why is culturally sensitive therapy important

Another example is the use of cognitive-behavioral therapy. A cultural analysis of the effect of talking on thinking. The definitions of cultural competence have points of convergence and divergence (Whaley & Davis 2007). Constantine (2002) correlated African American, American Indian, Asian American, and Hispanic clients treatment satisfaction with two measures of competency: one that assessed counselors competency in general (i.e., the Counselor Rating FormShort) and the other that measured cross-cultural competence in particular (Cross-Cultural Counseling InventoryRevised). ACES endorsement of the multicultural counseling competencies: Do we have the courage? The adaptations included changes in the language used to describe cognitive-behavioral techniques and inclusion of culturally specific content (e.g., African American family issues) in order to better situate the intervention in an African American context. In addition, ethnic and cultural concepts may clash with mainstream values inherent to traditional psychotherapies. The former has tended to focus on characteristics, values, attitudes, and skills on the part of the therapist that can minimize the social and cultural distance between care provider and client, whereas the latter has tended to examine changes in treatment procedures and content that more adequately address the cultural experiences of ethnic minority clients. Pistole MC. Client problems and issues (e.g., rape prevention, treatment of schizophrenia, prevention of drug abuse, depression, and self-esteem). S. Sue (1998) views cultural competence as a multidimensional process. Psychotherapy: Theory, Research, Practice, Training. Cultural values of interdependence and spirituality, and discrimination in the psychotherapy of ethnic minorities, are often ignored in treatment approaches to ethnic minority clients (Hall 2001). Sue DW, Bernier JB, Duran M, Feinberg L, Pedersen P, et al. Because cultural competency advocates emphasize the need to understand the cultural values and worldviews of members of different cultural groups. The languages have included Spanish (e.g., Armengol 1999, Gallagher-Thompson et al. ), methodology (random versus nonrandom assignment to treatment/control conditions, follow-up design, measures used, etc. Why Cultural Safety Is Essential in Mental Healthcare - Verywell Mind In: Norcross JC, Beutler LE, Levant RF, editors. However, because the study included general improvements as well as culturally relevant interventions, it was not possible to determine what factors in the interventions caused the favorable outcomes. HHS Vulnerability Disclosure, Help Our focus is on the first levelthat of the provider, therapist, or counselor and that of the specific treatment used. o Cultural matching of therapists and clients has better therapeutic outcomes Clients need to respect and explore the culture of their therapist O Some cultures have different norms that will change their interventions and interactions O Culture is a maladaptive coping mec. Culture is the integrated pattern of human behavior that includes thoughts, communications, actions, customs, beliefs, values, and institutions of a racial, ethnic, religious, or social group (U. S. Department of Health and Human Services [DHHS], 2001). Culturally relevant therapy helps clients to make connections in the brain, and it promotes the process of therapeutic alliance, therapy engagement, and neuro - . Griner D, Smith TB. We have not attempted to be exhaustive in our review of the relevant research; instead, we have examined the major issues and trends in cultural competency. The patients who received the adapted CBT had lower dropout rates than those who received CBT alone. By advocating for multicultural competencies for ethnic minority groups, are we discriminating against or ignoring other diversity characteristics such as gender, sexual orientation, and social class? While one therapist may have a masters degree in social work another may have a Ph.D. Each college, degree, and licensing board sets its own standards for how much training is needed in working with diverse populations. Disease management in Latinos with schizophrenia: a family-assisted, skills training approach. But first, its important to understand why doing so is worth the effort. Guidelines on multicultural education, training, research, practice, and organizational change for psychologists. 2006). The culturally sensitive psychotherapist's job is to develop an appreciation of his or her own culturally circumscribed constructs and learn to engage the client in a therapeutic discourse that allows the client's culturally nuanced ways of construing to be drawn out and be the focus of psychotherapy. Assoc. A good provider will A sk you questions and won't make assumptions about you. government site. For example, in a culturally adapted management training intervention for Latino parents, Martinez & Eddy (2005) not only conducted training sessions in Spanish but also addressed culturally relevant immigration and acculturation issues. In the mental health field, widespread attempts have been made to define the best forms of treatment. Ethnic/racial groups (African American, American Indian and Alaskan Natives, Asian Americans, and Hispanics). Similarly, relevant cultural content was included in a support group intervention for Hispanic traumatic brain injury survivors (Armengol 1999) and in an educational intervention program for low-acculturated Latinas (Guinn & Vincent 2002). Presidents New Freedom Commission on Mental Health. Further troubling were the welldocumented health status disparities between different ethnic and racial groups, as well as the nationally publicized studies regarding cultural bias in health care decision making and recommendations (Schulman et al. Hispanic and African American providers were included in videotaped materials for patients. Two metaanalyses are pertinent to this question. Patient-Centered Culturally Sensitive Health Care: Model Testing and 2023 Dotdash Media, Inc. All rights reserved. While a therapist may make some recommendations, the clients input is valued and they work together as a team. 2012;68(2):187-197. doi:10.1002/jclp.21829. Miranda J, Bernal G, Lau A, Kohn L, Hwang W, La Fromboise T. State of the science on psychosocial interventions for ethnic minorities. Federal government websites often end in .gov or .mil. As late as 1996, Chambless and colleagues (1996) could not find even one EST study that analyzed ethnicity as a variable. Martinez CR, Eddy JM. In either case, the manipulation of not adapted may be contaminated. 2004). Given the growing ethnic minority populations and the existing disparities in health and treatment, special attention to race and ethnicity is needed. In addition, for Hispanic clients, ethnicity tended to interact with acculturation in that low levels of acculturation appeared to profit greatly from culturally competent interventions. 128129): It is our contention that multiculturalism is infused with political meaning. Ethnic minority populations need access to the best forms of treatment. Malgady R, Rogler LH, Costantino G. Hero/heroine modeling for Puerto Rican adolescents: a preventive mental health intervention. Interventions involving African American girls (Belgrave 2002, Belgrave et al. It also organizes our cognitions, emotions and behaviors in both subtle and obvious ways that may be beyond awareness. Weinrach SG, Thomas KR. Griner & Smith (2006) included interventions with adults and children, whereas Huey & Polo (2008) focused on children and youths. For example, Kohn and colleagues (2002) examined the degree to which a manualized CBT intervention could be adapted in a culturally sensitive manner in treating depressed low-income African American women experiencing multiple stressors. National Library of Medicine Group discussions and skill-building exercises for youths focused on Asian familial values, acculturation issues, and intergenerational communication. The definitions also vary as to how amenable they are to research testing. Therapeutic community retention among Alaska Natives: Akeela House. However, studies that were focused on one ethnic/racial population yielded higher effect sizes than those in which mixed racial populations were included. Indeed, the reports varied considerably in terms of population studied (problems/disorders, age groups, ethnicity, etc. How to Find a Culturally Sensitive Therapist - Verywell Mind In: Corey G, editor. cultural adaptation, ethnic minority, evidence-based practice, treatment outcomes, mental health. 2002, Miranda et al. As noted by Pope-Davis et al. Gallagher-Thompson D, Arean P, Rivera P, Thompson LW. : How Political Correctness is Corrupting Medicine. Can a theoretical model be devised that explains cultural competency and why it works? Flaskerud JH, Hu L. Participation in and outcome of treatment for major depression among low income Asian-Americans. Handbook of Racial-Cultural Psychology and Counseling: Training and Practice. (2008). Therefore, it has been of paramount In addition, differences may exist in how the studies are interpreted. For example, one of the guiding principles of the American Psychological Association (2002, pp. A critical analysis of the multicultural counseling competencies: implications for the practice of mental health counseling. Others emphasize the outcome of cultural expertise. Assoc. . Administration on Aging, U.S. Department of Health & Human Services (HHS) (, Health Resources and Services Administration (, Substance Abuse and Mental Health Services Administration (. Justice or ethical grounds have also propelled cultural competency (Whaley & Davis 2007). Keywords: culturally sensitive treatment, culturally adapted treatment, depression, racial/ethnic minorities, adaptation, therapy Depression is among the most debilitating disorders and largest contributors to the world's global burden of disease (World Health Organization [WHO], 2008). Moreover, little research examines ethnic variations in response to treatment (Mak et al. Nevertheless, they state, In the absence of efficacy studies, the combined used of protocols or guidelines that consider culture and context with evidence-based care is likely to facilitate engagement in treatment and probably to enhance outcomes. Third, in contrast to the conclusions of Smith & Griner (2006), Huey&Polo (2008) state in their meta-analysis: there is no compelling evidence as yet that these adaptations actually promote better clinical outcomes for ethnic minority youth. Robinson et al. Some studies involved individual therapy whereas many others involved group interventions or a combination of the two. 10 Tips to Help Find Culturally Sensitive Health Care - AARP 2003) as well as the multicultural counseling competencies adopted by the organizations Division 17. (2003) studied the effects of school-based health center programs for African American students. In: Carter RT, editor. Psychol. Miranda and her colleagues (2003a) have studied whether cultural adaptations to CBT improve the outcomes of treatment for Hispanics. These studies explicitly report that treatment was conducted by therapists who were bilingual or who spoke the language of their clients. When you find someone who understands you, youll be much more likely to make progress in treatment. When Hurricane Ida hit New Orleans last year, Jasmin Pierre had to leave her home for the sake of her safety. Each person is important because together we form the one and only race in this world, and that is the human race. It typically involves direct questions like, What were you thinking when your friend turned you down? Some Native Americans or older European Americans may find those types of questions to be disrespectful. Hinton DE, Chhean D, Pich V, Safren SA, Hofmann SG, Pollack MH. 1991). 2008, Sue 1998). The investigators incorporated themes such as social judgment, control of aggression, and delay of gratification within Puerto Rican American culture and experiences. Flaskerud JH. Zane N, Aoki B, Ho T, Huang L, Jang M. Dosage-related changes in a culturally-responsive prevention program for Asian American youth. A Muslim woman discusses the importance of having a therapist sensitive to one's own culture and specific needs. For example, cultural competency methods are probably more important with unacculturated than with acculturated ethnic minority clients. Research shows that a healthy therapeutic alliance is the most important factor in determining how effective treatment is. Culturally Sensitive Therapy | Psychology Today Ireland Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Abstract. J Clin Psychol. Multicultural Counseling: Types, Strategies, and Techniques Racial and ethnic minorities receive a lower quality of health care than do nonminorities, have less access to care, and are not as likely to be given effective, state-of-the-art treatments (U.S. The interventions have ranged in terms of: The studies also vary considerably on the type of research design (experimental, correlational, and archival), outcome measures used, the inclusion of control or alternative intervention groups, rigor in design, follow-up assessment, and sample size. Method of delivery is intended to make the intervention more culturally consistent, increase credibility of the treatment or provider, or make the treatment understandable to ethnic minority clients. It should be noted that most definitions of cultural competency do not include treatment outcomes as the major criteria for competence. Indicators for the achievement of the NASW standards for cultural competence in social work practice. Find a provider who L istens to you. 3. Although heated at times, the debates in the literature have been instructive. Coleman HLK. Herman KC, Merrell KW, Reinke WM, Tucker CM. . 1999). Constantine MG. Predictors of satisfaction with counseling: racial and ethnic minority clients attitudes toward counseling and ratings of their counselors general and multicultural counseling competence. Despite consensus over the importance and significance of cultural values and behaviors in treatment, investigators have actually varied in their specific assumptions or focus for cultural competency. These guidelines provided a context for service delivery: Psychologists are encouraged to apply culturally appropriate skills in clinical and other applied psychological practices (p. 390). factors (Arredondo & Toporek 2004, Coleman 2004). Heppner MJ, Neville HA, Smith K, Kivlighan DM, Jr, Gershuny BS. Bethesda, MD 20894, Web Policies For example, most advocates of cultural competency do not see external factors (e.g., racism) as the sole or primary cause of mental disorders or that attention to ethnicity and race lessens concern over other diversity or individual differences (e.g., gender, sexual orientation, social class, etc.) Finding the right therapist for you will take some extra effort. Amy Morin, LCSW, is a psychotherapist and international bestselling author. 5. The importance of getting culturally sensitive therapy right is illustrated in an example raised at our 'All Cards on the Table' workshop in November 2017. Studies in which the client was matched with a therapist based on language (if other than English) had outcomes that were twice as effective as were studies that did not match language. Cultural sensitivity isnt just about race. (2007) conducted a review of clinical trial studies. You arent likely to make progress in your treatment if you feel like you have to educate your therapist on your cultural background or the societal issues you face. Compared with a nonadaptedCBT intervention group, womenin the adaptedCBT group exhibited a larger drop in depression. National Strategic Plan on Hispanic Drug Abuse Research: From the Molecule to the Community. Clients who have limited English proficiency have difficulties entering, continuing, and benefiting from treatment (Snowden et al. We believe that it is also important to acknowledge that, given the history of psychologys inadequacies with diverse populations, multiculturalism is not an apoliticized theory. 4. Making the case for selective and directed cultural adaptations of evidence-based treatments: examples from parent training. Ridley C, Mendoza D, Kanitz B. Multicultural training: reexamination, operationalization, and integration. Culturally sensitive therapy is an approach to psychotherapy that emphasizes the therapist's understanding of a client's background and belief system as it relates to their race, ethnicity . The evidence revealed that mental health services were not accessible, available, or effectively delivered to these populations. Huey SJ, Jr, Polo AJ. By presenting culturally familiar characters of the same ethnicity as the children, they felt that the folktales would serve to motivate attentional processes; make it easier to identify with the beliefs, values, and behaviors portrayed in the adapted cuentos; and model functional relationships with parental figures. How can the multicultural guidelines adopted by the American Psychological Association be implemented in research, practice, and training? Professional Psychology: Research and Practice. Miranda J, Azocar F, Organista K, Dwyer E, Areane P. Treatment of depression among impoverished primary care patients from ethnic minority groups. There are many ways to find a therapist. In terms of the kind of person one is, D.W. Sue and colleagues (Sue et al. The APA Ethics Code (APA, 1992) and theAPA Guidelines for Providers ofPsychological Services to Ethnic, Linguistic,and Culturally Diverse Populations (APA,1993) offer clear guidance against utilizing aEurocentric or monolithic perspective inworking with these individuals. Therapists, mothers, or group leaders read the cuentos bilingually, typically to children at risk for emotional or behavioral problems. They lament the fact that personswhorefuse to adopt the competencies may be accused of displaying unintentional racism or the results of the insidious ethnocentric aspect of our cultural conditioning (see Ivey & Ivey 1997, D.W. Sue 1996). You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. Constantine MG, Miville ML, Kindaichi MM. Do therapists address ethnic and racial differences in cross-cultural psychotherapy? A meta-analysis of evidence-based treatments for ethnic minority youths was conducted by Huey & Polo (2008). Originally conceptualized as cultural responsiveness or sensitivity, cultural competency is now advocated and, at times, mandated by professional organizations; local, state, and federal agencies; and various professions. Older individuals had higher effect sizes than younger persons. Besides language, other cultural competency adaptations were reflected in communication patterns. 1991, Takeuchi et al. Drug abuse treatment for Hispanics. Steering Comm. Improving care for minorities: Can quality improvement interventions improve care and outcomes for depressed minorities? In: Prinstein M, Patterson M, editors. My therapist was a white woman who proclaimed to have worked with people with trauma histories. The importance of cultural sensitivity and therapist self-awareness . Smedley BD, Smith AY, Nelson AR, editors. 2004, Sue & Zane 2006). (2005) take a more cautious position because of the lack of adequate tests for cultural competency effects. . Collaboration in multicultural therapy: establishing a strong therapeutic alliance across cultural lines. The .gov means its official. This may involve asking a client about their goals and needs as well as an open discussion about the frequency and duration of treatment. The APA has also had a history of involvement in ethnic, culture, and professional practice. The questions to be answered include what are the best forms of treatment for ethnic minority populations and whether cultural competency interventions add to positive treatment outcomes. Method: This . Why is Cultural Competency Important? The adolescents were randomly assigned to CBT (individual or group treatment) or IPT (individual or group treatment). Cultural Stigmas: Every culture has a different way of looking at mental health and, for many, there is a stigma. Third, discussions of culture, ethnicity and race, and multiculturalism are frequently heated and emotional. Given the relatively few empirical studies of cultural competency, more research is needed, especially randomized clinical trials and unpackaging research that examines which cultural adaptations are effective.

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