|Assessment And Psychological Counseling For
Individuals Of Varying Cultural/Racial Origins
In the United States at the present time, approximately one-third of persons experiencing psychological distress could be helped by professional service providers who understand their cultural identities and typical problems in living. Hall, in the 1997 American Psychologist, suggested that "cultural malpractice" among psychologists is now widespread. Unfortunately, a large majority of mental health professionals have not been trained to recognize culture-specific problems and behavioral expressions of discomfort. National surveys indicate that these professionals do not feel prepared by their training to provide competent services to persons of different cultural/racial backgrounds from themselves.
There is unrecognized bias among many professional caregivers with minimization of cultural differences that encourages confusion of cultural issues with mental illness. This is particularly likely to occur with persons who were born in different countries, recent immigrants for whom English is a second language, persons who are experiencing stress in the process of acculturation, or prejudice and discrimination in their daily lives. Standard psychological tests were developed for Anglo-Americans whose first language is English. These tests need to have "corrections" applied in the process of interpretation for most persons who have non-European ancestry or who are recent immigrants from European countries. "Corrections" are used to reduce the likelihood that these persons will be evaluated as deficient in intelligence, mental health status or personality functioning. These "corrections" include proper translations for persons whose first language is not English, reference norms or standards that adequately represent each cultural/racial group, and norms based on the extent to which individuals have retained their original cultural identities. At present, many translations of tests are inadequate. For example, with Latinos/Latinas separate translations are needed to reflect the idioms of Mexican-American, Cuban and Puerto Rican subgroups as well as for each Latin American country of origin. The available norms for standard tests do not adequately represent cultural/racial groups. Local norms or acculturation status norms are unavailable or infrequently used.
Guidelines in the form of cultural formulations are now available to help assessors to avoid labeling cultural differences as mental illnesses. These guidelines for using standard tests and corrections for these tests can be found in Dana, 1993. Counseling and psychotherapy, in general, also suffer from bias and lack of relevant training and experience among mental health professionals. Nonetheless, there are also guidelines for applying standard psychological treatments and culture-specific counseling techniques. These guidelines for American Indians/Alaska Natives, African-Americans, Asian Americans, Hispanics (Latinos/Latinas) can be found in Dana, 1998.
Dana, R. H. (1993). Multicultural assessment perspectives for professional psychology. Boston: Allyn & Bacon.
Dana, R. H. (1998). Understanding cultural identity in intervention and assessment. Thousand Oaks, CA: Sage.
Hall, C. I. J. (1997). Cultural malpractice: The growing obsolescence of psychology with the changing U. S. population. American Psychologist, 52, 642-651.
Richard Dana is by training a clinical psychologist who has specialized for over 20 years in cross-cultural and multicultural mental health assessment and intervention services, particularly in teaching, training, supervision, consultation, workshops and program evaluation. He has been an academic, program director, dean, and principal research investigator at ten universities and is the author or editor of 12 books, 20 book chapters, and over 150 papers.