Sep 10 03 11:27a PGSP 508566734 a1 Seeing the Forest and the Trees: The Complexities of Culture in Practice In the mid-1970s, 1 graduated from high school and left my family home in Soldotna, Alaska, to attend college at New Mexico State University (NMSU). I had chosen NMSU because it met my three criteria: (a) it bad a late admissions deadline, (b) it was someplace far away that I'd never been before, and (c) the climate was hot. (It also turned out to have some very good professors, but that was not on my mind at the time.) ‘A large proportion of the students at NMSU were Latino, and in those days, in New ‘Mexico, people of Latino heritage referred to themselves as “Spanish.” I was not Spanish, nor did I speak Spanish, but I wanted to learn, | remember one day talking with some friends about Spanish surnames. I was impressed that they all seemed to know which surnames were Spanish and which were not, and I wanted to know how they knew. “Take the name Garcfa,” I said in all sincerity, glancing at the sign over Garcia Hall. “Is that a Spanish name?” When the laughter died down, my friend Anita said, “Yes, itis.” “But how do you know?” I replied, a bit frustrated. She patiently answered, “T don’t know how I know; I just know.” During the past couple of decades, as North Americans have moved from an assimila- tionist orientation regarding cultures to one that recognizes and (at some levels of society) values differences, therapists are being expected to “just know’ increasingly more about the cultural influences relevant to a growing number of minority groups. This expectation may feel frustrating and, at times, even overwhelming. Fortunately, in response to the need for more information, multicultural research has expanded rapidly since the 1970s, ‘with whole fields of research being developed with specific populations (Fukuyama, 1990; Hays, 1996a).va PGSP BDUYDEU IS plu US 11: a| apprassine curtunat comprextties IN PRACTICE At this point, the most commen approach among U.S.-oriented multicultural Arendor counseling textsis to provide one chapter on African Americans, one on Asian Americans, the APA cone on Native Americans, and one on Latino Americans. Separate books exist for working ethical gu with gay and lesbian clients, older people, people who have disabilities, and women (see the follow reference lst). have found this focus on ethnicity tobe helpful for certain aspects of multi- tone Cultural education; howeves, the one-chapter per yroup appeeach has mations 1 ase namely that most people do not think of themselves in such unidimensional terms. Rather, : there are Latino and Latina elder, lesbian and gay people who have disabilities, Jewish » and Christian people who have immigrated and speak English asa second language Poot vel Euroamerican women who are homeless—and the list goes on of people whose identities, a are complex, multidimensional, and frequently changing depending on the context (Myers nt etal, 1991: Pedersen, 1990; Root, 1996). A related limitation of the one-chapter-per-group approach is that the groups * soc commonly chosen (i.¢., African, Asian, Latino, and Native American) are not necessarily mr relevant to therapists practicing outside the United States. Hogan (1995) estimated that sex less than 40% of psychologists now live in the United States. As political changes have led «Ind to Increasing numbers of immigrants and refugees internationally (Marsella, Bornemann, Taw Ekblad, & Orley, 1994), and Indigenous people have become more politically active and hu visible (Adams, 1995; Adelson, 2000; Kidd, 1997; Young, 1995), cross-cultural issues in * pat ‘counseling, social work, and clinical psychology are gaining recognition in many countries + gen and regions, including Canada (Waxlet-Morrison, Anderson, & Richardson, 1990). Giver Australia (Adams & Gilbert, 1998; Cox, 1989), New Zealand (Greenwood, 2000), Hong the influ: Kong (Spinks f Kao, 1995), South Africa (Louw, 1995), China (Lee & Gong, 1996). culturally Indonesia (Sarwono, 1996), and sub-Saharan Africa (Ebigho, Oluka, Ezenwa, Obidigho. & offers a 5 Okwaraji, 1996). Increasingly, practitioners are recognizing the need for information that form of « addresses the complexity of clients’ and therapist lives beyond as well as within U.S Disabiit borders (D'Andrea, 1999; Sleek, 1998; Sunar, 1996) orientatic In this book. { present a practtioner-oriented framework that I have found helpful in The 1 training therapists of diverse identities and origins to work effectively with clients of broad cat complex and multidimensional identities, This framework outlines specific principles and personal sidelines for working with people of minority, dominant, and mixed cultural groups, and the influc itmakes use of case examples, anecdotes, and the research literature to describe and illus- consists © trate this work. I call it the ADDRESSING framework. deeper ur a3 “reach clinical w The ADDRESSING Framework THE Ti In an effort fo focus practitioners’ attention on those groups that have traditionally been 1 ‘The ADD neglected, professional organizations in the United States and Canada have issued a therapists number of publications aimed at educating clinicians. “Guidelines for Providers of tional ex Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations” have been upbringin endorsed by the American Psychological Association (APA, 1995), as has “Multicultural own idem ‘Counseling Competencies and Standards” by the American Counseling Association (Sue, in whichSep iu us iiseva ruse BDUBDEE 734 Seng he Foret and tee | uulticultural Arrendondo, & MeDavis, 1992, further operationalized by Arrendondo et al., 1996). Both ‘Americans, the APA (1992) and the Canadian Psychological Association (1991) have revised their for working ethical guidelines to attend to cultural issues. Together, these guidelines call attention to women (see the following cultural influences (with related minority groups noted in parentheses): ‘ts of multi- i age and generational influences (e.g., children, adolescents, elders) limitations, * disability (e.g., people who have developmental or acquired physical, cognitive, fs Rather psychological disabilities) religion and spiritual orientation (e.g,, people of Muslim, Jewish, Buddhist, Hindu, guage, poor other minority religions and faiths) ‘se identities * ethnicity (e.g., people of Asian, South Asian, Pacific Islander, Latino, African, wext (Myers, African American, Arab, Middle Eastern heritage) she poupe + socoeconomiesats fg peopl of loner satus by occupation, education income, he group tural or urban habia, lay fame) ‘meade, + sexual orientation (¢.g., people who are gay, lesbian, bisexual) ‘led a + Indigenous heritage (eg in North Americo--Amevicam Indlans, Alaska Natives geshave le Inuit Mel, Pace Americans, including Native Hawalans Seman ood the . Chamero people of Guam) zacive and + national ovgin fe. Smigcans,refages, international students) and sa sues in + gender (eg. momen, transgender people reson Given the impossbtny of any one therapist holding insider level expertise with lof ‘00 eons the infuenees and groups included inthis ls. whet is needed at 2 fst step tomard coe see culturally responsive therapy is a system of organization, The ADDRESSING frememont Obiigb, & offer a sytem fr organining and adressng these cultural infueners and grou ne ‘Sumion that form of an acronym: Age and generational Infuences, Developmental snd seqsined within OS Disabilities, Religion and spntual evientation, Ethnic, Seclocconomic satus, Sevoa orientation, Indigenous este, Natoma gin and Gender (sys 19960) stata in The ADDRESSING lramework conceptualincs cross-cultural work ay involving two elem of broad categories of flor by the therapist. The fist category concerts the therpers tndples and personal selnexporation and growth Key to ths proces ha wowing uadersenting ot grovps and the influence of cate on une's own bel sstem ond ridvien: The second ategoy seand lus consists ofthe therapists sliedcation about cents cltures which asa eedsee deeper understanding of cent these two “pats” have been deserted by Aponte (994) ts “reaching within to understand” and “teaching out to undersand” (pp. 186-189) tn Glnical work, the wo areas frequently over. THE THERAPIST'S PERSONAL WORK only been The ADDRESSING approsch begins with an emphasis on understanding the impact on we issued a therpists’worlviews of diverse cultural infuences (eof therapist ge and ents woviders of tional experiences, experience or inexperience with tsebily religous or spel “have been poring. ene and soon) Through sere of exercises, therapist can euler the Sucotarl om idenstiesin ration teach a the ADDRESSING inuences By recogni the sess inton (Sue in which they are members of dominant groups therapists wil Become moe sare oeBDUBDEE 734 mays in which such identities can limit their knowledge base and experience, particularly ™ regarding minority cultures of which they are not members aw Therapists are encouraged to pay special attention to the role of privilege, defined as n the advantages one holds as a result of membership in a dominant group (see Mcintosh, Fi 1998). The areas in which a therapist holds privilege vary depending on the particular re therapist's identity. In general, one’s knowledge base and experience are greatcr in those w areas in which one is a member of a nondominant group. For example, as a result of her us ‘membership in a sexual minority group, a middle-class Euroamerican lesbian therapist is ‘Ato ‘more likely to be aware of the subtle sexist and heterosexist biases against lesbian, gay, and cultural bisexual dlients. However, this does not mean that she will automatically hold greater with the awareness with regard to people of color, people who have disabilities, or people of lower 1996).5 sodoeconomic status; the privileges she holds in relation to her ethnicity, education, and band or Professional status will generally work to separate her from people who do not hold such society ( Drivileges. Furthermore, if her friends and family are relatively homogeneous with regard Indians to ethnicity, social class, and disability, she will have to work hard to find sources of infor- Native mation that challenge her assumptions, biases, and ways of seeing the world. persona Sim LEARNING ABOUT CLIENTS’ CULTURES ‘ Sone Research suggests that at the level ofthe individual, prejudice is lower when one holds my idk the “knowledge structures” to categorize others as having multiple group memberships involve: (Hamilton, 1981; Sun, 1993). By calling attention to these multiple memberships amd these id Identities, the ADDRESSING framework helps therapists avoid making inaccurate himself generalizations on the basis of a client's physical appearance, language abilities, and/or "Alt family name. 1 ADDRE! For example, using the ADDRESSING acronym as a guide, a therapist attempting to category understand an older man of East Indian heritage would not consider as sufficient a general impor understanding of values, beliefs, and behaviors considered common among East Indian ; been wt people. Rather, the therapist would want answers to the following questions: groups | + What are the Age-related issues and generational influences on this client, particu- Boyd-Fr larly given his status as a second-generation immigrant? Alaska S + What is this man’s experience with Disability? That is, might he have a disability Latinos that is not immediately apparent or have experienced the impact of disability as a i speakiny caregiver for a partner, parent, ot child? (Aponte + What was his Religious upbringing. and what are his current beliefs and practices? Dana, 1 (Reasonable hypotheses would be that he is Hindu or Muslim or Sikh, but any one | Ponterot of these cannot be assumed; see Almeida, 1996.) Ave + What is the meaning of his Ethnic identity in an urban area where he is often number ‘mistaken by non-Indians to be Pakistani or Arab? by Cani + What is his current Socioeconomic status as defined by his occupation, income, i Huang, education, marital status, gender, ethnicity, community, and family name, and been we ight this status be different from that of his parents before their immigration? (1985), 1 + What is the client's Sexual orientation, not assuming heterosexuality simply because ‘Ther hae has been married? (Brown,Seeing th Foret and te es | 7 particularly 1 Might he hold Indigenous heritage in his premigration history? + What is his National identity (Indian, that of his country of residence, both, or 2, defined as neither?) and primary language (Hindi, English, or other language?)? © Mcintosh, 4 + Finally, what Gender-related inforshation (e.g., regarding roles, expectations, and ve particular relationships) is significant given the client's cultural heritage and identity as a iter in those whole? (See Assanand, Dias, Richardson, & Waxler-Morrison, 1990, and Almeida, cesult of her 1996, regarding the diversity of South Asians.) \ therapist is Around the world, it is now common to find individuals who hold more than one an, gay. and cultural identity simultaneously. Biethnic and multiethnic people may identify strongly aold greater with the differing minority and majority identities of their parents and grandparents (Root, ple of lower 1996). People of Indigenous cultures frequently identify simultaneously with a particular cation, and band or community, a larger Indigenous culture, and a national and non-Indigenous >t hold such society (e.g. see Allen, 1998, regarding the assessment of culturalidentity among American with regard Indians and Alaska Natives). For example, in Hawaii, the same individual may identify as ces of infor- ‘Native Hawaiian, asan Indigenous or Aboriginal person, and as an American (K. Ka’ Ahanui, personal communication, July 1. 2000) Similarly, many individuals hold a combination of ethnic and nonethnic identities (Comas-Diaz & Greene, 1994a; Hays, 1996c; Hermans & Kempen, 1998; Marsella, 1998; Robinson & Howard-Hamilton, 2000). For instance, a gay man of Filipino heritage zone holds may identify with a predominantly heterosexual Filipino community but also be emberships involved in a politically active, mostly Euroamerican gay community; the salience of erships and these identities may vary depending on the particular environment in which he finds Inaccurate himself (Chan, 1992). les, and/or Although therapists will not necessarily ask clients all of the questions raised by the ADDRESSING framework, they would certainly want to consider the relevance of each tempting to category and gather more information about the influences and identities that seem fata general important to the client. With a focus on one identity ata time, many excellent books have East Indian been written on working with members of the four largest ethnic and racial minority ‘groups in the United States, including African Americans (Bass, Wyatt, & Powell, 1982; nt, particu: Boyd-Franklin, 1989); Asian Americans (E. Lee, 1997; Uba, 1994); American Indians and ‘Alaska Natives (Herring, 1999; Swan Reimer, 1999; Swinomish Tribal Community, 1991): a disability Latinos and Latinas (Falicov, 1998; Geisinger, 1992; LeVine & Padilla, 1980); English- sabilty as a speaking West Indians (Gopaul-McNicol, 1993); and on the first four of these groups (Aponte, Rivers, & Wohl; 1995; Atkinson, Morten, & Sue, 1993; Baruth & Manning, 1991; 4 practices? Dana, 1993; Ho, 1987; C. Lee, 1997, who also adds Arab Americans: Paniagua, 1998; vut any one Pomterotto & Casas, 1991; Sue, Ivey. & Pedersen, 1996; Sue & Sue, 1999). A variety of U.S. ethnic groups were addressed by McAdoo (1999), an even greater he is often number by McGoldrick, Giordano, and Pearce (19%), and with regard to children of color by Canino and Spurlock (1994), Johnson-Powell and Yamamoto (1997), and Gibbs, 1, income, Huang, and Associates (1989). Canadian and Australian ethnic minority cultures have name. and been well-covered by Waxler-Morrison, Anderson, and Richardson (1990) and Pauwels sation? (1985), respectively, although neither fully addresses Aboriginal peoples’ concerns ply because There are also feminist therapy books that focus on women of diverse identities (Brown & Root, 1990; Comaz-Diaz & Greene, 1994b). And there are texts on assessmentruse BDUBDEE 734 Sep 1U Us ii: g | ADDRESSING CULTURAL COMPLEXITIES IN PRACTICE and counseling with diverse gay, lesbian, and bisexual people (Dworkin & Gutiérrez, ' Anoth 1992); people of religious and spiritual faiths (Burke & Miranti, 1995; Fukuyama & | is informa Sevig. 1999; Kelly, 1995; Lovinger, 1984; Miller, 1999; Shafranske, 1996): elders (Brink, Kiselica (1 1986; Burlingame, 1999: Dufly, 1999; Nordhus, VandenBos, Berg. & Fromholt, 1998; sharing of, Storandt &VandenBos, 1994; Zarit & Knight, 1996); refugees (Marsella, Borneman, | work. Tow Ekblad, & Orley, 1994); and people with disabilities (Krueger, 1984; Maki & Riggaz, the hope t 1997a; Olkin, 1999) | my areas « value to yc - utilized re Why This Book? humerous Given the impressive list above, you're probably wondering, why write a whole new book? ; 5 ‘The primary reason is that in teaching and supervising therapist in the United States'and | Organizat abroad, Ihave been unable to find a practitioner-oriented book that pulls together Practical —— suggestions for assessment, diagnosis, and therapy and that also addresses issues relevant i to pedple of al these overlapping groups. My solution has been to devélop a framework Chapters 2 that I Believe does this. Furthermore, by focusing on individual and family cases, rather assessmen, than on Sultural groups. I have tried to minimize the problems of overgeneralization the therap Untortinately it proved too dificult to include cases placed outside the United States necessity or Canada, Hause what constitutes a minority group in gue country may be a dominaat Getensive! culture in another. However, I do include examples and ases involving clients and thera~ particular pists of diverse eqnic and national cultures that are fot commonly found in U.S. texts— privilege + for example, Indonesian, Tunisian Arab, French Canadian, Haitian, East Indian, Cuban, Beginning Kenyan, Chinese Vidwgamese, Guatemalan, Filipino, Costa Rican, Korean, Greek, and assessmen ‘Alaska Native cultures Sand of course these/€xamples involve people of different ages, ' tamewoe sexual orientations, religions, physical abilities, and socioeconomic statuses. I do include \ othypets some cases set in Canada, because the histories of Canada and the United States are parallel ae in many ways, and their inclusidg helps to highlight U.S. assumptions. (Sec Elliott & Flevas, : 1992, sp a erin Takaki, 1993, regarding the United States; and i the specifi Dobson & Dobson, 1993, for an overview of professional psychology in Canada.) considerat In the multicultural counseling literature, I have also seen the need for guidelines in, | Sdentities. specific areas such as cross-cultural testinnd diagnosis. Unfortunately, much of the cross- | assessmen cultural testing literature seems stuck on igcussions of the need for better norms (for | standardia exceptions see Allen, 2000c: Cuellar, 1998; Dahg, 1993, 2000; Okazaki, 1998; and several ality asses others reviewed in chapter 7). Similarly, with xegard to diagnosis, there is very little | particular discussion in the miulticultural counseling literature of the 4th edition of the Diagnostic | approache ‘and Statistical Maral of Mental Disorders (DSM-IV: Ametican Psychiatcic Association, 1994) I. mainstrea and how to use it ina culturally responsive way; such work is found mainly in the psychi- minority 5 atric literature (an exception is Smart & Smart, 1997). Por these reasons, I add many | includiny practical suggestions regarding assessment, diagnosis, testing, and psychotherapy. These - suggestions, along with specific guidelines, are organized in Key Ideas lists following each tates the chapter and may be useful for instructors teaching multicultural counseling courses as anolder A well as clinicians American (A eneConcepts and Categories in Multicultural Research | factors fy ites | minority | assumpt Although the topic of terminology may not sound very interesting, understanding | Europea) commonly used concepts and categories is an essential aspect of cross-cultural work. A scheme, therapist's assumptions, knowledge base, experience, and reference points are all commu interraci 1 nicated to clients through the usc of language (Henley, 1995). Currently, the vast majority | Blood” c | of therapistsin the United States are Euroamerican (95% of U.S. psychologists—Hammond a child 0 & Yung, 1993; figures for master’s-level therapists and Canadians are not available). In heritage addition, therapists often hold higher social status in relation to clients by virtue of their | Ina professional position (e.g. Acosta, Yamamoto, Evans, & Wilcox, 1982). Research indicates enormot that Euroamericans commonly do not think of themselves as having a culture (Pack- i example Brown, 1999), suggesting that therapists’ judgments may be affected by influences of | many pe Which they are unaware. | there ae ‘earning why terms have different meanings fr different cultures and even different | there a Individuals can help to bring some of these assumptions and biases into awareness. In i sind addition, the perspectives of diverse groups are communicated by different concepts, i Edueatic categories, and terms. Four of the most frequently used (and confused) terms in the multi- i Woona cultural literature are culture, race ethmicty, and minoriy vonen awide r CULTURE } reservin Culture isthe most inclusive term but abo the most general, Definitions of culture abound | Progress {see Kroeber & Kluckhohn, 1952), but common to most is the idea that culture consists of indepen the “shared elements” involved in “perceiving, believing, evaluating, communicating, and { White p acting” that are passed down from generation to generation with modifications (Triandis, ‘controv 1996, p. 408). Shared elements include language, history, and geographic location. establish Although culture is often equated with race and ethnicity, the most commonly accepted race” th definitions of culture say nothing about biological links (which the concept of race implies), But and as such are broad enough to include people of nonethnic groups as well (Pope, 1995), Aspect o For example, Muslim religious communities within many cities in North America include Corel people of African, Arab, African American, Pakistani, East Indian, Indonesian, and Middle used ter Eastern descent (Abudabbeh, 1996; Bernstein, 1993). For many Muslims, the mosque Franklir functions as a cultural center, providing social, financial, and spiritual support for its rather t members. And in North America, prejudiced attitudes emanating from the dominant Pride" 1 Judeo-Christian society tend to reinforce a sense of separateness among many Muslims, cultural which in turn increases the latter's sense of themselves as a culture. tation. | that ev African RACE te The concept of race was originally used by European scientists to classify people on the Wh basis of geography and physical characteristics (such as skin color, hair texture, ot facial racial id features) into groups of genetically related peoples (Spickard, 1992). Over the years, apersor researchers made up differing classification schemes that emphasized a wide range of (ones,Seeing the Fores ad he Tes | 1 factors from skin tone to tribal affiliations, nationalities, language families, or simply minority status (Thomas & Sillen, 1972). Underlying many of these schemes was the assumption that races were organized hierarchically, with light-skinned, Christian derstanding Europeans at the top. Politics and belie of the time often determined the choice of a tral work. A. . scheme, which in turn reinforced racist beliefs and laws. For example, the illegality of allcommu- interracial marriage in many U.S. states until 1967 reflected the common belief that “White ‘ast majority blood” could be tainted by “Black blood.” Hence, in nine states at the turn of the century, ~Hammond a child of predominantly European ancestry and even one great-grandparent of African vailable). In heritage was for legal purposes considered a “Negro” (Spickard, 1992). ctue of their In addition, racial classifications are problematic in that they fail © account for the ‘ch indicates enormous variation in physical characteristics within the so-called radial groups. For ture (Pack- ‘example, many people who se-identify as “White” have skin that is visibly darker than Buences of many people who identity themselves as “Black” Most socal scientists now recognize that , there are no pure gene pools; human beings of dominant and minority cultures are quite en different mixed, genetically speaking (Betancourt & Lopez, 1993). zareness, In Recognizing the danger in presenting race as a biological fact, the United Nations w concepts, Educational, Sciemtfic, and Cultural Organization (UNESCO) (1979, in Yee, Fairchild, maul ‘Weizmann, & Wyatt, 1993, p. 1132) passed a statement recommending that the concept of ethnic group replace that of race, However, within the field of psychology, there is still wide range of opinions on the subject. For research purposes, Johnson (1990) suggested reserving the use of the term for work aimed at demonstrating the effects of racism and progress to eradicate it. However, many researchers continue to conceptualize race as an ure abount yung independent variable synonymous with culture—for example, by comparing Black and amin of White people on test scores yon thelr esponses to particule catmemts, Reeegnising the eae controversy, Yee and colleagues recommended thatthe American Psychological Assocation Son establish an interdisciplinary committee to develop “a comprehensive scenic policy on ay accepted race” that may be used to guide research (p. 1138) cimpne), But in dinieal practice, use of the term may be necessary because race isan essential ope. 1995) aspect of many individuals’ self-identitication (Glass Wallace, 1996; Thornton, 1996). As de indude Corel West (1993) put it, race matters. Currently. in the United States the most commonly and Middle used term for people of Aftican ancestry Is African American (eg., Moore Hines & Boyd- he mosque Franklin, 1996), which communicates an identification based on ethnic and social heritage port for its rather than on racial or physical characteristics. However, since the 1960s, when “Black dominant Pride” Jed to increased interest among many African Americens in family history and y Muslims cultural heritage (Boyd-Pranklin, 1989), the term Black has also acquired a positive conno- tation. However, language is continually changing, and therapiss need to keep in mind that even these two terms may be offensive to some older people, because Black and African were used derogatorily by White Euroamericans before younger generations reclaimed the terms. ple on the Whether or not a person uses a racial identification, i s helpful to remember that a 'e, or facial racial identity in itself provides little information about an individual: it says nothing about the year a person’s educational level, cultural context, religious upbringing, or current environment € range of (Jones, 1987), What is most important with regard to racial identity is an understanding EE eePSP GDUYDEE 134 12 | ADDRESSING CULTURAL COMPLEXITIES IN PRACTICE | of its meaning—~for the individual (if the person conceptualizes her or his identity in this | Mexican, way) for the dominant and minosity cultures, and forthe therapist | te not to | ormeani ETHNICITY i an ethnic For the purpose of understanding the beli(s, values, and behaviors of both alients and | persist be therapists, the concept of ethnicity is usually much more informative than that of race | Thats, 0 McGoldrick and Giordano (1996) defined the term as the “common ancestry through possiie ‘hich individuals have evolved shared values and customs” (p. 1). Although ethnicity is | Shit dep generally understood to involve some shared biological heritage, smostimportant aspects | euhnicty in terms of individual and group identity are those which are socaly consiruced (e, the stren beliefs, noms, behaviors, and institutions) | are then But the concept of ethnicity also includes complications. For one, the term holds vary. The ditferent meanings in different counttes. in the United States, where American Indians entice joined together early on with Atrican, Asian, and Latino Americans to cll for equal rights, individus the term enc minority assumed 1 include people of indigenous or Aboriginal heritage | onthe ti (The term indigenous is often used interchangeably with Aboriginal, asin Indigenous or Aboriginal people-—Adelson, 2000; Marace, 1994.) However, in Canada and Australia. | where Aboriginal people see their situations as separate from all subsequent immigrant MINO’ groups, the term ethnic minority is used to describe only cultures with a history of i ‘The term immigration. Because Aboriginal Canadians emphasize their originality in these ands, they is limitec donot conceive of themselves as ethnic minonty cultures (Elhott6 Fler. 1992): Aboriginal) religious ‘Australians ae similar in tis regard (see Young, 1995). i educated Aboriginal people of Canada are often referted 10 as Canada's First Nations, in contrast children with the Second Nations (Le. the Prench and English, who came as colonizers} andthe | and have Third Nations (all subsequent immigrant groups to Canada; Elliot © Fleas, 1992). | psycholo However, the term First Nation is perceived by some people to be exclusive because it | chien originates with the dominant cultural assumption that some nations are second or lesser | considere (Adams, 1995). The more inclusive term is Aboriginal peoples, which legally includes the | attention following four groups: 1 niot true j 1 status Indians—those adie to a central reps, afllated with one of 592 | ofco bands, and defined as Indian by the Indian Act of 1876 ot oppres 2. non-status Indians—those who are not governed by the Indian Act but are recog- | of “traits nized as Aboriginal peoples by the Canadian Constitution of 1982 | Pavilege 3. the Méus, people of mixed Aboriginal and European (primarily French) heritage | knowled 4, the Inuit, people of the Canadian Arctic, who never signed treaties with the { opportur Canadian government and recently formed a federally recognized territory Newmom ‘known as Nunavut (summarized from Eliott 6 Fleras, 1992) sieres Another problem with the description of people by ethnicity is that ethnic groups are . currently labeled very broadly, as in the use of the term Asian for people of Japanese, { Korean, Chinese, Vietnamese, Cambodian, Thai, and even East Indian and Pakistani CcHOO heritage (Uba, 1994). Similarly, the term Hispanic combines into one ethnicity the diverse ‘One's che cultures of Central American Indians, South Americans of African and Spanish heritage, | aisabiin‘entity in this 2 dents and that of race. stry through a ethnicity is tant aspects, tructed (e.g., 2 term holds ‘ican Indians equal rights, nal heritage. idigenous or ad Australia, at immigrant a history of ‘elands, they ); Aboriginal s.in contrast, fers) and the eras, 192). ve because it ond or lesser includes the 1 one of 592 utare recog- ach) heritage {es with the ved territory lec groups are of Japanese, ad Pakistani y the diverse ish heritage, PGSP GSUYSEE 134 ‘Seeing the Forest and the Trees ‘Mexican Americans, Cuban Americans, Puerto Ricans, and Dominicans (Novas, 1994). This is not to say that the broader, politically recognized ethnic groupings are always offensive or meaningless (because they are not always), but rather that there are dangers in assuming an ethnic identity and a specific meaning for an individual in a particular context. Recognizing these complications, Phinney (1996) suggested that misunderstandings persist because ethnicity is commonly conceptualized as a discrete categorical variable. ‘That is, one is considered either Latino or not Latino, despite the fact that there are other possibilities (e.g., a person may be bicultural, or the salience of this ethnic identity may shift depending on the context and on developmental changes). Phinney suggested that ethnicity needs to be broken down into its component parts—that is, norms and values; the strength, salience, and meaning of one’s ethnic identity; and minority status—which are then more accurately conceptualized as dimensions along which an individual may vary. Thus, “two individuals who belong to the same group may differ widely on their identification with the group and their commitment to ik” (p. 923). Moreover, even one individual may vary in his or her identification with a particular ethnic group depending on the time and context. MINORITY The term minorityhas traditionally been used in reference to groups whose access to power is limited by the dominant culture. In North America, the term may apply to ethnic, religious, national, and sexual minorities; elders; people who are poor, less formally educated, or of rural or Indigenous heritage; people who have a disability; and women and children. All of these populations fit the broad definition of a culture (Fukuyama, 1990) and have consistently been excluded, marginalized, or misrepresented by mainstream psychology: in this sense they may be considered cultural minorities. (Euroamerican. children and adolescents are somewhat of an exception in that, although they may be considered minorities in relation to the larger society, they have been the focus of much attention in psychology beginning with Freud’s developmental interests; this is certainly not true for children and adolescents of ethnic minority coltures.) Of course, there is more to being a member of a minority culture than the experience of oppression. Identification with a minority culture or group may lead to the development of “traits and qualities” that may not develop in people whose lives are buffered by privilege (Mcintosh, 1998, p. 101). Minority status may bring with it unique forms of knowledge, awareness, emotional and tangible support, a sense of community, and an opportunity to contribute to others in ways that are deeply meaningful (Newman & Newman, 1999). 1tshould be noted that describing a group of people as a minority culture is different from referring to a person as a minority. The latter may be perceived as disem- powering because it places a label on the individual, CHOOSING TERMS FOR DIVERSE GROUPS ‘One's choice of terms is equally important with regard to older people: people who have disabilities; gay, lesbian, and bisexual people; and women. For example, consider the BPGSP GOUYDEE 134 Pell differences in connotation between the set of descriptors “elderly, old, old man, old maid” both meas and a second set of “elder, older person, senior.” Although the two sets are quite similar, | someone the first may be perceived as patronizing, while the second set is more respectful “Eskimo” With regard to sexual orientation, the term sexual preference is offensive because it | people rei suggests that one has chosen to be gay or lesbian and thus can “change back.” The term when Ikn homosexuals also problematic because of its historical equation with sin and sickness; more | before usi affirmative expressions are gay, lesbian, and bisexual (Dworkin & Gutiérrez, 1992). also off- | Howe putting are questions that reflect an assumption that heterosexuality fs normal and other | the thera; orientations are not (eg. asking a cient why he thinks he became gay; therapists generally», | minority do not ask heterosexual cients why they became heterosexual; Martin, 1982) members ‘With regard to people who have disabilities, preferred identifications are those that people wi reference the person first, then the disability. Thus, describing someone as a “petson with | define the a disability” is more respectful than calling her or him a “disabled person.” In addition, | relation ‘emotionally neutral terms are preferable to those with negative connotations (e.g. victim, The ic alflicted, crippled, suffering: Maki & Riggar, 1997b). | own Saying that someone “uses” a wheelchair or other assistive device avoids the assump- | their tions embedded in “confined to” or “wheelchair bound,” which imply that the person and | claim chair are inseparable. The terms visually impaired and hearing impaired (or hard of hearing) | bird are more accurate then blind or deaf because the latter do not recognize the range of impait- 1 When us ‘ments that people may hold. In addition, people who identify with Deaf culture do not | become a consider themselves to have a disability; rather, its the hearing world’s ignorance of theit to use the language that creates the disability (Olkin, 1999). (Note that not all people who are hearing Wher impaired identify with Deaf culture.) Also, using the term blind as a synonym for ignorant, point at unaware, or unknowing is offensive (e.., “He was blind to the impact that his actions had | “Honestly on others” or “They robbed him blind”). at least. r the mem | learning: Caveats and Reassurances | lem | changing | With rege ‘As the preceding discussion indicates, therapists of dominant cultural backgrounds will involving need to be extra careful not to assume that commonly used terms (ie. terms commonly | terms; se used in the therapists milieu) are acceptable, because they may not be for everyone, In | terms ea: general, the more specific term is usually preferable because it shows a greater level of | awareness of the uniqueness of groups, although this is not always the case, For example, | the term Alaska Native is commonly used and accepted among the Indigenous peoples of | Conclusic Alaska and includes three broad cultural groups: Indians, Aleuts, and “Eskimos” (Morgan, | _ 1979). More specifically, Alaska Natives belong to 20 language and cultural groups: 11 | ‘Athabaskan language groups plus Aleut, alutig, Yupik Siberian Yupik, Inupiat, Eyal, ! ‘the rang Tlingit, Tsimshian, and Haida (Rennick, 1996). believe t Although the Yupik. Siberian Yupik, and Inupiat are commonly referred to as concept “Eskimo,” itis preferable to use the specific cultural names. The term Eskimo literally influence ‘means “raw flesh eater” and may be perceived as pejorative by some people (Herring, asingula 1999). The Inuit of Canada belong to the same cultural group—the terms Inupiat and Inuit deeper uPosh BDUBDEE 734 Poe Sep iu Us ii: Seeing the Forest and the Tees | 15 1, old maid” both mean “the people” (Adams, 1995; Maracle, 1994). Its important to note that calling tuite similar, someone by the wrong specific group may be quite offensive (e-g., calling someone ‘ful. “Eskimo” who is Alutiig, for example; Pullar, 1996). On the other hand, some Inupiat € because it : people refer to themselves as Eskimo (Swan Reimer, 1999). Thus, as a general rule, even "The term ‘ when Iknow the specific term, Lusually wait and listen for how clients describe themselves ness; more before using it. 2). Also off However, even when clients use a term to describe themselves, its not always OK for al and other the therapist to use it, Toward the goal of asserting the right to name themselves, some sts generally minority groups have reclaimed terms that were once used in a derogatory way by members of the dominant culture (e.g., “queer” for gay and lesbian people, “crip” for © those that people who have disabilities). This decision to take back the dominant culture's labels and. person with define them for oneself is a powerful act (Watt, 1999), as Williams (1999a) explained in In addition, relation to her biracial identity: (eg victim, The idea that individuals have a right to define their own experience, to create their ‘own personal meanings, to frame their own identity, to claim an “I” that is uniquely the assump- their own, shakes up many people's most dearly held beliefs about race, Courage to person and claim one’s own experience despite resistance and judgment from others allows dofhearng biracial people like me to begin to forge an authentic self. (p. 34) eof impair- When used by members of a particular group in reference to themselves, these terms ture do not become a form of “in-language.” On rare occasions it may be acceptable for nonmembers ince of their to use these terms; however, as a general rule itis not are hearing When I do workshops incorporating the preceding information, this is usually dhe or ignorant, point at which someone in the audience says, in a tone of controlled exasperation, actions had “Honestly, Pam, how do you expect us to remember all of this?” My answer is, I don’t. Or at least, not right away. What I do hope is that rather dan becoming overwhelmed with the memorization of terms and names, therapists will commit to the ongoing process of learning about cultures of which they are not a member. T emphasize the process aspect of this learning because cultures and languages are changing all the time; as a consequence, what one needs to learn is continually changing ‘With regard to language in particular, it may be helpful to think of this learning process as sounds will involving a willingness to seek out information about the broader cultural meanings of + commonly terms; seek out information about the group—specitic meanings of terms; listen for the veryone. In terms each client uses: and, when appropriate, simply ask. ter level of or example, s peoples of Conclusion s* (Morgan, —— — groups: 11 apiat, Eyak, ‘The range of influences and groups included in this book may seem overwhelming, but I believe that a broader focus is necessary if psychology is to move beyond unidimensional erred to as conceptualizations of culture and people. At frst, recognition of the complexity of cultural ‘mo literally Influences is more difficult than either ignoring these influences or simplifying them into le (Herring 2 singular dimension. But in the long run, recognizing this complexity can lead to a much fat and Inuit deeper understanding of our clients and ourselves. Cultural diversity i less a problem thanSDUYDEE 134 16 | ADDRESSING CULTURAL COMPLEXITIES IN PRACTICE a challenge—a challenge that offers the potential for personal growth, creativity, and deeper human connections. The next chapter explores the practical aspects of this challenge in therapists’ daily lives and work. ‘Summary of Cultural influences and Related Minority Groups Within ‘the ADDRESSING Framework Cultural Influences Minority Groups ‘Age and generational influences Children, adolescents, elders Developmental and acquired People with developmental or acquired Disabilities disabilities Religion and spiritual orientation Religious minority cultures, Ethnicity Ethnic minority cuftures Socioeconomic status People of lower status by class, education, ‘occupation, income, rural or urban habitat, | family name ‘Sexual orientation Gay, lesbian, bisexual people Indigenous heritage Indigenous people National origin Refugees, immigrants, international students Gender ‘Women, transgender people ‘Note: Adapted from Hays, FA. (1986). Addressing the complexes of culture and gender in coursing. Journal of Counseling and Development, 74 MarchiAgnl 1996, pp. 332-338, copyright American Counseling Assocation Reprinted with permision. No further reoroductionauthorzed without writen permission of the American Counsetng Assocation,