What impact does one's ethnicity have on the evaluation process? K.H. Barrett (2005) provides much for the multicultural clinician to ponder as they prepare for conducting competent assessments of individuals from other cultures. Multiculturally competent practices require that we consider knowledge of our own cultural milieu, that we have knowledge of our client's cultural background and his the history and present condition of their cultural background, and that we possess the skills necessary to competently address the needs of a client with a diverse background (Sue, et al., as cited by Sodowsky, Taft, Gutkin & Wise, 1994).
In our evaluation, we were conducting an assessment of an Ethiopian male. He immigrated to the United States three years ago, and has resided here in a segregated, same race community. In order to practice cross-cultural competence, according to the APA, "multiculturally sensitive and effective therapists are encouraged to examine traditional psychotherapy practice interventions for their cultural appropriateness…" (Bernal & Scharoon-del-Rio, 2001, as cited by the APA, 2002, p. 50).
Indeed, the clinician has to take a considerable amount of information into account in order to practice appropriately, and to fulfill their ethical responsibilities of benefice and to ensure that the client is treated in a manner consistent with our professional obligations.
The clinician must learn to recognize how sociodemographic variables such as race, culture, gender, religious affiliation, linguistic background, sexual orientation, age, and disability may influence the life of the client and the life and practice of the evaluator, including subsequent interactions in the evaluation process (Barrett, K.H., 2005, p. 109).
According to Barrett, it is important to understand how culture has influenced the following:
- the practice of psychotherapy
- psychological assessments
- diagnostic standards
- concepts of normality
Without proper consideration, the practitioner risks committing malfeasance and providing the client with incompetent counsel. As indicated, the counselor needs to recognize the central role that a client's worldview and cultural perspective have in the their life, as "…it should be clear then that the Worldviews Paradigm lies at the very heart of the analysis and must not be separated from it" (Kambon, K.K., 1998, p. 20).
The following is based directly on the work of K.H. Barrett in her chapter entitled, "Guidelines and Suggestions for Conducting Successful Cross-Cultural Evaluations for the Courts," and many of the questions we ask of ourselves and our client are taken directly from her work, and she should be credited for the vast contribution her work has made to our project.
As K.H. Barrett suggests, the practitioner needs to spend significant time preparing for the cross-cultural evaluation. She suggests the following:
Preparing for the Cross-Cultural Evaluation
Prepare to become culturally competent practitioners
Read Sue & Sue
- The APA "Guidelines for Providers of Psychological Services to Ethnic, Linguistic and Culturally Diverse Populations" (1993)
- The U.S. Department of Health and Human Services Surgeon General's Report (2001)
The clinician must consider whether or not he or she is the best person to conduct the evaluation, given the range of differences in background between him- or herself and the client.
The clinician should seek appropriate education and consultation to facilitate work from a multicultural perspective (if there is a lack of availability of professionals that are more qualified by virtue of their professional training and their cultural, racial, or ethnic similarities to the client)
Barrett further recommends that the clinician spend time determining whether or not to accept a referral.
Accepting a Referral
Evaluate level of knowledge
Evaluate level of experience
Evaluate interpersonal comfort in working with a client of a particular racial, ethnic, or cultural background
Assess one's competency to address the purpose of the evaluation
What is the level of knowledge w/ this client's background
- What is the comfort level?
- Does the evaluator have any negative feelings or associations with the group?
What are the interpersonal difficulties?
What are the knowledge gaps?
What was the nature of my own racial and cultural identity development?
- What biases, cultural values and prejudices may enter into my work?
Once we decided to accept the referral, we then needed to determine what the client was to be evaluated for, Barrett advises the following:
Determining the Scope and Purpose of the Evaluation
What is my role?
- What type of evaluation is to be conducted?
Does the referring source having difficulties understand the client for reasons of language or cultural differences?
If this is an evaluation for competency, what testing has previously be done? What indicators propelled referral for evaluation?
Is this an exploratory evaluation?
If the client is intellectually competent to stand trial, are there any communication or cultural barriers that need to be overcome for the client to have appropriate representation?
Has the attorney been provided with a copy of the APA diversity guidelines?
Has an immigration attorney been consulted to determine whether the outcome of any other proceedings would impact the client's status to remain in the country?
Does the attorney understand the racial or cultural dynamics that might be important to the client's case?
Is the attorney comfortable in discussing racial and cultural issues that may arise in court?
If the attorney is not prepared, has the evaluator recommended appropriate readings or educated them about issues that apply to the client's case?
What is the sociopolitical context of the evaluation?
What is the current climate that surrounds the particular ethnic group of my client?
Do my own personal political positions impact the outcome?
How will the evaluation be used in the broader social and political arena?
What are the client's political opinions?
Once we have determined the scope and purpose of the evaluation, then we needed to prepare for our evaluation with our client who has emigrated from Ethiopia. Barrett notes the importance of preparing the client for the evaluation as well.
Preparing for the Evaluation with the Client
I need to inform my client as to what will take place at the appointment
I need to let them know how much time will be needed
I need to assess any obstacles that might get in the way of the client coming to the appointment
I need to make sure that my client has clear directions to get to my office, that they know of any parking fees, and if necessary, I need to give directions to another person who might drive or assist.
If necessary, I should alert the parking attendant or office staff to be on the alert to assist the client.
I could also arrange to meet the client at a landmark
I need to make sure that the client understands the length of the appointment
I need to make sure that the client understands the need for timeliness
I need to make sure that if the client needs an interpreter, that the interpreter is given all pertinent information.
I need to allow time in my schedule to accommodate the client being late for the first appointment if coming to my office is an unfamiliar task
If I believe that the client is reluctant to come to the appointment because of avoidance of the traumatic material to be discussed, because of fear of outcome, or because they are resistant due to adversarial legal proceedings, I should discuss this with the client in order to clarify misplaced fears or to offer reassurance or a bit of empathy for the stress inherent in his or her situation.
Does the client have a counselor?
Does the client have a victim advocate?
Does the client have a psychotherapist?
Should adjunctive therapy to the evaluation process be recommended? This is especially important if the process is traumatic or for the evaluation of trauma or torture.
- I need to make sure that my client brings in a list of collateral contacts, including names and numbers of people that I may want to interview.
Once the client's needs have been taken into consideration, Barrett details the great extent to which the counselor must commit to develop competency with our particular client.
Preparing for the Evaluation: The Clinician
Cultural Background Information
Have I conducted a literature search in order to gain background information about Ethiopians, particularly since immigrants from Ethiopia are a newer phenomenon and not particularly common to the U.S.?
Ethnomed and Psychinfo are useful sources
- Major publishers and bookstores
- Cross-cultural interviewing techniques may be identified in various resources for interview planning
- Lexis-Nexis offers info on country conditions, ethnic conflict and war from periodic sources
- University departments that are ethnically or culturally based
- Community agencies may be willing to offer consultation on basic cultural norms
- The APA list of members of Division 45 – focuses on ethnic minority psychology
- Local/state psychological association list of cross-cultural consultants
Have I consulted appropriately in this regard?
Have I maintained my client's confidentiality, as ethnic tensions and conflicts may arise?
Have I ascertained the cultural style of communication?
Eye contact
- Use of negative and affirmative statements
- How yes and no are used
- High- or low-context communication culture
- Do I understand my client's culture's concepts of mental health? Mental illness? Disease? Treatment? How emotions are expressed? Whether or not indigenous healing systems are used are all important to explore
What are the gender and sex role norms?
What is the family organization and Hierarchy?
What are the child-rearing methods and discipline styles?
Religious and spiritual traditions?
Who/what are the central cultural values?
How do individuals approach authority figures?
What are the client's home country's social, economic and political conditions?
How did they impact my clients stress, potential traumas, and reasons for immigration?
What is my client's group's particular history within the U.S.?
What are my client's group's particular contributions to this country?
What types of discrimination has my client or their ancestors faced as a member of this group?
In what ways is my client different from the group cultural norms?
- Have I made checked myself for stereotyping?
Considerations regarding language use
Have I made arrangements for an interpreter who can assist me to conduct the evaluation in my client's language?
If my client believes that they don't need an interpreter, have I ascertained that it is not because of fear of being judged negatively for lack of English fluency? Are they overstating their skills?
If I am unsure of the client's language skills, have I consulted with a professional to assist with this determination?
Have I made sure I am using an interpreter who has been determined in advance to be appropriate?
In determining my client's ability to use English, have I asked them questions like:
How long they have been in the U.S.?
- How long have they studied English?
What is the client's level of educational attainment?
Did the client take English classes in their home country?
How long has the client spoken English on a regular basis?
Where and how frequently - does the client use English daily?
Does the client read and write in English?
What books has the client read in English?
- Does the client use English in his or her daily thoughts?
Have I made sure that my client will have the ability for them to use their first language when discussing emotional issues or traumatic topics?
What language does the parent use to speak to the child? Native language, English, Mixture?
Am I allowing the parent the space to interact with their child in their preferred language choice?
Am I making sure I am interpreting parent/child relationships through the appropriate cultural lens, allowing for culturally appropriate language, behavior, and terms of endearment?
Have I taken time to speak with the interpreter before and after to enhance my knowledge of the cultural context of my client?
If so, have I assured the interpreter that they are not being asked to evaluate the client, but to provide cultural information?
Have I taken gender of the interpreter/client match into account and made sure that my client and the interpreter are comfortable with gender differences if they exist?
If either are not comfortable, have I replaced the interpreter with one more suitable?
Have I ascertained that the interpreter and the client speak the same dialect?
Are there any potential ethnic, clan, political, religious or class conflicts that may exist between the client and the interpreter which would impact the evaluation?
- Have I made sure that if the interpreter's class is of a higher one than my client, or if the interpreter is more assimilated than the client, that my client is not being judged by the interpreter?
Have I informed the interpreter of the potential for traumatic subject matter if relevant? And have I ascertained that the interpreter, if they have faced a similar situation, such as refugee status, will be able to conduct the interpretation?
- Have I made plans to conduct the interview over a series of meetings to build a sense of trust and setting a tone of respect and integrity, allowing space for the client to be relaxed and comfortable disclosing information, and allowing for any cultural questions or points of confusion to be determined?
Consideration of Psychological Testing
Have I established the population norm and cross-cultural validity of instruments of psychological testing before administration with my client? Is there any instruments particular to Ethiopians specifically, or to Africans more generally?
Have I ascertained language proficiency if the test is in English, particularly since my client is from a high-context communication culture?
Have I familiarized myself with the dilemmas of interpreting some psychological tests, such as the MMPI, which indicate a loss of validity if exposed to interpreting?
Have I determined the etic and emic norming of the particular instrument I am using if interpreted?
Have I determined whether the reported results are grounded in cultural context and include pertinent cultural profile or tendency for the particular group to which my client belongs?
- Have I made sure that I am not using computerized assessment profiles which have not been designed for cross-cultural use?
The Clinician's Socialization Regarding the ethnic background of the person to be evaluated
Have I reviewed my learning experiences regarding the ethnic/cultural group of the client?
Have I determined my family attitudes and teaching, educational and peer experiences, societal stereotypes, and media portrayals that may have influenced my view of my clients' group?
What have been my personal or professional experiences with people from this group?
Have I had a high or low contact with people from my client's group?
Have I determined whether there are antagonisms or stereotypes about the relationship between your ethnic group/religion and the ethnic group/religion of the client?
Do I have any fears, anxieties or negative associations with this group?
Do I have any strong disagreements or conflicts with their cultural values, norms, or religion?
Is there a danger of stereotypes or prejudice creeping into my evaluation?
Will I feel comfortable discussing your racial/ethnic views, knowledge, or lack of knowledge about the group with client?
Are there ways that I have personally or professionally, actively rejected the values or norms that are important to this group in my own lie or practice?
Have I determined whether I would benefit from consultation regarding my socialization experiences about this group?
- Have I determined whether there are any ethical reasons to remove myself from the evaluation?
Review of Case Records
Have I made a thorough examination of all documents related to the client's case:
Arrest records
Criminal history
Client declarations regarding reasons for seeking asylum
Parenting evaluations
Depositions of other experts in various types of cases
Psychological evaluations conducted by other professionals
Police reports that document domestic violence, child abuse and other forms of client victimization
Client depositions that outline discrimination in the workplace
Have I noted inconsistencies that arise between written records and data gathered from the client and collaterals during evaluation interviews?
Have I reviewed contradictory, missing or inconsistent information with my client and my attorney?
- Have I found information in the records that is culturally biased, shows evidence of prejudice or stereotypes, misdiagnosis, or misuse of psychological testing for language or cultural reasons, or that is incorrect because of cultural errors or miscommunication, and presented this to the attorney and noted it in my report?
The Initial Interview
Acknowledging the Stresses Inherent in the Evaluation and Legal Process
Have I acknowledged the stressfulness of the evaluation for the client?
Have I acknowledged the stress of the client's legal situation, particularly noting that the client's ethnicity or race may intensify the situation?
Start by asking the client what they find to be the most stressful aspect of their case, which will demonstrate my empathy for their predicament and eliciting a good deal of valuable information to be used in the assessment.
Discussing the stressful nature of litigation is a good time to bring up issues of trust and mistrust in terms of the role of the evaluator and why the evaluator is in the position of seeking deeply personal information from the client – especially important when the evaluator is white and from the majority culture and the client is from a racial and/or ethnic minority group
State that I am aware of the racial and or cultural dynamics that exist between me and my client, and that this may add to the stressful or adversarial nature of the evaluation, and that I will strive to understand aspects of the client's cultural or racial background that may be unfamiliar to them.
- Have I alerted my client to the potentially adversarial role that they will play?
Clarification of the role of the evaluator in the evaluation process
Have I explained my professional role and credentials?
Have I clarified how I am to be involved I the client's case, including who has retained me and whether or not I will be testifying in court? Immigrant clients may not be accustomed to the adversarial legal process of the US court system and may trust professionals with knowledge who are not working on their behalf.
Have I, as a female evaluator, established a sufficient amount of professionalism since my client is from a cultural context in which women are limited to more traditional roles?
Ask the client what their understanding is about why they are being seen for an evaluation? Take this opportunity to deal with fears and misconceptions about the process.
Tell the client orally and in a written document the purpose of the evaluation, a description of a psychological evaluation, and how the information will be used in the case; outline the process or procedures used in the evaluation, and detail the limitations of confidentiality.
Outline to the client what will happen in the first meeting and in each subsequent meeting.
Explain the evaluation process to family members as the client's wishes dictate.
Inform the client that they can volunteer information whenever they feel it would be useful or important, so they understand that it is appropriate for them to do this.
Make sure to periodically restate what my client says, so I can verify their meaning, asking for correction because in some cultures correction of an authority figure, which I may be seen as, is taboo.
Determine with the client who would be valuable to interview as collaterals.
Religious figures
Relatives
Friends
Teachers
Physicians
- Employers
Content of the Next Meeting
Every client has a story to tell
Determine whether the client needs to divulge difficult questions, assessment of symptoms, and discussion of traumatic material for the second meeting, unless it seems as though the client is comfortable and at ease in the first meeting.
Begin with a developmental history
Include an inventory of risk and protective factors in development in order to build the contextual framework with which to understand any current symptoms described by the client to be used in formulating a diagnosis and in understanding the client's current status and legal situation.
- Make sure that the client feels comfort and trust, and doesn't sense disrespect, intimidation, impatience, racism, or disregard for his or her cultural background. This will facilitate the sharing of information.
Assessment of Symptoms
Determine whether structured interviews or questionnaires are appropriate by determining whether their language or descriptions of symptoms fit with the linguistic and cultural framework of the client's worldview or representational systems.
To the end, determine whether the client is having physical manifestations, such as the physical symptoms of depression: headaches, tiredness, digestive distress, anxiety through nervousness, jumpiness, and physical unrest.
Determine background information on how mental health symptoms are expressed in the culture of my client.
Use culturally appropriate language on assessments
- Keep structured interviews at hand to provide a useful reference to help me cover the necessary diagnostic categories and symptom sets (such as those offered by Sattler).
Debriefing
Conduct a short debriefing, inquiring as to whether my client feels as though there is any information that they wish to add.
Ask the client if they have any questions or feedback about the process or content of the evaluation.
Give the client's attorney any pertinent information at this point (for example, whether the client has misconceptions or is confused about the legal process, whether the client has omitted information that is important to add)
Make sure to educate the client in situations that may protect my client from risk of harm or offer short-term coping mechanisms for emotional distress.
Offer long-term treatment recommendations that appear in reports as relevant.
Re-clarify the purpose of the assessment at each meeting
Ask for questions and comments
Orient my client to the purpose of the current interview
Conclude by asking for questions and comments or additional information that was not covered.
Give encouragement and indications that the client is following procedures in the appropriate manner
Request permission to call the client to recheck details or to ask follow-up questions by telephone about minor points during the report preparation
Arrange an appointment to review the final results, conclusions, recommendations, report and testimony that will be presented, as this will be very important to the client and may not be shared by the attorney, and to do this prior to my court appearance.
- Explain diagnostic conclusions and psychological terminology to the client, so they better connect my conclusions to their experiences and perceptions of their problems, which is vital if the client will be asked about them in court.
Other questions or Areas to Include in a Comprehensive Cross-Cultural Assessment
Family and Developmental History
Should be asked of each parent in family-based or parenting evaluations
In what city in Ehtiopia were you born and what was the date of your birth?
Is this a large city, a small city or village, or a rural location?
What was your mother's race?
What was your father's race?
What was your mother's cultural background?
What was your father's cultural background?
What was your mother's religion? How often did she practice her religion? How central was her religion in her life? How central was her religion in your life?
What was your father's religion? How often did he practice his religion? How central was his religion in his life? How central was his religion in your life?
What was your mother's ethnicity or country of origin?
What was your father's ethnicity or country of origin?
What was your mother's native language?
Did she speak this at home?
What was your father's native language?
Did he speak this at home?
What was the highest level of education your mother achieved?
What was the highest level of education your father achieved?
Did your mother have employment outside of the home?
If so, what was her profession?
Did your father have employment outside of the home?
If so, what was his profession?
What was your parent's income level?
How many siblings do you have? What are their ages and names?
Have you had any deaths in your family?
Have there been in divorces in the family?
If so, do you have any stepparents?
What are your culture's or religion's views of divorce?
How would you describe your family's basic values and beliefs?
What were your family's religious beliefs and practices?
Where there any family legends, heroes or stories that were important to your family?
What languages were spoken at home?
Was there any conflict between your parents regarding cultural values, religious beliefs or ethnic affiliations?
What was your family organizational style?
Who were considered the family leaders?
What was the family structure, who was at the top, middle and bottom of this structure?
Were there distinctions between the boys and girls and men and women regarding dividing the work and responsibilities in the family or in determining other outcomes in your family?
How did your family discuss things, deal with disagreements or plan activities or goals?
What was your relationship like with your grandparents, aunts and uncles and cousins and other family members?
Were any of these family members highly involved in your childhood?
Did any of these people make decisions regarding your life or situation?
Was your family involved in a shared business or means of financial support?
What was your family relationship like with your community?
Was your family highly involved in the community?
Was your community supportive of your family?
Or was your family isolated from the community?
Was your family or community involved in of impacted by any of the following:
Any ethnic conflicts?
Intensity?
Length?
What was the result on your family?
War?
Intensity?
Length?
What was the result on your family?
Racism or discrimination?
Intensity?
Length?
What was the result on your family?
Religious persecution?
Intensity?
Length?
What was the result on your family?
What were your responsibilities for the upkeep of the household?
Did you have any household chores?
Did you have any responsibilities for care of other children?
Did you have any farming responsibilities?
What were your family's values regarding work?
What were your families values regarding education?
What methods of discipline did your family use?
Did your family express affection?
If so, how was this affection displayed?
Were rewards or encouragement given?
What are examples of unacceptable child behaviors?
How do children show respect for parents and adults?
Is a child's behavior a reflection on the family?
Is child and family activity oriented toward the family all together, or toward the promotion of individuality?
Did you ever feel that discipline in the family was too harsh or abusive?
Were the children in the family disciplined to the same degree?
Were the children in the family rewarded to the same degree?
Was the style of child rearing consistent with other families in your community?
What were your family's hopes and goals?
What are your hopes and goals for your children?
What are your family customs or beliefs regarding the following:
Dating?
Romance?
Sexuality?
Courtship?
Marriage?
Has there been any violence within your family of birth?
Is there any violence within your family?
Did anyone in your birth family abuse drugs or alcohol?
Was any child in your birth family abused?
Has any child in your current family been abused?
Is there any history of mental illness in your family?
Is anyone currently experiencing mental illness?
Have there been any significant illnesses within your family?
Did you grow up in a safe community?
If not, describe what was unsafe?
Did you babble, talk, sit-up, crawl and walk at times similar to others in your community?
Were there any delays in your development?
Did your mother have any problems during her pregnancy with you?
Did she receive prenatal care?
Did she receive appropriate care during delivery and postnatal?
How many years of education did you and your siblings receive?
Did you have positive relationships with children your own age and have time for peer activities?
How old were you when you had your first job?
What type of job was it?
When was your first romantic involvement?
Did you have any other romantic involvements?
What was the nature of those relationships?
Did you have any past sexual trauma, such as rape or an early sexual relationship?
Are you currently married?
When did you marry your spouse?
Did you have any previous marriages?
If so, when were you divorced?
What is the state of your current relationship?
Are you happy in this relationship?
Do you have any children?
How old are they?
What are their names?
Immigration and Acculturation
When did your family arrive in the United States?
What were the reasons for coming to the United States?
Please describe the social, economic, and political conditions in Ethopia before you or your parents left?
Is there a trauma history related to war, torture, and so forth?
Do you have any physical evidence, such as scars from this?
Are family members aware of one another's traumatic experiences?
Is there secrecy or permission to discuss traumatic events in the family?
If the family or client were refugees, were they in a refugee camp or other countries before coming to the United States?
If so, what were those conditions like?
Have you been the victim of human trafficking? Did anyone bring you to this country or take you from your home country against your will?
How did you get to the U.S.?
Did you come here as the result of someone else's efforts?
Were you comfortable with this arrangement?
Did anyone pay money to bring you here?
Was your employment in the U.S. pre-arranged?
If so, are you happy in this arrangement?
Did you come here for a pre-arranged marriage?
If so, are you happy with this arrangement?
What is the age of your spouse?
Have you ever been locked in a room or location, or not been allowed to leave somewhere?
If so, have you discussed this with your immigration attorney?
Have you ever been threatened about leaving?
If so, have you discussed this with your immigration attorney?
Did you or your parents feel a sense of loss or regret about leaving Ethopia?
If so, can you describe how you or they felt?
Are there any family members left behind?
Have there been any problems with legal residency status or difficulty with citizenship applications?
Are all eligible family members documented?
Is a referral to an immigration attorney needed?
Have there been changes in your professional status?
Have you had to change your type of work?
Have you had a change in your income or social class?
Have you taken on roles as a man that you would not have taken on in Ethopia?
Which members of your family are most active in the larger community in the United States?
Where do you work?
Does anyone else in your family work?
If so, where?
Have you and your family felt accepted in the community?
Why or why not?
How would you rate the level or respect that you feel for your ethnic group's values and traditions in the mainstream culture?
Have you or other members of you family experienced discrimination since coming to the U.S.?
What ethnic group do you affiliate with? What do you call your particular ethnic group?
Have you and your family found an ethnic community here that fits with your background?
Have you and your family found a religious community here that fits with your background?
Have you and your family found a cultural community here that fits with your background?
What percentage of your friends are from your ethnic group?
What percentage of your friends are from the mainstream community?
Do you feel comfortable visiting your children's school?
What languages are spoken in your home?
Are there any conflicts in your family regarding the observance of traditional cultural norms, traditions, and practices and the acquisition of new cultural practices that have been introduced from the mainstream U.S.?
Have there been any major role changes or marital conflicts that have been a result of children picking up American habits faster than you have?
Have there been any conflicts as a result of your wife becoming successful in work outside of the home?
Has there been a decline in the children's respect for their elders since coming to the United States?
Have the children in the family been rejected or marginalized in their school or peer community?
Have the children sought gang affiliations as a way of belonging in the community?
Have any family members developed health or mental problems since moving to the United States?
Have any family members become distant or isolated?
If so, have they sought treatment?
Have you been able to learn about community agencies and services such as health care, social services, counseling, youth activities, and the like?
What have been the gains and benefits of moving to the United States?
What have been the losses and disappointments as a result of moving here?
On a scale of 1 to 7, 7 being high and 1 being low, how would you rate your chances of becoming financially stable or comfortable in the United States?
How would you rate your chances of feeling socially comfortable in the mainstream community?
How would you rate your feelings of being socially comfortable within your ethnic group?
Experience with Racism
Have you ever felt ridiculed, criticized, or excluded because of your skin color, facial features, accent, or ethnic backgroud?
Describe your first experience of that.
Did such events happen occasionally or frequently?
How did this affect you emotionally?
Did this impact your relationship with your friends?
Did this impact your standing within your community?
Did anyone help you with coping with racist events?
To what extent was help given?
Please describe two or three events that occurred as a result of racial discrimination in the following areas within the past two years:
Your community?
Your children's school?
Your work?
Would you say that racist events or racial discrimination have had a small, moderate or large impact on your life?
Please describe.
How would you rate the frequency (infrequently, sometimes, often, or frequently) of racist events during the last year, such as:
Being followed in a store?
Being given poor service?
Being called a racist name?
Being told a racist joke?
Have any of the following events involving racial discrimination occurred in your life during the past 2 years, such as:
Being passed over for a job?
Not getting a raise that you felt was deserved?
Being stopped by the police or arrested for no reason?
Being the victim of racial violence or a hate crime?
Please describe the event and how you felt as a result.
Do you feel that racism or discrimination plays a role in this legal case, and if so, how? Please describe.
Ethnic, Cultural, and Racial Identity
What does it mean to be Ethiopian?
What does it mean to be African?
How would you describe your religious affiliations?
How would you describe your cultural affiliations?
What languages are spoken at home?
Have your children learned to speak your native language?
What language do you prefer to speak?
What traditions, either ethnic or religious, do you celebrate?
What values are most important to you at this time in your life?
Where do those values come from?
Are there any particular cultural or ethnic traditions or customs that you practice on a regular basis?
Do you participate in any community organizations specific to your Ethiopian background?
What are the ethnic backgrounds of your friends?
Have you ever been criticized for having non-Ethiopian friends?
Have you ever been ridiculed or criticized because of any of the following:
Your Ethiopian or racial features?
Your racial features?
Your language or accent?
Your traditions or cultural practices?
If so, how did this affect you?
Have you ever rejected your Ethiopian identity, values or traditions?
If yes, describe.
Do you feel a high, moderate, or low degree of comfort coming and going in mainstream settings (place of work, shopping, parks, theaters, schools, downtown, etc)?
If low, describe.
Do you feel accepted at:
Your children's school?
At your place of work?
In the larger community?
How would you rate your sense of trust in mainstream institutions, such as schools, police, courts, health care systems, and government? High, moderate or low?
Client/Family Mental Health History
How do you feel about the state of your health, both physically and mentally?
How do you feel about the state of the health of members of your family, physically and mentally?
Are you able to employ health care practices that were relevant in Ethiopia, for example, indigenous or spiritual healers or methods, here in the United States?
Does Ethiopian culture provide spiritual explanations for mental illness, such as angry spirits, spirit voices, and possession by evil spirits?
Do you use Western medicine practices as well as traditional ones?
What is the name and contact information of your physician?
Have you ever been to counseling or psychotherapy? Describe.
How do you feel that you have been treated by the medical and mental health practitioners you have seen?
Have you had any major illnesses or surgeries?
If yes, please describe.
Have you ever received a mental health diagnosis?
If yes, please describe.
Have you ever had a history of drug or alcohol abuse?
Educational and Employment History
What is the highest level of education you have completed?
Have there been any difficulties in your education? Describe.
What is your occupational history?
Are you currently employed?
What do you do for work?
Presenting Concerns, Stresses, Current Status
What are do you understand about your current legal difficulties?
If criminal charges, Do you understand the nature of the charges against you?
If child custody hearing, Do you understand that this is a child custody determination?
If a domestic violence case, Do you understand what you are being charged with?
If an asylum case, Do you understand the legal issues surrounding your immigration hearing?
How would this issue be treated in the Ethiopian judicial system?
Do you understand the U.S. judicial system?
Do you believe that you have effective counsel?
Are you able to have a working relationship with your counsel that benefits you?
Are you able to be a full participant in your own legal proceeding?
What other life stresses are impacting you at the present time?
Do you have a strong social network of support to assist you throughout this process?
Do you engage in any hobbies, sports or positive leisure activities?
How do you cope with stress?
What outlets do you have to release the pressures that result from your current legal situation?
What steps do you take to problem-solve? Please describe.
What are your goals for the future?
REFERENCES
American Psychological Association (2002). Guidelines on Multicultural Education,
Training, Research, Practice, and
Organizational Change for Psychologists. Retrieved December 06, 2008, from http://www.apa.org/pi/multiculturalguidelines.pdf
Barrett, K.H. (2005). Guidelines and suggestions for conducting successful cross cultural evaluations for the courts. In K.H. Barrett & W. H. George (Eds.), Race, culture, psychology & law
(pp.107-123).
Thousand Oaks, CA: Sage.
Kambon, K. K. (1998) The Worldviews Paradigm: On the Legitimacy of Cultural Differences in Psychological Analysis. The African Personality in America: An African-Centered framework. Tallahassee, FL: Nubian Nation Publications
Sodowsky, G. R., Taffe, R. C., Gutkin, T. B., & Wise, S. L. (1994). Development of the multicultural counseling inventory: A self-report measure of multicultural competencies. Journal of Counseling Psychology, 41(2), 137-148.
