Case Studies in Multicultural Counseling and Therapy
Derald Wing Sue, Miguel E. Gallardo, Helen A. Neville
- English
- ePUB (mobile friendly)
- Available on iOS & Android
Case Studies in Multicultural Counseling and Therapy
Derald Wing Sue, Miguel E. Gallardo, Helen A. Neville
About This Book
An indispensable collection of real-life clinical cases from practicing experts in the field of multicultural counseling and psychotherapy
Case Studies in Multicultural Counseling and Therapy is a one-of-a-kind resource presenting actual cases illustrating assessment, diagnostic, and treatment concerns associated with specific populations. The contributorsâwell-known mental health professionals who specialize in multicultural counseling and psychotherapyâdraw on their personal experiences to empower therapists in developing an individually tailored treatment plan that effectively addresses presenting problems in a culturally responsive manner.
Providing readers with the opportunity to think critically about multicultural factors and how they impact assessment, diagnosis, and treatment, this unique book:
- Covers ethical issues and evidence-based practice
- Integrates therapists' reflections on their own social identity and how this may have influenced their work with their clients
- Considers the intersectionality of racial/ethnic, class, religious, gender, and sexual identities
- Contains reflection and discussion questions, an analysis of each case by the author, and recommended resources
- Includes cases on racial/ethnic minority populations, gender, sexuality, poverty, older adults, immigrants, refugees, and white therapists working with people of color
- Aligns with the ACA's CACREP accreditation standards, tha APA guidelines for multicultural competence, and the AMCD Multicultural Counseling Competencies
Frequently asked questions
Information
- Diagnostically, Nia fit criteria for generalized anxiety disorder accompanied by sadness, loneliness, and difficulty with emotion regulation. Primary themes of treatment included identity, racism, and relationships (family, peers, interracial). Nia requested that she be seen individually, and I honored this despite cultural âcookbookâ recommendations that one should always see African Americans as a family. I saw Joyce separately approximately once every three weeks with sessions focused on parenting and how she could support Nia. Toward the end of treatment I saw them together for a few sessions.
- I worked with Nia from an integrated multicultural-humanistic orientation with a postmodern sensibility that values transparency, collaboration, technical flexibility, self-determination, and experiential awareness, and supports therapist self-disclosure where clinically indicated. I am a 50-plus-year-old, married African American woman with two adolescent sons. Over the course of therapy with Nia, I made these disclosures, as well as others related to my religious/spiritual journey and experiences coping with racism. We read Maya Angelou's poetry and autobiographies, sharing a particular love for the poem âStill I Rise.â Nia was already Âfamiliar with meditation and chanting. We identified the phrase âI riseâ as her personal mantra and integrated it into breathing, meditation, visualization, and chanting processes to address her excessive worry and rumination. Her name, which means âpurposeâ in Swahili, served as an organizing frame for working on issues related to identity and achievement of her goals.
- Nia's case raises many multicultural considerations that are important when working with African American clients:
- In addition to differential diagnostic procedures, early assessment should be culture and context centered. The genesis and maintenance of symptom expression can be understood, in part, as a function of the cultural and racial dynamics of the contexts of daily life. For example, assessing the racial-ethnic composition of Nia's environments (e.g., neighborhood, school, etc.) and the cultural norms and behaviors of the contexts within which she functioned (e.g., âsoccerâ culture) were very important to getting a comprehensive understanding of this client.
- Specific treatment strategies should be a culturally syntonic fit with the client's sociocultural experience, identities, and sensibilities. Treatment should be informed by examining how the intersections of person, culture, and context, and the congruence (or incongruence) between them, contribute to the African American client's internally experienced and externally expressed distress. Central to case conceptualization and treatment planning with Nia was constantly keeping in mind the interrelationships between her multiple cultural identities, her personal and psychological characteristics, and relevant contextual considerations. The use of bibliotherapy focusing on Maya Angelou's work was an example of selecting and implementing an intervention strategy that was a cultural fit for Nia.
- Conceptually, psychotherapeutic work with African American clients should be understood as treating the whole person-Âculture-context transaction, as a person cannot be understood or understand themselves outside of the relationships and contexts that make up their entire field of experiences. In an African-centered context, it is limiting to restrict oneself to a therapy that artificially separates the interconnected person-culture-context experience into segmented âtypesâ of therapy. Even in meeting primarily with Nia in one-on-one sessions I conceptualized my client not as Nia the individual but rather as âNia in context,â which included Joyce, her father, Eric (whom I never met), her brother in another state, other friends and family members, her school, as well as the African American community as a whole.
- It is important to identify not only a client's individual strengths but also strengths of African culture and the African American community and how these are manifested in the client's life. Therapeutic practice with African American clients benefits from infusing a strengths-centered perspective into the work. Nurturing confidence, self-efficacy, and empowerment are important treatment goals to consider. Joyce's parenting practices had integrated and capitalized on many cultural strengths, and it was important to highlight and affirm these strengths regularly with both Nia and Joyce.
- Identifying and challenging internalized racism is critical in work with African American clients. The insidious and pervasive presence of racism and anti-Black sentiments results in inevitable exposure to negative images, dominant narratives, and socialization messages that pathologize and devalue people of African descent. Historical hostility and internalized racism were conceptualized within a larger understanding of Nia's developing identity and relationships with her parents, teachers, coaches, and peers. With Nia, this issue was approached using an acceptance-based orientation. Interventions were designed to help Nia move from âfusingâ with her negative thoughts as reflecting a reality about herself or others to experiencing her thoughts and feelings as completely understandable, given her familial and sociopolitical contexts. We worked with self-compassion as a path to freeing herself from the emotional hold of her negative self-judgments that kept her paralyzed with overwhelming emotions and prevented her from making choices and changes.
- Incorporating attention to a client's multiple and intersecting dimensions of diversity that can contribute to the development of a healthy identity characterized by a sense of wholeness and pride is important. With Nia, it was critical to implement exposure to socialization messages and experiences that took into accou...