Case Studies in Multicultural Counseling and Therapy E-Book

Derald Wing Sue

• Herausgeber: John Wiley & Sons
• Kategorie: Geisteswissenschaft
• Sprache: Englisch
• Veröffentlichungsjahr: 2013

Seitenzahl: 526

Beschreibung

An indispensable collection of real-life clinical cases from practicing experts in the field of multicultural counseling and psychotherapy Case Studies in Multicultural Counseling and Therapy is a one-of-a-kind resource presenting actual cases illustrating assessment, diagnostic, and treatment concerns associated with specific populations. The contributors--well-known mental health professionals who specialize in multicultural counseling and psychotherapy--draw on their personal experiences to empower therapists in developing an individually tailored treatment plan that effectively addresses presenting problems in a culturally responsive manner. Providing readers with the opportunity to think critically about multicultural factors and how they impact assessment, diagnosis, and treatment, this unique book: * Covers ethical issues and evidence-based practice * Integrates therapists' reflections on their own social identity and how this may have influenced their work with their clients * Considers the intersectionality of racial/ethnic, class, religious, gender, and sexual identities * Contains reflection and discussion questions, an analysis of each case by the author, and recommended resources * Includes cases on racial/ethnic minority populations, gender, sexuality, poverty, older adults, immigrants, refugees, and white therapists working with people of color * Aligns with the ACA's CACREP accreditation standards, tha APA guidelines for multicultural competence, and the AMCD Multicultural Counseling Competencies

Leseprobe

Contents

Cover

Praise for Case Studies in Multicultural Counseling and Therapy

Title Page

Copyright

Foreword

Introduction: Moving From Theory to Practice in Multicultural Counseling

DEVELOPING REAL-LIFE DIVERSE CASES

EDUCATIONAL OBJECTIVES

CHAPTER OUTLINE

INTEGRATING CULTURAL FORMULATION INTO ASSESSMENT AND TREATMENT PLANS

REFERENCES

About the Editors

About the Contributors

Part I: Case Studies With U.S. Racial/Ethnic Minority Populations

Chapter 1: Clinical Applications With African Americans

AND STILL I RISE: THE STORY OF NIA

REFERENCES

REDEFINED: THE STORY OF ANDRE

REFERENCES

Chapter 2: Clinical Applications With American Indians and Alaska Natives

TREATING “DEPRESSION” IN A DYING NATIVE RELATIVE: THE STORY OF WILL

TREATING “DEPRESSION” IN A DEEPLY BEREAVED AND TRAUMATIZED CLIENT: THE STORY OF MARY

REFERENCE

Chapter 3: Clinical Applications With Asian Americans

FIGHTING CHANCE: THE STORY OF DONNA

INTERGENERATIONAL EFFECTS OF WAR: THE STORY OF WADE

Chapter 4: Clinical Applications With Latina/o Americans

MARGARET CAN'T DO IT ALL (BY HERSELF) ANYMORE

MULTIPLE ROLES, MULTIPLE IDENTITIES: THE STORY OF ELISANDRO

Chapter 5: Clinical Applications With Individuals of Middle Eastern and Northern African Descent

HARNESSING FEARS DURING A MEDICAL EMERGENCY: THE STORY OF JACOB M.

SILENCED: THE STORIES OF DALIA AND NABILA

Chapter 6: Clinical Applications With Individuals of Multiracial Descent

“YOU JUST DON'T GET ME!”: THE STORY OF ANITA

“I CAN MAKE IT ON MY OWN”: THE STORY OF DAVID J.

Chapter 7: Clinical Applications of a White Therapist Working With People of Color

TWO WORLDS: THE STORY OF MARCOS

MY WAR PARENTS FOUND MY GAY BOX: THE STORY OF BENJAMIN

REFERENCES

Part II: Case Studies Involving Special Circumstances With Ethnic Populations

Chapter 8: Clinical Applications With American Jews

L'DOR V'DOR, OR FROM GENERATION TO GENERATION: THE STORY OF SCOTT

THE “OTHER” IN US: THE STORY OF GABRIELLA

Chapter 9: Clinical Applications With Immigrants

NEGOTIATING CULTURAL CHANGE AND IDENTITY: THE STORY OF NADIA

LOSS AND POLITICAL EXILE: THE STORY OF PAUL

REFERENCES

Chapter 10: Clinical Applications With Refugees

FLEEING RELIGIOUS PERSECUTION: THE STORY OF LARISSA

AFTERMATH OF TRAFFICKING: THE STORY OF KAMALA

Part III: Case Studies With Other Multicultural Populations

Chapter 11: Clinical Applications With Women

LIVING IN THE SHADOWS: THE STORY OF MONIQUE

I'M A MOTHER FIRST! THE STORY OF SIMONE

Chapter 12: Clinical Applications With Men

MULTIPLE STORIES OF HENRY

REFERENCE

WHY AM I HERE? THE STORY OF MARTIN

Chapter 13: Clinical Applications With Transgender Individuals

JUST A “PHASE”? THE STORY OF LESLIE

AN INCOMPLETE EXPERIENCE: THE STORY OF ALICE

REFERENCE

Chapter 14: Clinical Applications in Sexual Orientation

NO HOME IN THE WORLD: THE STORY OF TONY

MISSION IMPOSSIBLE: THE STORY OF BETH

Chapter 15: Clinical Applications With People in Poverty

THE WHITE PICKET FENCE LIFE: THE STORY OF MARISOL

REFERENCES

DO YOU HAVE EYES TO SEE ME? THE STORY OF MICHELLE

Chapter 16: Clinical Applications With Persons With Disabilities

WHY DIDN'T YOU TELL ME YOU WERE IN A WHEELCHAIR? THE STORY OF JOLEEN

THERE IS NOTHING WRONG WITH YOU A JOB CANNOT FIX: THE STORY OF GEORGE

Chapter 17: Clinical Applications With Older Adults

THE CHALLENGES OF CAREGIVING: THE STORY OF SARAH

I'M NOT CRAZY: THE STORY OF MR. CHANG

Author Index

Subject Index

Praise for Case Studies in Multicultural Counseling and Therapy

Translating theory into practice is a challenge for every school of clinical orientation. This casebook has succeeded by focusing upon elements of process in multicultural counseling and therapy to give us a rich resource of conceptual and practical aids to assist the teacher, trainee, and practitioner in making a stepwise transition from cultural knowledge to practice competencies.

Anderson J. Franklin, Ph.D., Honorable David S. Nelson Professor of Psychology and Education, Boston College Lynch School of Education

Anchored in our latest knowledge and research regarding cross-cultural counseling and spanning the whole spectrum of diversity, this collection of multicultural case studies serves as a wonderful companion to Sue and Sue's Counseling the Culturally Diverse and fills a gap for rich and contextualized cases illustrating the complex tapestry of our clients' lives.

Frederick T.L. Leong, Ph.D., Professor of Psychology and Psychiatry; Director of the Consortium for Multicultural Psychology Research

Case Studies in Multicultural Counseling and Therapy offers a rich narrative of therapeutic engagement with diverse clients highlighting the complexities of intersecting dimensions of culture. Such emotionally-gripping cases facilitate a soul penetrating capacity for expanding cultural schema and increasing cultural empathy among mental health professionals and trainees.

Michael Mobley, Ph.D., Associate Professor, Salem State University

Having taught Multicultural Counseling for more than 10 years, Derald Wing Sue, Miguel Gallardo, and Helen Neville have finally answered students' most oft-repeated question, “How do I apply this knowledge to my clinical practice?” Based on real life cases, contributors offer a practical guide for students and instructors alike who are committed to enhancing multicultural competence. This is a must-have resource for every current and future mental health professional!

Lisa B. Spanierman, Ph.D., Associate Professor, McGill University

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Library of Congress Cataloging-in-Publication Data

Case studies in multicultural counseling and therapy / edited by Derald Wing Sue, Miguel E. Gallardo, Helen A. Neville.

   pages cm  Includes bibliographical references and index.  ISBN 978-1-118-48755-6 (pbk.)  ISBN 978-1-118-71583-3 (ebk.)  ISBN 978-1-118-52852-5 (ebk.)

 1. Cultural psychiatry–Case studies. 2. Cross-cultural counseling—Case studies. 3. Ethnopsychology—Case studies. 4. Clinical competence—Case studies. I. Sue, Derald Wing, editor of compilation. II. Gallardo, Miguel E., editor of compilation. III. Neville, Helen A., editor of compilation.

  RC455.4.E8C378 2013   616.89—dc23

2013011558

Foreword

The challenge of achieving congruence between the conceptual templates theorists develop and the practical strategies that result from the application of those constructs and principles to counseling and therapy, is a difficult one indeed. Yet, it is precisely this challenge that must be mastered if clinicians hope to find a broader utility for the ideas they develop that extend beyond the traditional or virtual library bookshelves. Derald Wing Sue, Miguel Gallardo and Helen Neville have mastered this challenging task, and their latest contribution, as a free standing text or an accompaniment to the hugely successful Counseling The Culturally Diverse: Theory and Practice (Sue & Sue, 2013), is a magnificent resource that will help create a greater bridge of understanding between the academic, research, and applied domains of the mental health professions.

What this text does so beautifully is bridge the gap between aspiration and actualization; between what a clinician strives to do and what he or she is able to deliver within the midst of a therapeutic encounter. And, it does so with a cultural flavor that is easy to follow, interpret, and understand, taking into account the complexities that reside where various elements of culture (race, ethnicity, age, gender, physical ability, sexual orientation, and religion) intersect and sometimes collide. For in my mind, that is the essence of congruence and that is what this text at its core represents.

These case studies provide a window into the heart of a challenging circumstance. Unlike raw theory, case studies provide a context for situations clinicians confront. Using elements like history, personal background, elements of culture that must be attended to, and an outline of other strategies that might have been employed prior to the pending intervention, they help to inform and shape the narratives of theoretical relevance. That is the space that is so critical, where clinicians decide what measure of convergence and divergence to employ when anchoring their intervention in the core principles of a theory and/or research.

Upon first glance, creating bridges of understanding between theory and practice seems like a simple enough task, and yet, if it were that routine, I suspect that the profession would be ripe with clinicians who were all masters at their craft. We would have no concern about misdiagnosis or mistreatment. There would be less talk about cultural competence and incompetence. And more importantly, the broader public who rely on professional counselors, psychologists, psychiatrists, clinical social workers, and therapists would be better served by those who desire to render quality care, but for whatever reason, fall short of their own as well as client expectations.

Decades ago, as a young graduate student, I recall studying the works and theories of those who were considered the “giants” in the field, including Freud, Jung, Adler, Skinner, Horney, Perls, Ellis, and Rogers. As each theorist outlined their set of constructs and principles, they helped to create a conceptual template that informed each of our practice with an intellectual roadmap that detailed elements of counseling and therapy, like the nature of humanity, the etiology of client distress, how and why people changed as a function of interventions from that theory's perspective, and in most cases, the role of the clinician/therapist in addressing whatever debilitation a client was struggling with. For many clinicians, however, the intellectual understanding of the theory was less of a challenge than the ability to operationalize that set of constructs into therapeutic practice. This was analogous to what Carl Rogers described as the difference between the “real” self and the “ideal” self, and it was that gap that created the most profound sense of incongruence clinicians and lay public alike struggled with.

Compounding the dilemma of achieving maximum congruence was the fact that so many of the theories were anchored in assumptions that were conspicuous by their degree of cultural sterility, particularly when it came to people of color, women, and others whose uniqueness was rarely, if ever, accounted for within the confines of a particular theory or orientation. As a consequence, there was an intellectual explosion of sorts where psychologists and counselors of African, Asian, Native American/Indian, Latina/o, and other descents contributed scholarship that both critiqued traditional mainstream approaches, and also outlined their own cultural variations of how a particular theory should be manifest within the context of work with a particular demographic group. Additionally, and quite possibly more relevant to many communities of color, are the contributions of scholars who advocate for moving beyond simply modifying existing mainstream theories, but also creating new paradigms that draw upon indigenous healing practices. And yet, even with that progress and some very profound and meaningful contributions to theory, there was still a gap between those constructs and how a professional helper could apply those ideas in work with particular populations.

In celebrating this welcome addition to the profession, and inviting all of you to take a serious look at the content within, we also owe a special thanks to the editors and their team of collaborators. This volume of multi-perspective case studies invites the reader to be a consummate risk taker. In this regard, these chapters invite you to be a mental risk taker, daring to stretch your thinking in ways that expose greater possibilities. The chapters invite verbal risks, where each of you will be challenged to break the silence of your own personal silos and discuss these case studies with colleagues and co-workers. These narratives invite you to take behavioral risks, if you dare to step outside of your personal comfort zones to try a different intervention you learned about through reading this volume.

We as professionals are committed to serving the students we teach, the clients we treat, and researching the questions that provide meaningful answers that inform our work. However, we also need the best tools and strategies that assist us in becoming more competent and proficient in our approaches. This volume on Case Studies in Multicultural Counseling and Therapy is a tremendous asset to your repertoire, and I for one would strongly encourage you take full advantage of all of this rich content and information.

Thomas A. Parham, Ph.D

University of California Irvine

Distinguished Psychologist

Association of Black Psychologists.

* NOTE: Scenarios help frame issues and provide context that allow for the application of theory in addressing a particular situation and circumstance.

Introduction: Moving From Theory to Practice in Multicultural Counseling

Case Studies in Multicultural Counseling and Therapy presents descriptions of real-life clinical cases encountered by practicing experts in the field of multicultural psychology. The casebook illustrates general principles, practices, and issues related to multicultural counseling and therapy by providing numerous cases illustrating specific assessment, diagnostic, and treatment concerns associated with specific populations (e.g., women, specific ethnic or religious groups, etc.). In the work, we acknowledge the rich diversity within each population. The chapters in the collection explore the ways in which social identities intersect with one another to influence presenting concerns and the therapy process; for example, how race, gender, sexual identity, class, and immigration status may influence one's work within a specific ethnic group and social context. The casebook is written to specifically accompany the best-selling sixth edition of Counseling the Culturally Diverse: Theory and Practice (CCD; Sue & Sue, 2013), but it also may be used as a free-standing accompaniment to any course or workshop related to multicultural mental health practice. The impetus for the development of a multicultural clinical casebook came from two primary quarters.

First, the mental health professions have recognized the central importance of training clinicians to work with an increasingly diverse population. Nearly all of the helping professions representing psychologists, counselors, social workers, and psychiatric nurses have proposed standards of practice and codes of ethics to ensure culturally competent services to different sociodemographic groups. The importance and central role of culturally responsive care are reflected in the guidelines and practices produced by various professional organizations and accrediting bodies.

In 2002, the American Psychological Association (APA) produced Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists (American Psychological Association, 2003).In 2003, the Association for Multicultural Counseling and Development published a stronger and updated version of its Multicultural Counseling Competencies (Roysircar, Arredondo, Fuertes, Ponterotto, Toporek, & Parham, 2003).In 2008, the Council on Social Work Education's Educational Policy Accreditation Standards (updated in 2012) fully endorsed the importance of cultural competency.In 2009, the Council for Accreditation of Counseling and Related Educational Programs (CACREP; being revised for 2016) included the centrality of “Social and Cultural Diversity” in curriculum standards for counseling specialties.

All these organizations share four common themes or goals in education, training and practice:

1. Clinicians need to develop cultural awareness, knowledge, and skills to work effectively with different groups.

2. Social justice and advocacy are central features of clinical practice.

3. Developing cultural competencies in the assessment, diagnosis, and treatment of disorders must be a top priority.

4. Ethical and legal decisions must be primary considerations when working with diverse populations.

In essence, a casebook approach bridges the gap between theory and practice.

A second impetus for the casebook came from numerous requests by faculty to supplement multicultural textbooks with practical clinical examples by which they could teach students to apply the theory, concepts, and research associated with culturally responsive care. Such requests came not only from teachers but from students and trainees desiring to advance their clinical skills in working with diverse populations in such fields as psychology, psychiatry, social work, and nursing. The use of these cases, however, assumes that trainees have been exposed to information related to the special populations covered in the text. Cases dealing with African Americans, people living in poverty, or immigrant populations, for example, are helpful only when trainees have been exposed to information about the specific client group under study. Thus, although each case comes with expert commentaries, none is sufficient for trainees to thoroughly master the concepts without additional resources provided through readings or by the expertise and guidance of faculty or other mental health professionals. The 17 core chapters in this book are organized around three categories; each chapter is focused on a specific population and provides background information about each case, a critical analysis of two case vignettes, reflections questions, and recommended resources. Thus, 34 real-life clinical case vignettes are presented.

Category I: Case Studies With U.S. Racial/Ethnic Minority Populations

African AmericansAmerican Indians and Alaskan NativesAsian AmericansHispanic/Latino/a AmericansMiddle Eastern/North African and Arab Americans (MENA)Biracial and multiracial personsWhite therapists working with people of color

Category II: Case Studies Involving Special Circumstances With Ethnic Populations

American JewsImmigrantsRefugees

Category III: Case Studies With Other Multicultural Populations

WomenMenTransgenderLesbian, gay, and bisexualPeople in povertyPersons with disabilitiesOlder adults

DEVELOPING REAL-LIFE DIVERSE CASES

We invited well-known mental health professionals who specialize in working with specific populations and who possess expertise in clinical practice to write chapters for each of the 17 diverse social identity groups. We asked contributors to produce two case studies to be used by trainees and mental health professionals in learning how to work with diverse populations. The cases they submitted are based on actual clients from current work or in the past, composites of clients from their caseload, and/or hypothetical creations based on their own experiences. In each case vignette, the authors and editors took care to remove identifying information and/or to change enough of the clinical information to ensure confidentiality and anonymity.

These 17 pairs of cases correspond to specific chapters of the newest edition of CCD; they highlight multicultural foundational clinical/counseling practices that provide readers with an overview of therapeutic/counseling considerations that address a range of diverse populations. Each contributor read the specific-population chapter from CCD carefully and was asked to consider the areas covered in the chapter when providing case vignettes for the casebook. This volume also includes chapters on working with men and transgendered populations and White therapists working with people of color. As we examined the comprehensiveness of the content of the casebook, we believed that the addition of these three chapters would enhance its overall utility, include critical areas of relevance, and advocate for the continued expansion of the intersection of social identity issues. We provided chapters from the CCD as a template for contributing authors to utilize, but the authors were authorized develop clinical vignettes they believed best represented the communities they were discussing. The contributors were encouraged to expand on the foundational considerations and provide an overview of specific cases reflecting these areas, but with a more detailed description of what real-world therapeutic encounters look like when working with culturally diverse individuals/families/communities.

EDUCATIONAL OBJECTIVES

The goals we hope to achieve in the casebook are to present therapeutic case vignettes as an educational tool to generate discussion among trainees and mental health professionals and to illustrate important principles of culturally responsive therapeutic practices. These cases can be used to help trainees and mental health professionals identify diversity issues in working clinically with a broad range of clients in terms of race, culture, ethnicity, nationality, gender, sexual orientation, ability/disability, class, and other important social identities. We fully understand that our lives are influenced by the intersection of multiple social identities. A Latino male client who is religious and in the process of coming out is an example of where ethnicity, religion/spirituality, gender, and sexual identity intersect. Intersectionality, as proposed by feminist and critical race theorists, was designed to encourage researchers and clinicians to consider the meanings and consequences of multiple social identities (Cole, 2009). Ultimately, when working within a therapeutic encounter, intersectionality situates the mental health professional to attend to the cultural and political histories of communities as well as how these social identities derive meaning from one another. Thus, we asked contributors to consider the ways in which social identities intersect to influence the presenting concerns, treatment plan, and, ultimately, therapeutic outcomes.

Additionally, we also wanted to help trainees and mental health professionals reflect on thematic issues that arise when working therapeutically with diverse clients. To this end, we asked contributors to reflect on the process of conducting culturally responsive therapy as they wrote the case vignettes. We encouraged them to think about questions such as: How do they address, therapeutically, the multiple ways in which people identify? Moreover, we encouraged them to reflect on their own social identities and how this may influence their work with clients. One of our educational goals in developing this casebook was to encourage trainees and mental health professionals to develop an enhanced awareness of who they are as cultural beings within the context of working therapeutically. While having behavioral skills certainly lessen the anxiety clinicians/counselors may experience when working with diverse communities they are not familiar with, behavioral skills may also provide a false sense of cultural responsiveness, without the necessary cultural mind-set and awareness needed as the precursor to successful therapeutic work with diverse communities. Therefore, we urge faculty and workshop facilitators to encourage students and attendees to reflect on who they are in the context of providing services to diverse communities and how this meta-awareness (taking self-awareness itself as an object of attention) either enhances or potentially disrupts therapeutic work.

We are hopeful that the case vignettes capture and expand readers' understanding of significant sociocultural and political issues when they arise in counseling/therapy and the influence of these factors on clients' presenting concerns and in the development of treatment planning. Although the presenting problem of the client is important, we are interested in helping trainees and mental health professionals understand how ignoring or being unaware of the intersection of presenting problems with various social, cultural, and political issues could result in therapeutic impasses.

The contributors provide a critical assessment of each case by identifying and presenting a discussion of the therapeutic issues. In many respects, the points raised by the expert contributors provide tips, clues, or hints for trainees and mental health professionals to consider in their assessment and treatment plans. One of the main goals of the casebook is to have readers reflect on issues of relevance when attempting to situate problems within the therapeutic context. Our aim is to help trainees and mental health professionals better understand what clients bring to the therapeutic encounter and, most important, learn how to think critically about these issues as precursors to actual therapeutic encounters.

CHAPTER OUTLINE

To aid trainees and mental health professionals in learning about each specific population, we asked contributors not only to provide brief case descriptions but to supply focus questions, brief topical analyses of the case vignettes, and additional recommended resources. For the most part, each case vignette within each chapter is divided into four parts.

Part I: Case Description

Each case description has been purposely kept brief and succinct, but with enough descriptive information to capture the details of the client's presenting issues within sociocultural and sociopolitical frameworks. This was done for two primary reasons: First, we have found that the law of diminishing returns applies to longer cases and that too much information may confuse and/or restrict the ability of trainees and mental health professionals to freely speculate and consider alternative explanations. Thus, we specifically asked contributors to briefly identify several primary multicultural themes in the therapeutic encounter and to weave them throughout the case description. Although some authors did offer specific treatments and interventions for clients, we encouraged them to concentrate on providing clues by which trainees might incorporate the themes into their own treatment plans.

Second, the cases are meant to be interactive in classroom or workshop training in that they allow trainees and mental health professionals to freely discuss their analyses; to provide rationales for their assessment, diagnosis, and treatment of clients, families, and client systems; and to compare and contrast their approaches with each other. We are hopeful that such an approach enables trainees and mental health professionals to:

1. Become aware of their own biases and assumptions about human behavior.

2. Understand the cultural worldview of the client being discussed.

3. Develop culturally responsive intervention strategies.

4. Broaden their awareness of how systemic and contextual forces affect not only culturally diverse clients but the helping relationship as well.

Part II: Reflection and Discussion Questions

Besides the case vignettes, contributors provide a series of reflection and discussion questions for readers to contemplate and discuss. Focus questions for trainees and mental health professionals illustrate cultural, clinical, sociopolitical, ethical, or legal issues related to the cases. These questions have been found to be very educational in stimulating classroom or workshop discussions. They identify culture-bound, class-bound, and linguistic factors that may bias the assessment, diagnosis, and treatment of culturally diverse clients and highlight multicultural issues that must be considered in culturally responsive treatment. Instructors and trainees may desire to use these discussions in any number of ways: as free-standing questions to generate discussions, as guideposts that help in case analysis, or as essay exam questions to test how well trainees understand and have integrated the material.

Part III: Brief Analysis of the Case

All contributors have supplied a brief analysis of each case from a culturally responsive perspective. This brief analysis provides readers with clues regarding multicultural issues that may arise for that particular population. While some of the analyses reveal more detailed information, the challenge to trainees and mental health professionals is using this knowledge or insight and incorporating it into actual practice with clients. Many chapters provide tips and hints as to how a counselor/therapist would approach the therapeutic work with a client but leave the majority of the work for trainees and mental health professionals to integrate into a treatment plan.

The therapeutic questions and potential answers posed in each chapter are extremely enlightening and helpful in developing a treatment plan. Some additional key questions for trainees and mental health professionals to consider when conceptualizing culturally responsive care for diverse clients in the assessment, diagnosis, and formulation of treatment plans are given below:

What does research tell us about working with diverse clients?Similarly, what if no or very little research exists regarding a particular community?Traditional research is often culture-bound and may prove culturally inappropriate in work with a different racial/ethnic minority and other special populations. How should clinicians use research or evidence-based practice in formulating treatment plans? (In this respect, it may be helpful to review Chapter 9, “Multicultural Evidence-Based Practice,” from CCD.

The APA Presidential Task Force on Evidence-Based Practice in Psychology (2006) defined evidence-based practice in psychology (EBPP) as “the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences” (p. 1). Ultimately, the contributors to this casebook provide a solid foundation by which readers can begin to conceptualize cases within a culturally responsive framework while utilizing research evidence, culture and context, and personal experiences in developing good evidence-based treatments. We hope that readers expand their perspectives of what accounts for legitimate “evidence” when responding to the needs of diverse communities. We advocate that readers consider EBPP from the perspective of not always privileging one component over another but implementing what is culturally congruent with the client/family while considering the historical context and political realities. In this regard, we also strongly urge readers to understand and implement culturally grounded and culture-specific approaches that are developed from a ground-up perspective and derived directly from the community as legitimate sources of evidence for use therapeutically.

In what ways can your theoretical orientation facilitate or hinder culturally responsive care with your client? Almost all theories of counseling and therapy have something to offer in work with clients. However, it is important to remember that nearly all the traditional forms of counseling/therapy originated from Western/European civilizations and may prove culture-bound and culturally inappropriate in application to racial/ethnic minorities, for example. Culturally responsive approaches have long emphasized that attempting to fit clients into a rigid mold or framework may constitute cultural oppression rather than healing. Thus, techniques and strategies must be flexible and adapted to the life experiences and cultural values of clients. How might this latter point impact your work as a therapist?Where do the sociocultural and/or sociopolitical experiences of the client fit into your approach? For example, most people of color value a collectivistic identity rather than an individualistic one. Likewise, experiences of discrimination, prejudice, and stereotyping may affect both the identity and worldviews of culturally diverse clients. How do cultural values and experiences of oppression affect the therapeutic relationship between you and your client? We know, for example, that culture may influence the manifestation of symptom formation, how disorders are perceived, and what is considered appropriate treatment. Furthermore, experiences of oppression may result in cultural mistrust of the therapist and the therapeutic relationship and process. In light of these factors, how would you establish a respectful working relationship with clients who have been marginalized in society? What specifically would you do?Related to these questions, we can also ask more specifically in what ways should you take into consideration client systems (family, friends, religious institutions, schools, and other systemic entities) in your treatment of clients? Traditional clinical approaches often emphasized intrapsychic or person-centered change as most appropriate because the assumption is that problems reside within the person. Yet if we acknowledge that most socially devalued groups in our society have been victims of stereotyping, prejudice, discrimination, and oppression, is it possible that many of their concerns, or “problems,” arise from the social system rather than within the client? If that is the case, where should therapeutic change be directed: at the individual level? At the systemic level? If the latter, what roles other than the therapist treating the client would you have to play? Would you feel comfortable or capable of playing such a role? How would you apply this approach to your culturally diverse clients? Is client self-disclosure always a precursor to therapeutic change?In culturally responsive therapy, the old adage “counselor know thyself” seems especially important in working with diverse clients who might not necessarily share the therapist's worldview, cultural assumptions, or values. How aware are you of your worldview, assumptions of human behavior, biases, values, and stereotypes? Worldviews determine how we perceive the world, our definitions of normality and abnormality, and how we define problems and solve them. Without this awareness, we may be guilty of cultural oppression or imposing our standards on culturally diverse clients who do not share our worldview. Rather than free or liberate, we may constrict, diminish, pathologize, or even harm clients. What personal challenges are likely to arise when therapists work with clients who differ from you in race, culture, gender, age, or sexual orientation, to name a few? If you believe, for example, that sexual orientation is a “choice” or that being gay is “immoral” or a “sin,” how will these perspectives impact the therapist's work with lesbian, gay, bisexual, and transgendered (LGBT) populations? How aware are mental health professionals of hot-button issues that may impede their work with culturally different clients? Additionally, are clinicians aware of how they might be perceived by others with regard to their race, ethnicity, gender, class, and so on? How might this perception impact what happens therapeutically? For example, if practitioners are working with clients from working class backgrounds, how might the practitioners' privileged status impact what their clients choose to disclose or withhold in therapy? We encourage readers to critically self-evaluate how they come across to others and how this potentially impacts relationships with them, in particular with clients.What are the potential ethical issues that may arise in working with diverse clients? Are there potential conflicts in the ethical guidelines and standards of practice advocated by the American Counseling Association, APA, National Association of Social Workers, and other professional associations that may hinder culturally responsive treatment with diverse clients? Remember that ethical guidelines and practices of professional associations have been developed within a Western/European framework and often reflect the values and assumptions of that culture. For example, in CCD, we identified five therapeutic taboos that may be derived from these guidelines:

1. A therapist does not give advice and suggestions.

2. A therapist does not engage in dual role relationships.

3. A therapist does not barter services.

4. A therapist does not accept gifts from clients.

5. A therapist does not self-disclose.

Although professional organizations have begun to acknowledge the culture-bound nature of these standards, they have still not adequately addressed how they may be adapted. Thus, we can ask these questions:

• How might these therapeutic taboos and others affect therapist ability to provide culturally relevant services?

• How would they overcome them?

• What would practitioners do when culturally responsive care clashes with “ethical” dictates?

• How therapists answer these questions may determine the degree to which they are able to provide culturally responsive care for clients. Developing multicultural counseling competencies and providing culturally responsive care is a process in which trainees and mental health professionals critically examine their values and assumptions, the theoretical and empirical literature on specific populations, and the intersection of the two on their clinical work with clients.

Part IV: Recommended Resources

To provide trainees with additional information on the specific topic associated with a particular case, our contributors have created a list of recommended resources. These resources generally fall into four main categories, although some authors have chosen to adapt them when the classification seemed too limiting:

1. Books and/or articles

2. Films and DVDs

3. Fiction/nonfiction readings

4. Inventories/Assessments

These resources provide a range of valuable information about each diverse population through academic channels, media productions, activities that allow for self-exploration, and the experiential realities of the group. They can provide trainees and mental health professionals with cognitive and emotive understanding of the groups they hope to serve. We have found these resources to be valuable tools in helping trainees and mental health professionals to understand the worldviews of their diverse clients and for stimulating excellent classroom or workshop discussions.

INTEGRATING CULTURAL FORMULATION INTO ASSESSMENT AND TREATMENT PLANS

1 Accurate assessment, diagnosis, and case conceptualization, key prerequisites to the provision of culturally responsive treatment, are dependent on the characteristics, values, and worldviews of both therapist and client (APA, 2006). A critical point in treatment is the ability to gather culturally congruent and contextually appropriate information that guides clinical decisions. This is most represented in intake interviews. Most intake forms generally include questions concerning client demographic information, the presenting problem, history of the problem, previous therapy, psychosocial history, educational and occupational experiences, family and social supports, medical and medication history, risk assessment, diagnosis, and goals for treatment. Fisher, Jome, and Atkinson (1998) reviewed the evidence supporting what they term universal healing conditions or common factors in a culturally specific context. These scholars concluded that there are four common factors across all therapeutic healing approaches:

1. It is now widely accepted across all therapeutic orientations or approaches to psychotherapy that the therapeutic relationship serves as a base for all therapeutic intervention across all cultures.

2. A shared worldview or conceptual schema or rationale for explaining symptoms provides the common framework by which both healer and client work together.

3. The client's expectation in the form of faith or hope, in the process of healing, exists across all cultures.

4. The therapeutic ritual or intervention takes place in the form of a procedure that requires the active participation of both client and therapist, and the procedure is believed by both to be the means of restoring the client's health.

In summary, it is critical for trainees to: (1) develop culturally respectful relationships with their clients; (2) find avenues to mutually understand the creation and maintenance of presenting concerns; (3) provide clients with a sense of hope; and (4) provide clients with a sense that the work trainee and client embark on together has the potential to create change, ultimately leading to the codevelopment of interventions that are culturally and contextually meaningful and feasible to achieve for clients. We believe it is the combination of these common factors that serve as a solid therapeutic template for trainees and mental health professionals. We are hopeful that readers utilize the EBPP and common factors frameworks to develop culturally responsive services for diverse communities.

Many of the intake questions are focused primarily on the individual with little consideration of situational, family, sociocultural, or environmental issues. Although it may be difficult to modify standard intake forms used by clinics and other mental health agencies, consideration should be given to these contextual factors when gathering data. In the next sections, we present common areas of inquiry found in standard diagnostic evaluations and the rationale for each (Rivas-Vazquez, Blais, Rey, & Rivas-Vazquez, 2001). We also include suggestions for specific contextual queries that can be used to supplement the standard interview and/or treatment for ethnic minorities and other diverse populations.

Identifying Information

Asking about the reason for seeking counseling allows the therapist to gain an immediate sense of the client and reason for seeking therapy. Important information typically gathered includes age, gender, ethnicity, relationship status, and referral source. When gathering and establishing information, it is critical to take the time to build culturally respectful relationships. Therapists must recognize that, for many diverse populations, the personal relationship holds more importance than rushing quickly to gather “clinical information.” Additionally, it is important to inquire about cultural or social identity groups to which a client feels connected. For ethnic minorities or immigrants, immigration history and the degree of acculturation or adherence to traditional values is important to determine. If relevant, ask about the primary language used in the home or the degree of language proficiency of the client or family members. Determine if an interpreter is needed. (It is important not to rely on family members to translate when assessing clinical matters and to use interpreters only when absolutely necessary.) For other social identities, such as religion, sexual orientation, age, gender, or disability, it is important to consider if and how these factors influence the client's lived experiences or any of the difficulties the client is facing.

Presenting Problem

In order to understand the source of distress in the client's own words, obtain his or her perception of the problem and assess the degree of insight the client has regarding the problem and its chronicity. Some questions to consider as you explore a client's culturally embedded explanatory model include these: What is the client's explanation for his or her disorder? Does it involve somatic, spiritual, or culture-specific causes? Among all groups potentially affected by disadvantage, prejudice, or oppression: Does the client's own explanation involve internal causes (e.g., internalized heterosexism among gay males or lesbians or self-blame in a victim of a sexual assault) rather than external, social, or cultural explanations? What does the client perceive are possible solutions to the problem?

History of the Presenting Problem

To assist with diagnostic formulation, it is helpful to have a chronological account of the perceived reasons for the problem. It is also important to determine levels of functioning prior to the problem and since it developed and to explore social and environmental influences. When did the present problem first occur, and what was going on when this happened? Has the client had similar problems before? How was the client functioning before the problem occurred? What changes have happened since the advent of the problem? When was the last time the problem did not exist? What was different about that particular time? Note that problems can occur in multiple spheres, including interpersonal, intimate relationships, family, work, and school. Are there any family issues, value conflicts, or societal issues involving factors such as gender, ability, class, ethnicity, or sexual orientation that may be related to the problem?

Psychosocial History

Clinicians can benefit from understanding the client's perceptions of past and current functioning in different areas of living. Also important are early socialization and life experiences, including expectations, values, and beliefs from the family that may play a role in the presenting problem. How does the client describe his or her level of social, academic, or family functioning during childhood and adolescence? Were there any traumas during this period? Were there any past experiences or problems in socialization with the family or community that may be related to the current problem? McAuliffe and Ericksen (1999) describe some questions that can be used, when appropriate, to assess social background, values and beliefs:

“How has your gender role or social class influenced your expectations and life plans?” “Do religious or spiritual beliefs play a role in your life?” “How would you describe your ethnic heritage; how has it affected your life?” “What was considered to be appropriate behavior in childhood, adolescence and as an adult?” “How does your family respond to differences in beliefs about gender, acculturation, and other diversity issues?” “What changes would you make in the way your family functions?” (p. 271).

These questions can be adapted, depending on the social identity and presenting concern(s) being addressed therapeutically.

Trauma History

Despite the potential importance of determining if the client is facing any harmful or dangerous situations, many trainees and mental health professionals do not routinely inquire about trauma and abuse histories, even with populations known to be at increased risk. In one study, even when the intake form included a section on abuse, fewer than one-third of those conducting intake interviews inquired about this topic (Young, Read, Barker-Collo, & Harrison, 2001). We encourage mental health professionals to attend to a range of abuse, including the types covered in most training programs, such as sexual, physical, and emotional abuse and neglect of children and adults. Additionally, it is critical to address any social and cultural issues and their contributions to histories of trauma in conjunction with background information, such as a history of sexual or physical abuse, as the culmination of these historical experiences can have important implications for diagnosis, treatment, and safety planning. As an example, these questions involve domestic violence for women (Stevens, 2003, p. 6), but can and should be expanded for use with other groups, including men and older adults:

Have you ever been touched in a way that made you feel uncomfortable?Have you ever been forced or pressured to have sex?Do you feel you have control over your social and sexual relationships?Have you been ever been threatened by a (caretaker, relative, or partner)?Have you ever been hit, punched, or beaten by a (caretaker, relative, or partner)?Do you feel safe where you live?Have you ever been scared to go home? Are you scared now?

If a client discloses a history of trauma during the intake process and there are no current safety issues, the therapist can briefly and empathetically respond to the disclosure and return to the issue at a later time in the conceptualization or therapy process. Of course, developing a safety plan and obtaining social and law enforcement support may be necessary when a client discloses current abuse issues.

We also urge readers to pay attention to areas of abuse that are often overlooked in our training programs but are of critical importance for diverse and underrepresented communities. In particular, mental health professionals should explore trauma experiences or the emotional reactions to abuse and/or terrible events related to clients' social identities. Historical trauma and trauma associated with racism or immigration, to name a few, are directly connected to the cases illustrated throughout this casebook. These questions could be included in any intake protocol:

Have you ever been discriminated against? If so, what events stand out to you the most?Do you think about this (these) experience(s)?Have one or both of your parent(s) experienced a significant form of discrimination? If so, describe the experience(s).If you have children, has one or more of your children experienced a significant form of discrimination? If so, describe the experience(s).

Strengths

It is important to identify culturally relevant strengths, such as pride in one's identity or culture, religious or spiritual beliefs, cultural knowledge and living skills (e.g., hunting, fishing, folk medicine), family and community supports, and resiliency in dealing with discrimination and prejudice (Hays, 2009). The focus on strengths often helps put a problem in context and defines support systems or positive individual or cultural characteristics that can be activated in the treatment process. This is especially important for ethnic group members and individuals of diverse populations subjected to negative stereotypes.

What are some attributes that they are proud of?How have they successfully handled problems in the past?What are some strengths of the client's family or community?What are sources of pride such as school or work performance, parenting, or connection with the community?How can these strengths be used as part of the treatment plan?

Medical History

It is important to determine if a client has medical or physical conditions or limitations that may be related to the psychological problem and important to consider when planning treatment.

Is the client currently taking any medications, using herbal substances, or using any form of folk medicine?Has the client had any major illnesses or physical problems that might have affected their psychological state?How does the client perceive these conditions?Is the client engaging in appropriate self-care?If there is some type of physical limitation or disability, how has this influenced daily living?How have family members, friends, or society responded to this condition?

These questions are especially important and relevant with older adults or elderly clients as aging comes with frequent major health risks and conditions.

Substance Abuse History

Although substance use can affect diagnosis and treatment, this potential concern is often underemphasized in clinical assessment. Because substance use issues are common, it is important to ask about drug and alcohol use.

What is the client's current and past use of alcohol, prescription medications, and illegal substances including age of use, duration, and intensity?If the client drinks alcohol, how much is consumed?Does the client (or family members) have concerns about the client's substance use?Has drinking or other substance use ever affected the social or occupational functioning of the client?What are the alcohol and substance use patterns of family members and close friends?

Risk of Harm to Self or Others

Even if clients do not share information about suicidal or violent thoughts, it is important to consider the potential for self-harm or harm to others. What is the client's current emotional state? Are there strong feelings of anger, hopelessness, or depression? Is the client expressing intent to harm him- or herself? Does there appear to be the potential to harm others? Have there been previous situations involving dangerous thoughts or behaviors?

* * *

Diversity considerations can easily be infused into the intake process. Such questions can help the therapist understand the client's perspective on various issues. Questions that might provide a more comprehensive account of the client's perspective are listed next (Dowdy, 2000).

“How can I help you?” This question addresses the reason for the visit and client expectations regarding therapy. Clients can have different ideas of what they want to achieve. Unclear or divergent expectations between client and therapist can hamper therapy.“What do you think is causing your problem?” The answer to this question helps the therapist to understand the client's perception of the factors involved. In some cases, the client will not have an answer or may present an explanation that may not be plausible. The therapist's task is to help the client examine different areas that might relate to the problem, including interpersonal, social, and cultural influences. However, the therapist must be careful not to impose an explanation on the client.“Why is this happening to you?” This question taps into the issue of causality and possible spiritual or cultural explanations for the problem. Some clients may believe the problem is due to fate or a punishment for “bad behavior”. If this question does not elicit a direct answer or to obtain a broader perspective, the therapist can ask, “What does your mother (husband, family members, or friends) believe is happening to you?”“What have you done to treat this condition?” “Where else have you sought treatment?” These questions can lead to a discussion of previous interventions, the possible use of home remedies, and the client's evaluation of the usefulness of these treatments. Responses can also provide information regarding previous providers of treatment and client perceptions of prior treatment.“How has this condition affected your life?” Answers to this question help identify individual, interpersonal, health, and social issues related to the concern. Again, if the response is limited, the clinician can inquire about the impact on each of these specific areas.

Finally, we would like to refer readers to the changes being implemented in the fifth edition of the Diagnostic and Statistical Manual of MentalDisorders (American Psychiatric Association, 2011) that include not only a Cultural Case Formulation section but also a Cultural Formulation Interview that identifies major areas of psychological assessment and evaluation that we incorporate throughout this casebook. We believe that, although it is not mandated for use, the Cultural Formulation Interview serves as a useful tool for implementation therapeutically. Some of the areas include:

Cultural identity of the individual (e.g., the individual's cultural reference groups, specifically relating to race, ethnicity, religion, social class and gender identity)Cultural explanation of the individual's illness (e.g., the meaning and perceived severity of the individual's symptoms in relation to norms of the cultural reference group)Cultural factors related to psychosocial environment and levels of functioning (e.g., environmental sources of stress)Cultural elements of the relationship between the individual and the clinician (e.g., What has it been like to describe and explain your problems and your situation to me?)Overall cultural assessment for diagnosis and care (e.g., discussion of how cultural factors affect diagnosis and determine treatment plan)

As trainees and clinicians begin the exploration of these multicultural cases, we hope that they will use a cultural formulation in the assessment, diagnosis, and treatment of clients. Culturally responsive assessment should be conducted in a manner that considers the unique background, values, and beliefs of each client. We hope that as mental health proviers proceed though these cases and read the chapters in Counseling the Culturally Diverse describing general characteristics and special challenges faced by various oppressed populations, they will remember that we are providing this information so they will have some knowledge of specific research or sociopolitical and cultural factors that might be pertinent to a client or family from this population. However, when counseling diverse clientele, it is critical to actively work to avoid succumbing to stereotypes (i.e., basing opinions of the client on limited information or prior assumptions). Instead, the task is to develop an in-depth understanding of each individual client, taking into consideration that individual's unique personal background and worldview. By doing this, therapists will be in a position to develop an individually tailored treatment plan that effectively addresses presenting problems in a culturally responsive manner.

REFERENCES

American Psychiatric Association. (2011). DSM-5: The future of psychiatric diagnosis. Retrieved from http://www.dsm5.org/pages/default.aspx

American Psychological Association. (2006). Guidelines on multicultural education, training, research, practice, and organizational change for psychologists. American Psychologist, 58, 377–402.

American Psychological Association Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practice in psychology. American Psychologist, 61, 271–285.

CACREP. (2009). Council for Accreditation of Counseling and Related Educational Programs 2009 Standards. Alexandria, VA: Author.

Cole, E. R. (2009). Intersectionality and research in psychology. American Psychologist, 64(3), 170–180.

Council on Social Work Education. (2008, updated 2012). Educational Policy and Accreditation Standards. Alexandria, VA: Author.

Dowdy, K. G. (2000). The culturally sensitive medical interview. Journal of the American Academy of Physicians Assistants, 13, 91–104.

Fischer, A. R., Jome, L. M., & Atkinson, D. R. (1998). Reconceptualizing multicultural counseling: Universal healing conditions in a culturally specific context. The Counseling Psychologist, 26, 525–588.

Hays, P. A. (2009). Integrating evidence-based practice, cognitive-behavior therapy change, and multicultural therapy. 10 steps for culturally competent practice. Professional Psychology: Research and Practice, 40, 354–360.

McAuliffe, G. J., & Eriksen, K. P. (1999). Toward a constructivist and developmental identity for the counseling profession: The context-phase-stage style model. Journal of Counseling and Development, 77, 267–280. doi: 10.1002/j.1556–6676.1999.tb02450.x

Rivas-Vazquez, R. A., Blais, M. A., Rey, G. J., & Rivas-Vazquez, A. A. (2001). A brief reminder about documenting the psychological consultation. Professional Psychology: Research and Practice, 32, 194–199.

Roysircar, G., Arredondo, P., Fuertes, J. N., Ponterotto, J. G., Toporek, R. L., & Parham, T. A. (2003). Multicultural Counseling Competencies. Alexandria, VA: American Counseling Association.

Stevens, L. (2003, November 20). Improving screening of women for violence: Basic guidelines for physicians. Medscape.

Sue, D. W., & Sue, D. (2012). Counseling the culturally diverse: Theory and practice. Hoboken, NJ: Wiley.

Young, M., Read, J., Barker-Collo, S., & Harrison, R. (2001). Evaluating and overcoming barriers to taking abuse histories. Professional Psychology: Research and Practice, 32, 407–414.

1 This section has been adapted from Counseling the Culturally Diverse: Theory and Practice (pp. 345–361), by D. W. Sue and D. Sue, 2013, Hoboken, NJ: Wiley.

About the Editors

Derald Wing Sue is Professor of Psychology and Education at Teachers College, Columbia University. He received his PhD from the University of Oregon and has served as a training faculty member with the Columbia University Executive Training Programs. He was co-Founder and first President of the Asian American Psychological Association, and past President of the Society for the Psychological Study of Ethnic Minority Issues and the Society of Counseling Psychology. Dr. Sue has served as Editor of the Personnel and Guidance Journal and Associate Editor of the American Psychologist and serves on the Council of Elders for Cultural Diversity and Ethnic Minority Psychology. Dr. Sue can truly be described as a pioneer in the field of multicultural psychology, multicultural education, multicultural counseling and therapy, and the psychology of racism/antiracism. His current research explores the manifestation, dynamics, and impact of racial, gender, and sexual orientation microaggressions. He currently applies this research to strategies for facilitating difficult dialogs on race in the classroom and public forums. He is author of more than 150 publications, including 16 books and numerous media productions. In recognition of his outstanding contributions, Dr. Sue has been the recipient of numerous awards from professional organizations, educational institutions, and community groups.

Miguel E. Gallardo is an Associate Professor of Psychology and Director of Aliento, The Center for Latina/o Communities at Pepperdine University, and a licensed psychologist. He received his PsyD from the California School of Professional Psychology, Los Angeles. He teaches courses on multicultural and social justice, intimate partner violence, and professional practice issues. Dr. Gallardo's areas of scholarship and research interests include understanding the psychotherapy process when working with ethnocultural communities, particularly the Latina/o community, and understanding the processes by which individuals develop cultural awareness and responsiveness. Dr. Gallardo is currently Director of Research and Evaluation for the Multiethnic Collaborative of Community Agencies(MECCA), a nonprofit organization dedicated to serving monolingual Arab-, Farsi-, Korean-, Vietnamese-, and Spanish-speaking communities. Dr. Gallardo has published refereed journal articles and book chapters in the areas of multicultural psychology, Latina/o psychology, and ethics and evidence-based practices. He coedited the book Intersections of Multiple Identities: A Casebook ofEvidence-BasedPractices with Diverse Populations and is coauthor of the book Culturally Adaptive Counseling Skills: Demonstrations of Evidence-Based Practices. Dr. Gallardo is a Fellow in the American Psychological Association.

Helen A. Neville is a Professor of Educational Psychology and African American Studies at the University of Illinois at Urbana-Champaign. She currently chairs the counseling psychology program and in the past was a Provost Fellow at the same institution. She received her PhD from the University of California at Santa Barbara in counseling psychology. Prior to coming to Illinois, she was on the faculty in Psychology, Educational and Counseling Psychology, and Black Studies at the University of Missouri-Columbia, where she cofounded and codirected the Center for Multicultural Research, Training, and Consultation. She is the lead Editor of the Handbook of African American Psychology and is a past Associate Editor of the Counseling Psychologist and the Journal of Black Psychology. Dr. Neville has been recognized for her research, teaching, and mentoring efforts including receiving the American Psychological Association Graduate Students Kenneth and Mamie Clark Award for Outstanding Contribution to the Professional Development of Ethnic Minority Graduate Students and the Charles and Shirley Thomas Award for mentoring and contributions to African American students and community. She is a Fellow in the American Psychological Association and recently received the Association of Black Psychologists' Distinguished Psychologist of the Year award.

About the Contributors

Julie R. Ancis, PhD, is an American Psychological Association (APA) Fellow and Associate Vice President for Institute Diversity at the Georgia Institute of Technology. She previously served as Professor of Counseling Psychology at Georgia State University. Dr. Ancis received the 2012 Woman of the Year Award from the Society of Counseling Psychology (Division 17) Section for the Advancement of Women and chairs the section. She has published and presented extensively in the area of multicultural competence, race and gender, university climate, women's legal experiences, and DSM-5 proposals. She is the author of several books, including The Complete Women's Psychotherapy Treatment Planner (Wiley) and Culturally Responsive Interventions: Innovative Approaches to Working With Diverse Populations