September 29th, 2009 — Uncategorized
Open Inquiry
Do ask about tribal, ethnic, or background differences that are obvious or are made obvious by information provided by the client.
Don’t insist on a more thorough exploration of these differences than is offered.
Do realize that acculturation and cultural identity are ?uid and developmental.
Don’t assume all members of a given family group or couple have the same levels of cultural identity or the same experiences interfacing with the dominant culture.
Family
Do recognize that for many or most nondominant cultures in the United States, the role of family is central. The concept of family is often broader, more inclusive, and more de?nitive in a given individual’s sense of identity. Therefore, be attuned to matters of family with heightened awareness and sensitivity.
Don’t impose either your own de?nition of family or the de?nition of family you’ve read about with regard to the client’s culture. Simply be open to the client’s sense of family.
Do graciously allow family members to attend some part of an initial interview if they so request.
Don’t de?ne family strictly along biological lines.
Communication Styles
Do remember that patterns of eye contact, direct verbalization of problem areas, storytelling, and note taking all have culturally determined norms that vary widely.
Don’t assume a chatty or overly familiar style, even if that is your predominant style. Strive to demonstrate respect.
Do ask for clari?cation if something is not clear.
Don’t ask for clari?cation in a manner that suggests your lack of clarity is the client’s problem.
September 29th, 2009 — Uncategorized
The second domain identi?ed by Swartz Kulstad and Martin is family environment. Because the family is a signi?cant mechanism through which culture is transmitted, and because it is also the primary source of support for most individuals, gaining information about family dynamics is crucial. We know Russian immigrants who came to the United States during World War II who forbade their children to speak anything but English. They gave their children popular English names and pushed them full speed into the culture. We know Laotian refugees determined that their children have the best of both: to excel at all things American and yet retain all things Laotian. We also know Iranian families in deep con?ict because their children have rejected their original cultural values. In all these cases, there is variance in the degree of dependence on the family or adherence to family expectations concerning family roles and hierarchies, communication styles, individuation, and maintenance of culture. In a sense, the family can become a source of great support for an individual, while at the same time, be a cause of great stress as that individual seeks to reconcile family environmental expectations with other systems in which he or she interacts .
Listening to your client along the family dimension might involve covering the following: What is the nature of the overall family environment? Is there a strong nuclear and/or extended family? What is the proximity to, or availability of, family sup392 Interviewing Special Populationsport? What is the level of dependence on the family for support? Ask: “Tell me about your family. How did you grow up? What kinds of things did your parents do? How often does your whole family get together? What happens when all the grandparents and aunts and uncles get together?” Listen for subtle or overt expectations for conformity to family beliefs and values.
September 29th, 2009 — Uncategorized
Putting It in Practice 13.4Asian Americans are only the third largest multicultural group represented in mental health services in the United States , yet they hail from the world’s largest continent both in land mass and in population. Asia is diverse in terms of geographic features; it is even more diverse in terms of religion, custom, lifestyle, and ancestry. The major countries comprising South Asia are India, Bangladesh, and Pakistan; those making up Southeast Asia are Burma, Cambodia, Laos, Vietnam, Malaysia, Indonesia, and the Philippines. East Asia’s major countries are China, Japan, North and South Korea, and Taiwan .
The Role of the Family
Again, among Asian peoples, we ?nd stronger, more inclusive family roles than is true in most White cultures. Similar to Hispanic family structure, the father is considered the head of the household and holds the dominant role. In fact, each family member’s role, based on sex, birth order, and marital status, is ?xed and cannot be changed .
Individual acts, therefore, re?ect quite directly on the family. Individualism is not viewed positively. Decisions that affect the family should be decided by the family rather than the individual. The family should be strong enough, wise enough, and have enough resources to handle problems encountered by the individual. Failing this task and seeking outside help in the form of counseling brings a shameful loss of face . Therefore, an interviewer conducting a ?rst session with an Asian American client or family must consider the fact that it took a great deal of stress to cause the client to seek help. Consequently, the situation is probably quite serious and must be approached as such.
September 29th, 2009 — Uncategorized
-Christina Chao, “We Do Not Even Eat Rice the Same” 384 Interviewing Special Populations
Working with a Hispanic Client
Rosa is a 19 year old single female whose family moved from Mexico to Michigan 15 years ago. She has two sisters, ages 16 and 21, and three brothers, ages 14, 17, and 22. She and her family live in a community that is primarily Mexican American and where Catholicism is a signi?cant part of people’s lives. Rosa is living at home while she studies journalism at a local college, where she has consistently been named to the Dean’s list for academic excellence.
She came to counseling because she had been feeling depressed over the last two months. She noted that she is not sleeping or eating well, and is “having a hard time just getting through each day.” She stated that it was dif?cult to come to counseling because her family would not approve of her discussing personal things with an outsider, but she came anyway because friends at her college strongly encouraged her.
When asked about her life, she burst into tears. She was thoroughly enjoying college until she noticed that her family was treating her differently. Looking back, she thought it started as soon as she began college, but the novelty of the experience helped her overlook the differences. Rosa said her brothers, especially, were keeping their distance from her and when they spoke to her, they treated her like she wasn’t like them anymore. One time she overheard her older brother accuse her of trying to be better than them. She also noticed that she couldn’t relate as well to her old friends. When they met, they often ran out of things to say after a few awkward minutes. She ?nally said, “It’s just not worth it to me-I’m going to quit college. I just don’t know who I am anymore!” How would you explore the importance of family with Rosa? What else would you need to know about her? Her friends? How would you ask? Would you consider incorporating other helping sources in your work with Rosa? Discuss these with a partner.
September 29th, 2009 — Uncategorized
The Role of the Family
People of African descent place great importance on nuclear family and extended kinship systems. This pattern of family relationship was true in Africa before they were brought to North America and was reinforced by the extreme conditions families faced as slaves. Every family member, no matter how remotely related biologically, is highly valued.
Multicultural and Diversity Issues An Initial Interview with an American Indian Client Willard is a 26 year old, single Navajo male who grew up on the Navajo reservation in rural New Mexico. He served four years in the Navy immediately after high school and is now a junior in college majoring in mathematics and education. College administration required Willard to seek counseling after he was arrested for assault during a ?ght in the dorm, and his status in school was contingent on completion of ?ve sessions. The incident report noted that he and two other students became involved in an altercation after one of the other students made inappropriate gestures toward Willard’s girlfriend.
During his ?rst session, it was noted that he was a large, well muscled young man with long hair freely falling around his shoulders. He did not smile upon introduction. However, he did make direct eye contact. He indicated that he was aware of the conditions placed on his continued enrollment, but he was not enthusiastic about participating in counseling.
Working in small groups or dyads, consider how you might proceed with the initial interview with Willard. Begin by creating a list of items that need to be considered given the circumstances of his referral. Which of the items on your list have cultural implications? Next, consider the issues that are relevant to establishing a therapeutic relationship with Willard. How would you begin the interview? Finally, what information would you want to know about Willard that would in?uence your work with him in the future? Do stereotypes or assumptions that you might have about Native Americans in?uence anything on your list? Discuss these with your group.
September 29th, 2009 — Uncategorized
Odell, M., & Campbell, C. E. . The practical practice of marriage and family therapy: Things my training supervisor never told me. New York: Haworth. In contrast to more theoretical and sterile approaches to writing about and teaching marriage and family therapy, this article has a strong practical and clinical focus. For example, it includes such chapters as “It Ain’t Like the University Clinic” and “So What Do I Do after the Intake?” This practical approach is usually appreciated by beginning students who have had enough of reading and discussing theory.
Scarf, M. . Intimate worlds. New York: Random House. In this article, popular mental health and relationship writer Maggie Scarf explores family dynamics. Her approach to studying families involves numerous in depth interviews, and her orientation is generally family systems with a psychodynamic ?avor. She emphasizes use of the Beavers Scale of Family Health and Competence for determining levels of family functioning. Scarf is an excellent writer, and this article provides readers with good background information about family functioning from a systems psychodynamic perspective.
Skerrett, K. . From isolation to mutuality: A feminist collaborative model of couples therapy. In M. Hill & E. D. Rothblum , Feminist perspectives . New York: Harrington Park Press. This chapter brie?y describes a feminist approach to couples counseling.
Tannen, D. .You just don’t understand: Women and men in conversation. New York: William Morrow, Ballantine. This article explores sex differences in human communication.
370 Interviewing Special PopulationsChapter MULTICULTURAL AND
DIVERSITY ISSUES with Darrell Stolle
Let me be quite succinct: the greatest sin of the European Russian American complex which we call the West is not only greed and cruelty, not only moral dishonesty and in?delity to the truth, but above all its unmitigated arrogance toward the rest of the human race.
September 29th, 2009 — Uncategorized
Hendrix, H. . Getting the love you want: A guide for couples. New York: Holt and Company.
Hendrix’s article is a popular homework reading assignment for couples who are in counseling.
It emphasizes how unconscious and biological factors in?uence human attraction and coupling. It also provides numerous couple exercises for breaking out of relationship struggles.
International Association of Marriage and Family Counselors. . Ethical code for the International Association for Marriage and Family Counselors. Family Journal: Counseling Interviewing Couples and Families 369and Therapy for Couples and Families, 1, 73
September 29th, 2009 — Uncategorized
In addition, the exposure caused by joining a relationship or set of relationships increases the likelihood of tripping our own unresolved family or relationship issues. A big problem with unconscious unresolved issues that might affect our work is that, of course, they are unconscious. The following list is intended to help you glimpse areas that may be active con?icts for you. Consistent patterns of reactions provide clues to areas that might be ripe for personal exploration and growth.
- Do you have any topics that you would rather not talk about? For example, as we
discussed earlier, it can be dif?cult for couples and interviewers to bring up sexual matters in counseling. Mothers in law, stillborn babies, the use of belts for punishment, the denial of pets, forced consumption of food-we all carry wounds, sore spots, and fears that can be triggered by common family or couple issues.
- Do you have any biases about clients from diverse cultural or ethnic backgrounds?
For example, some counselors have dif?culty accepting patriarchal or macho styles associated with some Hispanic couples, religious couples, and others.
- Do you have biases against gay or lesbian people? Further, do you have beliefs
about the appropriateness of lifetime exclusive romantic commitments between people of the same sex ?
- Do you ?nd you cannot get certain con?icts or client problems out of your mind?
This may manifest by ?nding yourself thinking about a family or couple excessively, or dreaming about them, or barely resisting talking about them with family or friends.
- Are certain areas of con?ict or trouble guaranteed to cause you to condemn one
person or be overly sympathetic to the other? This is, of necessity, not an exhaustive list. It is important to register your reactions and ways of being on an ongoing basis and to seek professional supervision and collegial support when you suspect your own background, values, beliefs, or con?icts are getting in the way of your work with couples or families.
September 29th, 2009 — Uncategorized
Identi?cation, Projection, Joining, and Avoiding Working with couples and/or families comes as close to proving the existence of the unconscious as any professional activity we can think of. You will ?nd it challenging to keep your own early learning, beliefs, attachment issues, and the resulting current struggles from affecting your professional work with couples and families. The common term for this reaction is countertransference, mentioned in Chapter 5. Couples and families elicit signi?cant countertransference reactions worthy of consideration.
Adding to the complexity is the fact that effective assessment and assistance is enhanced by interviewers’ life experiences. Even if it were possible to exclude your own personal family and relationship issues from your work , it would be inadvisable. Common experiences form part of the foundation of any relationship and assist us in understanding other peoples’ experiences. Individual and Cultural Highlight 12.1 describes a technique to help you explore your own relationship and family issues.
Working with couples and families usually involves a joining that is more pronounced than in individual work. It is analogous to empathy but perhaps more incluInterviewing Couples and Families
Family Choreography
Family choreography is a technique developed by Peggy Papp and used in many treatment programs. To explore some of your own family of origin material, choose members of the class to represent all the salient members of your family of origin and position them physically according to the roles they played in your family. Then position yourself in your own role. You can hold a particular arrangement for a minute or two and feel the power of the rigid positions, or direct movement and interactions that represent your family dynamics. Then have someone stand in for you and walk around the creation you have fashioned, observing the stand in family members. Finally, change the action or structure in some way that would have been positive for you. Move positions, change interrelationships, remove members. Do whatever you like and, again, view what you’ve done.
September 29th, 2009 — Uncategorized
You Are Not the Only Therapist in Town
An excuse often offered for doing individual, couples, and family work interchangeably with the same people is that the people involved insist on it. Underlying their preference is their belief that you have done excellent work. This is ?attering, but not a convincing argument. Choosing to cross the boundaries and do the additional work can, in fact, undo some of the good work you did in the ?rst place. Avoiding dual roles, an ethical guideline present in all mental health professional ethics codes, includes avoiding being someone’s family therapist and individual therapist if being in both roles may cause you to lose objectivity .
Catering to the clients’ ideas that you are the best or only option is, in fact, not even necessarily healthy. Helping clients attain a more ?exible manner of functioning in the world and increasing their capacities for relationships are goals that undergird most forms of therapy. Encouraging an individual to try a different therapist because you were his or her couple counselor can be an important vote of con?dence in the client.
It communicates that you believe the client can connect with another professional and can use that therapeutic relationship to grow and change. It is rarely, if ever, justi?ed to 366 Interviewing Special Populationsallow or encourage client dependence on you as the counselor. Obviously, in some rural settings, managing multiple therapy relationships in one family may be unavoidable. In fact, you may not be the only competent therapist in town, you may be the only therapist in town .
