Lakeesha’s & Rhonda’s Subgroup Report

 

 

 

 

 

 

 

 

 

Barrett Article Activity

The Chicago School of Professional Psychology

 

 

What impact does 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, and 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:

Prepare to become culturally competent practitioners

• Read the relevant literature
  
• Make sure you understand the professional ethical standards that are applicable to multicultural competency
  
• The clinician must consider whether 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)
  

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
  

 Once we decided to accept the referral, we then needed to determine the purpose for evaluating the client. Barrett advises us to first determine the scope and purpose of the evaluation. Further, we also want to ensure that the client is comfortable with the meeting place and if necessary has an interpreter. Once the client's needs have been taken into consideration, Barrett details the great extent to which we must commit to developing competency with our particular client.

Preparing for the Evaluation: The Clinician

Take the necessary steps to have knowledge of the culture, the impact that the culture will have on the evaluation process, and the skills needed to conduct a culturally competent evaluation. Clinicians must ask themselves, "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.?" and "have I consulted appropriately in this regard." Further preparations should include: review of case records, ascertaining the cultural style of communication, acknowledging the stresses inherent in the evaluation and legal process, clarifying the role of the evaluator in the evaluation process

The Initial Interview

The subject of the following questionnaire is an adult male from a minority group who emigrated to the U.S. from Ethiopia and has been in the U.S. for three years. The man lives in a segregated, same-race community. According to the Barrett article, there are certain questions one would want to consider when developing a questionnaire for a person who is not of the dominant culture. The following questions are based on the guidelines from the Barrett article;

1. What were your reasons for coming to the United States from Ethiopia?
   Do you feel accepted in your community? You live in a community that is predominately-African immigrant; does that help you establish a sense of culture in the United States?
   
2. What ethnic groups do you associate with in the US and in what way do you associate with these groups?
   
3. Do you consider yourself an African American? Do you feel there is a distinction between yourself and American born persons who have African descent?
   What languages do you speak in your household? Do you speak these languages outside your household?
   
4. Have you experienced discrimination in the United States?
   
5. Do you feel connected to your homeland?
   
6. Do you still have family members in Ethiopia?
   
7. Do you feel your cultural background has been challenged in any way since coming to the United States? Is the culture different from the one you came from in major ways?
   
8. Have your family members been sick mentally or physically after the immigration to the United States? Did they receive treatment for illnesses? Is treatment easy to obtain in your community?
   
9. On a scale of 1 to 10, with 1 being the lowest and 10 being the highest, how would you rate your financial security at this time? Do you think that will change in the future?
   
10. On a scale of 1 to 10, with 1 being lowest and 10 the highest, how would you rate your chances of being socially comfortable in the United States?
    
11. What does it mean to be Ethiopian?
    
12. What does it mean to be African?
    
13. Have there been any problems with legal residency status or difficulty with citizenship applications?
    
14. Do you engage in any hobbies, sports or positive leisure activities?
    
15. How do you cope with stress?
    
16. What outlets do you have to release the pressures that result from your current legal situation?
    
17. What steps do you take to problem-solve? Please describe.
    
18. What are your goals for the future?
    
19. What have been the losses and disappointments as a result of moving here?
    
20. What traditions, either ethnic or religious, do you celebrate?
    
21. Do you understand the U.S. judicial system?
    
22. Have you and your family found a religious community here that fits with your background?
    
23. Have you ever felt ridiculed, criticized, or excluded because of your skin color, facial features, accent, or ethnic background?
    
24. What is the highest level of education you have completed? Have there been any difficulties in your education? Describe.
    
25. Have you ever rejected your Ethiopian identity, values or traditions?
    
26. Does Ethiopian culture provide spiritual explanations for mental illness, such as angry spirits, spirit voices, and possession by evil spirits?
    
27. What values are most important to you at this time in your life?
    
28. Are there any particular cultural or ethnic traditions or customs that you practice on a regular basis?
    
29. Have you been able to learn about community agencies and services such as health care, social services, counseling, youth activities, and the like?
    
30. Have you ever received a mental health diagnosis?
    
31. Have you ever had a history of drug or alcohol abuse?
    
32. Do you participate in any community organizations specific to your Ethiopian background?
    
33. What percentages of your friends are from your ethnic group?
    
34. What have been the gains and benefits of moving to the United States?
    

Content of the Next Meeting

Determine whether the client needs to divulge difficult questions, assessment of symptoms, and discussions 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 an in-depth developmental history
  
• 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.
  
• Determine background information on how mental health symptoms are expressed in the culture of my client.
  
• Use culturally appropriate language on assessments
  

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.
  
• 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
  
• 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.
  

   
   

   
   

   
   

 

 

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.