group members as individuals. Justifies prejudice and discrimination.

33 Exercise: Headbands Do not tell someone what is on their headbandWalk around and follow the instructions on each others’ headbands

34 Prejudice: It is the process of pre-judging something. Prejudice generally refers to existing biases towards members of a group, which are often based on stereotypes. Racism: Racism is defined as the belief that race is the primary determinant of human traits and capacities and that racial differences produce an inherent superiority of a particular race. Overt Covert

35 Video: True Colors General reactions to the video?Were these examples of racism in the video or something else? What are your feelings towards John? What are you feelings towards Glen? Why do you think the salesperson does not help Glen? Why do you think John is told that an apartment is available when Glen is told otherwise? Would you move to this community if you were John? Glen?

36 Culturally-Biased Assumptions We all make assumptionsCulturally-Biased Assumptions We all make assumptions. Can assumptions be helpful or problematic? Cultural Encapsulation: assumptions that are based solely on our own world views and don’t take into account the context from which others are from. Module F.

37 Pederson’s Culturally Biased AssumptionsWe all share a single measure of “normal behavior.” “Individuals” are the building blocks of society Problems are defined by a framework limited by academic discipline boundaries. Others understand our abstractions in the same way that we intend them. Independence is desirable and dependence is undesirable. Clients are helped more by formal counseling than by their natural support systems. Everyone depends on linear thinking to understand the world around them, where each cause has an effect and each effect is tied to a cause. Counselors need to change individuals to fit the system and not the system to fit the individual. History is not too relevant for a proper understanding of contemporary events. We already know all of our assumptions

38 Activity: Crossing The LineActivity to focus on diversity to celebrate the similarities and differences that we see and acknowledge some of the incorrect assumptions we may have made about others in the room.

39 Exercise: Crossing the LineCross line, pause and face group before returning to your place in line Please remain silent. Respect our confidentiality agreement. No pressure. If you feel uncomfortable or have doubts about sharing your experiences, it is OK to decide not to cross the line. Interpret the categories as best as you can there will be some gray areas

40 Sharing Circle 1. Each person gets a chance to share.2. It is OK to pass when it is your turn. Silence should be respected. 3. Once you have spoken, you are done. 4. You are not allowed to speak unless you are holding the sharing stick. 5. You are to share your own experiences rather than comment on what someone else has said or shared. 6. Listen when other people are sharing.

41 DAY 2 Multicultural Training Good MorningDAY 2 Multicultural Training Good Morning! Native American Greeting Activity The Activity did not take more than five minutes. Everyone stands in a circle. The group leader begins on her left and shakes the person’s hand and continues around the circle with everyone following suit.

42 Two Day Workshop AgendaIncreasing awareness of own assumptions, values, and bias Understanding the world view of the culturally diverse or different client Day 2 Continued work on understanding the world view of the culturally diverse or different client Developing appropriate counselor interventions, strategies and techniques

43 G-1

44 Dynamic Sizing The information generated in this workshop will need to be held as generalizations. However, the variability within cultural groups is often as large as or larger than the variability between groups. Thus these generalizations need to be held lightly. When applied to specific clients, one needs to use this information, but also be careful not to overgeneralize to your client without checking it out first. The most reliable source of information about your clients is going to come directly from your clients.

45 The Federal Five Purpose of this section:To increase our skills in working with culturally diverse and different clients by increasing knowledge.

46 Cultural Dimensions -there are different dimensions that have been identified that cultural groups may differ on. Federal Five Religious and/or Spiritual Values Family Roles Communication Patterns Gender Roles Cultural Norms Historical Context Views on Mental health or drug/etoh African American American Indian Asian American/ Pacific Islander Hispanic White Americans

47 African American Religious Influences- Church = CommunityFamily Roles- Extended family Communication Patterns- Assertive, Affect, High Context Gender Roles- Egalitarian Cultural Norms- Cultural “healthy” paranoia, “people-hood” Historical Context- Slavery, racism Mental Health Concerns- 50% drop out after one session

48 American Indian Religious Influences- Shaman and traditional healersFamily Roles- Respect for elders Communication Patterns- Oral tradition, non-linear Gender Roles- 27% female head of household Cultural Norms- collective orientation, harmonic values Historical Context- boarding schools, treaty negotiations, 512 tribes Mental Health Concerns- higher suicide rates, high drop out rate

49 Asian American/ Pacific IslanderReligious Influences- Buddhist, Confucian, Christian Family Roles- Extended family, filial piety Communication Patterns- limited eye contact, use of silence Gender Roles- patriarchal, submissive females, authoritarian parenting Cultural Norms- collective orientation, shame, model minority Historical Context- internment camps, Vietnam War, boat people Mental Health Concerns- advice seeking, controlled emotions

50 Hispanic Religious Influences- CatholicismFamily Roles- Extended family, group identity Communication Patterns- high context, ESL Gender Roles- Patriarchal, Machismo, Marianismo Cultural Norms- Fastest growing population in US Historical Context- Latino/a vs. Chicano/a vs. Hispanic Mental Health Concerns- role of fate, ¾ speak Spanish in home

51 White Americans Religious Influences- Christian influencesFamily Roles- Nuclear family Communication Patterns- low context, verbal, direct, written Gender Roles- patriarchal, female is homemaker Cultural Norms- individualistic, action oriented, protestant work ethic Historical Context- European immigrants Mental Health Concerns- verbal, self-disclosure valued

52 Major Barriers to Cultural CompetenceLanguage Differences: -Verbal communication

53 Non-verbal CommunicationProxemics The use of personal space Kinesics Body language and physical expressions, including eye contact Paralanguage Variation in vocal pitch, rate, accent, silence High/Low Context Communication-degree that people rely on other factors than explicit speech to convey their message. Low context: say exactly what you mean directly High context: implying a message by relying on situational cues to communicate what is meant

54 Values Deeply held beliefs.Ideals, customs, institutions of a society toward which the people have an affective regard. Principles, standards, or qualities considered worthwhile or desirable by the person who holds them. Abstract ideas about what a society believes to be good, right, and desirable. Guide our behavior and sense of identity. Others?

55 Survival Exercise

56 Cultural clashes can be avoided if counselors recognize and accept differences in values, & learn to work within the client’s value system. Keep in mind: One thing that may differentiate the values that individual members of a culture may hold is related to their ethnic identity.

57 Racial Cultural Identity Model (Sue and Sue, 1990)Conformity Preference for dominant culture Identify with White Americans Dissonance In conflict with previously held beliefs Questioning and challenging May encounter racism for first time Resistance and Immersion Holds minority views Rejects dominant views Guilt, shame, anger common in this stage Introspection Psychologically draining to be angry all the time More focus on self and discovering who you are Integrative Awareness Appreciate own culture as well as dominant culture Commitment to eliminate all forms of oppression

58 White Identity Model Sue & Sue (1990)Conformity Ethnocentric Colorblind Dissonance Person is forced to deal with inconsistencies May feel guilt, shame, anger, depression Resistance and Immersion Question and challenge own racism White Liberal Syndrome—over-identification with minority group Introspective Phase Reformulation of what it means to be White Accepts being White and seeks to define identity of that social group Integrative Awareness Understanding self as racial/cultural being Appreciating cultural diversity We were running out of time so we did not do the exercise after discussing the White Identity Module.

59 Creating a Personal ToolkitThere is not just one way to be multiculturally competent. There are specific skills that are useful to know This toolkit outlines those skills No model or knowledge will apply to all situations. Client populations are always changing The skills will apply broadly across populations and situations You can take this toolkit with you and reference it when working in cross cultural situations

60 Personal Toolkit Self Awareness Solid Clinical Assessment SkillsConsultation Hypothesis testing Credibility and Giving Utilizing Multiple Perspectives Creating Multiculturally Relevant Intervention Plans

61 TOOL #1: Assess your Self-Awareness and take steps to prepareKnowledge of Ourselves Knowledge of Others Strengths and Weaknesses Take steps to fill gaps in awareness/knoweldge

62 An individual who is unaware of his or her own cultural values is like a cup with a hole. Without knowledge of the hole, the liquid inside leaks out onto the owner, the floor, and anything else it touches (Sue & Sue, 1990) Did not do Toolkit exercise, no time.

63 Would we rather have someone use the “oops” rule or the “ouch” rule?

64 Tool #2: Clinical AssessmentBetween and Within Group Differences Gender Roles Support System Historical/ Political Factors Views on Mental Health Communica- tion Style Spirituality Accultura-tion Level Ethnic Identity Stage Oppression/ Racism Values Person/ Family Influences or Worldview SES Presenting Problem

65 Tool #3: Assess your own knowledge of particular client’s background and consultA client comes to you who has been abusing alcohol. He has recently immigrated to the United States from the middle east. He indicated that he had been planning to immigrate to the US for the last few years but recently made the move because he had been given the “evil eye.” He said that since he was given the evil eye, his life has gone downhill and he moved to try and improve his situation. He stated that unfortunately the evil eye followed him to the US and he is at a loss for how to regain his prosperity. He said that he started drinking more frequently to try and escape his bad luck.

66 Tool # 4. Hypothesis TestingForming multiple hypotheses Holding hypotheses lightly Comparing hypotheses to other information (finding converging evidence) Continually testing and adjusting strategy Consulting with others Continual assessment to narrow list of possible hypotheses.

67 Scientific Mindedness - practiceYou are the clinical coordinator at your agency. You have an American Indian client who presents because she was charged with possession of a controlled substance. You know very little about the client other than the information provided above. You have a new American Indian counselor starting at your agency in two weeks. Would it be better for you to wait and refer the client to the new counselor or to assign her to one of the agency’s existing counselors (who are not American Indian)? What hypotheses might you have about your client that you would want to hold lightly? What information would you want to find out in order to make this decision? What questions might you ask to get the information needed to check out your hypotheses (hint--look back at the assessment exercise)

68 Scientific Mindedness - practiceThe client calls you the next day and the first words out of her mouth are “I am not guilty of possession. The police set me up because I am Indian. They are always out to get us.” What hypotheses might you have now? How would that impact your decision about therapist match? What if the client said “I am not guilty of the charges. I am not one of those dumb minorities that you see on tv.” How would this impact your decision about therapist match?

69 Tool #5: Attending to credibility and givingGain Street Credibility Consider Pre-therapy Preparation Give “Gifts” to your Clients Recognize Credibility Failures

70 Tool #6: Utilizing Multiple PerspectivesBe aware of the psychological set of your client and expectations regarding counseling Utilize multiple methods of problem resolution strategies Be aware of the limitations of traditional mental health services

71 Tool #7: Creating Multiculturally Relevant Treatment PlansIdentified Problems/Diagnosis Treatment Goals Specific Treatment Discharge/Follow-up

72 Identified Problems/DiagnosisDid you complete a thorough clinical assessment (e.g., ethnic identity, historical influences, immigration patterns) Are there socio-political factors that are relevant to consider in identifying the presenting problem (e.g., racism, privilege) Did you test multiple hypotheses?

73 Goals What are the client’s expectations for counseling?What would be considered a good outcome for the client? Do you need to consult with other knowledgeable people about appropriate goals for this person’s particular background? Who referred the client to treatment (self, family, court, other)

74 Plan for Treatment Are there multiple means for problem resolution?Are the practices from the client’s culture you might want to consider? Are lower level needs met first?

75 Discharge/Follow-up Is the family involved in the treatment?What support system exists in the community for this person? Were the client’s goals met from treatment?

76 Personal Toolkit Self Awareness Solid Clinical Assessment SkillsConsultation Hypothesis testing Credibility and Giving Utilizing Multiple Perspectives Creating Multiculturally Relevant Intervention Plans PRACTICE, PRACTICE, PRACTICE