College aantekeningen
Diversity in Clinical Practice Lecture notes and articles summary
There are notes from all lectures and summaries of assigned articles.
[Meer zien]Voorbeeld 4 van de 88 pagina's
Voorbeeld 4 van de 88 pagina's
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Voorbeeld van de inhoud
Week 1.Diversity: Considering individual differences in the human population broken into
classifications such as thinking style, language, religion, ethnicity, experiences, culture, race,
sexual orientation, age, and gender.
When we talk about diversity, we often have to make general statements about groups to
identify patterns or differences. However, there's a risk of overgeneralizing because people
within the same group can be very different from each other—sometimes even more different
than they are from people in other groups. This is called heterogeneity, meaning there's a lot
of variety within groups.
When we talk about diversity, several factors influence how we understand and describe it.
Here’s what each of these terms means and how they shape diversity:
1. Acculturation: This is the process by which people adapt to a new culture. It can
influence how individuals within the same group differ from each other.
Example: Someone of the same ethnicity who recently immigrated might have
different values, language skills, or cultural practices compared to someone who has
lived in the same country their whole life.
2. Interaction between variables: This refers to how different aspects of identity (like
ethnicity and socioeconomic status) interact to create unique experiences.
Example: Two people might share the same ethnicity, but if one grew up in a wealthy
neighborhood and the other did not, their life circumstances might be very different.
This interaction shapes their individual experiences within the same ethnic group-e.g.,
similar ethnicity, but different life circumstances
3. Intersectionality: Provides a framework to talk about oppressions and privileges that
overlap and reinforce each other = unique individual experiences.
Intersectionality is the overlap or "crossroads" of various aspects of identity, such as race,
gender, sexual orientation, and socioeconomic status. These combined identities influence an
individual's experiences and challenges in unique ways.
Example: A black woman may face different social and economic challenges than a White
woman or a Black man because of the intersection of her race and gender.
Intersectionality highlights the complexity within groups and helps us recognize that people's
experiences are not shaped by a single factor (like just race or gender) but by the combined
effect of multiple factors.
,(Example )
Oppressions:
● Racism: As a Black person, she might face discrimination or unequal treatment
because of her race.
● Sexism: As a woman, she might experience inequality, such as being undervalued or
stereotyped because of her gender.
● Combined Oppression: The intersection of racism and sexism means she may face
unique challenges that neither Black men (who face racism but not sexism) nor white
women (who face sexism but not racism) experience.
Privileges:
● Other Aspects of Identity: She may still have privileges in areas like:
○ Education: If she has access to higher education, that could be a privilege.
○ Socioeconomic Status: Being financially stable or in a higher social class can
provide advantages.
○ Sexual Orientation: If she is heterosexual, she avoids the discrimination
LGBTQ+ individuals might face.
● Discussing diversity requires pointing out generalities
● The danger of overgeneralizing: within-group variability may be greater than
between-group = Heterogeneity
Patients are increasingly diverse
-The number of diverse people who seek mental health services continues to grow
-Population is becoming increasingly more ethnically and racially diverse
-The population over 65 is growing
Minority Groups: Longer Suffering, Under-Treatment, and More Comorbidity:
Minority groups often face extended periods of illness or distress, receive less adequate
treatment, and experience higher rates of comorbidities (multiple health conditions at once).
For example, someone from a minority group might have untreated anxiety that leads to
physical health issues over time. This longer suffering is often linked to systemic barriers to
accessing quality healthcare.
1. Stigma: Minority groups can face stigma both within society and in healthcare
settings. Stigma includes negative stereotypes, discrimination, and biases. For
example, a person from a minority background might be perceived as "overreacting"
or "less resilient," leading to their symptoms being dismissed or minimized. This
, stigma can deter people from seeking care and affects how providers interact with
them, contributing to inadequate treatment.
2. Underdiagnosis: People from minority groups are often less likely to be correctly
diagnosed for certain conditions. For example, mental health conditions like
depression or anxiety might go undiagnosed because providers may attribute
symptoms to "cultural differences" or dismiss them entirely. Underdiagnosis means
these individuals miss out on timely treatment, which can worsen their conditions.
3. Underestimated Abilities: Minority patients may be perceived as less capable of
understanding their health needs or participating in treatment plans. For instance,
providers may assume a patient doesn’t fully understand medical recommendations
due to language barriers or educational background, leading to simplified or less
effective communication. This assumption underestimates the patient’s capacity to
engage actively in their care.
4. Providers Are Less Diverse: The healthcare workforce does not reflect the diversity
of the population, leading to a shortage of providers who understand the cultural,
linguistic, and social nuances of minority groups. A less diverse provider pool cannot
often relate to or fully understand the experiences of minority patients. This gap can
contribute to biased treatment, lack of trust, and miscommunication, reinforcing
disparities in care and outcomes.
Multiculturalism as the “fourth force”
Multiculturalism helps psychologists better understand and treat people by considering how
culture influences their experiences and expressions of mental health issues.
- Refers to recognizing the importance of cultural factors in shaping human behavior,
thoughts, and emotions.
- "fourth force" in clinical psychology because it represents a significant paradigm shift
that builds upon and enhances previous major psychological movements
(psychoanalysis, behaviorism, and humanism). Not a challenge but an enhancement.
- It emphasizes understanding and incorporating cultural factors in client treatment.
This paradigm shift allows therapists to consider clients' unique worldviews and
experiences shaped by their cultural backgrounds
Multiculturalism highlights the need to explore the patient’s cultural conceptualization of
distress—how they understand and interpret their problems based on their cultural
background.
, ● What do you call your problem (or illness or distress)?
● What do you think the natural cause of your problem is?
● Why do you think this problem has occurred?
● How do you think this problem should be treated?
● How do you want me to help you?
● Who else (e.g., family friends, religious leaders) do you turn to for help?
Not just in treatment and assessment, but also in alliance building.
Importance of Therapeutic Alliance
The therapeutic alliance—the quality of involvement between therapist and client or patient
—is a key factor in the effectiveness of psychotherapy.
-Can be healing in itself
-May be reason for under-utilization and high drop-out among minority groups–Why?
1. Specific Factors ( Therapeutic Technique )
Therapeutic Technique: Specific therapeutic techniques are methods or interventions
unique to a particular type of therapy. For example, in CBT, therapists may use cognitive
restructuring to help clients challenge negative thought patterns. Each therapy type has its
techniques thought to produce specific changes.
2. Common Factors
● Therapeutic Alliance: This is the bond between therapist and client. It includes
mutual trust, collaboration, and agreement on the goals of therapy. A strong
therapeutic alliance is one of the most consistent predictors of positive therapy
outcomes, regardless of the type of therapy used. It creates a safe space where clients
feel understood and supported, allowing them to engage more openly and deeply in
therapy.
● Expectations: Clients’ beliefs about the likelihood of improvement can influence
their outcomes. When clients believe that therapy will help, this positive expectation
can enhance motivation, persistence, and openness during the therapeutic process.
● Credible Rationale: Providing a clear and understandable explanation of how the
therapy works (e.g., explaining how specific techniques can help with symptoms)
helps clients feel that the process is logical and tailored to their needs. When clients
trust the approach, they are more likely to engage fully in therapy.
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