1. CHAPTER 5: Working with Culturally Diverse Families
Family Therapy: History, Theory, and Practice
6th Edition
Samuel T. Gladding
Developed by Nathaniel N. Ivers, Wake Forest University
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved

2. Overview Differences in culture and ethnicity regarding family
Working with gay and lesbian families
Working with culturally diverse families
Working with specific cultural family groups
African American Families
Asian American Families
Hispanic/Latino Families
Native American Families
Arab American Families
European American Families

3. Terms related to Culture
Multicultural
Intercultural couples
Integration
Coexistence
Lack of resolution
Worldview
Cultural competency

4. Dynamics of Culturally Diverse Families
Overt and covert criticism of patterns of family interaction
Appearance
Access to mental health services
Economics

5. Issues in Working with Culturally Diverse Families
Sensitivity
Experience
Acceptance
Ingenuity
Specificity
Intervention

6. Working with Gay and Lesbian Families
Four percent of Americans identify themselves as gay or lesbian (Centers for Disease Control and Prevention, 2013)
Approximately 1 in 10 cases in marriage and family therapy are involves gays or lesbians

7. Gay and Lesbian Families
Gay and lesbian families are intergenerational
A cycle to gay and lesbian family life
Gay and lesbian families are varied
Gay and lesbians couples have mixed levels of satisfaction in their relationships

8. Therapists Working with Gay and Lesbian Families
Work with self to sort out feelings regarding gay and lesbian families
Address both external and internal issues associated with being a gay or lesbian couple or family
Work with society at large and its institutions to deal with matters of prejudice and discrimination
Recognize that gay and lesbian families deal with matters besides their sexual orientation

9. African American Families
Second largest minority group in the U.S., comprising 13% of the population
African American families are diverse regarding background and traditions
Commonalities
Many have ancestors who were brought to Americas as slaves
Dark skin color differentiates them from the majority of people in the United States
May face racism and discrimination, resulting in socioeconomic disadvantage and stress

10. Strengths of African American Families
Kinship bonds
Religious orientation and spirituality
Cooperation
Motivation to achieve
Role adaptability
Caring parenting
Family structure
Strong work orientation

11. Factors Affecting African American Families
The following negative factors may affect African American families:
Surveillance by mental health and social work professionals regarding strict parenting practices
Tension with male-female relationships
Outside pressures such as racism, prejudice, poverty, and discrimination

12. Family Therapists Working with African American Families
Provide psychoeducation when appropriate
Be attuned to African American experiences and perceptions
Understand multigenerational family systems
Be sensitive to the importance of respect for elderly family members
Assure families that through the therapeutic process they can learn how to handle many of their problems

13. Working with African American Families
Address social and institutional issues adversely affecting African Americans
Address concerns bout having a non-African American therapist, if applicable
Do not assume familiarity with the family in first sessions
Join with family before gathering sensitive information
Conduct home visits, if needed
Acknowledge strengths, successes, and resources
Use appropriate metaphors and scriptural references when appropriate

14. Asian American Families
Constituted about 5% of U.S. population in 2011
Projected to number 20 million by 2020
Trace cultural heritage to a variety of countries, such as Japan, Philippians, Pacific Islands, etc.
Differ in regards to language, history, and socioeconomic factors
Share many cultural values, such as respect for elderly, extended family support, family loyalty, and high value on education, as well as values associated with self-discipline, order, social etiquette, and hierarchy.

15. Working with Asian American Families
Take acculturation into account
Be aware of the effect of racism on Asian American families
Recognize the potential importance of being knowledgeable of Asian philosopher
Create a safe and nurturing environment that mirrors a supportive and caring family

16. Working with Asian American Families
Assess support available to the family
Assess past history of immigration
Establish professional credibility
Be problem focused/present focused
Be directive in guiding the therapy process
Provide reframing that encourages the family

17. Hispanic/Latino American Families
Comprises one in every six residents of the United States
Nations largest minority
Most Hispanic/Latino families trace their ancestry to Mexico, Cuba, or Puerto Rico.
Considerable diversity exists among Hispanics/Latinos and their families
Tend to be family-oriented

18. Common Hispanic/Latino Cultural Values
Collectivistic
Dignidad (dignity)
Orgullo (pride and self-reliance)
Confianza (trust and intimacy)
Respeto (respect)
Simpatía (smooth, pleasant relationships)
Personalismo (Individualized self-worth)
Familismo (family connectedness)
Marianismo (female self-sacrifice)
Machismo (male self-respect and responsibility)
(Carlson et al., 2004)

19. Working with Hispanic/Latino Families
Develop a basic knowledge about cultural traditions before attempting to employ treatment modalities
Take into account personalismo
Be aware of socioeconomic factors affecting Hispanic/Latino families
Assess for acculturation level as well as acculturative stress
Utilize outside resources to facilitate treatment, such as the Catholic church
Be aware of potential family hierarchy and roles

20. American Indians and Alaska Native Families
Approximately 3.6 million American Indians and Alaska Natives live in the United States
Extremely diverse group
Belong to 557 federally recognized and state-recognized nations
Traditionally, their lives built around harmony, acceptance, cooperation, sharing, and respect for family and nature
Importance of extended family

21. Challenges for American Indian / Alaska Native Families
Break up or dysfunctionality of families
Geography and culture (biculturalism)
Joblessness, poverty, gangs, and substance abuse

22. Working with American Indian and Alaska Native Families
No one size fits all model
Cultural knowledge, sensitivity, and innovation
Build relationships with local leaders and communities
Recognize culturally sensitive techniques
Recognize interconnectedness between physical and psychological distress
Consider the use of home-based therapy
Consider therapeutic techniques that are directive

23. Arab American Families
Fast growing, mosaic group that is more than three-fourths immigrant
Large percentage are Christians; however, they make up the largest cohort of Muslims in U.S.
Tend to be high context rather than low context
Family is the most significant element in most Arab American subcultures
Traditionally, a patriarchal, hierarchical structure exists in the family

24. Working with Arab American Families
May be reluctant to seek family therapy
Be aware of the potential emphasis on honor and shame
Be aware of cultural context in which the family operates
Be mindful of the issue of leadership and importance of authority figures in family

25. Working with Arab American Families
Be attentive to the role of the extended family in decision-making
Be aware of the influence of culture on therapy
Consider a strengths-based approach
Balance activity so as not to be seen as a rescuer or a threat
Consider exploring identity issues
Concentrate on couple dynamics
When appropriate, focus on religious and other group support

26. European American Families
Majority of people in the U.S.
It is assumed that European Americans embrace WASP values such as individualism, mastery over nature, competitiveness, and Christianity, that is not necessarily the case
Diverse group of people

27. Working with European Americans
Consider using an existential approach, as it focuses on uniqueness
Consider incorporating universal techniques, such as genuineness, empathic understanding, and structuring

28. Guidelines for Selecting Treatment Approaches with Culturally Diverse Families
Two main approaches
Culture-specific model
Universal perspective model

29. Roles of the Therapist
Be aware of own cultural heritage and respect cultural differences
Be comfortable with differences that exist between themselves and the clients with regard to cultural backgrounds and beliefs
Be sensitive to circumstances that may dictate referral of a family
Be knowledgeable of own racist attitudes, beliefs, and feelings

30. ESCAPE Four major investments Engagement with families and process
Sensitivity to culture
Awareness of family potential
Knowledge of environment