As our country is becoming increasingly diverse, it is more important than ever for clinicians to be ready to meet the needs of clients from varied ethnic, racial, and cultural backgrounds. Currently, in the United States, 39 percent of our population are people of color, including those of Black, Hispanic, Asian, Native/Indigenous heritage, and multiracial individuals. Half of children and new births are people of color, and according to the US Census, White people will be a minority by 2045. Because of our changing demographics, therapists today need to be skilled in working with clients from many different ethnic groups, cultures, and communities.
When I graduated with my doctorate in clinical psychology in 2007, there were no courses in multicultural counseling skills required or even offered in my graduate program. Although most new therapists are emerging from training programs with at least some basic multicultural education, there is a whole generation of practitioners who were never exposed to any such training at all. Thus, it would be a mistake to assume that any given therapist knows how to work effectively with people from different ethnic and racial backgrounds. Because of gaps in training, older, more experienced therapists may be even less skilled than newly-minted clinicians. When clinicians lack needed skills and knowledge to effectively interact with those who are ethnoracially different, clients of color may be left feeling misunderstood, invalidated, or sometimes even traumatized. As a result, people of color may fail to return for treatment after just a single session.If you are a person of color, how can you know if your therapist is equipped to work with people like you? Here is a list of 10 questions that every therapist should answer before working with people across racial and ethnic differences. 1. Have you had at least a one-semester graduate course focused on multicultural counseling skills? How have you applied it in your professional work? It seems that social workers and counselors usually have some formal training in culturally-informed care, but for clinical psychologists, training is spotty, and for psychiatrists, it tends to be exceptionally thin. Ideally, clinicians should have had two semesters of diversity training that include an experiential component emphasizing self-reflection. For those who haven’t had coursework, it would be important to know what (if any) training they sought out on their own. It is possible to get continuing education credits for diversity-focused training, and some states require it. 2. Have you had useful clinical supervision focused on issues surrounding race, ethnicity, and culture? If so, how did it aid your professional work? Classroom learning is important, but it is no substitute for supervised hands-on work with diverse clients. Therapists should have experience working under a supervisor who can skillfully help navigate issues surrounding culture, race, and stigma with their clients. 3. Have you prepared a written cultural conceptualization about a client that was subsequently evaluated by a knowledgeable supervisor? Therapists should be able to devise a case formulation with culturally-specific understandings of the social, emotional, and psychological factors that impact the health and well-being of their clients. They should understand the client’s explanatory models for the causes of their symptoms, and be able to anticipate when culturally-specific adaptations may be needed to established protocols. 4. Are you willing to address racial differences with clients early in therapy? Give an example of how you approach this and how it has worked. If therapists are unable or unwilling to discuss racial or ethnic identity with clients of color, it can appear that the therapist is uncomfortable with these kinds of differences. Clients should feel that therapists are able to easily talk about any issues that could be important for the development of the therapeutic relationship. Author from Psychology Today
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