_________________________________________________________ Cultural Humility in Behavioral Health
Self-Assessment Quiz Question 4. All the following statements are accurate EXCEPT:
opportunities that are readily available to others (Frye, 2019; Seethaler, 2014; Van Soest, 2013). Barriers include restricted access to resources and opportunities such as high-quality public education and stable, well-paying jobs. Oppression is a pervasive system. It has its foundation in history and is maintained via individual and institutional systematic discrimination, personal bias, bigotry, and social prejudice. Oppression leads to a condition of privilege for the person or the group that is the oppressor(s) (NCC, 2021). Oppression is expressed in a systematic manner and enforced by cultural ideology and the threat of violence (Van Soest, 2013). It is not accidental, and it is not avoidable by the populations that experience it. It is meant to maintain the current societal status quo (Seethaler, 2014). It is important to understand “the unavoidability of oppressive forces for many groups” (Seethaler, 2014, p. 43). Oppression is not something individuals can work their way out of or avoid by changing their behavior. In the context of counseling, it is essential to recognize and address the systemic nature of oppression and the role it plays in clients’ and counselors’ lives. In individual counseling sessions the power dynamic within the counseling relationship needs to be identified. Attention needs to be paid to equalizing the relationship and to entering into a partner- ship with clients; it must be recognized that both the counselor and client bring essential knowledge to the relationship (Sue & Sue, 2021). As part of practicing with cultural humility, mental and behavioral health professionals are called on to take an active role in addressing issues of oppression outside the office on institutional levels and to make efforts to reduce any power differentials that affect the client within the service environment or other areas within the client’s life. Privilege is a central concept for mental and behavioral healthcare professions in their work to address oppression and marginalization of certain groups and the resulting privi- leging of other groups. The concept of White privilege and male privilege were clearly articulated and widely disseminated through McIntosh’s work in the 1980s. McIntosh articulated White male privilege as “an invisible package of unearned assets which he can count on cashing in each day, but about which he was ‘meant’ to remain oblivious. White privilege is like an invisible weightless knapsack of special provisions, assurance, tools, maps, guides, codebooks, passports, visas, clothes, compass, emergency gear, and blank checks” (McIn- tosh, 1998, p. 1). Privileging is “a process where chances or odds of being offered an opportunity are altered or skewed to the advantage of members of certain groups” (Minarik, 2017, p. 55). Essentially, privilege functions by providing some groups of individuals (e.g., White, male, heterosexual, abled, middle class) with preferred treatment in the form of special opportunities and advantages, while withholding that prefer- ence from other individuals (e.g., African American, female, LGBTQ, disabled). Privilege can include many advantages, including being given the benefit of the doubt and feeling a sense of belongingness (Minarik, 2017). Individuals who are not privileged experience the opposite—such as being an auto-
A) In the U.S. 61 million adults live with a disability. B) The most common type of functional disability is related to cognition. C) More than half of LGBTQ Americans report hiding a personal relationship. D) Transgender individuals face unique obstacles to accessing healthcare. The complexity of individual diversity is inclusive of not just racial and ethnic identity but also of variables such as socio- economic class, disability, and LGBTQ status. While these facets of diversity are not exhaustive, they do represent some important categories of diversity. Healthcare professionals must consider the unique array of diverse identities that are represented within each individual encountered in each thera- peutic relationship. The complexity embodied within each patient affects the way that the patient understands and views the healthcare professional and the professional relationship, just as the complexity of the healthcare provider’s diversity dimensions affects the way that the healthcare professional understands and views each patient. It is impossible to pro- vide information that allows healthcare professionals to gain knowledge about categories of people and how they behave or view the world, because not only is the variation within individual ethnicities and races endless, but the variation within each individual also is endless. Instead, healthcare professionals should aim to understand the societal landscape that privileges and oppresses individuals. The experiences of oppression experienced by various diverse groups are likely to provide them with a unique perspective on both the larger society and on their relationship with healthcare professionals.
OPPRESSION, PRIVILEGE, AND MARGINALIZATION
Understanding the concepts of oppression, privilege, and marginalization is essential for practicing with cultural humil- ity. There are various aspects of individual identities that oppress or privilege people vis-a-vis their marginalization or empowerment. Oppression is a commonly referenced term in many of the mental and behavioral health disciplines. Because the term has several definitions, or in some instances, the term is left undefined, there can be confusion regarding its meaning in a therapeutic context. Oppression can be defined as “unjust or cruel exercise of authority or power” (Merriam-Webster, 2021), but a more expansive description is that oppression consists of the barriers present as a result of cultural and sociopoliti- cal forces that serve to prevent certain populations of people, based on group characteristics (e.g., LGBTQ, impoverished, African American, Muslim), from accessing resources and/or
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