Diversity is a broad and potentially daunting subject that all therapists must be able to broach and manage for themselves as clinicians, with their clients, with their trainees and with their peers. With multiculturalism comes special gifts, as well as complex challenges. Some of these are described below:
Challenges-
Where do you come from? Why don't you go back where you came from? You are out of place! The white questioner does not recognize that s/he too is an outsider. After all the United States is a country of mostly outsiders. In the United States it is not so important that we are different colors, shapes, sizes, abilities, etc., but that we perceive the other as "in or out" based on who has power to determine place. I live in a culture where whites have held the power to define who is powerful, beautiful, successful and acceptable. People without power often feel marginalized, angry, helpless or rebellious. Therapists who treat people who society marginalizes must be willing to help them find their own power and to channel their anger towards usable outcomes. This is a difficult task.
Gifts-
Learning about others, laughing with them about some of the things they were taught as kids; celebrating commonalities while accepting difference is all possible in the United States because democracy provides space for differences. When we have lots of resources, people seem more generous, outward looking and accepting. Race and ethnicity are difficult subjects to talk about, but culture can be dissected, joked about, discussed and embraced.
This intermediate course is comprised of five articles. The first article asks readers to consider a paradigm shift from a focus on the intrapersonal to the socio-cultural context in psychotherapy. Therapists are encouraged to consider the impact of bigotry and oppression of clients, as well as the cultural values and beliefs held by the client. The second article discusses the knowledge, skills and awareness necessary for treating people representing key ethnic groups. A brief history of the each ethnic group is provided, as well as information about the worldview or orientation that guides each culture. Although many members of each of the identified groups has adopted and adapted to the majority culture, the oppressive forces of bigotry and racism inform the lives of all these specific ethnic groups. The third article is a poignant review of a clinical book that surfaces intense multicultural issues between the two reviewers. It brings to life the issues that are more dryly identified in the guidelines. The fourth article reviews key principles for mental health professionals to practice with all clients. Illustrative examples are provided for each principle. The fifth article provides vignettes for the clinician to consider, invoking ethically and multiculturally competent decisions.
