Topic 10: Culture, Race, Poverty, & Urbanization {by 11/21}

There are two readings due this week: Text Ch. 9 – Culture: A challenge to concepts of normality, and Text Ch. 10 – Race, Class, & Poverty.  Address the following two discussion points:  (1) Based on your reading of Ch. 9, provide your response to the following quote: “Throughout the mental health field, therapeutic models have generally been presented as if they were free of cultural biases, rather than reflections of the social assumptions out of which they arise.”  (2) Simply identify and explain two specific points from Ch. 10 that resonate with you as a therapist working with diverse populations.  Your original post should be posted by the beginning of class 11/21.  Have your two replies no later than 11/23.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

30 Comments (+add yours?)

  1. Kirsten Chirichetti
    Nov 17, 2013 @ 20:31:44

    (1) After reading chapter nine, it is evident that an individual’s cultural identity has a profound impact on his or her sense of well-being, mental status, and physical health. However, as noted in the above quote, many of the therapetuic models that are utilized in the mental health field are based on social assumptions that are not completely free of cultural biases. For instance, even though human behavior is based on a wide variety of factors such as one’s personal facets, family ties, socioeconomic status, religion, inter-personal relations, and more, many therapetuic models emphasize or focus in exclusively on one’s personality traits as the basis of treatment. In this way, an individual’s culture, which greatly influences and is rooted in all of the factors mentioned above is not appreciated and is often neglected (Walsh, 2003). In addition, when culture or ethnicity is discussed in the mental health field it often tends to focus on marginalized, non-European groups (i.e., African, Latino, and Asian) and how these cultures differ from the so-called norm. Thus, non-marginalized, distant cultures are often not included, limiting the field’s knowledge on the tremendous ethnic diversity within American society. Moreover, when mental health professionals discuss these marginalized, non-European cultural groups, they bring up their “otherness” and the groups’ deficits, rather than their adaptive strengths or place in larger society (Walsh, 2003). This restricted view does not allow counselors to gain a clear understanding of these cultural groups or the different clinical issues relevant to each group. In order to help mental health professionals become more culturally competent counselors, it is critical that researchers study the several different cultures present in the United States and not simply those that are kept at the periphery of society (Walsh, 2003). Therefore, multicultural frameworks for therapetuic models can be developed and utilized in the mental health field, enabling professionals to be more responsive to the broad spectrum of ethnic, racial, and religious identities. Counselors can also continue to challenge society’s dominant universal assumptions, increasing their flexibility to adapt in the multicultural society, being more aware and vigilant of ethnic biases, and keeping their minds open to new cultural experiences.

    (2) One point from chapter ten that resonates with me as a counselor working with diverse populations is the impact of race on raising African American children. In particular, how African American parents must educate their children about racism and discrimination and the “invisibility syndrome” that exists in American society. Throughout society, especially in school systems, there are many degrading messages towards minority children (i.e., they will fail, drop-out, etc.) (Walsh, 2003). As a counselor working with African American families, it is important to realize that African American parents will be making a conscious effort to instill a sense of racial pride and strong positive identity in their children, by making them aware of the realities of racism and discrimination and to prepare them for the negative images they may encounter. However, at the same time, African American parents must have a balance of giving their children the tools to understand racism (so they do not internalize the process) and instilling in them a belief that they can achieve, overcoming racism, without being engulfed with rage and fury (Walsh, 2003). Therefore, therapists working with African American families can do their best to help the parents maintain this balance, role-playing with them different ways they can communicate this information to their children and brain-storming other learning opportunities to help them navigate this difficult task. In addition, the “invisibility syndrome” or how the legacy of slavery has contributed to a fear in society of African American males, leading others to treat them as if they are “invisible,” is also an important factor to consider when working with this population. As African American male children become older, they are often perceived by their teachers and even some therapists as intimidating and are labeled as “aggressive, hyperactive, and as failures” (Boyd-Franklin et al., 2000, as cited in Walsh, 2003, p. 262). These labels leave many African American families stuck in difficult situations when raising their sons, waning their sons to be assertive, but on the other hand, not wanting others to see them as aggressive. Thus, a counselor working with an African American family with a son must consider these possible labels and practice with them different child-rearing practices that can help the child develop assertiveness in a variety of different ways that limits his aggressiveness. In addition, the counselor can also communicate with the child’s school system if he or she feels that the child is being inaccurately stereotyped or labeled in class and develop with them a plan that can make the learning environment a more pleasant and open experience.

    Another point from chapter ten that resonates with me, as a therapist working with diverse populations is the “victim system.” Throughout American society, many minority communities remain in multigenerational poverty, experiencing a wide-range of problems including drug and alcohol abuse, homelessness, dangerous public housing, violence and death, underemployment, and more (Walsh, 2003). For this reason, many African American families (and other ethnic minorities) feel that there are limited options for their children to experience success and achievement in educational and vocational domains. This feeling of being trapped has been labeled as the “victim system,” in which different community barriers limit African Americans’ achievement in education and employment, which in turn leads to poverty and stress in relationships, which reduces one’s performance in family roles (Walsh, 2003). The vicious cycle that this creates causes many African American individuals to experience disempowerment, rage, and fear for the future of themselves and their children. As a counselor working with this population, it is important for him or her to understand this concept and emphasize with the difficulties that these families face. Counselors may also want to help their clients feel more empowered, by giving them activities or tasks in which they have control over or by challenging their negative thoughts and giving them the skills necessary to increase their performance in their family role. Additionally, therapists should make an effort to become aware of the different resources available to African American families in the community in order to help them combat the stressors of poverty and reach achievements in educational/employment domains.

    Reply

    • Julianna Aguilar
      Nov 21, 2013 @ 11:03:32

      Kirsten, I also found the concept of “invisibility syndrome” and it’s consequences interesting. Even for people who assume that they are not influenced by race, they may be unknowingly perpetuating the “invisibility syndrome” by treating African American individuals differently than people of other races and ethnicities. Not only is this difference in treatment harmful to the individual in the moment, but it can have significant negative effects on educational attainment, social functioning, and employment, among other important areas. Like you said, it is important for therapists to be aware of this concept and be careful provide the same support and guidance to African American individuals as clients of any other race or ethnicity.

      Reply

  2. Julianna Aguilar
    Nov 19, 2013 @ 08:33:54

    Among many other qualities, one of the of the hallmarks of a “good therapist” is to be judgment-free. As such, our therapeutic models are built on a foundation that is presumed to be free of cultural bias. However, the very nature of imposing one’s own values of function versus dysfunction on another individual implies that these “judgement-free” techniques actually arise from one’s social assumptions. Specifically, Walsh (2003) notes that the values of certain European groups have tended to be viewed as normal, thus leading other cultures to be labeled as “ethnic” by association. As a result, these ethnic cultures are marginalized for being outside the norm. These specific values and social constructions (e.g., who is in the “norm” and who is not) can then influence how mental health workers approach therapeutic intervention. Walsh (2003) writes, “[e]very intervention is value laden. We must not use the notions of neutrality…We must have the courage of our convictions, even while realizing that we can never be too certain that our perspective is the ‘correct’ one. It means we must learn to tolerate ambiguities and continue to question our stance in relation to the position and values of our clients” (p. 251-252). In this quote, Walsh does not criticize value-based therapeutic models. In fact, he encourages their use. However, these therapeutic models are most effective when the therapist is sensitive to the meaning of the client’s thoughts, emotions, and behaviors within his or her particular culture. Additionally, there may be aspects of the client’s culture or identity that are difficult for us to understand or accept, but we must be aware of and accept those ambiguities in order to understand both the client and our perception of the client more clearly. Overall, an important therapeutic goal is not necessarily to attempt to be completely judgement free, but rather to be aware of one’s assumptions and work to help clients understand their issues in relation to their identity, history, community, and family, among other important cultural factors.

    Two important points from Chapter 10 that particularly resonate with me being a therapist working with diverse populations are the difficulties for African American male children in the school system and the chronic trauma and stress of families living in the inner-city. First, Walsh (2003) describes the issue of “fourth-grade failure syndrome” in which teachers and therapists become intimidated by African American male students, and thus label them as aggressive, hyperactive, and failures (p. 262). Early identification of African American male children with negative qualities restricts the way parents can raise their sons. For example, parents may feel if they teach their sons to be assertive, a generally positive quality, that it will be interpreted as aggression simply because they are African American. Being seen as aggressive can then have negative consequences beyond struggles in school including unemployment, prison, and early death due to complications on the streets. Another important issue to consider when working with diverse populations is the possibility of chronic stress for families who live in the inner-city. These individuals, particularly children, face daily stressors including walking through unsafe areas (e.g., with drugs and violence), experiencing physical or sexual abuse, and witnessing deaths of family or community members, among other traumatic events. As a result of these events, children often exhibit behaviors consistent with oppositional or conduct disorders, anxiety, and depression. Walsh (2003) notes that prominent features of Post Traumatic Stress Disorder (e.g., flashbacks, nightmares, generalized anxiety) are often overlooked by therapists, however. For this reason, it is important that therapists pay particularly close attention to the root of the difficulties (e.g., traumatic event) that inner-city clients present with in order to better understand their symptoms and intervene in the most effective way for the particular client.

    Reply

    • Kristina Glaude
      Nov 20, 2013 @ 20:18:58

      Julianna-
      I liked your point on working with families with chronic stress. When working with children and families it is important to review all stressful daily events no matter how big or small as each event may influence an individual differently. For it would be difficult for the therapist to work on ways to lower anxiety with the child in school if the child is frequently thinking about the walk home from school and what may occur on this walk. If safety skills such as walking home with a buddy could be established and this helped to lower after school anxiety then the therapist could focus on the anxiety in school.

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    • Brandon Pare
      Nov 22, 2013 @ 21:57:48

      Julianna
      I agree that as a therapist our number one role is to remain as non bias as possible when working with individuals from a background that maybe different from our own. This can be proven to be difficult given social bias but also any bias we may have that we do not know we are contributing. Cultural sensitivity is important and as therapists we should not only be aware of societal expectations but also the stereotypes and expectations that are in each culture.

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  3. Brandon Pare
    Nov 19, 2013 @ 23:31:19

    1. What has happened in our society is that we have developed models to be used for all individuals with the goal of not discriminating against a particular race. But upon doing this we have create models that don’t cater to specific characteristics or believes of other cultures that affect human behavior. This of course has an impact on social behavior and how a culture fits in within society. Some models design are homogenous when our society is more heterogenous. Client’s behavior and beliefs are effect by both their culture and society and their ethnic background. So it is important when working with anyone that the psychological model that is being implicated is adjusted to meet the clients needs instead of trying to push the client to meet a model that not work for them based on their social and cultural background.

    2. The two topics of this chapter that resonate with me as a therapist working with diverse populations were single parent families and class. As the chapter indicates, “social class is extremely complicated” (Walsh, 2003,p263) in our society. It becomes even more complicated when race is involved. Income for a particular culture could be considered a different class within the culture then within normal society. This can create a conflict. The other fact that resonates for me as a therapist is the single parent household. This is typically a female role that can occur for a number of reasons that are not just dysfunctional in nature. The chapter indicates that when comparing dysfunctional to non-dysfunctional African American families that the functional families typically had definitive boundaries and designated role responsibilities. When we think of these single family homes we sometimes can assume an absent parent that isn’t given an opportunity for responsibility or doesn’t want to take responsibility. But it is important to remember that single family homes can occur for other reasons such as death, single parents choosing to adopt, and divorce.

    Reply

    • Kristina Glaude
      Nov 20, 2013 @ 20:06:45

      Brandon-
      I liked your points about single family homes. I think it is important to remember that not in all cases is there a parent that does not want to take responsibility of the situation and the child they have. But rather some other event could have occurred leading to a single parent home. In some cases it could be a single parent home for a short period of time such as a parent travels for business or a longer period of time where a parent is deployed with the service. The reading notes that although there is a trend of women having children older, most African American single parents obtain this when unwed teenagers. With that said I think it is possible that the other parent may not even know that they are the parent of the child thus, never able to take an active rule with the child.

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    • Sara Grzejszczak
      Nov 21, 2013 @ 18:11:10

      Brandon, I really like the fact that you pointed out the our society is more heterogenous and because of this there are certain characteristics of each culture that need to be addressed differently. I also like how you pointed out that single parent families are important to think about when talking about our clients, from any culture because there are many different reasons as to why these families only have one parent. I feel like just as with our previous discussion on single parent families many times these families are not dysfunctional because of the many ways a family becomes a single parent family and therapists need to be open to exploring how the family system works before deciding if it is functional or not.

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    • Katrina Mitchell
      Nov 23, 2013 @ 20:50:15

      Brandon,
      I agree with your comment that many of our theories and therapies today fail to consider the specific characteristics or beliefs of an individual’s culture as it affects their behavior. As a result, much of our treatments have become, as you say, “homogenous”. These theories, therapies, and treatments are a result of westernized cultures that focus on individual personality factors rather than considering the connections made within particular cultures. However, all of these factors are crucially significant to understanding each individual client and providing them with the appropriate therapy in order to meet the clients’ needs.

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  4. Kristina Glaude
    Nov 20, 2013 @ 19:51:16

    1) As I did the reading for this week and thought about the quote above I thought about culture and how no one is exactly the same. When we work as therapists with families each family is going to be different. Although two families may come from the same culture they are still two different families. The therapist should try to keep an open mind avoiding stereotypes, misunderstandings and body language. Within everyone’s culture individuals are complications that may arise when in treatment. Culture influences treatment and the individual has specific values and core beliefs that they hold important to them. When working with clients we must work to review what these are for the individual in order to develop treatment specific for the client. I thought that the quote from page 245“we may feel negative, proud, and appreciative of your cultural heritage, or we may be unaware of the cultural groups to which we even belong. But our relationship to our cultural heritage will influence our well being, as will our sense of our relationship to the dominant culture”. I thought this quote was important to mention for every person is different when it even comes to how they feel about their culture. No assumptions during treatment should be made, but rather note with the client how it influences or does not influence their decisions and life choices.

    2) Two points that were key for me from this chapter are strengths and kinship network in families and religion. I feel that the first point of strengths and kinships in family networks is important when working with families. I often feel that we look at all the things that are going wrong within a family and don’t focus on positive strengths that the family already has developed for themselves. Often times when treatment starts with a family a therapist is coming not when things are at their best but rather when the family is struggling. Thus when first starting with a family trust may be difficult to develop but however, once a therapist is able to establish this with the family they will begin to see all the key players within the family. With this trust the therapist can start to understand the depths that the family structure may expand out into the community. The second point that was key for me was religion. Through the use of religion families may find support, strength and hope. The use of religion can be used as a positive with a family to give examples of struggle and outcomes that in context families may understand and draw strength from. The church also allows for the family to have other community supports and connections for them in both good and bad times. The church allows for activities for family members of all ages. Walsh also notes on page 270 that a family doe s not have to be associated with a specific church to still be spiritual. Families may tend to come to their spiritual foundation when facing more difficult times in their life. Examples of some of the difficult times are when someone is ill or dies.

    Reply

    • Brandon Pare
      Nov 22, 2013 @ 22:12:46

      Kristina
      I like how you highlighted the points strengths and kinship network in families and religion.They were different then the ones I choose to focus on but you bring up great points with each of them. When we first start to see families they can be in a state of crisis and can be presenting negatively. It is important to keep in mind the positive attributes that makes the family who they are and how they have been successful in the past until this point. I also think you bring up a great point in terms of religion. Religion may not play such a major role in a person’s life until they find themselves closer to it in times of crisis such as the loss of a loved one. This can make them feel more connected to a belief that normally wouldn’t have resonated as much before.

      Reply

    • Katrina Mitchell
      Nov 23, 2013 @ 21:06:45

      Kristina,
      I like how you connected family kinship and religion. Similar to what you wrote, the woman I work with in therapy tends to look at the things going wrong with what family she has left instead of appreciating the family she has left that could actually provide the strength for her that she heavily relies on her religion for. However, she very much does use religion for support, strength, and hope. Over the summer we did much work in exploring her passion. Little else interested her except for her religion and now it is a true motivation for her in her work with me during therapy. Additionally, the church provides connections. For this particular client, two of her friends run senior trips and encourage her to participate in what they plan. This gives her connection and she is now having Thanksgiving as well as Christmas celebrations with these friends. As as a result, her spiritual foundation proved imperative and continues to during difficult times in her life such as illness and death as you pointed out.

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  5. Katrina Mitchell
    Nov 20, 2013 @ 23:23:41

    With the rise in immigration to America over the past century, it has become more and more crucial for therapists to incorporate cultural facets into theory and therapy for clients who gain a sense of self through their heritage. While therapeutic models have generally been presented as free of cultural bias, this freedom denies the consideration of cultural facets in therapy. It would be more beneficial and meaningful to have therapeutic models that reflect the different social characteristics of a given culture. Cultural aspects of a client’s identity contributes to their physical, psychological, and spiritual self as well as to their beliefs, values, and sense of well-being. It determines our thoughts and feelings towards what we eat, the work we do, who and what we love among other major roles of life. Yet, many western cultures define an individual as a being who demonstrates growth and development through autonomy as opposed to eastern cultures who define an individual demonstrating growth and development through empathy and making connections. Because westernized cultures are seen as dominant cultures, their assumptions surrounding culture and society has become the universal standard. As a result, human behavior tends to only be considered along personality factors rather than along the interplay of personal, cultural, familial, and socioeconomic factors. Much behavior can be recognized as an outcome of deeply rooted cultural norms.

    As a therapist working with diverse populations one specific point that resonates with me is “Poverty and the “Victim System””. Many of the children I work with come from or have family members involved in low-income housing, drug and alcohol abuse, crime, public housing, teenage pregnancy, unemployment, high school drop outs, and ongoing issues with the police. These deficits often decrease many of the opportunities among different realms of these children’s lives. Such results from poverty creates increasing stress that becomes a burden for children surrounded by it. As a result, children experience barriers to opportunity and limits to education that support achievement and attainment of skills leading to a vicious cycle of less and less opportunity for children living in poverty.
    Another specific point that resonates with me is “Religion, Spirituality, and Other Survival Skills”. One older woman I work with establishes a great sense of community and connectedness from her church and church members who she speak spiritually with. Her center or her passion is her spirituality. Much of her treatment relies on seeking out her faith on a daily basis by visiting the church, participating in church events and activities, completing the rosary, and going to confession. She has little else to turn to as she is unemployed, has little to no biological family connections, and lives on her own. For her, it is her faith that provides support. When she becomes disconnected from the church she demonstrates a major difference in her thoughts, feelings, and behavior. Therefore, church is a strength and survival mechanism for this older woman.

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    • Stacie Z.
      Nov 23, 2013 @ 21:08:20

      I found the example that you gave of your client nicely describes what we read about the strength religion and spirituality can provide to those who do not have as many educational, employment, or financial opportunities as others. As therapists I think figuring out with our client what sources of support he/she has used in the past, and finding a way to reconnect with it, can be an important step. I find it interesting how you describe her connection with the church is so strong that it becomes a type of survival mechanism as well.

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  6. Emily B
    Nov 21, 2013 @ 07:38:38

    Therapeutic models use social assumptions that allow the models to be “judgment free.” Often cultural considerations are developing awareness of a group of people that have been marginalized or cultures that have struggled to adapt to the American culture. Therapist might struggle with understanding the meaning of a client’s thoughts, feelings, and behaviors as it relates to his or her culture. This is because therapists are asked not to judge their clients and their culture. But exploring these differences and meanings with the client might allow the client to feel more comfortable expressing concerns with the clinician. Non-European groups are often focused on by discussing their struggles to adapt to American cultures instead of focusing on the strengths of their culture. It is important to study and develop models that are focused not only on cultures that are more prevalent in American like Hispanic, Asian, and African cultures but other subcultures within these groups and other cultures that have been overlooked.

    One point that resonated with me was the struggle of African American males. I found the concept of the “fourth grade failure syndrome” to be particularly interesting. African American males are seen as intimidating by teachers and therapist when a child may be expressing common traits of a normally developing child. Instead the child is labeled as aggressive and worse yet failures. In previous classes we discussed how a teachers perception effects a child’s performance and their confidence to continue to achieve in school. This may be a reason why in inner city classroom so many African American males drop out. The second point that resonated with me as a counselor is the idea of the “victim system.” Living in low income bi-generational families come with many stressors that are at times impossible to avoid. These families often live in low-income neighborhoods that have significant amounts of crime, drug use, unemployment, teen pregnancy, and the police. With constant threats remaining assisting clients in remaining motivated to finish school and assisting them and connecting them with positive influences that will assist them in achieving their goals of furthering their education may help the individual feel like they have a way out of the neighborhood and the ability to make their own life somewhere new.

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    • Julianna Aguilar
      Nov 21, 2013 @ 08:23:31

      Emily, I like how you pointed out the importance of utilizing the strengths of the client’s culture. Many people are quick to focus on how well a client has adapted or assimilated to the United States without much mention to the country from which the individual originated. One might assume that the more Americanized a person can become, the more success (e.g., social, psychological, financial, etc.) he or she will have. However, attempting to leave one’s home country behind can cause significant emotional turmoil that makes integrating into a new culture even more difficult. Therefore, more emphasis on integration of the past and current cultures as opposed to having to choose one over the other would help clients retain their important values and traditions while adopting new ones as well.

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    • Paige Hartmann
      Nov 23, 2013 @ 14:09:49

      Emily, I liked how you pointed out that not only do individuals struggle to have others understand their own culture, but immigrants also have difficulty when attempting to adapt to the new culture of the country they immigrated to. This can be especially difficult as individuals do not want to abandon their native culture while trying to adapt to their new one.

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  7. Anthony Rofino
    Nov 21, 2013 @ 11:02:11

    In many aspects of life, it is important to make things as culturally unbiased as possible to not give an advantage to any one particular race. However, when it comes to therapy, this should not always be the case. The culture or race of a person can affect everyday living. Culture can dictate various personality traits, how one deals with psychological issues, how one interacts with environmental stressors, etc. By ignoring the cultural roots of a person’s personality, the therapist is not truly analyzing every aspect of a person’s life. Similarly, it should not be considered a problem if a person of a different culture does not necessarily act like someone from a western culture. Adapting to the normative culture is difficult, and the process must be addressed.

    In chapter ten, I found the “victim system” to be very interesting. It is unfortunate for African-American clients from the lower class feel like the barriers on their life from their race and poverty level affect them so deeply. The importance of our job as therapists is to make our clients aware of the resources that are available to our clients. In order to do so, we must make sure our clients do not feel like victims and feel like they can accomplish things with their life. Self-esteem work is important. The second aspect i found interesting was the aspect of rage and “black on black” crimes. We as clinicians must understand that rage may be directed at us, but this is transference. It is important to help our clients talk about their rage and to recognize what they are truly angry at

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    • Sara Grzejszczak
      Nov 21, 2013 @ 18:02:46

      Anthony, I like how you pointed out that the therapist is truly not looking into every aspect of a clients life throughly if they ignore the cultural roots the person has and hat if they are not acting like the dominant culture it does not necessarily mean that something is wrong. I also found it the “victim system” interesting because of the fact that the African American population feels so helpless because of multigenerational poverty.

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  8. Paige Hartmann
    Nov 21, 2013 @ 16:45:14

    Generally, it is important to view situations or people in a culturally unbiased manner. Within the therapeutic relationship, the therapist should both consider and understand an individual’s cultural background during treatment. The cultural environment in which an individual was brought up aids in the formation of the individual’s beliefs, norms, and influences the way in which the individual would handle a situation. This is especially important for a therapist to consider when an individual is seeking therapy for a psychological disorder. If the therapist is not familiar with the individual’s cultural background, the client can provide some insight to their therapist to inform them of their culture and beliefs. It is essential for the therapist to first understand their client’s cultural background in order to understand how it impacts their life and how it relates to their psychological disorder.

    One point that resonates with me from Chapter 10 is the concept of the “victim system”. Many African Americans are affected by the “victim system” in which barriers prevent these individuals from both opportunity and education. This can lead these individuals into poverty or cause them to experience stress within their relationships. The “victim system” becomes a vicious cycle that limits the functioning of these individuals. The second point that stood out within this reading was the discussion of chronic posttraumatic stress disorder. The chapter discussed inner-city children and families who tend to experience both chronic trauma and stress. Their trauma and stress tends to be related to fears associated with walking through dangerous areas of their communities or witnessing a traumatic event such as a violent act within their neighborhood. This can lead to increased acting out behaviors as well as anxiety or depressive symptoms.

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    • Amanda Thomas
      Nov 23, 2013 @ 16:28:36

      Paige, I also thought a lot about what you mentioned in your second point for chapter 10. It makes complete sense that symptoms of anxiety and or depression can arise from being present in an area that has a reputation for being unsafe never mind witnessing a traumatic event. Without a doubt this has a negative impact on children and their families.

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  9. Stacie z.
    Nov 21, 2013 @ 17:26:07

    In developing a therapeutic relationship it is important not only to recognize the bias of some therapeutic models, but also for the therapist to have an awareness of his/her own cultural biases. Clients that are marginalized or stereotyped by the wider society can benefit greatly, and should expect to experience, a therapeutic environment that is neutral. In deciding what type of therapeutic approach to take or intervention to suggest, the therapist needs to carefully examine what, if any, elements are inappropriate for his/her client. Being aware of how personal experiences and upbringing has influenced our viewpoints is necessary in order to ensure that we are hearing what the client is saying in an objective manner. The chapter discusses in detail the variation among and within cultures regarding what is a “family” and how is therapy viewed. Choosing a family therapy intervention that focuses on an individual’s needs when the members are from a culture that supports a wide network of what is considered “family,” may not be as effective, even when there is strong support for the intervention in addressing the family’s problems. The author highlighted that ethnicity is “a powerful influence in determining identity,” a theme that is important to remember in treating clients in a culturally competent manner. Therapists can gain understanding about their client’s cultural by asking questions of the client, reading literature, and seeking out culturally rich opportunities where they will not be the dominant culture present.

    The author in chapter 10 mentions that therapists often miss the objective signs and symptoms of PTSD in clients experiencing poverty, lack of opportunity, substance abuse, and other chronic risk factors. She describes the daily experience of children witnessing drug use, walking through parks with needles strewn around, violence, and how these children often internalize or externalize the behaviors. Reading this I wondered if the attention is so focused on certain externalizing behaviors that treatment is aimed at reducing those behaviors that are most disruptive for others, at the expense of not addressing the trauma symptoms. A second point that I found important was the idea that when poor, single mothers do come for help their symptoms can easily be overpathologized. She explains how it is “crucial to appreciate the context of their sense of being overwhelmed or their disorganization and lack of resources to manage realistically overwhelming situations” (p. 269). I feel that this reflects many of the issues discussed over the semester in that meeting basic needs, whether after a natural disaster or in chronic poverty situations, is essential and needs to be addressed before initiating traditional therapeutic interventions.

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    • Kirsten Chirichetti
      Nov 21, 2013 @ 18:41:17

      Stacie, I thought it was interesting that you mentioned the point that many therapists often miss the objective signs of Posttraumatic Stress Disorder in young clients from underprivileged backgrounds. There are several different environmental stressors that children encounter on a daily basis that can be very traumatic (i.e., gang violence/crime, substance abuse, domestic disputes, etc.). In addition, many children living in poverty are often not having their basic needs met or satisfied, creating more stress in addition to other dangerous living conditions. For this reason, it is important that counselors take into consideration all of these stressors that this youth population faces and the toll that this stress/trauma can have on their mental health. Moreover, as therapists make an effort to understand this stress, they should also closely look for symptoms of Posttraumatic Stress Disorder and how this diagnosis could be impacting their functioning at home, school, and in the community.

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  10. Sara Grzejszczak
    Nov 21, 2013 @ 17:58:24

    Culture has more to do with who people are than everyone first tends to believe. Traditions that occur on a daily basis or even a yearly basis with certain events and holidays all started from some other place at some point in time. Even then people of the same culture are not exactly the same. By having therapeutic models “free or cultural biases” is the say that everyone is exactly the same and has the same exact customs and mannerisms. The social assumptions that were once made by therapists, with things like lowering eyes and avoiding eye contact that could be construed as being unable to relate interpersonally, are actually the correct thing to do in the culture that the person is from. With so many different customs from people coming from many different cultures there cannot just be one model anymore. Therapists need to make great effort in talking to others who are familiar with a culture if the therapist himself is not familiar with it so that therapy can be altered for that individual.

    Two points from chapter 10 that resonate with me personally working with diverse populations are poverty and survival skills. Many families that live in the inner city are living in poverty for one reason or another. Far too often the families in poverty are in this cycle where the cannot get out of being in poverty and are scared that the street life will take over their children. Many of the kids that I work with now are from the inner city and most do not live in conditions that you or I would choose to live in willingly. These types of conditions lead to many different problems, which will bring these clients to us (most of the time unwillingly) and we need to be prepared to work with them. Most likely these clients will not be very willing to open up to therapists at first because of their culture and the fact that we are mostly “white middleclass” clinicians who could not understand what they are going through. The survival skills that minorities and other populations come up with to stay alive and make the best of their situation is very important because they do not have the same type of family structure. A lot of times because African American women tend to be single mothers they rely on other family members and even church members to help raise their children and take care of the children while they are at work. This means that the key person that holds a family together may not be someone in the immediate family that the therapist is treating. Great care needs to be taken in hopes that the therapist can talk to others that may not normally be a part of therapy sessions but still have an important role in the lives of the clients once the therapist is able to gain the trust of the family.

    Reply

    • Kirsten Chirichetti
      Nov 21, 2013 @ 18:33:01

      Sara, I really like that you pointed out that it is critical for counselors to take into consideration the various cultural practices of their clients. As therapists practice in the mental health profession, they must continuously educate themselves on different cultures and new interventions. Some different ways that counselors can keep up-to-date on their knowledge of other cultures is talking to other individuals who are from/study that culture, attending seminars, and reading journals or books. In addition, counselors may benefit greatly from having conversations with their clients about their culture, to not only increase their knowledge on the topic but to also build rapport. By taking the time and effort to understand one’s culture and practices, a therapist can gain the trust, respect, and acceptance of the client.

      Reply

  11. Melissa Recore
    Nov 21, 2013 @ 18:50:23

    1. Every culture has its own set of cultural norms, values, practices, and even belief systems. The therapeutic models cannot be used as a blanketed approach to dealing with any individual because the cultural differences make each culture and individual within that culture very different. Although therapeutic models have the best intentions they cannot be mass delivered effectively. For example, let’s think about turkeys, pilgrims, and the birth of our nation; also known as Thanksgiving. Thanksgiving is not an American citizen holiday which effects all individuals who currently reside in the United States of America. Many individuals who live in America but originate from South America and European countries may not celebrate this Thanksgiving. Clinically should we assume that every patient who has social anxiety needs to be prepared for the big family gathering the fourth Thursday of November?, No, clinicians are obligated to get to know their clients individually and determine weather or not such an intervention would be appropriate. Clinicians also must be aware of cultural differences when determining how to intervene with the client.

    2. The first point which resonated with me was the “victim system” which discussed how individuals fall into this cycle in which they can’t get education or services to bring themselves out of poverty or reduce all the daily stressors they face (not having basic needs met, living in an unsafe environment, etc.) so instead they develop these negative coping skills such as drinking, drugs, or even participating in crime because they have no other means of surviving in their culture. I personally have heard statements such as “my dad is going to jail so I’m going to go to jail”, or “my dad sold drugs so why shouldn’t I?” These statements are examples of how individuals becomes overwhelmed and stressed by the obstacles in their environment until they eventually succeed to that environment and in a sense conform to their perceived destined roles.
    The second point which resonated with me was the importance of spirituality with individuals who are experiencing impoverished lifestyles. Spirituality and faith does not have to be devotion to a specific perish or church according to Walsh but instead he discussed how the participation in church activities gave many families positive experiences in their otherwise stressful lives. Spirituality was used as a source of strength which allows many individuals to find meaning and peace in their disadvantages.

    Reply

    • Paige Hartmann
      Nov 23, 2013 @ 13:57:31

      Melissa, I really liked your example about Thanksgiving within the United States and how within one country exists a multitude of different cultures, some which celebrate Thanksgiving and others that do not. It is definitely an important piece to consider within the therapeutic relationship of how one’s culture may impact the way they think, act, or handle situations.

      Reply

    • Amanda Thomas
      Nov 23, 2013 @ 16:21:32

      Melissa, I also like your thanksgiving example. As a therapist it is important to understand and be accepting that there are many people who do not fit perfectly into cultural stereotypes, like an American celebrating Thanksgiving. Even among those who do celebrate or participate in Thanksgiving per say, there is still no defined mold in which they do so. Being aware of cultural celebrations or practice is helpful but also knowing that there is individuality as well.

      Reply

  12. Amanda Thomas
    Nov 23, 2013 @ 17:30:32

    Therapists attempt to practice in the absence of cultural biases or via social assumptions however without cultural or social influences a therapist cannot do his or her job well. Since people are so strongly influenced by their culture, values, and beliefs that are dictated through social practices it seems trivial that this would be a guiding force for a therapists. Appreciating cultural and social diversity will allow a therapist to be better connected with his or her clients, which in turn will yield better outcomes. Having knowledge regarding social and cultural differences should be the vehicle through which therapy is delivered.

    There were two points from chapter 10 that resonated most for me. One point was about class or social class and how it is coupled with race. The example in the text was about how black families have different class distinction in comparison to broader American society. In some poorer neighborhoods, black families are considered “middle class” based on their values, aspirations, and expectations for their children. I thought that was interesting way to make class distinctions. Another point that stuck out to me was “healthy cultural paranoia”. I guess I had never thought too much about this phenomena, but it makes sense. This paranoia or suspicion occurs when there has been a history of involvement with child protective services, police, and legal and criminal or justice systems. Poor families are often intruded upon by the aforementioned service professionals and develop a paranoia or suspicion and as a result are reluctant to accept help. This made me sad that people are judged based on the class or race.

    Reply

    • Stacie Z.
      Nov 23, 2013 @ 20:27:25

      I found the section on “healthy cultural paranoia” informative as well. Being aware of where families with a history of involvement in child and family services or the legal system are coming from, would likely influence the approach a therapist would take. Although establishing rapport and a level of trust is essential to the therapeutic relationship, I think that in this type of situation the process might take longer and require a greater amount of focus on developing trust. When a family’s history with social agencies consists of being intruded upon and told what to do, it can be difficult to help the families understand that the therapeutic relationship will be a more collaborative effort to problem-solving and working through difficult issues.

      Reply

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Adam M. Volungis, PhD, LMHC

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