Building Multicultural Competence Pamela A. Hays, Ph.D. www.drpamelahays.com 11/7/2018

The Personal Work (9am-12pm) -Personal qualities & essential knowledge Agenda The Personal Work (9am-12pm) -Personal qualities & essential knowledge -Cultural self-assessment Lunch (12-1pm) The Interpersonal Work (1-4pm) -Understanding identities -Building relationships -ADDRESSING Culture in the Classroom 11/7/2018

The ADDRESSING Framework Cultural Influences Minority Groups Age/generational Children, adolescents, elders Developmental disabilities People with developmental disabilities Disabilities acquired People with disabilities acquired later in life Religion & Spirituality Religious minority cultures Ethnic & racial identity Ethnic & racial minority cultures Socioeconomic status People of lower status by educ, income, occup, rural/urban habitat Sexual orientation Gay, lesbian, & bisexual people Indigenous heritage Indigenous/Aboriginal/Native people National origin Refugees, immigrants, international students Gender Women, transgender people 11/7/2018

Two Categories of Work Personal Interpersonal 11/7/2018

Personal Work a) Personal Qualities b) Essential Knowledge 11/7/2018

A major obstacle to the development of these Qualities, Abilities & Knowledge is DEFENSIVENESS. 11/7/2018

What led to your defensive feelings? Think of a situation with a person in which you began feeling defensive: What led to your defensive feelings? What were your physical sensations & emotions? What were you thinking? What did you do? What did you say? What did the other person do & say? Did you spiral down or were you able to stop the spiral? 11/7/2018

Preventing Defensive Behaviors Become aware of physical sensations related to feelings of defensiveness. In the moment, take a deep breath, exhale slowly, and focus on your breath. Refrain from defensive behaviors . Ask yourself: What does this person want? Try focusing on the content (vs. voice tone, volume, or nonverbal behaviors ). 11/7/2018

Preventing Defensive Behaviors… 6. Question the need for this person's views to match your own. 7. Reframe irritations & annoyances as opportunities for growth. 8. Recognize your need for additional information and/or experience. 9. If appropriate, discuss the limitations of your knowledge and experience with the person. 10. If appropriate & possible, use humor. 11/7/2018

Essential Knowledge 1. Bias is best thought of as a tendency to think, act, or feel in a particular way. 11/7/2018

Essential Knowledge… 2. We’re all biased but we don’t all belong to dominant cultural groups. 3. Bias + Power = Systems of privilege (‘isms). 11/7/2018

Essential Knowledge… 4. Nonprivileged members are socialized to be aware of the lines separating those who have privilege from those who do not. 5. Privileged members are socialized to ignore these lines & differences. 6. Privilege separates people & cuts both Privileged & Nonprivileged off from valuable knowledge. 11/7/2018

Cultural Self-Assessment Age/generational-- Developmental disabilities-- Disabilities acquired later in life-- Religion & Spirituality-- Ethnic & racial identity-- Socioeconomic status-- Sexual orientation-- Indigenous heritage-- National origin-- Gender -- 11/7/2018

Values Permeating Psychotherapy emotional expressiveness individualism & independence assertiveness self-disclosure verbal skills insight 11/7/2018

ADDRESSING Cultural Influences on Ourselves Name 3 values supported by your family, peers, & culture as you were growing up. Did the dominant culture support these values? Were these values shaped by any social movements during your teenage & early adult years? How do these values relate to your current occupation? 11/7/2018

Resolving Value Conflicts Look for a shared or similar value. Recognize differences in expression of a value. Recognize differences in the priority given to values. Use positive language to describe these differences. 11/7/2018

3 Ways to Fill Knowledge Gaps & Change Bias Individual work Critical thinking re: info Peer-level, close relationships w/ diverse people 11/7/2018

II. The Interpersonal Work: Understanding Identities When developing hypotheses, use the ADDRESSING framework as a reminder of identities that may be meaningful for a person. 11/7/2018

Understanding Identities Remember that a particular identity may have one meaning in the dominant culture, another in a minority culture, & another person-specific meaning. 11/7/2018

Questions for Clients a. How would you describe yourself? b. Would you tell me about your cultural heritage or background? c. Did you have a religious upbringing? Do you have a religious connection or spiritual practice now? d. How would you describe your childhood? What was your family’s economic situation growing up? 11/7/2018

Questions for Clients… e. Do you have experience with disability, or been a caregiver for someone who does? f. Are there ways in which your disability is part of this… [presenting problem]? g. What did it mean to grow up as a girl/boy in your culture and family? h. Do you currently have a partner? Could you tell me about the significant intimate relationships you have had? 11/7/2018

Understanding Identities 3. Be aware of your own perceived/visible identity re: interactions with clients & students. 11/7/2018

Understanding Identities: Questions for Oneself a. How am I being perceived by this person, based on my visible identity? b. How might my identities interact with those of this person? c. How might my identities and experiences limit my understanding of this person? 11/7/2018

Building Relationships 1. Remember respect. 11/7/2018

Culturally Related Personal Strengths pride in one’s culture religious faith or spirituality artistic and musical abilities bilingual and multilingual skills group-specific social skills sense of humor culturally-related knowledge and practical skills (e.g., fishing, hunting, farming, medicinal plants) culture-specific beliefs that help one cope (e.g., with racism, prejudice, discrimination) respectful attitude towards the natural environment commitment to helping one’s own group (i.e., through social action) wisdom from experience 11/7/2018

Interpersonal Cultural Supports extended families including non-blood-related cultural or group-specific networks religious communities traditional celebrations and rituals recreational, playful activities story-telling activities that make meaning and pass on history of the group involvement in political/social action group a child who excels in school 11/7/2018

Environmental Cultural Supports altar in home to honor deceased family members space for prayer and meditation culture-specific art and music culturally preferred foods for cooking & eating animals to care for gardening area access to outdoors for subsistence or recreational fishing, hunting, farming, observing night sky communities that facilitate social interaction by location or design 11/7/2018

Building Relationships 2. Adapt to the person’s language pace. 3. Do not assume knowledge of an individual’s personal experience, even if you are knowledgeable about their culture. 4. Be prepared for the possibility of multiple relationships. 11/7/2018

Building Relationships… 5. Be aware of different meanings of nonverbal communication (gestures, eye contact, silence). 6. Recognize cultural differences re: physical space. 7. Do not touch assistive devices without asking. 11/7/2018

Building Relationships… 8. Consider what your office location, accessibility, and furnishings communicate. 9. Avoid psychological jargon and if the other person uses it, ask about its meaning. 10. Continually use critical thinking re: meanings of verbal & nonverbal communication. 11/7/2018

Instructor Students Course content Teaching methods ADDRESSING Culture in the Classroom: Four Dimensions Of Teaching & Learning Instructor Students Course content Teaching methods (Marchesani & Adams, 1992) 11/7/2018

ADDRESSING Culture: Program Strategies Course requirements (1 cr3crintegration) Integrate required readings throughout program Diversity committee of faculty, staff, students Use ADDRESSING acronym to comb all written and visual materials for diversity. Fund guest speakers. 11/7/2018

Assessing Clients’ Needs 1. Respect cultural norms re: styles of questioning & types of questions. 2. Look for multiple sources of info & think systemically. 3. Use cultural history to understand personal history. 11/7/2018

Assessing Clients’ Needs 4. Ask about the client’s understanding of the situation, problem, and health care practices. 5. Develop Tx plans, set goals, & choose interventions collaboratively. 11/7/2018

Assessing Clients’ Needs 6. Consider family systems. a. Define family broadly b. Recognize power differentials 11/7/2018

Is power distributed by: Age or generational status (including couples with a large age difference)? How does this interact with gender? DD physical or mental abilities? Religious commitment or leadership? Interaction w/ gender? Ethnic or Indigenous heritage (e.g. Who holds the dominant cultural identity in bi- or multicultural couples/families? Are there differences in status related to skin color or other ethnically related characteristics?) Socioeconomic status (i.e. Who makes the money, or holds the highest status by income, education, or occupation?) Sexual orientation (Do LGBT members hold lower status?) National origin (e.g. Who is a citizen or holds a work visa? Who speaks English most fluently)? Gender? 11/7/2018

Assessing Clients’ Needs 7. When judging unusual perceptions, beliefs or behaviors, recognize cultural differences. 11/7/2018

Preventing Inaccurate Conclusions 1. How might my judgment be influenced by the ADDRESSING influences on me? 2. Might there be some info I don’t have that is important in understanding the client’s view? 3. Could there be a positive, culturally related purpose for the behavior, belief, or feeling that I judge dysfunctional? 11/7/2018

Assessing Clients’ Needs 8. Remember: a traumatic experience is culturally influenced and person- specific. 9. Be careful re: the use of diagnoses, especially Personality Disorders. Actively look for culturally related strengths and supports. 11/7/2018

Strengths & Supports: Key Questions What do you consider your strengths & supports? What would your mom/kids/friend say? Do you have a connection to any religion or spiritual practice? 11/7/2018