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Multicultural Competency: How Are We Different? Let Us Count the Ways
by William M. Liu, Ph.D.

4 CE Hours - $99

Last revised: 09/14/2016

Course content © copyright 2011-2016 by William M. Liu, Ph.D. All rights reserved.


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Learning Objectives

This is a beginning to intermediate level course. After completing this course, mental health professionals will be able to:

The materials in this course are based on the most accurate information available to the author at the time of writing. The areas of multiculturalism and multicultural competencies are dynamic and grow daily. New information, research, and theories are continuously being developed and published, hence new information may at times supersede the course materials. The course content is provocative in places because it covers topics and materials which may challenge previously held beliefs about self and others.

Outline

Introduction

In my multicultural competencies course for graduate students, I used to start the course by asking my students a simple question. “Is there a difference between a culturally competent counselor/psychologist and just a generally good counselor/psychologist?” The natural question which followed was, “it depends.” Among helping professionals, being immersed in the literature and competencies discussions, we typically have the benefit of a framework through which to evaluate other helping professionals. As a multiculturally competent supervisor, I can usually tease out the subtle biases and value systems of other professionals and link my observations to supervision. We discuss these issues and understand the larger issues premising the need for competencies. So for we helping professionals, there is a difference between a helping professional who is culturally competent and one who is not.

But another necessary question was the perspective of the client. Does the client see a difference and would the client care of these differences? If the client’s needs are met, and the crisis is addressed, and the client is in an empathetic and caring relationship, how would cultural competencies add to this already good outcome? The answer is that multicultural competencies are more than just additive to the helping professional. It is unfair for critics to say that multicultural competencies just add a little to the value of the therapeutic relationship. Multicultural competencies are not just additive, they are transformative to the helping professional and to the therapeutic relationship. Multicultural competencies are critical to the therapeutic relationship just as much as a theoretical orientation. Just as much as one could not practice therapy or counseling without a theoretical orientation (psychodynamic, cognitive, humanistic), one could not practice therapy or counseling without multicultural competencies.

The research and scholarship on multicultural competencies and orientations toward diversity and multiculturalism generally show that helping professionals who are culturally competent and who address diversity issues (e.g., race, gender, ability, sexuality, and age, to name a few), tend to retain clients in therapy longer and are able to develop good working relationships with them (Smith & Trimble, 2016). Certainly there are many factors contributing to positive therapy outcomes such as the therapist’s perceived competency, ability to develop a working alliance and relationship, and the client’s motivation and participation, but generally the results of several meta-analyses suggests positive relationships between multicultural competency and client perceptions. The better able a therapist or helping professional is able to address diversity and multicultural factors in counseling, the better the therapist is also able to reconcile tensions and conflicts in the relationship that may arise from diverse worldviews, and the more likely the client will not only stay in therapy but benefit from counseling (Smith & Trimble, 2016).

In the end, I stopped offering this question because it engenders a false dichotomy. Good helping professionals are ones who are theoretically competent and multiculturally competent and oriented (they have an interest in diversity and an interest in growing to learn more about themselves as cultural beings); who have clinical experience with diverse clientele; and who have a good awareness of their own worldview, biases, and expectations for counseling and for the client.

Multicultural competencies are part of every step of the therapy process. From intake, to assessment, to building the relationship, to interventions, to assessment, to termination, multicultural competencies are implicated and necessary throughout every step. The need for multicultural competencies is present from the first contact with a client.

For instance, imagine being a male therapist walking into the waiting area to greet a client. The new client happens to be a Muslim woman wearing a hijab (head covering). What can the therapist assume about the client and what may he not assume? Even more simply, may the therapist shake hands with the woman (Ali, Liu, & Humeidan, 2004)? And if a mistake were to take place, is it appropriate to address this misstep in therapy (Liu & Pope-Davis, 2005)? How might this misstep be addressed in a culturally congruent manner? Finally, if the therapist were to address it, what might he expect the client to do with and for him in that moment? Multicultural competencies are implicated as necessary skills from the very first instant of therapeutic contact.

Why Multiculturalism and Multicultural Competencies

Counseling is about the ways in which we help people tell their lives. Over repeated telling, we learn the narrative and arcs of the lived experiences. Counselors and other helping professionals are involved in working with clients to tell their stories in such ways that the client learns about him/herself, better understands contexts for behaviors and attitudes, develops skills to increase adaptation, and develops healthier relationships. Simple in some ways, but as any helping professional knows, we are involved in the most complex and dynamic human relationships, because not only are we attempting to learn about the client but we are simultaneously helping them change.

Multicultural competencies are involved in every step of the helping professional’s role and counseling process. Multicultural competencies are not necessarily a distinct theory but rather they represent a transtheoretical approach to working with clients. Similar to the stages of change wherein all clients may be regarded as “in the process of seeking help and changing oneself,” (Prochaska & DiClemente, 2005), multicultural competencies are meant to be considerations made by helping professionals in every step of the counseling process. How might one create better relationships with the client? How might interventions be better adapted for the client? How might the working alliance be strengthened? In all of these questions, the helping professional should be assessing levels of multiculturalism related to understanding one’s own worldview, culture, values, and biases and those of the clients as well.

Multicultural competencies and orientations are also helpful for the counselor in developing a greater awareness of oneself and oneself as a cultural being in an interaction with another cultural being. Simply stated, multiculturalism also provides the counselor with a framework to better understand cultural issues that may impact the therapy relationship. For instance, a client may not even be aware of her/his racial bias against working with an African American counselor. Instead, the client may use “proxy” terms to discuss her/his dissatisfaction or resistance to therapy such as questions about qualifications, payment, or experience. For the counselor some of these concerns may be explained by therapeutic resistance and also the client’s racism. The counselor benefits from a dual exploration of these issues with the client.

Multicultural competencies are transtheoretical and so are not an explicit theory of development, psychopathology, mental health, or treatment. There is no one multicultural theory that posits a framework for the development of psychopathology. But multicultural competencies are implicated in the ways that variables and constructs are identified and evaluated as contributions to psychopathology, for instance. For example, if we were to examine paranoia within a population, it may be important to consider the role of race. For some African American men, a healthy paranoia may be a survival instinct and worldview which helps them navigate racism and discrimination; therefore an African American completing a personality inventory may express elevated scores on paranoia, but may not be pathological (Majors & Billson, 1992). Thus, multicultural competencies represent conditions and considerations that the helping professional needs to integrate when working with clients. These considerations are meaningful in face-to-face contact but also are important elements in writing assessment protocols, clinical notes, and evaluations of a client.

Historical Imperatives for Multiculturalism

The history of how multiculturalism became mainstream in the helping professions also provides a glimpse into how culture, race, and oppression/marginalization have been treated in the helping professions. Starting with the question of why racial-ethnic minorities were not staying in treatment (Smith & Trimble, 2016), to our contemporary questions about identity and intersectionality, helping professionals have wrestled and struggled with how best to integrate important but personally and politically charged constructs and variables in counseling. Along with these concerns has been a steady change in the demographics of the United States. Suffice it to say that if the helping professions resist adapting our science and practice to work better within these communities, many of the helping professions risk obsolescence (Iijima Hall, 1997).

Changing racial and ethnic demographics have been an important impetus toward changing the practice of our helping professions. Many have already heard various demographic predictions wherein the dominant White racial majority is likely to be a minority by 2050 (CNN, 2008). Much of the “coloring” of the United States will be from Latinos as well as other racial groups such as Asian-Americans, and from racial intermixing. Although it is true that racial ethnic minority groups have been and are growing in substantial numbers, it is also important to remember that “diversity” has always existed in the U.S. Women, gays and lesbians, the elderly, and the differently-abled (to name just a few) have always been present. Their numbers may have been different, but their presence has been a part of American history since there was an America to write about. The problem for many of these “minority” groups has been recognition, integration, and political power. The cultural context for much of American history has largely marginalized their personhood and status to be outside the norm of those who were deemed rightfully to be in power (Harris, 1993).

More specifically, the advent of a growing diversity in the United States, and worldwide, is an important impetus for psychologists, counselors, and other helping professionals to develop competencies to work with these different communities. For the future, diversity is a compelling need which psychologists and helping professionals need to meet. History is an equally important justification and one that is sometimes overlooked or not focused upon because it may be deemed as not relevant to multicultural competencies. Yet history, and a thorough understanding of it as it pertains to diversity and multiculturalism, helps us understand why we are discussing and learning about diverse others at all. As I just noted, the United States has always had diversity and diverse individuals and communities. I believe it would be safe to assume that there were women, racial and ethnic minorities, people with disabilities, and gay and lesbian people throughout the history of the United States. What history allows us to understand better is why this diversity is not reflected in our history texts, our cultural knowledge, and our important institutions such as law and education. What we can usually learn from our uncovering of these diverse histories is the ways in which these peoples and communities were segregated, isolated, and marginalized. And the ways in which these diverse communities were disregarded and invalidated helps us to understand how these problems still persist today and how these issues may manifest in an individual’s worldview. For helping professionals, deciphering, uncovering, and then connecting these historical and systemic issues to the client’s presenting concerns, and linking them to how the client will become better, is an integral aspect of multiculturalism. History and an analysis of these dynamics allow us to introduce topics such as privilege, power, exclusion, marginalization, and resilience. All of these topics, which will be covered later in this course, are pertinent in the ways in which know and do not know about culturally diverse others, our biases and stereotypes, and our assumptions in our work within these communities.

One of the difficulties people have with multicultural competencies is the belief that they must know and master all the ways in which people are diverse, immediately. I hear this often in my courses where students, as they start to learn about one cultural group, start to see the immensity of that one cultural group and they grow frustrated in having to learn about many different cultural groups. I often try to reframe their experience in class and explain that in part, they are a product of their learning environment and many of them have not yet been challenged and/or exposed to a diverse literature or histories.

The other issue that many students struggle with is their own cultural encapsulation. By this I mean that some students and individuals come from environments where they are the dominant group or a member of the majority group; their assumptions about the world are normalized by those around them; and they tend to associate with culturally similar individuals. One also has a particular cultural framework to interact with the world and that framework typically is derived from how one was raised, and not much can make that worldview change. It is even possible that an individual can travel the world and interact with diverse peoples and still be culturally encapsulated; the individual, in his/her interactions with diverse peoples, still focuses on how “others” are different or similar to Americans, for instance, and there is no real attempt to understand or learn the other person’s worldview. As a result, some of these individuals find it difficult to develop a new framework to understand and integrate cultural knowledge and awareness from other groups.

These frustrations sometimes express themselves in the assumption that they (the students) are expected to master cultural knowledge about every diverse cultural group. This, as a practical matter, is a sheer impossibility that is not required of anyone, in any circumstance, in any level of training, for applied psychologists or other helping professionals. There is no situation where a trainee would be expected to master every theoretical orientation available. Yet, I understand that this belief is a form of resistance that forces the conversations away from self-understanding to a more intellectualized discussion of the volume and magnitude of diversity. What I try to have people understand is that one’s ethical and professional responsibility is specifically tied to learning about and knowing the clients one is most typically likely to encounter. For instance, if one were working as a staff psychologist in a counseling center at a college or university, there is a prototypical client (e.g., 19 year old White middle-class female). Even at a university counseling service, the intersections of cultural diversity that stem from working with a 19 year-old White woman are complex. There are gender, sexuality, religious, age, and ability issues at the least, as well as the intersections of these identities. “Start somewhere that is close to you,” is what I suggest; “Start with something you know and work out from there.” Variability also depends on context and geography. At a counseling service in Washington, D.C., a staff psychologist may see more African American students if the university or college is a historically Black institution. The demands on the helping professional are the same (understanding one’s clients), but the information, data, history, and skills necessary to effectively work with the most common client varies from context to context.

The intent of any multicultural course, then, is to assist the helping professional develop the strategies and framework to not only understand one’s current clientele, but to continue learning and expanding their scope of information about cultural diversity and, just as important, one’s own worldview, values, and biases. In developing any competencies, supervised practice and consultation with those who are competent are important in developing and refining one’s competencies. A static course is insufficient to develop and master any competencies. Demonstrating that one has continued learning and growing is not only a critical and necessary clinical skill, but there is also a practical component. I doubt there is any client that would seek out a practitioner who stated that she or he stopped learning about psychology on the day she or he graduated from school. Demonstrating constant learning via the books and journals one displays in an office is an important artifactual communication to the client that the clinician is continually refining and growing one’s competencies and skills. In the same way, the helping professional needs to communicate to the clients that she or he is consistently developing awareness, knowledge, and skills to work with diverse clients.

Diversity and Multiculturalism

An important differentiation in terms is necessary here. Diversity and multiculturalism are often used synonymously and the practical effect of that is that these terms lose agency with respect to identifying different processes occurring. The conflation of the terms may lead one to believe that diversity (a change in numbers) is necessarily the same thing as multiculturalism (a change in power) (Liu & Pope-Davis, 2003). Diversity, as I use it here, is referring to the “bean-counting” of differences. The question of how many from under-represented groups are present in any context is usually a good example of a focus on diversity. Diversity does not refer to changes in power structures or processes. For instance, a focus on diversity in terms of admissions to a college usually means increasing under-represented groups (e.g., African Americans). The problem that occurs by focusing only on increasing numbers is that the new community members are expected to “fit in” to an existing structure, and their failure to fit in or to matriculate becomes an internal dispositional failure (e.g., the person did not try to fit in). Rather than addressing the environment and the intersection between the person and environment, the status quo existing structures are left relatively intact and without fault.

In contrast to a focus only on diversity, multiculturalism would mean – in addition to increasing under-represented groups – changing the racial composition of faculty, critically evaluating and growing the curriculum, and educating the campus community.

Also, there is some confusion as to what is considered “multicultural.” For some individuals, multicultural is the “catch-all” term for any form of diversity. So, race and gender may be equally legitimate forms of diversity as being a cancer patient. Here, I attempt to clarify what I mean by multicultural; that is, what forms of diversity are considered to be multicultural constructs.

A multicultural construct regarded as “in” multiculturalism is, to begin with, a form of diversity or difference from the person perceiving. In this case, if the helping professional is White, almost any racial differentiation from White may be considered a “difference.” Race and racial difference is an important multicultural competency because race, in the United States, has a history related to power relations, privilege, oppression, and marginalization. In response to these concerns, helping professionals look toward ways to empower racially diverse individuals and seek socially just ways to rectify past inequalities.

Other cultural dimensions which fall into this framework would be gender (specifically focused on women), social class (specifically focused on those in poverty and lower social class groups), age (especially focused on those regarded as expendable because of age), and disability (especially those with visible disabilities which render them invisible to the dominant groups). For these groups and many others (e.g., gay and lesbian individuals), their history is also connected to systemic and cultural forms of marginalization (legal, social, and educational). That is, for many of these groups, their marginal status is codified in law and legitimized as normal. Finally, helping professionals themselves come to work with these groups with some biases and distortions of their own and, consequently, helping professionals need to assess and evaluate their reactions as they work with these individuals and communities. For me, if a form of cultural diversity (e.g., religious identification) does not have these interconnections, history, and effects on helping professionals, then it cannot be considered a form of diversity within multicultural competencies. For example, wearing glasses is a way in which people are diverse, but if the construct of wearing glasses does not fulfill these other interconnections, history, and bias, then it is not a competency that needs to be addressed.

Prejudice, Discrimination, Stereotypes, Power, and Racism

Other important definitions are provided here as well. Prejudice is considered a negative attitude against an individual or group (Ponterotto, Utsy, & Pedersen, 2006). Discrimination is a form of behavior stemming from a prejudice. A stereotype may be considered a cognitive script or short-cut an individual may employ as a “snapshot” way to understand an individual. Stereotypes are not, in and of themselves, inherently negative, but because people do not usually challenge their rudimentary frames of understanding “others,” the stereotypes tend to be negative because of their rigidity (inflexibility) and chronicity (use of this schema or script regardless of the situation).

One more clarification I will make is about racism and prejudice. The simplest definition of racism (or other “isms”) is prejudice plus power. To some extent that is true. While an African American may be prejudiced or even discriminate against a White person, the African American person’s negative actions are unlikely to carry with them the same kind of cultural legitimacy or effect as when a White person is racist against an African American. What I would also offer as another component to understanding racism is that power is important, but so is history and context. So, for me, racism is prejudice plus power AND history AND context AND systems. This context is important because it reminds us to consider what may be construed to be a “racist” event within the framework of history. Using the previous example, if an African American person is prejudiced and discriminatory against a White person, does this act by the African American have a historical context (is there a racial legacy that the African American individual is enacting, or is there a racial ideology that legitimizes this action)? But if we were to turn the situation around so that a White individual is acting in a prejudicial and discriminatory way, and we ask these two questions, then the likely answer helps us see the enactment of power.

A good example of the intersection of power, history, context, and racism has to do with Whiteness and those White individuals coming to see themselves as cultural and racial beings. That process is not easy because it is not just about seeing oneself as White but also learning a new language about oneself and race and being comfortable talking about race. DiAngelo (2011) speaks directly to this topic in her scholarship on White fragility. She describes most White individuals as growing up in culturally encapsulated environments where they have been protected from “race-based stress” (p. 54). The fragility arises when “even a minimum amount of racial stress becomes intolerable, triggering a range of defensive moves...[that is] outward display of emotions such as anger, fear, and guilt..[to] reinstate white racial equilibrium” (p. 54). White people are raised to assume a particular type of world, especially when it comes to how race is discussed and their role in racial matters.

Triggers may arise from challenges to objectivity (which challenges a White person’s belief that they are speaking from a non-racialized experience), when racial ethnic persons talk about race and racism (which challenges a White person’s belief that they should not be involved in discussions about race and if they are, the minority person should take care of the White person’s feelings), when other Whites do not agree with the White person’s worldview or describe the White person’s behaviors and attitudes as racist (which challenge the White person’s idea that all White people think alike and that the White person is a good liberal and non-racist), and when a racial ethnic person is in a position of authority (which challenges the White person’s expectation that White people are always in authority) (DiAngelo, 2011).

These triggers are a good framework to start a better understanding of multiculturalism because the concept of fragility works in other privileged identities as well. Christian, masculine, or social class privileges may also create forms of fragility wherein negative feelings are elicited that may challenge the privileged worldview. The concept of fragility was helpful to me, for example, in better navigating people’s responses in workshops and classrooms because it not only allowed me to interpret their responses but to also anticipate their reactions with a more empathetic response.

Complicating Multicultural Education and Training

Unlike other areas in psychology, teaching and talking about multiculturalism requires additional facets of discussion that are unnecessary in traditional areas of psychology. For one, there is a greater need for contextualization, and so the multicultural literature is often rife with history and other analyses necessary for a full understanding of a group to be examined. (e.g., African Americans, see Jones, 2010 text). Psychologists and other helping professionals need to be more critical of the research used to support their theories and practices. Other authors have already criticized premier psychology journals for relying too heavily on college-student-aged populations on which to rest theory and practice (Bulboltz, Miller, & Williams, 1999; Graham, 1992; Liu, Ali, Soleck, Hopps, Dunston, & Pickett, 2004). In fact, Henrich, Heine, and Norenzayan (2010) criticized contemporary psychology as full of assumptions which may not be universally applicable. The use of college students has skewed research toward Western, Educated, Industrialized, Rich, Democratic-society (WEIRD) peoples. I would add White as an additional “W” in that WEIRD description. Although most researchers explicitly state limitations related to participants, it is not always clear if people heed these cautions when interpreting and implementing research findings.

In doing this excavating, as part of multicultural research, issues of perspective and, of course, politics arise because much of the presented history and context deals with issues of oppression, marginalization, and other forms of discrimination. It is impossible to discuss multiculturalism and multicultural competency without these expressed terms and constructs. It is as much a part of the development of these peoples and communities as air, food, and water; it requires the reader and student to be prepared to think about psychology differently than as an objective science.

But in looking at the history of many of these historically marginalized communities, it is important to note not only the deleterious conditions in which they exist, but also the resiliency found within many of the communities. For the person becoming multiculturally competent, it is a balancing act to learn and be critical, while also empathizing and admiring. Racial ethnic groups, women, gays and lesbians, to name a few, have lived and thrived in varying epochs throughout our American nation; their visibility has ebbed and flowed in uneven patterns and differed depending on where they lived geographically. Some communities have forged strong identities and relationships and have made positive political statements for themselves, while at other times making detrimental political and community choices. These groups are not monolithic with any specific political agenda, and the variability within their groups are often greater than any between group differences.

Multiculturalism, Self, and Other

Multicultural competencies are not just learning about others who represent difference or variance from oneself. This is critical, but solely learning about others is insufficient in the development of multicultural competencies. Rather than just a focus on others, multicultural competencies and multiculturalism is founded on the self-awareness and self-understanding an individual has about her or himself: her or himself as a person of and with diversity, and her or himself as a person of and with diversity within the context of both diverse and culturally similar others. Multiculturalism and multicultural competencies is not a one-person psychology, but instead is predicated on self and other.

The self-awareness component is critical because much of what we do as helping professionals relies on using our own reactions and evaluations in developing our relationships, creating interventions, and writing assessments. Nothing we do is completely objective. This basic awareness allows us to recognize when we are biased against someone and how to best counter or respond to our internal reactions. In some multicultural competency courses, students at the beginning of the course tend to evaluate themselves high on multicultural competency. They often believe that they have no biases or have had frequent interracial or intercultural contact and so, based on this contact, they do not believe they are susceptible to bias and distortion. But over time in the course, the students begin to realize that their sense of multicultural competency is not as pristine as they first imagined. At the end of the course, a paradox sometimes may occur in that, rather than rating themselves higher on multicultural competency, they may in fact rate themselves low; their lower self-evaluation is a recognition that they need to do more work on themselves and on understanding others as well.

Exploring and potentially understanding and undoing a particular cultural bias and practice is not simply accomplished by learning new facts. If that were the case, then we could cure racism and other “isms” by simply teaching our way out of these problems. Knowing oneself requires that we explore our language, assumptions, and worldviews but also their function. For the most part, our racial understanding of ourselves and others and the ways in which we talk about these constructs are directly related to how we want to relate to important people in our lives. Racism is not only about demeaning and hating a racial group but also how we engage people in that discussion and worldview. We connect to others through racism and our earliest connections are parents and relatives who socialized us into seeing the world a particular way. Changing the way we see ourselves and interrogating our racism means that potentially we jeopardize these important and intimate relationships.

Along with these relationships are other cultural constructs that reinforce relationships and worldviews. One important construct has to do with our superstitions and belief in supernaturalism that may be linked to our prejudicial beliefs and discriminatory behaviors. For instance, the notion of an ever-present and omnipotent being that evaluates us as either doing good or bad is also linked to superstitions that regulate and normalize discrimination. Multicultural awareness necessitates multiple levels of development and exploration.

Knowing one’s own biases and distortions also necessitates an active behavioral change. A person has to recognize he or she is having a reaction that is stereotypical or biased and then he or she has to cognitively work against that stereotype so as to not to act on these prejudices. For instance, in one study of medical students at one training institution, a majority of the participants were found to have implicit preferences for White and affluent patients; the potential consequence of this implicit preference might be to provide poorer service or different diagnoses and treatments for non-White and non-affluent patients. But remarkably, the researcher also found that, even though these medical students had this unguarded implicit bias, this preference did not manifest in their treatment of patients, assessments, or diagnoses (Haider et al., 2011).

With respect to the content of this course, this paradigm of self and other is implicated in every facet. Even though the content, for some individuals, is focused on diversity of people who may be different, what is equally important is that the reader of this course considers her or his reactions to the content. What are the personal reactions one might have while going through the course? Is there a sense of resistance to the material? Is there a growing sense of frustration related to this course?

All of these reactions are quite normal in multicultural competency courses. It is, what I would consider, a relatively common reaction and sentiment because some of the course material challenges many previously held notions related to oneself, assumptions of how the world operates, fairness, equality, and stereotypes of other individuals and communities.

Multicultural Competencies

So much has been written about “multiculturalism” that it would appear that the profession and science is itself undergoing a paradigmatic shift. Because of this shift, there has been increased study and visibility of persons of color in the psychological literature. However, this newfound visibility deserves review and critical analysis. The hope of such a critique is to answer the question, are the “new clothes” in psychology more than rhetoric?

One of the glaring realities of multiculturalism is the great confusion surrounding it. This confusion has lead “multiculturalism” to be invested with meanings and definitions that have obscured its original intent: to transform the science and practice of psychology to incorporate the multiplicity of peoples’ experiences that may be shaped in part by gender, race, ethnicity, nationality, sexuality, ability, and age, to name a few. A similar confusion over race has resulted in “race” having a multiplicity of meanings (Gotanda, 1995). For instance, Gotanda (1995) outlined the number of meanings given to “race” that includes “status-race,” which is an indicator of “social status” (p. 257); “formal-race,” which sees race as a social construction with no links to “ability, disadvantage, or moral culpability” (p. 257); “historical-race,” which implies some history of “racial subordination” (p. 257); and “culture-race,” which uses race as a proxy for “culture, community, and consciousness” (p. 258). The difficulty of discerning the exact meaning of race may in fact keep racism entrenched. That is, the lack of clarity and agreement regarding race may not only allow the status quo to remain, but the “confusion” may provide the opportunity not to take the discourse seriously and, therefore, continue business as usual.

In terms of multiculturalism, what is supposed to be multiculturalism may actually be a diversification of a community in racial, ethnic, gender, or socioeconomic class (to name a few) compositions. While diversity is crucial in an environment eventually becoming multicultural, diversifying a community is only an initial step. Historically marginalized people have been politically impotent because the issue of power has been left unexamined (Davis, 1996). Perhaps then, because power is not critiqued, psychology programs and departments readily yield to the need for diversity but resist transforming traditional training and epistemological assumptions. As a result, only paying attention to diversity may conceal the power relationships that prevent the transformation of psychology which ultimately leave us saying that “there isn’t anything there.”

Multicultural Competencies Overview

The notion of competency, especially racial-cultural competency, has been best advanced among multicultural competency researchers. Framed within the trinity of knowledge, awareness, and skills (Sue, Arredondo, & McDavis, 1992), multicultural competency, or the ability and capacity to carry out a specific task or objective related to multicultural competency (Pedersen, 1996; Ponterotto, Casas, Suzuki, & Alexander, 1995; Pope-Davis & Coleman, 1997; Sue, Ivey, & Pedersen, 1996), has been argued as a necessary characteristic of current and future counselors (Hall, 1997; Pedersen, 1991; Sue et al., 1992; Sue, Bingham, Porche-Burke, & Vasquez, 1999). Consequently, multicultural competency has permeated much of counselor training (e.g., Pope-Davis, Reynolds, Dings, & Nielson, 1995; Sodowsky, Kuo-Jackson, Richardson, & Corey, 1998; Speight, Thomas, Kennel, & Anderson, 1995).

In 2003, the American Psychological Association approved of some basic guidelines for helping professionals. The six guidelines are listed here:

  1. Be culturally aware of one’s self and others
  2. Recognize the importance of multiculturalism to work effectively with racially different individuals
  3. Use multiculturalism in psychological education
  4. Be aware of culture in research
  5. Use culturally appropriate skills in psychological practice
  6. Work to transform institutions and organizations to be culturally supportive

Although the APA Guidelines are written with a focus on race and ethnicity, the multicultural competencies are supposed to be construed as an important consideration for various cultural groups (e.g., gender and social class). Although each group is unique in its sociopolitical histories and contexts, they all are similar in that each operates within social networks of power; they are all socially constructed; individuals experience deleterious effects from existing within these situations and socialization; and there is interdependency between all the constructs (e.g., race, class, gender). Thus, clinicians need to be aware of these multiple cultural contexts people exist within and be knowledgeable about how to work effectively in therapy.

The six guidelines were based on the general multicultural competencies proffered by Sue, Arredondo, and McDavis (1992). These basic multicultural competencies can be conceptualized within a matrix.

In this framework, there are three general domains of competencies: (a) clinician’s awareness of own assumptions, values, and biases; (b) understanding the worldview of the client; and (c) developing appropriate interventions and strategies. Within each of these domains are three sub-categories of competencies: knowledge (i.e., factual information, or what the psychologist understands), awareness (i.e., self-and-other sensitivity and consciousness, or what the psychologist is aware of), and skills (i.e., demonstrable proficiency, or what the psychologist can show as an integration of his/her knowledge and awareness). (Smith & Trimble, 2016; Sue, Arredondo, & McDavis, 1992).

Within each of these three areas, helping professionals should develop knowledge, awareness, and skills. For instance, in understanding one’s own biases and worldview, the helping professional needs to develop knowledge, awareness, and skills that will not only help him or her learn about his or her current worldview and biases, but also a framework to continue this lifelong learning. Knowledge is simply the factual information necessary to understand one’s own and other people’s diverse cultural heritage. Knowledge can come from books, movies, articles, and classroom learning. Knowledge is sometimes the easiest to access since there are a variety of sources from which an individual may gain this understanding (books, library, internet). But even though it may be easily accessible, people sometimes still find it difficult to digest information about one’s own culture or the heritage of another culture that does (a) not fit into preconceived notions and stereotypes; and/or (b) not cast one’s own or another culture in a positive light. In my experience, for some individuals, learning about Native American history or the slave trade for Africans coming to the United States is difficult to read and discuss. Although the facts and history are indisputable, resistance in the classroom still arises. One way resistance arises is when a student may say, “Well, that happened a long time ago and they should get over it,” or “I’m not responsible for what other people did.” Sue and Sue (2008) describe some aspects of the knowledge competency to be: knowing about the sociopolitical system in the United States; knowing about the institutional barriers for different communities; and knowing about different cultural groups.

The next area is the development of awareness. Awareness is the sensitivity one may develop about not only one’s self as a cultural being, but others as cultural beings as well. Awareness arises from cultural contact with others, and in that process, the individual becomes sensitive to her or his reactions, biases, and worldview. Awareness may be the positive feelings that arise from inter-group contact, but certainly may also be the negative feelings. In the process of counseling, awareness is the sensitivity that an individual has as she or he reads body language of the client, voice intonations, and physical gestures. In the same way as gaining knowledge may increase resistance, so may the development of awareness. In this case, the individual must learn to cope with new reactions, thoughts, and feelings that are triggered from learning about other people. Sue and Sue (2008) describe some aspects of the awareness competency to be: awareness of one’s own cultural heritage; aware of one’s own biases; and aware of differences between groups and individuals.

The final area is skills. Skills are simply the practical and applied abilities an individual helping professional has that can be effectively used in a therapeutic relationship. Skills relates to understanding and knowing when and how to probe, how to interpret client reactions that link culture with the interpersonal process, and how best to intervene. Sue and Sue (2008) describe some aspects of the skills competency to be: skills at generating verbal and nonverbal helping responses; skills in receiving accurate information about the client; and skills which allow the helping professional to work in and out of the session and counseling room.

To this last point, one of the more advanced skills that multiculturally competent helping professionals need to develop is an ability and capacity to work with and for the client in session, but also out of session, as well as outside the therapy room. For some racial and ethnic groups, a credible and trustworthy helping professional is someone who is also engaged in the larger community. Although this invites potential strains with respect to multiple relationships, in a multicultural context these multiple relationships are likely to be therapeutically necessary and do help to strengthen the therapy relationship. Advocacy, with and for the client, outside the therapy context, is sometimes warranted as well. For some clients who may not be familiar with negotiating with health insurance companies, for example, the helping professional should assist the client to learn and become comfortable with these agencies (Hopps & Liu, 2006). A multimodal and multimethod approach to helping clients is necessary in multicultural competencies.

I would also like to add that in most classrooms, awareness and knowledge are easy to disseminate. The skill portion is much more difficult to develop. In part, the development of multicultural skills necessitates a multiculturally competent supervisor. A diverse context would be a nice addition to the development of skills, but in my experience, even working in a largely homogenous environment can facilitate multicultural skill development. For instance, many of my students in Iowa seek out “diverse” clientele (i.e., racially diverse). But I also remind them that there are other forms of diversity that need to be addressed and are just as salient to the client (e.g., religion, social class, gender).

As an example of the multicultural competencies, in Liu (2005), I discuss multicultural competencies with respect to working with men. Such competencies would include the following:

Knowledge. The psychologist understands his/her bias that psychological well-being is conceptualized as masculine, and mental illness is often synonymous with femininity (Broverman, Broverman, Clarkson, Rosenkrantz, & Vogel, 1970). Psychologists understand that dismissing male behavior as boys will be boys minimizes sexism, heterosexism, and homophobic attitudes and behaviors, and reinforces gender inequality.

Awareness. The psychologist is aware of his/her stereotypes of typical and traditional masculine behavior and attitudes, and recognizes them as a part of the client’s socialization and, therefore, not innate. The psychologist is aware that, whereas a man may present overtly as healthy with nothing bothering him, he may in fact be experiencing tremendous pain, depression, anxiety, and stress. Similarly, the psychologist is aware that men’s ways of being are sometimes associated with poor health (Courtenay, 2000).

Skills. If a man prefers not to show emotions or has difficulty labeling his affective state, he may not be resistant to therapy but, instead, may be reflecting his masculine socialization, and the psychologist will find ways to not induce shame on the man for his behavior (e.g., Krugman, 1995; Levant, 1998; Levant et al., 2003). The psychologist does not minimize health complaints and problems as tertiary to the presenting issues for men, but rather assesses for health complaints as a way to understand the man’s world (Courtenay, 2000).

Example. The author established clinical services at a local shelter for the homeless and provided brief supportive therapy to men who are homeless and living at the temporary shelter. The men in the shelter presented themselves as stoic, cool, silent, and non-emotional – generally, at first impression, poor candidates for therapy. When approaching all the men and suggesting that they come in and speak with the psychologist, the author framed therapy as a time to “just talk and work things out.” Men who come to therapy are quiet and stoic initially, but frequently become very articulate and insightful about their current circumstances. They understand why they are in the shelter and what they need to do to move out of the shelter. The author needed to confront his own bias and assumption that the men in the shelter were poor clients for therapy, were inexpressive, and not insightful.

Multicultural competencies may also be applied to work with children and adolescents. For example, Liu and Clay (2002) applied and modified the multicultural competencies to work effectively with children and adolescents, suggesting the following guidelines:

1. Evaluate which, if any, cultural aspects are relevant.

2. Determine the level of skills and information necessary for competent treatment and possible referral.

3. Determine how much, when, and how to incorporate cultural issues.

4. Examine potential treatments and understand the cultural assumptions of each.

5. Implement the treatment using cultural strengths.

Multicultural Competency Research

In regard to multicultural competency research, the field has evolved. At first, much of the research underpinning multicultural competencies was built upon client preferences and perceptions of counselors. Briefly, the research showed that client preferences and perceptions varied according to cultural trust and mistrust (Poston, Craine, & Atkinson, 1991), sex role (Blier, Atkinson, & Geer, 1987), acculturation (Gim, Atkinson, & Kim, 1991), ethnicity (Atkinson & Lowe, 1995; Coleman, Wampold, & Casali, 1995; Hess & Street, 1991; Lin, 1994), intent to use services (Akutsu, Lin, & Zane, 1990), counseling style (i.e., directive versus non-directive) (Atkinson & Matsushita, 1991), language (Flaskerud & Liu, 1991; Lin, 1994), and presenting issue (Abbott, Tollefson, & McDermott, 1982).

The next iteration of multicultural competency research focused on counselor competencies in regard to specific pre-counseling activities such as case conceptualization (Coleman, 1997; Constantine, 2000; Constantine & Ladany, 2000; Ladany, Inman, Constantine, & Hofheinz, 1997; Worthington, Mobley, Franks, & Tan, 2000). The assumption underlying much of this research was that clients would respond positively to counselors who (a) were like them racially and culturally, and (b) understood the client’s worldview (Pope-Davis, Liu, Toporek, & Brittan, 2001). The problem was that there existed no research to support these assumptions or on the efficacy of counseling with multiculturally competent counselors (Abreu, Chung, & Atkinson, 2000; Pope-Davis et al., in press; Yutrzenka, 1995).

In order to address this missing connection, the new question arising from multicultural competency research has focused on the client’s experiences (Pope-Davis et al., in press). In one research project examining the client’s experiences with multiculturally competent counselors, Sodowsky et al. (1999) examined multicultural competencies among counselors, supervisors, and clients. Thirty masters- and doctoral-level counseling students working with students in an English as a Second Language (ESL) after-school program were surveyed. The results showed that the working alliance between the client and counselor increased by the end of the relationship, which supports the notion that cultural competency positively facilitates the counseling relationship. But the results of this study are difficult to generalize since the clients were students in an after-school program and not therapy clients.

In another study using therapy clients reflecting about their experience in a cross-cultural counseling relationship, Pope-Davis et al. (2002) used a qualitative methodology to investigate client experiences. The results showed that clients did appreciate the counselor’s use of culture in therapy, but it depended upon the salience of culture in the client’s life, its relevance to the presenting issue, and how culture was relayed in the session. The limitation to this qualitative examination was that multicultural competency was not measured among the counselors and that, as a retrospective study, attributions and biases may have colored the reported experiences by the participants in the study. Additionally, it was unclear if clients were being asked to report their experiences with a condition or with a specific treatment.

The construct of multicultural counseling competencies (e.g., APA, 2003; Constantine & Ladany, 2000, 2001; Sue et al., 1992) has been examined in many studies such as case conceptualization ability (Constantine & Ladany, 2000), perceived competency of the counselor and supervisor (Constantine & Ladany, 2000; D’Andrea et al., 1991; LaFromboise et al., 1991; Ponterotto et al., 1995; Quintana & Bernal, 1995; Sodowsky et al., 1994), social desirability (Constantine & Ladany, 2000; Sodowsky et al., 1998; Worthington et al., 2000), and counselors’ attributions (Worthington et al., 2000). Several instruments have also been developed to measure the concept of multicultural counseling competencies from the participants’ self-report, such as the Multicultural Awareness-Knowledge-Skills Survey (MAKSS; D’Andrea et al., 1991), the Multicultural Counseling Awareness Scale-Form B (MCAS-B; Ponterotto et al., 1996), the Cross-Cultural Counseling Inventory-Revised (CCCI-R; LaFormboise et al., 1991), and the Multicultural Counseling Inventory (MCI; Sodowsky et al., 1994). Among the various multicultural assessments, the MCI is one of the few instruments that has been used extensively in research (Pope-Davis & Dings, 1995). The MCI has four subscales reflecting the dimensions Sue et al. (1992) set forth, plus one additional focusing on relationships. The first is Multicultural Counseling Awareness, which assesses a person’s sensitivity, multicultural interactions and experiences, cultural understanding, and advocacy (Sodowsky et al., 1994). The second is Multicultural Knowledge, which measures an individual’s case conceptualization, treatment ability, and cultural knowledge. Third is Multicultural Skills, which measures general counseling skills; and finally the Multicultural Relationship, which reflects the individual’s “interpersonal process with racial and ethnic minority clients” (Constantine & Ladany, 2001, p. 484).

Although self-report multicultural competency measures are popular, one potential problem is that respondents report anticipated versus actual behavior and so answer in socially desirable ways (Constantine & Ladany, 2000). Social desirability refers to a person’s attempts at impression management (Paulhus, 1991), such that the responses given by a person are socially acceptable versus actual feelings and behaviors. For instance, Sodowsky et al. (1998) showed that the full-scale MCI was significantly related to social desirability and therefore recommended the use of a social desirability measure when using self-report multicultural competency assessments. If significant relationships between social desirability and self-reported multicultural competencies appear, statistical control is capable of controlling for the confounding effect of social desirability.

One area of promising scholarship and multicultural practice comes from the literature focused on culturally adapted psychotherapy (CAP) (Benish, Quintana, & Wampold, 2011; Griner & Smith, 2006). In CAP, the focus is on exploring the ways in which illness is explained in the client’s particular culture (illness myth). Understanding how the client conceptualized illness also allows the counselor to adapt current psychotherapy interventions to help with the client.
Mental illness and interventions for recovery are both culturally constructed. That is, the manifestations may be similar (e.g., depressive symptoms), but often the explanations may vary as well as what may be considered to be healing interventions. As a part of cultural adapted therapy, the counselor works with the client to explore what the client believes is causing the illness. That is, “asking explicit questions about what the client believed caused the problems, symptoms experienced, consequences of the illness, and treatments that were acceptable to the client” (Benish et al. p. 287).

This particular form of competency may require the counselor to validate and accept the client’s first or initial understanding of her/his problem rather than rejecting it as not meaningful (e.g., if a client believes a spirit or lack of a spirit is causing the illness). The counselor and client may then work toward developing a collaborative explanatory model (co-created) that allows for current treatments to also be involved (alongside indigenous treatments).

Race, Ethnicity, and Culture

Most of the early research and theories on multicultural competencies were predicated on race and racism. Race is and was a commonplace and familiar topic for most individuals, and racism could be easily identified as a form of prejudice and discrimination. In some ways, race and racism serve as the foundation from which we understand most other forms of oppression and marginalization (e.g., sexism, classism, and homophobia). In addressing racism, similarly to the other multicultural competencies discussed, helping professionals should grow to understand not only racially diverse others, but also to understand their own reactions and responses in working with these communities.

One of the most confusing and often frustrating issues in multicultural competency is terminology. Three terms that are often used synonymously, interchangeably, and in conflated ways are culture, race, and ethnicity. Certainly, there is a good argument to be made that these terms, especially race, are culturally constructed and have no real meaning beyond what a society imbues it with (Yee, Fairchild, Weizmann, & Wyatt, 1993). With the diversity within each group, and the gradients of phenotypic features found among cultural groups, it is fair to argue that distinct racial groups are relatively non-existent. For instance, in border regions of Asia and Russia, and India and Pakistan, what is considered racially Asian becomes very problematic since the slight variations of skin tone and physical features become difficult to differentiate.

But arguing that there are no racial groups is not the same as saying there is no racism. That is, simply trying to dismantle the significance of race, especially in the United States, does nothing to dismantle racism. Race and racial attitudes are not static, but change over time (Thornton & Taylor, 1988). Gotunda (1991) proposed that race has served as a proxy for (a) political and economic socialization patterns, (b) different cultural values, and (c) psychological characteristics inferred from physical characteristics. With all the confusion over race, the one constant seems to be that race is a social construction that is contingent upon, and defined by, specific socio-historical moments (Helms, 1995; Omi & Winant, 1994; Pope-Davis & Liu, 1998). Thus, the assessment of racial identity is seen as contextual (state versus trait), or a fluid sense of self that is contingent upon a number of factors and environment (Frable, 1997; Lemon & Waehler, 1996).

In examining race as a social construction and as an intra-psychic phenomena, racial identity theories seem to best account for the fluidity within group differences of race among a particular group of people.

Other psychologists have gone on to suggest that because race is not significant or meaningful, it makes sense to use one term rather than the other. Phinney (1996) for example, uses the term “ethnicity” instead of “race,” but still goes on to define the ethnic groups in terms of available racial groups (i.e., African, Asian, Latino, and Native American). Following this proposal by Phinney (1996), Helms and Talleyrand (1997) argued that Phinney’s proposition only made the terminology more confusing and did not address issues of racism or the cultural significance of the racial categories.

Definitions

Race

Race is defined as “the category to which others assign individuals on the basis of physical characteristics, such as skin color or hair type, and the generalizations and stereotypes made as a result” (Cooper & Leong, 2008, p. 134).

Ethnicity

Ethnic identity is reflective of cultural practices as well as the acquisition and maintenance of cultural characteristics (Cokley, 2005).

Culture

I define culture to be “customs, norms, practices, and social institutions, including psychological processes…[and] beliefs, values, and practices, including religious and spiritual traditions” (Cooper & Leong, 2008, p. 133). Among Asian Americans, cultural values and beliefs; such as filial piety, deference authority, and saving face; often span across many Asian ethnic groups such as Chinese, Japanese, and Koreans (Kim & Hong, 2004).

How to Make Use of Race in Multicultural Counseling

The Therapy Relationship

The therapeutic relationship is considered by some to be one of the principle healing tools in counseling (Bordin, 1979; Gelso & Carter, 1985; Sexton, & Whiston, 1994). Consisting of three interdependent parts: the working alliance, a transference configuration (transference and countertransference), and the real relationship (Gelso & Carter, 1994). The components of the relationship are rooted in psychodynamic theories (Patton & Kivlighan, 1997) and are limited in their application to some people regardless of cultural background. For example, clients who are not interested in developing insight do not appreciate counselor non-directiveness, or psychodynamic therapy interventions such as free association and dream interpretation, and may not stay in therapy. Although there are limitations to psychodynamic therapy (Carter, 1995), the concept of the "therapeutic relationship" does have general applications to counseling that extend beyond its psychodynamic framework (Bordin, 1979; Grencavage & Norcross, 1990; Kelly, 2000). Furthermore, authors have also proffered various ways that psychodynamically based counseling can be used effectively with cultural minority clients (Ivey, D’Andrea, Ivey, & Simek-Morgan, 2002).

Using the framework of the therapeutic relationship and its applications in a multicultural counseling context, the therapeutic relationship can be conceptualized as the "interpersonal process by which the therapist and client attempt to help the client achieve a post-therapy state that is better in some way than the one in which he or she entered therapy" (Helms & Cook, 1999, p. 159). In other words, the therapeutic relationship represents the negotiated tasks and goals between the counselor and client; the strength of the relationship will necessarily impact the outcome of therapy. Even though the therapeutic relationship seems to have general applications regardless of cultural background of the client, the problem with applying some of these concepts to a multicultural context is that much of the empirically based research on therapy ruptures and impasses are either merely theoretical or based predominantly on White clients and samples (e.g., Hill, Nutt-Williams, Heaton, Thompson, & Rhodes, 1996; Kivlighan & Shaughnessy, 2000). Hence, because the empirical data is limited, discussions about the therapeutic relationship and its applications to non-White clients should be considered speculative and applied with some sensitivity to this missing aspect in the research.

Transference Configuration

The therapeutic relationship revolves around three interdependent components. The first is the transference configuration, consisting of the client transference and the counselor's countertransference. Client transference is defined as "the repetition of past conflicts with significant others, such that feelings, attitudes, and behaviors belonging rightfully in those relationships are displaced onto the therapist; and countertransference is the therapist's transference to the client's material, both to the transference and the nontransference communications presented by the client" (Gelso & Carter, 1994, p. 297). In regard to the multicultural counseling relationship, the transference configuration can easily represent the extent to which the client repeats behaviors and attitudes that were learned from other interactions, either familial or extra-familial. Some previously learned behaviors and attitudes might be culturally based. Countertransference though, represents the feelings and behaviors that clinicians need to be aware of in session, since some of these reactions to clients may not be based on the actual therapy material but rather on issues the therapist needs to struggle with outside of the therapy relationship. For instance, countertransference typically can appear for counselors when working with clients who create discomfort or anxiety (Gelso, Fassinger, Gomez, & Latts, 1995).

Carter (1995) has noted that the construct of transference and countertransference has potential limitations within a multicultural counseling context. Specifically, counselors who are focused on understanding transference and managing countertransference could “miss the centrality of race in an individual’s intrapsychic and identity structure” (p. 72), and too much focus on the “intrapsychic” aspects of the client could obscure the contextual issues of the client’s problems. But Chin (1993) and Ivey et al. (2002) posit that the idea of countertransference has multicultural applications, since a counselor’s prejudicial attitudes will certainly manifest as some reaction to the client. Moreover, several researchers have attempted to incorporate cultural context into the constructs of transference and countertransference (Ivey et al., 2000; Leong, Wagner, & Tata, 1995). Authors have also offered suggestions to practitioners about addressing the different cultural values between psychoanalysis and patient values (Cabaniss, Oquendo, & Singer, 1994); incorporating indigenous parental constructs into psychodynamic theories (Chin, 1993; Comas-Diaz & Minrath, 1985; Scheidlinger, 1999); and encouraging counselors to understand their “racial and culturally” based countertransference (Comas-Diaz & Jacobsen, 1995; Holmes, 1992), the client’s experience in psychodynamic therapy (Aslami, 1997), and transference onto minority therapists (Tang & Gardner, 1999). This sample of applying research and theory of psychodynamic concepts with minority groups suggests that the transference configuration potentially has some applicability within multicultural competencies.

As a personal account of countertransference, I offer this example. As a psychodynamic psychologist, I am always interested in my countertransference. Countertransference is essentially the unconscious reactions, distortions, and biases we may have toward others. Because of its unconscious nature, countertransference cannot just be explored. Instead, for many psychologists, being aware and sensitive to extreme reactions and being willing to understand the root of these feelings is at the core of analysis of countertransference. My countertransference was triggered one afternoon while I was washing the dishes and I had some cable news program playing in the background. My focus was on the dishes and I was tangentially attending to the news items, when one news item stopped me. Two teenagers were filing a lawsuit against McDonalds for making them obese (Santora, 2002). From the reports, the teenagers did not realize that a McMuffin in the morning and a Big Mac, Super-Sized fries, Super-Sized Coke, and apple pie (total calories 1600) in the evening would make them fat. They just did not know. My countertransferential anger was intellectualized as “how doesn’t one know that all that McDonald’s food would make you fat?” And I caught myself. Well, that’s right, how would they know? Where would they learn that 1600 calories for one meal is exorbitant? How would they know what a calorie was and how it is used metabolically? Even if this information was posted in McDonalds, how does a person make sense of it? Finally, what are the alternatives for these children? It simply was not sufficient to avoid these legitimate questions and blame the children for lack of willpower, discipline, or self-control. Instead there are critical issues related to behavior which help explain and contextualize how and what people do.

The Real Relationship

The second component of the therapy relationship is the real relationship. The real relationship is "that dimension of the total relationship that is essentially nontransferential, and is thus relatively independent of transference" (Gelso & Carter, 1994, p. 297). The real relationship also has two dimensions: genuineness ("ability and willingness to be what one truly is in the relationship - authentic, open, and honest") and realistic perceptions ("perceptions uncontaminated by transference distortions and other defenses") (Gelso & Carter, 1994, p. 297). The real relationship represents the empathic bond that exists between client and counselor, independent of distortions. In other words, the real relationship also is the “interactive nature of the personal relationship between the client and counselor that is based on direct, genuine, and undistorted interactions” (Sexton & Whiston, 1994, p. 11). Broadly construed, the real relationship reflects the Rogerian conditions of facilitating the therapeutic bond between the client and counselor with non-directive, client-centered therapy.

The Working Alliance

Finally, the working alliance is perceived to be the most important aspect of the relationship if therapy is to proceed and be effective (Bordin, 1979; Gelso & Carter, 1994; Grencavage & Norcross, 1990; Horvath, 2000; Safran, Muran, & Samstag, 1994). Research suggests that positive ratings of the working alliance typically result in favorable therapy outcomes (Safran et al., 1990; Safran et al., 1994), and symptom reduction through the development of social support (Mallinckrodt, 1996). It is important to note again that research supporting the working alliance has typically been conducted on mostly White participants and thus, may have limited generalizability to non-White and non-middle-class clients.

Within the therapeutic relationship, the working alliance, as it is defined in the psychodynamic literature, is "the alignment or joining of the reasonable self or ego of the client and the therapist's analyzing or ‘therapizing’ self or ego for the purpose of the work" (p. 297). Simply, the working alliance refers to the capacity to which the counselor and client negotiate collaborative goals and tasks in the therapy relationship for the expressed purpose of achieving a post-therapy state that is better than the pre-therapy state (Helms & Cook, 1999). As a construct, the working alliance has strong connections to multicultural counseling because of its reliance upon the collaborative relationship and negotiating goals and tasks. The stronger the working alliance, the better able the client and counselor can develop therapy goals, tasks, and an emotional bond.

Multicultural Application of the Therapeutic Relationship

While all three components of the therapeutic relationship are intimately related to multicultural counseling, what is of interest for this chapter is the working alliance and its relationship to therapy impasses that result from a misapplication of multicultural competencies. The working alliance, with its emphasis on joining together for therapy work and negotiating tasks and goals, is relevant to multicultural competencies, since therapists sometimes may have an agenda that is not congruent with the client's (Pope-Davis et al., 2001). Comprehending the misalignment in therapy goals and tasks may help us to understand one variable in premature termination among minority clients. This is not to infer that counselors should not confront the client or engage in difficult dialogues. In fact, engaging in difficult dialogues is a reflection of a robust working alliance. Rather, this is to suggest that counselors need to be sensitive to ruptures and impasses resulting from cultural issues that lead to therapy attrition.

If the working alliance is strong, the therapy relationship may be able to withstand incongruent agendas, tasks, and goals to some extent as a process of therapy. This issue of incongruent agendas may have salience for counselors in training. As they start to learn about counseling processes and multicultural issues and concerns (e.g., racial identity, gender conflict, ableism), there may be some interest on their part to over-include these issues in therapy as a way to master these dialogues. Clients, however, may not realize that counselors in training are employing these issues for the counselor’s benefit, and consequently, incongruencies may arise. The key in the working alliance will be the resiliency of the client and the ability of the counselor to recognize and process these "incongruencies" and "impasses" in therapy.

To further understand the client, many helping professionals make use of various theories, measures, and assessments which are focused on cultural identity and acculturation. While I will cover these theories here, it is important for the helping professional to understand that these are not clinical or counseling instruments. In other words, these are research instruments and are not intended for use as a form of diagnoses, assessment, or evaluation. Unlike the Minnesota Multiphasic Personality Inventory (MMPI), racial identity measures and acculturation instruments are used only for research purposes.

These racial identity and acculturation measures have been used extensively in research and do provide information and results with clinical utility, but it is likely not useful to give a client one of these measures as part of therapy.

Racial Identity

Race and racism are so pervasive and ubiquitous in our society that it makes sense that psychologists have been and still are interested in the ways in which racism functions in people’s lives. We understand that racism is deleterious to the individual, both to their psyche and physical health (Clark, Anderson, Clark, & Williams, 1999). Thus, it also makes sense that we want to understand how individuals see themselves and others with respect to race since knowing this helps us conceptualize how racism may affect interpersonal interactions.

The first way to understand how individuals understand themselves as racialized beings is through typology models. An example of a typology model is Model of Chinese American Personality. This typology theory, advanced by Sue and Sue (1971), posited three types of personalities. First, the traditionalist is someone who subscribes strongly to Chinese values and behaviors (e.g., filial piety, harmony in relationships). Guilt is a typical consequence of not being able to fulfill one’s duties and responsibilities. Racism and discrimination are not dealt with well, and failures are attributed to the White society and the self. The second type is the marginal man. This individual identifies strongly with the White culture, eschews Chinese culture, and as a result, is caught in between two cultures. Failures in achieving parity in the White culture leads to self-hate and denigration. And finally, the third type is the Asian-American. The Asian-American is defined by his/her ability to incorporate both cultures to construct a new sense of self. The ideal result from this type is the bicultural individual.

Concerns about this model are its limited validity and generalizability because of its focus on negative consequences. While attempting to explain the responses to racism, the theory does not illuminate the ways in which people develop these personality types. Another shortcoming of this theory is its apparent lack of empirical support to evince these types (Kohatsu, 1992).

The second way to frame how people come to understand themselves as racialized beings is via the stage models. The early models exemplified epigenetic-like models. That is, the models posited stages that correspond with certain developmental levels (i.e., cognitive processing capacity). Each stage represents a higher order of processing (Helms, 1990), but as each person moves through the stages, progress is not always linear. Re-theorizing the significance of one stage representing the racial identity attitude of the individual, theorists have offered the possibility that people may reflect different stages simultaneously, but to different degrees (Kohatsu, 1992). Thus, while all stages are represented within the individual at any given time, one stage may at times be prominent and the others in an auxiliary position (Helms, 1995).

The third and most prominent way is via racial identity theories. Racial identity theories were originally developed to explain the manner in which African Americans dealt with issues of racism (Helms, 1990). The pervasive effect of race and racism on the lives of African Americans (Klonoff & Landrine, 1999) was also assumed to be the case for other people of color. Cross’ (1971) original theory has been expanded to include other minority groups through such theories as the Minority Identity Development Model (Atkinson et al., 1993). Theoretically similar to previous stage models, Atkinson et al.’s (1993) MID and Helms’ (1995) POC models attempt to explain how racial minorities in the U.S. deal with race and racism. Extending the work of Cross (1971), the models have five stages from which people think about, feel, and act toward racism in their lives. The major difference between Atkinson et al.’s and Helms’ POC model is the use of status in Helms’ model. Helms elects to describe her model as statuses because she believes each domain is permeable and fluid, rather than static and rigid as described in stage models. Helms’ more fluid definition of the theory allows the possibility that different statuses could be reflected simultaneously within the individual.

Racial Identity Model

The first status is Conformity. In this status, the person idealizes the values, beliefs, and culture of the White dominant society and denigrates his/her own race and culture (Atkinson et al., 1993; Helms, 1995). The internalization of racism and racial hatred into the lives of the racial minority manifests as hatred and negative attitudes toward others of his/her same race and culture. Typically, a person in this status believes he/she enjoys the advantages of being in the White group. This individual is also likely to act negatively toward other racial minorities.

The second status is Dissonance. In this status, the person struggles with conflicting attitudes toward the White and minority groups. Encountering an experience or information that changes his/her perception (i.e., positive toward minority group and negative toward White group), this individual is coming to terms with race and racism in his/her life. The previously held beliefs (i.e., stereotypes) of minorities are questioned, as well as their affiliation toward the White dominant group.

The third status represents two interdependent processes, Resistance and Immersion. These represent the individual’s attempt to fully plumb the effects of racism in his/her life. Consequently, the reaction typically exemplified in this status is anger and hostility toward those of the White group. Guilt, anger, and shame are salient effects in this status. In an effort to purge “Whiteness” and racism from his/her life, the cognitive stance usually positions anything connected to Whiteness as evil and bad, while anything of the minority culture is good and true.

The fourth status is Introspection. This status reflects the minority individual’s attempt to be introspective over the choices he/she has previously made. With the amount of incongruent information and feelings of conflict in his/her life, the individual is attempting to mete out a sense of consistency, such that aspects of the dominant (i.e., White) culture are allowed examination for their positive aspects. Again, a sense of confusion may pervade the individual as he/she struggles with feelings of affiliation and allegiance to minority and dominant values. There is a burgeoning understanding that a dichotomous worldview that posits minority culture as all “good” and White culture as all “bad” is too simplistic.

The final status is Synergetic Articulation and Awareness (Atkinson et al., 1993). The principle motivation in this status is the work against racism. At this point, the individual is supposed to have a better sense of self and no need to denigrate any group, individual, or culture. Ideally, the multicultural person is reflected in this status.

Racial identity has been studied in several studies. Morten and Atkinson (1983) assessed 169 African Americans on their preferences for a counselor’s race. The results showed that those in Resistance and Immersion preferred racially similar counselors while those in Synergetic Articulation and Awareness did not. Problematically though, this study only employed these two statuses and did not investigate other statuses, so it is unknown how preference for counselor race would have varied according to racial identity.

Ascribed and Subscribed Identity

Related to racial identity theory is the notion of ascribed and subscribed identity. Ascribed identity is defined as cultural assumptions made by others that are put on to an individual. For instance, an example of ascribed identity is when someone may see another person with dark skin and assume that the individual they are seeing is African American. The assumption may also lead to specific beliefs and behaviors which attempt to reinforce the perceiver’s beliefs and assumptions and the perceiver may even behave in ways to try to “force” the other individual to fit into that category. In this situation, for example, seeing someone as dark-skinned and assuming the person is African American, may lead to prejudicial behavior that the individual has against other African Americans. Another example may be seeing an Asian-American individual who is ethnically Japanese-American, but because the focus is on the racial features, the perceiver may call the Japanese-American individual a Vietnamese slur (e.g., gook) because the perceiver has a preconceived prejudice against Vietnamese individuals.

The target of the ascribed identity has no real control over these ascribed features. But the target of the ascribed identity does need to adapt to these ascribed identity features.

Subscribed identity is the internal cultural identity of the individual. Subscribed identity is the identity the individual is likely to report when asked, “What culture do you belong to?” Subscribed identity may be a racial group (e.g. Asian-American), or even an ethnic group (e.g., Chinese-American). For some individuals who come from cultural groups with strong racial and ethnic group identity, a person may have multiple subscribed identities (e.g., Asian-American, Chinese-American, second generation). The struggle many individuals may have is that their subscribed identity is neither recognized nor acknowledged by other people or even more troubling, that their subscribed identity is completely invisible, and instead the person must struggle with an externally imposed ascribed identity.

Case Example

One way racial identity may be salient in a clinical/counseling example is through the experience of an African American college student on a predominantly White campus. For one African American student who comes from another predominantly White environment, this student may see him or herself as part of the dominant group; he or she may even subscribe to the prejudices against other African Americans; and he or she may revel at being seen as “not like other Blacks.” In this situation, the African American student may be conceptualized as being in a Conformity status. It may be possible that this student goes through his or her entire life not being challenged or encountering any situation which disrupts this Conformity status worldview. The struggle for this student is the conflict he or she experiences when he or she encounters a racist situation which dislodges this Conformity status worldview. In addition to racist situations, it is also possible that the student has a positive encounter with a racially similar person and this positive experience dislodges stereotypes of African Americans. As the student attempts to reconcile these new thoughts about being African American, the counselor and helping professional should also anticipate the student going through an immersion status.

The immersion status is a worldview wherein everything that is Black or African American is seen in a positive light, everything that is White is demonized and regarded as negative, and everything that is from a non-White group (e.g., Latino), is perceived as either positive or neutral, but unlikely to be seen as negative. This dichotomous worldview is expected and a normal part of one’s evolving racial identity. The problem is that, because the client is in a predominantly White campus environment, the student may withdraw from social contact, change social support groups, and even disengage from academic endeavors. This student may be at risk for academic problems.

In assessing a client’s academic problems, it is necessary to understand a client’s social support. A relatively simple question of “tell me the racial make-up of your friends” is very telling of the individual’s preferences. But it is also important to ask about any changes the client has made or experienced in the recent past.

Acculturation and Enculturation

Acculturation theory was largely based on the psychological experiences of immigrants who, in many of the empirical studies, are ethnic and racial minorities (Berry, 2001). That is, these individuals moving into new geographic contexts were typically from ethnically (e.g., Taiwanese) or culturally (e.g., Cuban) homogenous societies, but in the host country were numerically a minority group and/or racially part of the minority groups in the host country. Although it is incredibly important to understand the experiences of people of color as migrants, it is also imperative that given the global diaspora of people, psychologists understand migration to involve any racial and ethnic group. In addition, it is important to understand the role of gender as an important variable in the migration experience. However, acculturation research has traditionally focused primarily on the role of race and ethnicity in migration.

Movement into these new geographic contexts is not simple or easy, and host countries vary in the ways in which immigrants are welcomed, accepted, and integrated that may range from open warmness to legislated hostility. Moreover, not all migrants are the same. We will discuss three groups of migrants: immigrants, sojourners, and refugees. Immigrants are usually those who may be psychologically and sometimes economically prepared to move and settle into a new country. Many immigrants choose countries which have some reason to draw them. That is, immigrants are not random in their selection of countries, and usually the immigrants are part of a long history of chain migration (e.g., family reunification; Chan, 1991; Takaki, 1993).

Sojournors, or U-Turn migrants, are individuals who are similar to immigrants who migrate into a new country, but this group intends to return at a later date, which may be months to years in the future (Chan, 1991; Takaki, 1993). This might include international students, government or military personnel, or individuals temporarily relocated by their employer. Finally, there are groups of refugees, who are unlike the immigrants or U-Turn migrants because these individuals are not psychologically prepared to migrate, and most often have little or no resources. Additionally, many refugees have a history of migration, typically desettlement and movement within their country of origin as a result of wars, famine, political upheaval, or flooding, to name a few (Chan, 1991; Takaki, 1993). For refugees, countries are often reluctant to accept their relocation since refugees are a financial cost to the receiving nation, and initial refugee settlement may also mean the beginning of chain migration (Takaki, 1993).

Of course, these distinctions are arbitrary and there is overlap in these groups, but for sake of discussion and clarity, these definitions are provided as orthogonal categories. Thus, individual acculturation or psychological acculturation (Berry, 2001) is a product of how the individual assimilates and accommodates the host culture norms, values, and beliefs, and how the host culture integrates the individual into the country.

Acculturation theories usually frame the ways in which people adapt to a culture’s customs, values, and beliefs. This adaptation implicates how gender roles may evolve, but little research has specifically investigated this premise. Certainly research has explored sex and gender differences in acculturation (Kwak & Berry, 2001; Phinney & Flores, 2002; Tang & Dion, 1999), but few have explored, for instance, how masculinity may change as a result of migration (Connell & Wood, 2005; Hooper, 2000). A man moving into a new cultural domain often experiences the pressures and expectations to adopt the host culture’s norms, values, and expectations. Simply stated, this external pressure to conform and adopt is considered part of the process of acculturation, and acculturation is the extent to which the man incorporates and inculcates the host culture’s values, beliefs, and norms (Berry, 2001; Berry, Phinney, Sam, & Vedder, 2006; Nesdale & Mak, 2000; Phinney, Horenczyk, Liebkind, & Vedder, 2001).

But acculturation is not a unidimensional process by which an individual’s native culture is lost as the host culture is gained. Berry (2001) theorized a typology of acculturation that explained various ways in which people negotiated between maintaining their cultural heritage and seeking relationships with the dominant group. In this typology, Berry suggests that assimilationists are those who do not retain their cultural heritage and seek frequent interactions with the host culture; the separationist is someone who wants to maintain his culture of origin and avoid persons from the host culture; the integrationist is someone interested in maintaining his culture of origin and also enjoys interactions with the host culture; and the marginalist is someone who has little interest in his own culture of origin and also has little interest in interacting with the host culture.

Another process intimated by Berry’s acculturation paradigm is the extent to which the man endorses and subscribes to their native culture’s values, beliefs, and norms. Enculturation is usually conceptualized as an ethnic or racial minority process, since people of color are typically in the role of moving to dominant cultures and their subscription to their native culture may moderate and/or mediate their acculturation experiences in a new host culture (Kim, 2007, 2009; Kim, Ahn, & Lam, 2009). Enculturation, similar to acculturation, also implicates gender roles, expectations, and beliefs as part of the larger construct of “culture,” but does not specifically identify or explicate gender or masculinity.

Acculturation and enculturation theories suggest that healthy adaptation to a host country or society is based on positive integration of one’s native culture and the host culture, and that an optimal outcome is to be competent in multiple cultures or to move seamlessly between cultural groups (LaFromboise, Coleman, & Gerton, 1993). Assimilation, for instance, or the complete negation of one’s native culture in favor of the host culture, is not typically regarded as a positive psychological way to integrate into a host country; similarly, subscribing only to one’s native culture, or being a separationist (Berry, 2001), is unlikely to produce positive outcomes. What the assimilationist and the separationist may point to are the ways in which people may attempt to manage the psychological stress and demands of migration. This distress is usually conceptualized as acculturative distress or stress arising when one’s resources and ability to adapt to a new environment are non-existent, overtaxed, become fatigued, or deteriorate. Assimilation (giving in) and separation (giving up) are extreme examples of psychological adaptive responses. And in general, research suggests that persons experiencing acculturative distress sometimes experience symptoms of depression, anxiety, or both, and at times may turn to substance use and abuse as a means to ameliorate the psychological distress (Caetano & Clark, 2003; Cortes, 2003; Gong, Takeuchi, Agbayani-Siewert, & Tacata, 2003). Thus, for helping professionals working with immigrant men for example, these manifest symptoms may disguise larger psychological distress related to a history of migration.

In many situations, as people decide to move from one culture to another, acculturation into the host culture does require some adaptation and readjustment. This may come in the form of language acquisition, food tolerances, and friendship networks. There is some degree of acculturation conflict that occurs, but for many this conflict and readjustment is not debilitating. For others though, acculturation conflict and the inability to adapt to a new environment expresses itself as social withdrawal, depression, and anxiety. Related coping behaviors may be excessive drinking and smoking, or other behaviors that stress social networks and intrapersonal resources. Acculturation conflict may be transitory, but in some instances the counselor and helping professional should be aware of the persistence and chronicity (frequency) of this conflict.

Acculturation conflict may also come in the form of intergenerational conflict. Intergenerational conflict arises when members of a family or social network acculturate to a host environment at different rates. Typically, when a family relocates to a host culture, children and adolescents may find acculturating to the new culture easier than parents and elders. The acquisition of a new language or adoption of new traditions and customs may not always conjure the same feelings of loss as among an older generation. As separate individuals, this difference in acculturation levels is not necessarily problematic. The intergenerational conflict that arises occurs when these individuals within the same social or family network need to interact, discuss, and support each other. A sentiment from elders in the community might be that the younger individuals are losing their cultural heritage and their cultural identity; sentiments from the more acculturated members toward less acculturated members may be that these individuals are not successfully adapting and negotiating their new environment and are at risk of being ostracized or marginalized by the larger community.

As helping professionals, one important role we may serve in these communities is in the psychoeducation role. If one is perceived to be a credible and trustworthy help giver, then psychoeducation is a legitimate role, and one may be regarded as a valuable “teacher” in the community. Educating individuals in the community about the stress and strain of acculturation is important, and helping individuals to see that acculturation does not necessarily imply loss of culture is important (for both sides). Finding ways for both groups to appreciate these differences, celebrate traditions, and recognize new forms of cultural development is vital to easing intergenerational conflicts.

Color-Blind Racial Ideology

One popular form of discussion related to race and racism is to declare oneself color-blind. In an effort by the individual to see everyone with strengths and positivity, the person might state something to the effect of “I don’t see any race, just the human race.” This particular stance is an admirable worldview to have and one to which we strive; people want to see themselves as treating everyone equally. However, the research on color-blindness tends to suggest that individuals with this particular worldview tend to perpetuate racism.

Color-evasion is what color-blind racial ideology is according to Neville, Awad, Brooks, Flores, and Bluemel (2013). In their definition, the individual who might hold a color-blind ideology and attitude may tend to deny differences and emphasize sameness but may also deny racism by “emphasizing equal opportunities (power-evasion) (p. 455). Color-blindness is a form of contemporary racism that may justify the status-quo by focusing on the idea that race and racism should not be considered factors in society and that everyone has the same chances at success regardless of background and history.

The research strongly suggests that individuals who endorse this color-blind worldview tend to engage in “racially insensitive behavior” (p. 456). In part, the color-blind person does not construe his/her behavior as potentially racist and simultaneously does not have a frame to understand racialized responses and reactions. That is, if a person of color responds by being offended, the color-blind person may see it as idiosyncratic to the person and not a part of a larger racist problem in which the person just committed a racial offense. For example, African American students often talk about White students wanting to touch their hair and when the African American student says no or is aghast at the request, the White student who holds a color-blind attitude does not see his/her behavior as racially offensive and may in fact blame the African American student for not allowing the White student to explore his/her cultural world.

As a counselor, the research evidence suggests that discussing race and racial issues is pertinent in developing a collaborative working relationship with a racial ethnic minority client (Smith & Trimble, 2016). By trying to be color-blind and not bringing up the words race or racism, the relationship may suffer because the racial ethnic client sees the world through this important lens and needs to feel comfortable with a help-provider and know that the counselor can and will discuss these potentially difficult topics (Neville et al., 2013).

“Isms”

The roots of poverty, classism, and racism are linked to the socio-political (e.g., the unequal distribution of power), socio-historical (e.g., biased and inaccurate histories of peoples), and socio-structural (e.g., legal, education, and economic systems) forces that marginalize and oppress (Liu & Ali, 2005). Poverty, classism, and economic/resource inequality are not merely unfortunate consequences of American capitalism, but are integral to the "healthy" functioning of the American economy. Zinn (1991) suggests, for instance, that the founders and authors of the Constitution were fully cognizant of the divide between the poor and rich, Black and White. Their motivation was to retain privilege and wealth for those who had it (i.e., land-owning wealthy White men), and suppress dissent and protest related to poverty and debt. The founders believed God ordained those with riches due to providence and hard work and sought to codify power and privilege among a certain group of men. Built into this assumption, of course, was the belief that wealth and poverty were "natural" aspects of human society, without regard and acknowledgement for family wealth and privilege passed through multiple generations (Zinn, 1991). As generations of the privileged sought and gained access to power and resources (e.g., government subsidies, tax waivers, special access) due merely to their status, the division between rich and poor grew. In effect, the rich gained momentum while the poor stagnated. Yet the great myth that occluded this stratification was the notion of meritocracy, and that hard work was the remedy for poverty. This myth, the belief that inequality was natural, was the "false consciousness" perpetuating stratification.

Another aspect that was afforded Whites, but denied to African, Asian, Latino, and Native Americans early in American history was the currency assigned to White skin (Harris, 1993). In America, masculinity, Whiteness, and citizenship have been so conflated and propertied (i.e., Whiteness was given value as a type of social commodity) that the three are often assumed to be one entity (Harris, 1993; Jacobson, 1998). Thus, Whiteness often represents what is ideally an “American:” the White middle-class male (Kimmel, 1996).

The White male existed in privilege since his color, citizenship, and manhood were synonymous terms that were codified in legislation. Whiteness and citizenship was imbued with value and currency (Harris, 1995; Jacobson, 1998), and it determined who could own property and who could be property (Jacobson, 1998). Whiteness was so important to define that the American legal system went through several contortions to restrict White privileges to a select group of land-owning aristocrats (Harris, 1993).

One prominent ideology that naturalized inequality was the Protestant Work Ethic (PWE). Weber (1904, 1905) coined the term "Protestant ethic," and posited the founder of PWE to be John Calvin, who believed working was a duty for all persons. Work was a means to transform the earth to reflect God's vision (Braude, 1975). Idleness was a form of evil, and work (i.e., manual labor) was idealized. For psychologists, attitudinal concepts such as the PWE, which is defined as the “degree to which individuals place work at or near the center of their lives” (Mudrack, 1997, p. 217), have been associated with an individual’s expectations and perception of career barriers, and potentially, their willingness to persevere. In PWE, work is perceived to be a positive attribute while leisure activities are regarded suspiciously, and those who endorse PWE are likely to structure their time toward work, be purposeful, avoid procrastination, be punctual, delay gratification for long-term gains, and be “type-A” personalities (Mudrack, 1997). Endorsement of PWE is related to persistence at work tasks regardless of monotony and repetitiveness, discounting the value of relaxation, regarding long commutes as normative and an accepted part of the work day, working to the end of a given time allotment rather than quitting a task early (Mirels & Garrett, 1971), achievement, endurance, willpower, self-discipline, and order; but negatively associated with impulsivity and autonomy (Mirels & Garrett, 1971).

Related to PWE may be Belief in a Just World (BJW). BJW “is the tendency of people to blame victims of misfortunes for their own fate” (Furnham & Procter, 1989, p. 365) and believe that people get what they deserve because the world is orderly, stable, and somewhat predictable. Thus, people are poor because they are lazy (Mudrack, 1997). BJW may be related to middle-class values of delayed gratification, for instance. Lerner and Miller (1978) suggested that, without endorsing this belief, people would not be able to “commit himself [sic] to the pursuit of long range goals or even to the socially regulated behavior of day to day life” (p. 1030). Researchers using the BJW construct have found relationships with the Protestant Work Ethic (PWE) ranging from .21 (p < .01) (Wagstaff, 1984) to .35 (p < .01) (Lerner, 1980); attitudes toward poverty .30 (p < .01) (Smith & Green, 1984); and personal income .21 (p < .05) (Smith & Green, 1984). Furnham and Procter (1989) suggest that BJW’s relationship to PWE is no surprise since PWE suggests hard work and personal asceticism are needed to achieve prosperity (Furnham, 1989; Mirels & Garrett, 1971).

The PWE is an important concept in our conceptualization of classism and inequality. PWE underscores the attribution of poverty to internal dispositions rather than structural disparities, and the PWE may help individuals to justify their prejudice and discriminatory behavior toward those in poverty. Since there are a higher percentage of African Americans and Latinos living in poverty, this racism is difficult to tease apart from classist attitudes. The major drawback of current psychological research is that social class and classism are not directly identified as constructs, but rather tangentially implied through concepts such as PWE and BJW.

And while we know much about racism and other forms of oppression, the helping profession has little information on social class and classism. As suggested by Liu and his colleagues (Liu, 2001, 2006; Liu & Ali, 2008; Liu, Ali et al., 2004; Liu, Soleck et al., 2004; Liu & Arguello, 2006), understanding and integrating social class and classism into counseling is an important multicultural competency. But using social class and classism is a problem if sociological perspectives are used rather than a subjective and phenomenological approach. That is, counselors understand and use the interpersonal and intrapsychic construction of race and racism, for instance, and frame their work with clients with theories such as racial identity and acculturation. Counselors do not focus specifically on race but on the psychological construction and experiences of race (i.e., racial identity, acculturation). In the end, counselors and all helping professionals need to be able to integrate multiple levels of understanding to fully comprehend the cultures and identities of a client. This multiple level of assessment, theory, and framing allow the helping professional to better understand the intersections of oppressions and marginalizations a client may be experiencing. Certainly these levels of identities do not end with race, gender, and social class, and so the helping professional needs to continue developing and evolving his or her awareness of these oppressions.

Racism and Ethnocentrism

Simply, racism may be regarded as prejudice (attitudes) and discrimination (behaviors) against those perceived to be racially dissimilar. Within this definition may also be ethnic-centrism or ethno-centrism which may be defined as prejudice and discrimination against those perceived to be ethnically dissimilar.

Covert racism is the idea that overt prejudice is not socially acceptable (e.g., direct racism against someone), and so the racism is expressed in covert ways often via proxy terms and constructs. For instance, rather than saying that “Black people are inferior or lazy” (overt racism), covert racism is often more subtle and is couched in terminology which is socially sanctioned. In this case, covert racism may be expressed as “Black people are often unqualified for their jobs.”

Aversive racism (Gaetner & Dovidio, 1986) is marked by both bias against a group and a person’s inherent belief and valuing of equity and egalitarianism. Aversive racism is best used to describe the “good White liberal” who is able to see racism when the boundaries of what is considered racism and not-racism are very clear. For instance, at a public event a Latino man may be called a “wetback” and told to “go back to Mexico.” For most aversive racists, that is a clear racist event and this person would act in ways that support his/her belief of him/herself as a White liberal (e.g., speak out in support of the Latino man). But in instances where the boundaries of what are considered racist and not-racist are less clear, what often comes across is more ambivalent racial attitudes and prejudices (“If only Blacks would work harder, they could be more successful”); The White liberal aversive racist in these instances may rely on stereotypes to help evaluate what they need to do or say (e.g., in a police shooting incident, the White liberal may not be aware of his/her inclination to support the police officer and blame the person who is shot).

Sexism

Sexism may be defined as prejudice and discrimination against another person due to gender. In most cases, sexism is against a woman and the perpetrator may be a man or woman. The defining feature in sexism, as it is in racism, is the position of power and the ability to determine another person’s opportunities, privileges, and life-course. Not all sexism is overt though. In fact, benevolent sexism (Becker & Wright, 2011) is just as pernicious. Benevolent sexism is masked as behaviors and attitudes which are protective or helpful, but in fact, tend to undermine the other individual. Benevolent sexism may be a behavior or attitude toward a woman where one believes she cannot do a particular activity (e.g., opening a door, changing a car tire). It may be possible that the woman does not know how to change a tire, but the expectation that ALL women cannot change a tire (and not considering that not ALL men can change a tire either) or stepping in and automatically changing a tire without asking is a form of benevolent sexism.

Classism

Classism is conceptualized as negative attitudes and behaviors directed toward individuals perceived to be in a different social class. Liu (2001) posited three types of classism which are directed and experienced in relationship to other people:

Downward classism (or prejudice and discrimination directed at those who are perceived to be in a lower social class group);

Upward classism (or prejudice and discrimination directed at those who are perceived to be in a higher social class group, such as labeling someone “elitist” or a “snob”); and

Lateral classism (or prejudice and discrimination directed at those perceived to be in a similar social class group which may be experienced as pressure to “Keep up with the Joneses because the Joneses keep reminding you to”).

In a revision of the SCWM, Liu (in press) theorizes another type of classism which is always triggered, Internalized Classism. Liu (in press) suggested in the SCWM-Revised that internalized classism (or feelings of inadequacy, anxiety, frustration, and depression resulting from not being able to maintain one’s social class position) is always triggered when one experiences any form of classism (i.e., downward, upward, or lateral). Internalized classism is evoked and motivates the person to find ways of accommodating and adjusting to these new demands and expectations.

Homophobia

Simply, homophobia is prejudice and discrimination against another person because of the perceived or actual sexual orientation of another person. Within this definition is also the idea of internalized homophobia which is the person’s internalization of society’s prejudice and discrimination toward a particular identity which he or she holds as well.

Heterosexism

The assumption, implicit and explicit, that the world is normatively heterosexual. Heterosexism may manifest as the assumption that “everyone is free to hold hands with romantic partners in public.” The reality is that for heterosexual couples, holding hands is normative and expected, but for many gay couples, holding hands in some environments is an invitation for hostility and aggression.

Internalized “isms”

One term some people may have seen or heard is “internalized racism/classism/homophobia” etc. The construct is not too difficult to theoretically understand, but very difficult to discern in therapy. Internalized “isms” are the introjections and personalization of society’s prejudice and discrimination against a particular group or cultural identity. For instance, racism against African Americans may be internalized by some African Americans; for these individuals, they also harbor anger, frustration, resentment, and prejudice against African Americans. This idea is simple enough, but the expression of this by an individual and its salience in therapy varies. In my experience, an African American who may have internalized racism against other African Americans may (a) not socialize with African Americans even if they are given opportunities; (b) see him/herself as unique and different from other African Americans and may even report in therapy that other non-African Americans also have that perspective and be quite happy about this recognition; and (c) denigrate other African Americans with the same magnitude as racist non-African Americans.

Micro-aggressions

Micro-aggressions are subtle or covert behaviors or statements that convey negative slights and insults toward people of color (Sue et al., 2007; Sue, Nadal et al., 2008). Sue and Sue (2008) describe them as “brief and commonplace daily verbal or behavioral indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative racial slights and insults that potentially have a harmful or unpleasant psychological impact on the target person or group” (p. 110). An example of a micro-aggression is when someone (usually a White American person) says to me (a Chinese American man), “You speak English so well,” or “You don’t act like other orientals.” The expectation that I would speak English with an accent comes from the belief that ALL Asians are foreigners and that ALL Asians speak with a heavy accent. Additionally, a comment about my English speaking ability also puts the evaluator (the person making the remark) in the role of a legitimizer or gate-keeper of cultural customs; the evaluator becomes the person who is implicitly saying, “Hey you’re like me…you’re just as normal as me.”

Micro-aggressions may also come in the form of stereotypes or jokes. Telling a racist joke, even if not about the ethnic or racial group to which I belong, is a form of micro-aggression because it speaks to the general insensitivity toward cultural diversity which is typically the point of jokes against racial ethnic individuals. As a psychologist, I also know that these jokes, even though the teller of the joke usually prefaces the joke by saying “please don’t think I’m racist,” in fact reveals the person’s true racist inclinations (Hodson, Rush, & MacInnis, 2010).

The examples above are all forms of micro-aggressions. And to be even more specific in their distinctions of micro-aggressions, Sue and Sue (2008) also go on to describe several other variants of micro-aggressions. They describe micro-assaults which are “blatant verbal, nonverbal, or environmental attack intended to convey discriminatory and biased sentiments” (p. 111). An example of this is simply the use of a blatant and overt form of racist or other derogatory term (e.g., “fag”). Micro-insults are considered to be “unintentional behaviors or verbal comments that convey rudeness or insensitivity or demean a person’s racial heritage identity, gender identity, or sexual orientation identity” (p. 111). Being surprised at the English ability of an Asian-American may be considered a form of micro-insult. Finally, Sue and Sue (2008) describe micro-invalidations, which are “verbal comments or behaviors that exclude, negate, or dismiss the psychological thoughts, feelings, or experiential reality of the target group” (p. 112). In discussing an altercation between two people, dismissing the possibility that race plays a role in the conflict is a form of invalidating the salience of race for one of the individuals in the altercation.

Worldviews

Worldview may be defined as “sets of beliefs or assumptions that describe reality” (Koltko-Rivera, 2004, p. 3). This definition is about how life within that worldview is described, is lived, its goals, and its limits. “A worldview defines what can be known or done in the world, and how it can be known or done” (p. 4). More simply, worldviews are a kind of lens through which we see the world, and these lenses color, distort, magnify, and limit what is seen and what information is taken in by the individual.

The worldview of people comprises their experiences, value systems, contacts with cultural groups, and experiences with marginalization. This last point, marginalization, is related to their experiences with discrimination, oppression, and alienation with respect to any of their cultural identities. This is important since any person may have an experience of marginalization (e.g., heterosexism, homophobia, racism, sexism). Some persons are much more familiar with these experiences, and have coping styles and mechanisms, while for some others it is a new experience which they have difficulty understanding, and yet for others, they may completely not recognize when someone or some group marginalizes them. All of these experiences become part of their worldview – the lens through which the world is experienced, how cultural information is understood, and how people act upon the world. There is no pristine worldview and so there are always distortions and biases which are part of the worldview.

Because there are always distortions and biases, the helping professional’s role is to (a) understand his or her own worldview, and (b) understand the client’s worldview. Understanding what triggers us in therapy (e.g., countertransference) is a vital multicultural competency. And understanding the ways in which the client constructs his or her worldview is another critical multicultural competency. These two components are necessary in developing appropriate therapy relationships and effective interventions in therapy.

One therapy example comes from my work with homeless men. I conduct a therapy group with a group of men who are homeless and who are a part of a permanent housing program designed to help them work in a group and live with each other. During one of our discussions, one of the men became enraged when discussing an encounter with another resident. This other resident just happened to be absent that day. So the enraged man described their encounter and then went a verbal rampage. This resident used every vile descriptor possible in this one-minute rant. He was angry and was looking for conflict from the other men in the group; he wanted a fight even though his complaint was not targeted toward anyone specific in the group. In this situation, my cultural worldview is one that values interpersonal harmony and minimization of conflict. Asian cultural values also focus on saving face, and in this situation, I sought to minimize any shame for that man. These are aspects of my cultural worldview. Personally, I was hurt for the other man and part of me wanted to use my professional role to punish the speaker for his vitriol. I knew I could phrase it in a way that would have used the full force of my credentials and position to isolate and punish him for speaking out. For the man, his worldview was comprised of intense and frequent experiences of marginalization and alienation and his last encounter with this other resident only reinforced these previous experiences. His current worldview also accustomed him to verbal and physical altercations, so he was expecting to be verbally and possibly, physically attacked.

In this situation, I used what would be considered the most simple and basic counseling skills. I used emotional reflection. I said to him, “I see you are frustrated and angry and it is possible no one has really heard you.” At that, he sat down and physically he became less tense; he sat back and eased his body back into the chair; his chest deflated, and his shoulders became less tense. He responded in a normal tone and just said, “I’m really angry.” The rest of the group also relaxed. I realized also for the rest of the group members that this expression of rage was unfortunately familiar to them and that they were likely re-experiencing their own histories of traumas and violence in interpersonal relationships. I needed to also address them and bring them together. I used an open question that focused on their feelings and said, “How is everyone feeling now?” This query allowed people to focus on themselves and not on the speaker and to then relate to the rage, the experience, and even bring in their own histories.

Value Systems

Value systems are principles and frameworks by which we see the world and which guides our actions. Kluckhohn and Strodtbeck (1961) attempted to classify different ethnic and racial groups’ value systems according to particular areas of relationships. For instance, they categorized White Americans as having value systems that (a) value mastery over nature, (b) have a future orientation, (c) value individual relationships, (d) value doing and action, and (e) have a dichotomous view of the world as either good or bad. The authors also posited these same categories for Asian, African, Latino, and Native Americans. In their categorization, each of the racial groups varied from White Americans. For example, most of the other groups were assumed to value harmony with nature, present-time orientation, collectivism, action, and to see the world as generally good. With some slight variability, White Americans tended to be regarded as different in value systems from the racial minority groups.

Individualism and Collectivism

One of the most basic forms in which cultures may vary is with respect to their expectations for how an individual operates as a member of a group. Individualism and collectivism is a descriptor for this basic value scheme. A simple definition is that individualism and individualistic-valuing cultures prefer independence, autonomy, and separation. The individual is responsible for his/her own actions and conduct. In contrast, collectivism values interdependence, social integrity, in-group norms. In collectivism, there may be a diffusion of responsibility such that the group takes on the role of regulating, reinforcing, or punishing conduct. In this last example, it may be that in some collectivistic groups, if one is not behaving in accordance to group norms and behaviors, rather than a single person confronting the individual, a group of individuals may confront the person, or it may be possible that someone tangentially connected to that target individual is the person to reprimand or reinforce poor behavior.

While it may seem that these two dimensions are orthogonal or mutually exclusive, the actual presentation of individualism and collectivism within any one person is more complex. Rather than seeing these two dimensions as unique and mutually exclusive, I believe these dimensions are both present in any person. For any person, there are “high” and “low” anchors for individualism and collectivism such that a person may be potentially “high” in both individualism and collectivism, or perhaps “low” in both individualism and collectivism. A “high” on both dimensions may represent someone who is able to switch well between cultural groups who both value individualism and collectivism. Consider a college student from a racial and ethnic minority background who is the first to attend college. At the college, the student learns the value of individualism, but when the student returns home, the student is able to revert to and feel comfortable with the collectivistic values of the family and community environment. Conversely, someone who might be “low” in both individualism and collectivism is someone who may regard him or herself as socially alienated from the larger society; someone who does not subscribe to the norms of any particular group; and someone who has difficulty moving between cultural contexts.

Although the “high” and “low” on both dimensions are possible, it is most likely that people are within the middle of both dimensions at any given time. I also do not believe that “individualism” only represents modern, industrialized, and White cultural groups and “collectivism” only represents marginal, and racial and ethnic cultural groups. While it is fair that many racial and ethnic groups tend to be collectivistic because of their cultural heritage, many cultural groups worldwide are struggling with the changes in these basic value systems. Societies which were agrarian and pre-industrialized, and are now shifting to more modern industries (e.g., China), are faced with a conflict of value systems wherein collectivistic values which were important for interdependence and survival do not always work well in industrialized and monetary societies, which value individual success and wealth.

Moreover, I teach at a large university in a rural state, and some of my students are from the surrounding rural areas. Although the United States may be considered by many as an individualistic-focused society, there are a great many communities which still highly value collectivism. Students will describe how they were taught to be self-reliant (individualism) but they are still expected to call their parents every night and discuss any significant decisions throughout their day (collectivism).

High- and Low-Context Communication

Sue and Sue (2008): An "HC communication or message is one that is anchored in the physical context (situation) or internalized in the person. Less reliance is placed on the explicit code or message content. An HC communication relies heavily on nonverbal and the group identification/understanding shared by those communicating (p. 167)… Low-context cultures place a greater reliance on the verbal part of the message. In addition, LC cultures have been associated with being more opportunistic, more individual rather than group oriented, and as emphasizing rules of law and procedure.” (p. 168).

Examples of high-context communication are typically language stylings from minority racial and ethnic groups (e.g., Asian, Latino, and African Americans). High-context communication is usually heard as the same word being spoken in a native language, but depending on the situation, the word itself has a different meaning. For example, saying “Aloha” can mean hello and goodbye depending on when it is used. There may be slight tonal variations in the word, but the context or situation, as well as other gestures communicate the meaning of the word.

Low-context communication styles are typical in most industrialized societies. The United States is one example of a society which typically relies on low-context communication. There is a word for an object, for instance (e.g., table), and that word does not vary regardless of a change in situation. Low-context communication is important since science, business, and law, for instance, depend on language that is distinct and relatively invariable. It is important to communicate concretely.

Other Types of Identity Models and Cultural Frameworks

There are other identity models and cultural frameworks that may also be integrated into therapy. Two examples are social class, and how men come to struggle with their gender role expectations. There are many other models available and it is far beyond the scope of this course to cover them all. There are identity models for sexual orientation, disability status, and gender development for women, to name a few. The two examples presented here illustrate with case studies how these additional frameworks intersect and can be additive in a helping professional’s understanding of a client.

Gender Role Conflict

Before the normative approach to investigating masculinity, much of the literature focused on masculine traits. In his book, The Myth of Masculinity (1981), Joseph Pleck suggested that the gender role identity (GRI) paradigm (i.e., trait) did not, and could not, explain the multitude of issues facing men. It was Pleck’s (1981) opinion that the gender role identity paradigms reinforced, rather than critiqued, gender roles.

The GRI paradigm proposed that people need to have a gender role identity, and that this identity was related to the degree to which the individual subscribed to that gender role. Gender roles were basically “behaviors, expectations, and values defined by society as masculine and feminine” (O’Neil, 1990, p. 24). The process of adopting a gender role was itself strenuous, conflicted, and had negative effects on the man (Pleck, 1995). However, failure to define one’s gender role identity could lead to homosexuality, hypermasculinity, and negative attitudes toward women.

Pleck (1981) proposed an alternative theory of masculinity: gender role conflict. He believed that gender roles are fluid, inconsistent, and often have contradictory expectations for men. O’Neil, Good, and Holmes (1995) further clarified gender role conflict as the “psychological state in which socialized gender roles have negative consequences on the person or others” (O’Neil et al., 1995, p. 166). Conflicts are expected as a result of the gender role journey that brings a man from traditional masculinity through ambivalence, confusion, anger and fear, to personal and professional advocacy (O’Neil et al., 1986). The conflicts affect the person’s cognitions, emotional life, behaviors, and unconscious experiences, and can be brought on by others, the self, or expressed toward others (O’Neil et al., 1995).

Gender role conflict is triggered when one (a) deviates from gender role norms, (b) tries, and meets or fails to meet gender role norms, (c) experiences a discrepancy between the real and ideal selves related to gender role norms, (d) personally devalues, restricts, or violates oneself, (e) experiences from others devaluation, restrictions, and violations, or (f) devalues, restricts, or violates others because of gender role stereotypes (O’Neil et al., 1995, p. 167). In an attempt to further understand gender role conflict, an instrument was developed that reflected six patterns of gender role conflict arising from a fear of femininity and the negative consequences for those who deviate from the prescribed masculine role. The six theoretical patterns (i.e., domains) of gender role conflict measured in the Gender Role Conflict Scale (GRCS) are (a) restrictive emotionality, (b) control, power and competition, (c) homophobia, (d) restrictive sexual and emotional behavior, (e) an obsession with achievement and success, and (f) health problems resulting from gender role socialization (O’Neil et al., 1995, p. 171). In developing the instrument, a study with a sample of 527 college men found that, of the six domains, there were actually four interpretable domains including (a) success, power, and competition, (b) restriction of emotions and a lack of emotional responsiveness, (c) homophobia, and (d) a restriction of affect toward other men (O’Neil et al., 1986).

The GRCS (O’Neil et al., 1986) is designed to measure a man’s experience of gender role conflict. Unlike the MRNI, which measures a person’s endorsement of traditional masculine norms (e.g., “A man should always be the boss”), the GRCS measures the distress and anxiety that result from endorsing these traditional norms (e.g., “I worry about failing and how it affects my doing well as a man”). The instrument consists of 37 statements to which individuals indicate their level of agreement or disagreement on a 6-point Likert-type scale. In addition to a total score, the GRCS can also yield scores on four subscales: Success, Power, and Competition Issues (e.g., “Winning is a measure of my personal value and worth”); Restrictive Emotionality (e.g., “I have difficulty expressing my tender feelings”); Restrictive Affectionate Behavior Between Men (e.g., “Affection with other men makes me tense”); and Conflict Between Work and Family Relations (e.g., “My work or school often disrupts other parts of my life: home, health, or leisure”).

Gender role conflict, as measured by the GRCS, has been found to be significantly related to numerous critical psychological variables. For instance, gender role conflict has been found to relate to depression, stress, anxiety, and self-esteem in men across a variety of racial and ethnic groups (O’Neil, 2008). In addition, studies of non-American men have found significant relationships between subscales on the GRCS and psychological variables such as depression, stress, and anxiety among men from England, Ireland, Australia, Russia, Indonesia, Germany, Taiwan, Korea, and Japan (O’Neil, 2008). While this research confirms that gender role conflict is not merely an American phenomenon, there is not enough evidence to draw conclusions about how the construct operates in different cultures. It is possible that the various types of gender role conflict manifest themselves differently in different cultures. For instance, in cultures where affectionate behavior between men is common, this type of gender role conflict may be less applicable. Alternatively, some types of gender role conflict may be more salient in other parts of the world than they are in the United States.

Social Class Worldview Model – Revised

The original SCWM (Liu, 2001, 2002) was developed as a theoretical framework that shifts the psychological discourse around social class away from the stratification and sociological paradigms which have permeated much of the theoretical and empirical literature. The SCWM provides a theoretical model, a heuristic that integrates both social class and classism and allows psychologists a means to explore the subjective social class experiences of individuals. Worldview is used as the psychological construct from which social class is understood by the individual. The SCWM is meant as a way to model, frame, and understand social class behaviors, attitudes, and cognitions, and comprises multiple components, so consequently, there is no one measure that adequately assesses the entire model. The SCWM (Liu, 2001, 2002; Liu & Arguello, 2006; Liu & Ali, 2008) is comprised of three components which are theoretically linked in a feedback system to help the individual maintain homeostasis, or a positive sense of self within his/her social class. The first assumption of the SCWM is that people are motivated to maintain a sense of normality within their perceived social class group. Individuals’ motivations are to perceive and act on the world in similar ways to their peers and cohorts, and if successful, they achieve a sense of homeostasis. Disequilibrium occurs when new demands and expectations are exacted on the individual, and the person must configure behaviors, resources, and attitudes to reestablish their homeostasis. For instance, disequilibrium may occur when new materialistic demands are placed on a person such as a new car or a larger home. If the individual believes these new materialistic expectations are a part of being normal in the social class group, then the individual will act in ways to obtain the new object(s). A second assumption of the SCWM is that people live within different Economic Cultures (ECs) or neighborhoods or communities within which the individual seeks social class position and status. For instance, economic cultures vary such that there is not one unitary “middle-class” group but many “middle-class” groups or ECs. There are not necessarily any real geographic or material boundaries demarcating these ECs, but certainly for some individuals an EC may be a certain neighborhood or community with familial roots, economic markers (e.g., gated communities), or setting (e.g., school or work).

These different ECs vary with regard to expectations and demands on a person. In one EC, physical attributes may be highly valued, and individuals in that EC may feel pressure to develop and maintain physical attributes and features. Athletes for instance may find themselves in ECs where physicality is valued above other resources, and physical prowess is a type of capital (resource) that is employed to maintain one’s social class position. Another example may be professors where intellectual abilities are favored and social capital (one’s social network) is equally important to nurture. Thus, an EC is important because it shapes the expectations and demands an individual experiences with regard to accumulating and using certain kinds of capital or resources. Within the SCWM, there are three types of capital to accumulate: cultural capital (aesthetics important in the EC), social capital (important relationships), and human capital (important physical or intellectual skills).

The second component is the worldview, or the lens through which the individual attempts to understand these different capital demands and how these resources are to be used. The individual’s worldview is in part composed of socialization messages from parents and peers. Another group which provides socialization messages is the group to which the individual aspires (e.g., upper-class groups). Other components of the worldview are an individual’s materialistic attitudes, perceived social class-congruent behaviors (e.g., etiquette, accent), and lifestyle considerations such as the way a person spends time (e.g., leisure, work, vacations). These aspects of the worldview are not all equally salient but vary depending on the EC. Depending on the EC of the individual, one of these dimensions will be prominent and be the likely way through which the world is experienced and perceived. For instance, an individual may live in an EC where social network capital is highly valued, and one way the individual believes (and is reinforced in believing) that these interpersonal relationships are developed is through material possessions. Thus, for this person, others are valued for “what they have,” the self is valued for what is possessed, and a motivational factor is the accumulation of belongings as a way to maintain one’s social class position.

The final component is classism. In the SCWM, classism is both interpreted and used by the individual to maintain one’s social class. Classism, therefore, is both employed by the individual to gain resources, and experienced by the individual when interacting with people from perceived different social class groups. For example, if it were important in an EC to maintain social capital and social networks through the exclusion of individuals believed to be from “upper-class” groups, then the labeling of those perceived to be “elitist” would be a form of upward classism. These forms of classism are, in some ways independent of the objective social class position of the individual such that one could be from an upper social class group (defined by extreme wealth, high education, and prestigious occupation), but still characterize someone as “elitist” or a “snob.” Upward classism is one of four types of classism in the SCWM. The four types of classism are: downward (against those perceived to be in a lower social class), upward (against those perceived to be in a higher group), lateral (against those perceived to be in a similar group and may be experienced as pressure to keep up with the Joneses because the Joneses keep reminding them), and internalized (against the self for not being able to maintain one’s social class position).

Although downward classism has been largely recognized as a dominant form of oppression and a principle factor related to inequality (Smith, 2000, 2005, 2008; Smith, Foley, & Chaney, 2008), Liu and Ali (2008) and Liu and Pope-Davis (2003) have argued that classism, much like other forms of oppression and marginalization has to be conceptualized as a network of power relationships and that this oppressive web is nurtured by any and all forms of classism. And while the effects of downward classism and inequality are pernicious, upward and lateral classisms help to reinforce and feed the interpersonal prejudices and biases which solidify discrimination against those who are poor.

One form of classism that Liu proposes is internalized classism. Internalized classism is not just the introjections of negative stereotypes about being poor. Instead, internalized classism, as part of the SCWM, is conceptualized as the feelings of anxiety, depression, or inadequacy resulting from one’s inability to maintain one’s social status. Internalized classism is not classism to be used against others, as lateral or downward classism are. This redefinition of internalized classism represents a slight revision to the SCWM and posits that internalized classism is always activated as a result of experiences with upward, downward, or lateral classism and not just activated when the individual is unable to meet the expectations of the economic culture. More specifically, internalized classism is an intrapsychic classism experience that is triggered when new social class demands and expectations are placed on the individual or when resources are inadequate to meet one’s current social class standing. For instance, Liu posits that internalized classism is regularly triggered when new products (e.g., cars, computers) are introduced and meant to appeal to the individual’s economic culture. As people within the economic culture purchase the product, lateral classism may be exerted and experienced by the individual (i.e., keeping up with others in one’s cohort). The effect of lateral classism is to remind individuals what is necessary to maintain one’s social class position. Internalized classism is always enacted internally (i.e., feelings of inadequacy, anxiety) as the individual recognizes they are deficient. At issue, and most important, is whether the individual possesses the capacity to meet these new demands. If the opportunity and capacity exists, then the individual may obtain the possession and maintain homeostasis. If the individual is unable, then the person is in a state of disequilibrium and must find some means to reinstate equilibrium (e.g., purchasing the material object on credit) or potentially shift the economic culture within which these demands originate.

Internalized classism helps psychologists potentially understand the relationships between the individual experiencing internalized classism and his/her relationships and mental health. For instance, as Liu (2002) speculated in his discussion of social class and men, internalized classism may be a factor related to the despair, depression, and anxiety men experience when they lose their job. It is not only the loss of the “breadwinner” status (Kimmel, 1996) but the job loss also means the man is unable to maintain his social class position. Liu also speculates that internalized classism is possibly one aspect related to adjustment disorders for first-generation college students. As these men and women enter college and universities and begin interacting with students across the social class spectrum, they may start to experience internalized classism related to new social norms and values. Especially pertinent for first-generation college students from working-class or lower-class backgrounds are distinct pressures toward obtaining new material goods and products. Certainly some material purchases are practical (i.e., computer) others may be disguises that allow this particular student to “pass” for a social class group (i.e., clothes, iPod). It may be no surprise then that credit card use may often start in college (Roberts & Jones, 2005). Unfortunately, focusing on material objects to cope with interpersonal issues and conflicts is ineffective and may only further exacerbate the interpersonal problems by adding on financial burdens.

This framework has been used to guide exploration of an individual’s social class experiences and worldview (APA, 2007; Liu & Ali, 2008; Liu & Arguello, 2006). Clinicians are encouraged to explore the three interrelated components as a means to help the person develop insight about their experiences and to develop healthy coping skills to navigate his/her economic culture and environment.

Case Example

An eighteen-year-old White male comes to the college counseling center complaining of depression. He is a first-year student and has not declared a major. He lives in the “freshman house” on campus, and reports no close friends. He appears in the first session unusually dressed for a “typical” freshman on campus. He wears expensive new dress shoes, pressed slacks, and an oxford shirt and blazer. He is neat and seems well mannered. As a way to understand this client, the clinician uses the three-step exploration around social class to gather more information.

To understand his economic culture, the clinician asks about the economic cultural environment with which he most identifies. He stated that he sees himself as part of the university and identifies highly with being a college student. He referred to himself as the college’s mascot for emphasis. For him, the most important aspect of a college experience was developing a friendship network (social capital) that he believed would lead to job connections in his future. Secondarily, he thought that in order to best “fit in” he also needed to know “all the things that these people knew.” When pressed, he started to describe in detail how important it was for him to know about art, music, clothes, and food (cultural capital).

In exploring his social class worldview, he described the salience of social class behaviors, property relationships, and lifestyle. He talked about how he constantly scanned fashion magazines, movies, and television for what was “cool” and the “latest.” In fact, as a new student, he discovered that he qualified for multiple credit cards that he used to facilitate his purchase of the “coolest” and “latest” fads (e.g., Kottler, 1999). He believed that, when he gets his job after college, he would make enough money to pay everything off quickly. The group that communicated the most salient social class messages for him was his peer group, and hence, he tended to listen and incorporate much of what they told him and how he was to be. As the exploration turned to his family (i.e., his group of origin), he became more reticent in counseling. Information that came forward was that he was the first in his family to go to college, and that his family lives on a farm in a far off county. Because of his reluctance to discuss his background, the clinician gained some insight into potential sources of his internalized classism and what could be contributing to his current depressed mood.

In a discussion about classism in his life, the most palpable pressure he felt was to be like his peer group (i.e., lateral classism). He spoke constantly about how each person in his peer group would deride another for not having the “right” shoes or driving the “best” car. For the client, he exhibited downward classism toward others he regarded as “white trash.” He wanted to distance himself as far as possible from those who reminded him of his own background, which he pejoratively characterized as “white trash,” “hillbillies,” and “from a trailer park.” Unfortunately, he was also feeling extremely anxious about being “found out” or “not passing” as part of his new college group. His perceptions of lateral classism were so profound that he never talked about his family at all, to anyone, and recently started to invent stories about his family to make them appear more favorable to his friends.

As the client and counselor talked, it became apparent that the client was spending an inordinate amount of energy and time canvassing his environment for subtle social class clues, maintaining the façade of being “middle class,” and distancing himself from his family. Consequently, his friends started to notice his inconsistencies about his family and who he was, and started to distance themselves from him. Hence, as his peer group started to dissipate, he felt his ability to maintain his capital accumulation being threatened, and not having any other skills, other than being classist, to regain his friends, his internalized classism became increasingly apparent.

Case Discussion

In this case, several unique issues arise that need to be explored with the client. First, the client is a first-generation college student and has shifted economic cultures. Switching economic cultures assumes that the client experienced some changes between growing up on a farm and coming to a university. Second, his worldview is oriented around social class demonstrations of who he believes he is and how he wants to be perceived by others. In other words, he spends much of his energy and time consumed with maintaining a “false” self. Finally, the client struggles with distancing himself from what he identifies as “white trash” culture, which invariably includes his family. Interestingly though, as counseling progressed, he spoke very fondly of his family, and his inability to talk about his family in an open and honest manner created conflicts for him. He also was acutely aware of his façade and became anxious about being discovered to be a “fake” middle-class person (e.g., Croizet, & Clarire, 1998). Any questions revolving around his family background evoked a similar heightened anxiety response.

As counseling progressed, the counselor attempted to normalize the pressures and conflict the client was experiencing. The counselor also worked with the client to understand better how his social class worldview operated and how classism functioned in his life. Specifically, the counselor and client talked about the conflicts, strain, and energy that he used to maintain his “false” self. Eventually, through the course of short-term counseling, the client developed a different extended friendship network outside his current group that reflected more of his evolving value system. He also focused on choosing a major and discovered other avenues to success that were possible beside social networks. As his friendship network changed, so did his social class worldview, and as a result, his anxiety and depression lessened.

Critiques of Multiculturalism

In order to begin a critique and reconceptualization of diversity and multiculturalism, we revisit the operational definition of these two terms. With both definitions, there are some overlaps of concepts, since each is related to each other in strategic ways. However, we will provide, what we think are appropriate distinctions between the two constructs.

First, as noted earlier, diversity is best defined as numbers and representation. Metaphorically, the diversity is reflected in the tiles of the mosaic or ingredients in salads, stews, and stir-fries. Diversity is an attempt by some group or organization to reflect the putative variability of peoples in their environment. It is often a tactic (i.e., a means to an end) that employs either no long-term plan or only short-term gains. There is no need to critique the power relationships or the status-quo when diversity is used. Within applied psychology programs, diversity is best illustrated by attending to the “one” multicultural course as an indicator of the program’s commitment to multiculturalism. Additionally, the burden of diversity and diversification efforts are often placed on the shoulders of the “people of color” or people of other “diverse” backgrounds. Consequently, diversity becomes a “minority” or “people-of-color” issue, which often implies that it is a marginal issue.

As for multiculturalism, the definition includes diversity and diversification efforts, but moves far beyond it. Multiculturalism is a concerted plan (i.e., strategy) that employs multiple knowledges of people, histories, and contexts in an effort to challenge the current state of mental health practice, theory, and training. Multiculturalism is not just a philosophical worldview (Helms & Richardson, 1997) wherein clinicians will take into account the similar and different experiences that people have and remember to be sensitive to them. Instead, multiculturalism should be omnipresent in every course taught and in the way training is conducted. Multiculturalism is not just remembering to be beneficent for the client, but a plan of action that employs the knowledge of people, culture, history, and context to effect the way theories are used, diagnoses are done, and treatment plans are made. In training, whether or not an instructor states it explicitly, some psychological theory is invoked. This psychological theory helps the instructor organize and make sense of the client, and these are the learned experiences that he or she want to impart onto the trainee. When multiculturalism becomes a part of all training, such that it becomes an unconscious schema (i.e., non-explicit) used to organize and make sense of the environment, then multiculturalism will have met the goal of integration. This integration would be beyond the ability of people to point it out, since multiculturalism is a part of everything. Finally, multiculturalism would be a part of everyone’s life and would not be limited to only diverse groups or “people of color.”

Due to the lack of a unified definition of multiculturalism and diversity, there has been some misunderstanding about the intent and goals of multiculturalism.

A Basic Misunderstanding of Multiculturalism in the Helping Professions

An example of these kinds of misunderstanding is best illustrated by an article written by Fowers and Richardson (1996) that asked “Why is Multiculturalism Good?” The article provides a good study in how multiculturalism is often misinterpreted and confused with other issues (e.g., relativism), and why the discourse over multiculturalism is often burdened with the necessity to clarify. In the article, the authors accepted one of the great misnomers of multiculturalism, that cultural relativism is a defining feature (Fowers & Richardson, 1996; Orwin, 1996). A relativistic understanding and acceptance of culture means that any cultural behaviors are tolerated within multiculturalism, e.g., “Serbian nationalism...[and] ethnic slaughter in Rwanda” (Fowers & Richardson, 1996,p. 615). As a result, American society has been characterized by “democratic, egalitarian, [and] liberal principles” (Fowers & Richardson, 1996, p. 613), causing an erosion of its national identity. Other events championed by multiculturalism that have also caused the degradation of American values and institutions are the “liberation movements, the mass influx into North American universities of students of non-Western backgrounds, the influence of the ‘postmodernist’ celebration of difference…[and] the anti-Americanism of the 1960s” (Orwin, 1996, p. 6). Orwin’s (1996) position was clear in his critique of “multiculturalism:” he polemically seeks to re-center “Whiteness” as quintessentially “American,” and to reorganize the relationships of power that benefit his group. For him, America has much to worry about because the liberal 1960s, with its Civil Rights, affirmative action, and changes in immigration policy, contained events that set the stage for America’s lessening position in the world. It was imperative for him to reassert “American” values and beliefs rooted in a nostalgia of America before the 1960s, because the multicultural value system seems to be antithetical to his “America.”

In a similar way, Fowers and Richardson (1996) also seek to reassert the position of Western/American/Euro-American Whites as the foundation for multiculturalism. Fowers and Richardson (1996) want to remind multiculturalists that Western culture has provided the foundational values and ethics that structure and drive the multicultural movement. In an effort to create similarity between non-Western and Western contributions to multiculturalism, the authors’ analogizing allows them to “stay focused on [their] own situation without grappling with the other persons’ reality” (Grillo & Wildman, 1997, p. 619). In essence, Fowers and Richardson talk about “multiculturalism” but stay focused on the “White” condition. While they agree that Western society has participated in racism and oppression, their linear view of American and world history has concluded that it is essentially beneficent. For these authors, Western civilization’s major epochs (e.g., Enlightenment and the Reformation) have served to clarify and reinforce the value of citizenship, equality, and individual rights. Fowers and Richardson also neglect to mention that the pillars of European intellectual thought (e.g., Plato and Aristotle) “were not interested in theorizing or empowering ways that women, slaves, or other culturally marginalized people might speak” (Nakayama & Krizek, 1995, p. 292). This exclusion of rights and privilege was not only a feature of pre-modern civilization but an institutionalized facet of American democracy.

Another problem with Fowers and Richardson’s supportive argument was its singular focus on European events and avoidance of investigating how the “West” achieved these ideals. Specifically, Fowers and Richardson do not explore the roles of colonization and imperialism that created the links with other peoples (Said, 1993) from which the belief system of other groups was confiscated by the West. One clear example is the democratic ideals often connected to Thomas Jefferson and James Madison that were first created and nurtured by Indigenous Americans (Loewen, 1995). Thus, by circumventing the context from which the Western value system developed, it appears that the Western value system was a natural (i.e., inevitable) progression of European culture which in turn was given to other (i.e., inferior) cultural and racial groups (Blaut, 1993).

The absence of history from their argument allows Fowers and Richardson to equivocate European and non-European history and culture and minimize the role power, racism, sexism, and privilege have played. In their view, because the similarities outweigh the differences, contemporary psychology and multiculturalism share liberal tenets that should be examined and operationalized. Multiculturalists should stop focusing on the problem of power, and instead forge stability among all the different peoples and cultures in the U.S. The question then becomes, if this is the trajectory multiculturalism takes, who does it benefit? The answer seems to be that those in power positions within psychology benefit because, again power is not critiqued, and instead the esthetics of multiculturalism (i.e., diversity) are manipulated.

The relativistic point of view and the recognition of cultural difference may perpetuate oppressive and exclusionary viewpoints. Like the Ku Klux Klan who now preach “White love,” racist ideology may now be embraced as a form of diversity. The responsibility for not being tolerant is no longer on the racist, but on those around who may not share his or her worldview. A typical comment that legitimizes racism under the guise of relativism is, “if this sounds racist, then I accept it, but you are not being very tolerant of my worldview.” Diversity’s uncritical stance on power allows for White racism to be seen as an aspect of multiculturalism.

While cultural relativism is a means to incorporate culture, not all cultural characteristics may be beneficial or valid. To argue that multiculturalism advocates cultural relativism serves to reinforce the dominant hegemony since it would be clear that most rational people would oppose embracing extreme value systems such as genocide or genital mutilation… or would they? Because we end up focusing on the negative cultural manifestations, we forget that the multicultural agenda focuses on critiquing these cultural forms as well. Cultural relativism, as equated with multiculturalism, serves to distract the focus away from dominant hegemonic power relations.

References

Abbott, K., Tollefson, N., & McDermott, D. (1982). Counselor race as a factor in counselor preference. Journal of College Student Personnel, 23, 36-40.

Abreu, J.M., Chung, R.H.G., & Atkinson, D.R. (2000). Multicultural counseling training: past, present, and future directions. The Counseling Psychologist, 28, 641-656.

Akutsu, P.D., Lin, C.H., & Zane, N.W.S. (1990). Predictors of utilization intent of counseling among Chinese and White students: A test of the proximal-distal model. Journal of Counseling Psychology, 37, 445-452.

Ali, S.R., Liu, W.M., Humeidan, M.A. (2004). Islam 101: Understanding the religion and therapy implications Professional Psychology: Research and Practice, 35, 635-642.

American Psychological Association. (2003). Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists.” American Psychologist, 58(5), 377-402.

American Psychological Association, Task Force on Socioeconomic Status. (2007). Report of the APA Task Force on Socioeconomic Status. Washington, DC: American Psychological Association.

Aslami, B.A. (1997). Interracial psychotherapy: A report of the treatment of inner-city adolescents. The Journal of the American Academy of Psychoanalysis, 25, 347-356.

Atkinson, D.R., & Lowe, S.M. (1995). The role of ethnicity, cultural knowledge, and conventional techniques in counseling and psychotherapy. In J.G. Ponterotto, J.M. Casas, L.A. Suzuki, & C.M. Alexander (Eds.), Handbook of multicultural counseling (pp. 387-414). Thousand Oaks: Sage.

Atkinson, D.R., & Matsushita, Y.J. (1991). Japanese-American acculturation, counseling style, counselor ethnicity, and perceived counselor credibility. Journal of Counseling Psychology 38, 473-478.

Atkinson, D.R., Morten, G., & Sue, D.W. (1993) (Eds.). Counseling American minorities: A cross-cultural perspective (4th Ed.). Dubuque, IA: Wm.C. Brown.

Becker, J.C., & Wright, S.C. (2011). Yet another dark side of chivalry: Benevolent sexism undermines and hostile sexism motivates collective action for social change. Journal of Personality and Social Psychology, Vol. 101(1), 62-77.

Benish, S.B., Quintana, S., & Wampold, B.E. (2011). Culturally adapted psychotherapy and the legitimacy myth: A direct-comparison meta-analysis. Journal of Counseling Psychology, 58,279-289. DOI: 10.1037/a0023626

Berry, J.W. (2001). A psychology of immigration. Journal of Social Issues, 57, 615-631.

Berry, J.W., Phinney, J.S., Sam, D.L., & Vedder, P. (2006). Immigrant youth: acculturation, identity, and adaptation. Applied Psychology: An International Review, 55, 303-332.

Blaut, J. M. (1993). The colonizer’s model of the world: Geographical diffusionism and Eurocentric history. New York: Guilford Press.

Blier, M.J., Atkinson, D.R., & Geer, C.A. (1987). Effect of client gender and counselor gender and sex roles on willingness to see the counselor. Journal of Counseling Psychology, 34, 27-30.

Bordin, E.S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, research, and practice,16, 252-260.

Braude, L. (1975). Work and workers. New York: Praeger.

Broverman, I.K., Broverman, D.M., Clarkson, F.E., Rosenkrantz, P.S., & Vogel, S.R. (1970). Sex-role stereotypes and clinical judgments of mental health. Journal of Consulting and Clinical Psychology, 34, 1-7.

Buboltz, W. C., Jr., Miller, M., & Williams, D. J. (1999). Content analysis of research in the Journal of Counseling Psychology (1973-1998). Journal of Counseling Psychology, 46, 496-503.

Cabaniss, D.L., Oquendo, M.A., & Singer, M.B. (1994). The impact of psychoanalytic values on transference and countertransference: A study in transcultural psychotherapy. The Journal of the American Academy of Psychoanalysis, 22, 609-621.

Caetano, R., & Clark, C.L. (2003). Acculturation, alcohol consumption, smoking, and drug use among Hispanics. In K.M. Chun, P.B. Organista, & G. Marin (Eds.). Acculturation: Advances in theory, measurement, and applied research (pp. 223-240). Washington, D.C.: American Psychological Association.

Carter, R.T. (1995). The influence of race and racial identity in psychotherapy: Toward a racially inclusive model. New York: Wiley-Interscience Publication.

Chan, S. (1991a). Asian Americans: An interpretive history. Boston, MA: Twayne.

Chin, J.L. (1993). Transference. In J.L. Chin, J.H. Liem, M.A. Domokos-Cheng Ham, & G.K. Hong (Eds.), Transference and empathy in Asian American psychotherapy: Cultural values and treatment needs (pp. 15-33). Westport, CT: Praeger.

Clark, R., Anderson, N. B., Clark, V. R., Williams, D.R. (1999). Racism as a Stressor for African Americans: A Biopsychosocial Model. American Psychologist, 54 (10), 805-816.

Cokley, K. O. (2005). Racial(ized) identity, ethnic identity, and Afrocentric values: Conceptual and methodological challenges in understanding African American identity. Journal of Counseling Psychology, 52, 517-526.

Coleman, H.L.K. (1997). Conflict in multicultural counseling relationships: Source and resolution. Journal of Multicultural Counseling and Development, 25, 195-200.

Coleman, H.L.K., Wampold, B.E., & Casali, S.L. (1995). Ethnic minorities’ ratings of ethnically similar and European American counselors: A meta-analysis. Journal of Counseling Psychology, 42, 55-64.

Comas-Diaz, L., & Jacobsen, F.M. (1995). The therapist of color and the white patient dyad: Contradictions and recognitions. Cultural Diversity and Mental Health, 1, 93-106.

Comas-Diaz, L., & Minrath, M. (1985). Psychotherapy with ethnic minority borderline clients. Psychotherapy, 22 (2), 418-426.

Connell, R.W., & Wood, J. (2005). Globalization and business masculinities. Men and Masculinities, 7,347-364.

Cortes, D.E. (2003). Idioms of distress, acculturation, and depression: The Puerto Rican experience. In K.M. Chun, P.B. Organista, & G. Marin (Eds.). Acculturation: Advances in theory, measurement, and applied research (pp. 207-222). Washington, D.C.: American Psychological Association.

Constantine, M.G. (2000). Social desirability attitudes, sex, and affective and cognitive empathy as predictors of self-reported multicultural counseling competence. The Counseling Psychologist, 28, 857-872.

Constantine, M.G., & Ladany, N. (2000). Self-report multicultural counseling competence scales: Their relation to social desirability attitudes and multicultural case conceptualization ability. Journal of Counseling Psychology, 47, 155-164.

Courtenay, W.H. (2000). Constructions of masculinity and their influence on men’s well-being: A theory of gender and health. Social Science and Medicine, 50, 1385-1401.

CNN (2008), http://articles.cnn.com/2008-08-13/us/census.minorities_1_hispanic-population-census-bureau-white-population?_s=PM:US. Found December 27, 2010.

Cooper, S., & Leong, F.T.L. (2008). Introduction to the special issue on culture, race, and ethnicity in organizational consulting psychology. Consulting Psychology Journal: Practice and Research, 60, 133-138.

Cross, W.E. (1971). The Negro-to-Black conversion experience. Black World, 20 (9), 13-27.

D’Andrea, M., Daniels, J., & Heck, R. (1991). Evaluating the impact of multicultural counseling training. Journal of Counseling and Development, 70, 143-150.

DiAngelo, R. (2011). White fragility. International Journal of Critical Pedagogy, 3 (3), 54-70.

Flaskerud, J.H., & Liu, P.Y. (1991). Effects of an Asian client-therapist language, ethnicity and gender match on utilization and outcome of therapy. Community Mental Health Journal, 27, 31-42.

Fowers, B.J., & Richardson, FC. (1996). Why is multiculturalism good? American Psychologist, 51,609-621.

Frable, D. E. S. (1997). Gender, racial, ethnic, sexual, and class identities. Annual Review of Psychology, 48, 139-162.

Furnham, A. 1989, ‘Predicting one’s own and others’ 16 PF scores’, Current Psychology, Spring, pp. 30-37.

Furnham, A., & Procter, E. (1989). Belief in a just world: Review and critique of the individual difference literature. British Journal of Social Psychology, 28, 365-384.

Gelso, C.J., & Carter, J.A. (1985). The relationship in counseling and psychotherapy: Components, consequences, and theoretical antecedents. The Counseling Psychologist, 13, 155-243.

Gelso, C.J., & Carter, J.A. (1994). Components of the psychotherapy relationship: their interaction and unfolding during treatment. Journal of Counseling Psychology, 41, 296-306

Gelso, C.J., Fassinger, R.E., Gomez, M.J., & Latts, M.G. (1995). Countertransference reactions to lesbian clients: The role of homophobia, counselor gender, and countertransference management. Journal of Counseling Psychology, 42, 356-364.

Gim, R.H., Atkinson, D.R., & Kim, S.J. (1991). Asian-American acculturation, counselor ethnicity and cultural sensitivity, and ratings of counselors. Journal of Counseling Psychology, 38, 57-62.

Gaertner, S. L., & Dovidio, J. F. (1986). The aversive form of racism. In J. F. Dovidio & S. L. Gaertner (Eds.), Prejudice, discrimination, and racism (pp. 61-89). New York: Academic Press. (Reprinted in A. G. Halberstadt & S. L. Ellyson [1990], Social psychology readings: A century of research. New York: McGraw Hill.)

Graham, S. (1992). “Most of the subjects were white and middle class”: Trends in published research on African Americans in selected APA journals, 1970-1989. American Psychologist, 47, 629-639.

Grencavage, L.M., & Norcross, J.C. (1990). Where are the commonalities among the therapeutic common factors? Professional Psychology: Research and Practice, 21, 372-378.

Griner, D., & Smith, T.B. (2006). Culturally adapted mental health intervention: A meta-analytic review. Psychotherapy: Theory, Research, Practice, Training, 43, 531-548.

Gong, F., Takeuchi, D.T., Agbayani-Siewert, P., & Tacata, L. (2003). Acculturation, psychological distress, and alcohol use: Investigating the effects of ethnic identity and religiosity. In K.M. Chun, P.B. Organista, & G. Marin (Eds.). Acculturation: Advances in theory, measurement, and applied research (pp. 189-206.). Washington, D.C.: American Psychological Association.

Gotunda, N. (1991). A critique of “Our constitution is color-blind.” Stanford Law Review, 44 (1), 1-73.

Grillo, T., & Wildman, S.M. (1997). Obscuring the importance of race: The implication of making comparisons between racism and sexism (or other isms). In A.K. Wing (Ed.), Critical race feminism: A reader (pp. 44-50). New York: New York University Press.

Hall, C.C.I. (1997). Cultural malpractice: the growing obsolescence of psychology with the changing U.S. population. The American Psychologist, 52, 642-651.

Haider, A.H., Sexton, J., Sriram, N., Cooper, L.A., Efron, D.T., Swoboda, S., Villegas, C.V. et al. (2011). Association of unconscious race and social class bias with vignette-based clinical assessments by medical students. Journal of the American Medical Association, 306, 942-951.

Harris, C.I. (1993). Whiteness as property. Harvard Law Review, 106, 1709-1791.

Helms, J.E. (1990). Black and White racial identity: Theory, research, and practice. Westport, CT: Greenwood Press.

Helms, J.E., (1995). An update of Helms’ White and People of Color racial identity models. In J.G. Ponterotto, J.M. Casas, L.A. Suzuki, & C.M. Alexander (Eds.). Handbook of multicultural counseling (pp. 181-198). Thousand Oaks, CA: Sage.

Helms, J.E., & Carter, R. (1990). A preliminary overview of the Cultural Identity Attitude scale. Unpublished manuscript.

Helms, J.E., & Cook, D.A. (1999). Using race and culture in counseling and psychotherapy: Theory and process. New York: Allyn & Bacon.

Helms, J.E., & Richardson, T.Q. (1997). How “multiculturalism” obscures race and culture as differential aspects of counseling competency. In D.B. Pope-Davis & H.L.K. Coleman (Eds.) Multicultural counseling competencies: Assessment, education and training, and supervision, (pp. 60-82). Thousand Oaks, CA: Sage.

Helms, J.E. & Talleyrand, R. (1997). Race is not ethnicity. American Psychologist, 52(11), 1246-1247.

Henrich, J., Heine, S, J. and Norenzayan, A. (2010, May 7). The Weirdest People in the World? RatSWD Working Paper No. 139. Available at SSRN: http://ssrn.com/abstract=1601785.

Hess, R.S., & Street, E.M. (1991). The effect of acculturation on the relationship of counselor ethnicity and client ratings. Journal of Counseling Psychology, 38, 71-75.

Hill, C.E., Nutt-Williams, E., Heaton, K.J., Thompson, B.J., & Rhodes, R.H. (1996). Therapist retrospective recall of impasses in long-term psychotherapy: A qualitative analysis. Journal of Counseling Psychology, 43, 207-217.

Hodson, G., Rush, J., & MacInnis, C.C. (2010). A joke is just a joke (except when it isn’t): Cavalier humor beliefs facilitate the expression of group dominance motives. Journal of Personality and Social Psychology, Vol 99(4), 660-682.

Holmes, D.E. (1992). Race and transference in psychoanalysis and psychotherapy. The International Journal of Psychoanalysis, 73 (1), 1-11.

Hooper, C. (2000). Masculinities in transition: The case of globalization. In M.H. Marchand & A. S. Runyan (Eds.), Gender and global restructuring (pp. 59-73). London: Routledge.

Hopps, J., & Liu, W.M. (2006). Working for Social Justice from Within the Health Care System: The Role of Social Class in Psychology. In R. L. Toporek, L. H.
Gerstein, N. A. Fouad, G. Roysircar, & T. Israel (Eds.), Handbook for social justice in counseling psychology: Leadership, vision, and action (pp. 318-337). Thousand Oaks: Sage.

Horvath, A.O. (2000). The therapeutic relationship: From transference to alliance. Journal of Clinical Psychology, 56, 163-173.

Iijima Hall, C.C. (1997). Cultural malpractice: The growing obsolescence of psychology with the changing U.S. population. American Psychologist, 52, 642-651.

Ivey, A.E., D’Andrea, M., Ivey, M.B., & Simek-Morgan, L. (2002). Theories of counseling and psychotherapy: A multicultural perspective (5th ed.). Boston: Allyn & Bacon.

Jacobson, M.F. (1998). Whiteness of a different color: European immigrants and the alchemy of race. Cambridge, MA: Harvard University Press.

Jones, J.M. (2010). I’m white you’re not: The value of unraveling ethnocentric science. Perspectives on Psychological Science, 5, 700-707.

Kelly, A.E. (2000). Helping construct desirable identities: A self-presentational view of psychotherapy. Psychological Bulletin, 126, 475-494.

Kim, B. S. K. (2007). Acculturation and enculturation. In F. T. L. Leong, A. G. Inman, A. Ebreo, L. Yang, L. Kinoshita, & M. Fu (Eds.), Handbook of Asian American psychology (2nd ed., pp. 141-158). Thousand Oaks, CA: Sage.

Kim, B. S. K. (2009). Acculturation and enculturation of Asian Americans: A primer. In N. Tewari & A. Alvarez (Eds.), Asian American psychology: Current perspectives (pp. 97-112). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.

Kim, B. S. K., Ahn, A. J., & Lam, N. A. (2009). Theories and Research on acculturation and enculturation experiences among Asian American families. In N. T. Trinh, Y. C. Rho, F. G. Lu, & K. M. Sanders (Eds.), Handbook of mental health and acculturation in Asian American families (pp. 25-43). New York: Humana Press.

Kim, B. S. K., & Hong, S. (2004). A psychometric revision of the Asian Values Scale using the Rasch model. Measurement and Evaluation in Counseling and Development, 37, 15-27.

Kimmel, M. (1996). Manhood in America: A cultural history. New York: Free Press.

Kivlighan, D.M., & Shaughnessy, P. (2000). Patterns of working alliance development: A typology of clients' working alliance ratings. Journal of Counseling Psychology, 47, 362-371.

Klonoff, E.A. , & Landrine, H. (1999). Cross-validation of the schedule of racist events. Journal of Black Psychology, 25 (2), 231-254.

Kluckhohn, F.R., & Strodtbeck, F. L. (1961). Variations in value orientations. Evanston, III: Row, Peterson.

Kohatsu, E. (1992). The effects of racial identity and acculturation on anxiety, assertiveness, and ascribed identity among Asian American college students. (Doctoral dissertation, University of Maryland, College Park). Dissertation Abstracts International, 54 (2), 1102B.

Koltko-Rivera, M. E. (2004). The psychology of worldviews. Review of General Psychology, 8, 3-58.

Krugman, S. (1995). Male development and the transformation of shame. In R. F. Levant & W. S. Pollack (Eds.), A new psychology of men (pp. 91-126). New York: Basic Books.

Kwak, K., & Berry, J.W. (2001). Generational differences in acculturation among Asian families in Canada: A comparison of Vietnamese, Korean, and East-Indian groups. International Journal of Psychology, 36, 152-162.

Ladany, N., Inman, A.G., Constantine, M.G., & Hofheinz, E.W. (1997). Supervisee multicultural case conceptualization ability and self-reported multicultural competence as functions of supervisee racial identity and supervisor focus. Journal of Counseling Psychology, 44, 284-293.

La Fromboise, T., Coleman, H., Gerton, J. (1993). Psychological impact of biculturalism: Evidence and theory. Psychological Bulletin, 114, 395-412.

LaFromboise, T. D., Coleman, H. L. K., & Hernandez, A. (1991). Development and factor structure of the Cross-Cultural Counseling Inventory-Revised. Professional Psychology Research and Practice, 22, 380-388.

Lemon, R.L., & Waeher, C.A. (1996). A test of stability and construct validity of the Black Racial identity Attitude Scale, form B (RIAS-B) and the White Racial Identity Attitude Scale (WRIAS). Measurement and Evaluation in Counseling and Development, 29, 77-85.

Leong, F.T.L., Wagner, N.S., & Tata, S.P. (1995). Racial and ethnic variations in help-seeking attitudes. In J.G. Ponterotto, J.M. Casas, L.A. Suzuki, & C.M. Alexander (Eds.), Handbook of multicultural counseling (pp. 415-438). Thousand Oaks: Sage.

Lerner, M. J., & Miller, D. T. (1978). Just world research and the attribution process: Looking back and ahead. Psychological Bulletin, 85, 1030-1051.

Levant, R.F. (2003). A new psychology of men. Professional Psychology: Research and Practice, 27, 259-265.

Levant, R.F., Pollack, W.S. (Eds.) Pollack (Eds.) (1995). A new psychology of men (pp. 91-128). New York: Basic Books.

Levant, R.F., Richmond, K., Majors, R.G., Inclan, J.E., Rossello, J.M., Heesacker, M. et al. (2003). A multicultural investigation of masculine ideology and alexithymia. Psychology of Men and Masculinity, 4, 91-99.

Lin, J.C.H. (1994). How long do Chinese Americans stay in psychotherapy? Journal of Counseling Psychology, 41, 288-291.

Liu, W.M. (2001). Expanding our understanding of multiculturalism: Developing a social class worldview model. In D.B. Pope-Davis and H.L.K. Coleman (Eds.), The intersection of race, class, and gender in counseling psychology (pp. 127-170). Thousand Oaks, CA: Sage Publications.

Liu, W.M. (in press). Developing a social class and classism consciousness: Implications for research and practice. In E. Altmaier and J.I. Hansen (Eds.). Handbook of Counseling Psychology. New York: Oxford Press.

Liu, W.M. (2005). The study of men and masculinity as an important multicultural competency consideration. Journal of Clinical Psychology, 61, 685-697.

Liu, W.M., & Ali, S.R., (2005). Addressing social class and classism in vocational theory and practice: Extending the emancipatory communitarian approach. The Counseling Psychologist, 33, 189-196.

Liu, W. M., Ali, S. R., Soleck, G., Hopps, J., Dunston, K., & Pickett, T., Jr. (2004). Using social class in counseling psychology research. Journal of Counseling Psychology, 51, 3-18.

Liu, W.M., & Arguello, J. (2006). Social class and classism in counseling. Counseling and Human Development, 39 (3), 1-12.

Liu, W.M., & Clay, D. (2002). Multicultural counseling competencies: Guidelines in working with children and adolescents. Journal of Mental Health Counseling, 24 (2), 177-187.

Liu, W.M., Hernandez, J., Mahmood, A., & Stinson, R. (2006). The link between poverty, classism, and racism in mental health. In. D.W. Sue & M.G. Constantine (Eds.). Racism as a barrier to cultural competence in mental health and educational settings. (pp. 65-86). New York: Wiley.

Liu, W.M., & Pope-Davis, D.B. (2003a). Moving from Diversity to Multiculturalism: Exploring Power and the Implications for Psychology. In Pope-Davis, D.B., Coleman, H.L.K., Liu, W.M., & Toporek, R.L. (Eds.) The handbook of multicultural competencies in counseling and psychology, (pp. 90-102). Thousand Oaks: Sage.

Liu, W.M., & Pope-Davis, D.B. (2005). The Working alliance, therapy ruptures and impasses, and counseling competencies: Implications for counselor training and education. In R.T. Carter (Ed.) Handbook of racial-cultural psychology and counseling, Vol. 2. (pp. 148-167) New York: John Wiley and Sons.

Liu,W.M., Soleck, G., Hopps, J., Dunston, K., & Pickett, T. (2004). A New Framework to Understand Social Class in Counseling: The Social Class Worldview and Modern Classism Theory. Journal of Multicultural Counseling and Development, 32. 95-122.

Loewen, J. W. (1995). Lies My Teacher Told Me: Everything Your American History Textbook Got Wrong. New York: Touchstone/ Simon & Schuster.

Majors, R., & Billson, M. (1992). The cool pose: The dilemmas of Black manhood in America. New York: Simon and Schuster.

Mirels, H. L., & Garrett, J. B. (1971). The Protestant ethic as a personality variable. Journal of Consulting and Clinical Psychology, 36, 40-44.

Morten, G., & Atkinson, D.R., (1983). Minority identity development and preference for counselor race. Journal of Negro Education, 52, 156-161.

Mudrack, P. E. (1997). Protestant work-ethic dimensions and work orientations. Personality and

Individual Differences, 23(2), 217-225.

Nakayama, T. K. & Krizek, R. (1995) 'Whiteness: A Strategic Rhetoric' Quarterly Journal of Speech. Vol. 81 291:309.

Nesdale, D., & Mak, A.S. (2000). Immigrant acculturation attitudes and host country identification. Journal of Community and Applied Social Psychology, 10,483-495.

Neville, H.A., Awad, G.H., Brooks, J.E., Flores, M.P., & Bluemel, J. (2013). Color-blind racial ideology: Theory, training, and measurement implications in psychology. American Psychologist, 68, 455-466.

Omi, M., & Winant, H. (1994). Racial formation in the United States: From the 1960s to the 1990s. New York: Routledge.

O’Neil, J.M. (1990). Assessing men’s gender role conflict. In D. Moore & F. Leafgren (Eds.), Problem solving strategies and interventions for men in conflict (pp. 23-38). Alexandria, VA: American Counseling Association.

O’Neil, J.M. (2008). Summarizing 25 years of research on men’s gender role conflict using the Gender Role Conflict Scale. The Counseling Psychologist, 36, 358-445.

O’Neil, J.M., Good, G.E., & Holmes, S. (1995). Fifteen years of theory and research on men’s gender role conflict: New paradigms for empirical research. In W.S. Pollack and R.F. Levant (Eds.), New psychotherapy for men (pp. 164-206). New York: John Wiley and Sons, Inc.

O’Neil, J.M., Helms, B.J., Gable, R.K., Davis, L., & Wrightsman, L. (1986). Gender Role Conflict Scale: college men’s fear of femininity. Sex Roles, 14, 335-350.

Orwin, C. 1996. All quiet on the post(western) front?. Public Interest, Issue 123, 3-21

Patton, M.J., & Kivlighan, D.M., Jr. (1997). Relevance of the supervisory alliance to the counseling alliance and to treatment adherence in counseling training. Journal of Counseling Psychology, 44, 108-115.

Paulhus, D.L. (1991). Measurement and control of response bias. In J.B. Robinson, P.R. Shaver, & L.S. Wrightsman (Eds.), Measures of personality and social psychological attitudes (pp. 17-59). San Diego, CA: Academic Press.

Pedersen, P.B. (1996). The importance of both similarities and differences in multicultural counseling: Reaction to C.H. Patterson. Journal of Counseling and Development, 74, 236-237.

Ponterotto, J.G., Alexander, C.M., & Grieger, I. (1995). A multicultural competency checklist for counseling and training programs. Journal of Multicultural Counseling and Development, 23, 11-20.

Ponterotto, J.G., Casas, J.M., Suzuki, L.A., & Alexander, C.M. (Eds.). (1995). Handbook of multicultural counseling. Thousand Oaks: Sage.

Ponterotto, J. G., Riefer, B. P., Barrett, A., Sparks, R., Sanchez, C. M., & Magids, D. (1996). Development and initial validation of the Multicultural Counseling Awareness Scale. In G. R. Sodowsky & J. C. Impara (Eds.), Multicultural assessment in counseling and clinical psychology (pp. 247-282). Lincoln, NE: Buros Institute of Mental Measurement.

Phinney, J.S. (1996). When we talk about American ethnic groups, what do we mean? American Psychologist, 51, 918-927.

Phinney, J.S., & Flores, J. (2002). “Unpackaging” acculturation. Journal of Cross-Cultural Psychology, 33, 320-331.

Phinney, J.S., Horenczyk, G., Liebkind, K., & Vedder, P. (2001). Ethnic identity, immigration, and well-being: An interactional perspective. Journal of Social Issues, 57, 493-510.

Pleck, J.H. (1981). The myth of masculinity. Cambridge, MA: MIT Press.

Pleck, J.H. (1995). The gender role strain paradigm: an update. In R.F. Levant & W.S. Pollack (Eds.), A new psychology of men (pp. 11-32). New York: Basic Books.

Ponterotto, J. G., Utsey, S.O., & Pedersen, P.B. (2006). Preventing prejudice: A guide for counselors, educators, and parents (2nd ed.). Thousand Oaks, CA: Sage.

Pope-Davis, D.B., Liu, W.M., Toporek, R., & Brittan, C. (2001). How do we identify cultural competence in counseling: Review, introspection, and recommendations for future research. Cultural Diversity and Ethnic Minority Psychology, 7, 121-138.

Pope-Davis, D. B., & Dings, J. G. (1995). The assessment of multicultural counseling competencies. In J. G. Ponterotto, J. M. Casas, L. A. Suzuki, & C. M. Alexander (Eds.), Handbook of multicultural counseling (pp. 287-331). Thousand Oaks, CA: Sage

Pope-Davis, D. B., Reynolds, A. L., Dings, J. G., & Nielson, D. (1995). Examining multicultural counseling competencies of graduate students in psychology. Professional Psychology - Research & Practice, 26, 322-329.

Pope-Davis, D.B., Toporek, R.L., Ortega-Villalobos, L., Ligiero, D.P., Brittan-Powell, C.S., Liu, W.M., Bashshur, M.R., Codrington, J.N., & Liang, C.T.H. (2002). A qualitative study of clients’ perspectives of multicultural counseling competence. The Counseling Psychologist, 30, 355-393.

Poston, W.S.C., Craine, M., & Atkinson, D.R. (1991). Counselor dissimilarity: Confrontation, client cultural mistrust, and willingness to self-disclose. Journal of Multicultural Counseling and Development, 19, 65-73.

Prochaska, JO.; DiClemente, CC. The transtheoretical approach. In: Norcross, JC; Goldfried, MR. (Eds.) Handbook of psychotherapy integration. 2nd ed. New York: Oxford University Press; 2005. p. 147-171.

Quintana, S. M., & Bernal, M. E. (1995). Ethnic minority training in counseling psychology: Comparisons with clinical psychology and proposed standards. The Counseling Psychologist, 23, 102-121.

Roberts, J.A., & Jones, E. (2001). Money attitudes, credit card use, and compulsive buying among American college students. The Journal of Consumer Affairs, 35, 213-240.

Safran, J.D., Muran, J.C., & Samstag, L.W. (1994). Resolving therapeutic alliance ruptures: A task analytic investigation. In A. O. Horvath & L. S. Greenberg (Eds.) The working alliance: Theory, research, and practice (pp. 225-258). New York: John Wiley and Sons, Inc.

Safran, J.D., Segal, Z.V. (1990). Interpersonal process in cognitive therapy. New York: Basic Books.

Said, E. (1993). Cultural and imperialism. New York: Alfred Knopf.

Santora, M. (2002, November 21). Teenagers’ suit says McDonald’s made them obese. New York Times.

Scheidlinger, S. (1999). On concepts of amae and the mother-group. The Journal of the American Academy of Psychoanalysis, 27, 91-100.

Sexton, T.L., & Whiston, S.C. (1994). The status of the counseling relationship: An empirical review, theoretical implications, and research directions. The Counseling Psychologist, 22, 6-78.

Smith, J. M. (2000). Psychotherapy with people stressed by poverty. In A. N. Sabo & L. Havens (Eds.), Real world guide to psychotherapy practice (pp. 71-92). Cambridge, MA: Harvard University Press.

Smith, L. (2005). Psychotherapy, classism, and the poor: Conspicuous by their absence. American Psychologist, 60, 687-696.

Smith, L. (2008). Positioning classism within psychology’s social justice agenda. The Counseling Psychologist, 36, 895-924.

Smith, Kevin B., and David N. Green. 1984. "Individual Correlates of the Belief in a Just World." Psychological Reports 45:435-38.

Smith, L., Foley, P. F., & Chaney,M. P. (2008).Addressing classism, ableism, and heterosexism within multicultural-social justice training. Journal of Counseling and Development, 86, 303-309.

Smith, T.B., & Trimble, J.E. (2016). Foundations of multicultural psychology: Research to inform effective practice. Washington, D.C.: American Psychological Association.

Sodowsky, G.R., Kuo-Jackson, P.Y., Richardson, M.F., & Corey, A.T. (1998). Correlates of self-reported multicultural competencies: Counselor multicultural social desirability, race, social inadequacy, locus of control racial ideology, and multicultural training. Journal of Counseling Psychology, 45, 256-264.

Sodowsky, G. R., Taffe, R. C., Gutkin, T. B., & Wise, S. L. (1994). Development of the Multicultural Counseling Inventory: A self-report measure of multicultural competencies. Journal of Counseling Psychology, 41, 137-148.

Speight, S.L., Thomas, A.J., Kennel, R.G., & Anderson, M.E. (1995). Operationalizing multicultural training in doctoral programs and internships. Professional Psychology: Research and Practice, 26, 401-406.

Sue, D. W., Arredondo, P., & McDavis, R. J. (1992). Multicultural counseling competencies and standards: A call to the profession. Journal of Counseling and Development, 70, 477-486.

Sue, D.W., Bingham, R.P., Porche-Burke, L, & Vasquez, M. (1999). The diversification of psychology: A multicultural revolution. The American Psychologist, 54, 1061-1069.

Sue, D.W., Capodilupo, C.M., Torino, G.C., Bucceri, J.M., Holder, A.M.B., Nadal, K.L., & Esquilin, M (2007). Racial microaggressions in everyday life: Implications for clinical practice. American Psychologist, 62, 271-286.

Sue, D.W., Ivey, A.E., & Pedersen, P.B. (1996). Basic assumptions of a theory of multicultural counseling and therapy. In D.W. Sue, A.E. Ivey, & P.B. Pedersen (Eds.), A theory of multicultural counseling and therapy (pp. 13-29). Pacific Grove: Brooks/Cole.

Sue, D.W., Nadal, K.L., Capodilupo, C.M., Lin, A.I., Rivera, D.P., & Torino, G.C. (2008). Racial Microaggressions against Black Americans: Implications for counseling. Journal of Counseling and Development, 86(3), 330-338.

Sue, S., & Sue, D.W. (1971). Chinese-American personality and mental health. Amerasia Journal, 1, 35-49.

Sue, D.W., & Sue, D. (2008). Counseling the culturally diverse: Theory and practice (5th Ed.). New York: John Wiley and Sons.

Takaki, R. (1993). A different mirror: A history of multicultural America. Boston: Little Brown and Co.

Tang, T.N., & Dion, D.L. (1999). Gender and Acculturation in Relation to Traditionalism: Perceptions of Self and Parents Among Chinese Students. Sex Roles, 41 17-29.

Tang, N.M., & Gardner, J. (1999). Race, culture, and psychotherapy: Transference to minority therapists. The Psychoanalytic Quarterly, 68, 1-20.

Thornton, M.C., & Taylor, R.J. (1988). Intergroup attitudes: Black American perceptions of Asian Americans. Ethnic and Racial Studies, 11, 474-488.

Wagstaff, Graham F. 1983. “Attitudes to Poverty, the Protestant Work Ethic, and Political Affiliation: A Preliminary Investigation.” Social Behavior and Personality 11(1): 45-47.

Weber, M. (1904, 1905). Die protestantische ethik und der geist des kapitalismus. Archiv fur sozialwissenschaft. 20-21. Translated by T. Parsons. The protestant ethic and the spirit of capitalism. New York: Charles Scibner's Sons.

Worthington, R.L., Mobley, M., Franks, R.P., & Tan, J.A. (2000). Multicultural counseling competencies: Verbal content, counselor attributions, and social desirability. Journal of Counseling Psychology, 47, 460-468.

Yee, A.H., Fairchild, H.H., Weizmann, F., & Wyatt, G.E. (1993). Addressing psychology’s problems with race. American Psychologist, 48, 1132-1140.

Yutrzenka, B.A. (1995). Making a case for training in ethnic and cultural diversity in increasing treatment efficacy. Journal of Consulting and Clinical Psychology, 63, 197-206.

Zinn, H. (1991). Declarations of independence: Cross-examining American ideology. New York: Harper Collins.

 

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