Self-Assessment Quiz Question #8 When exploring one’s own beliefs about White identify, it is important to acknowledge that: a. Most White people perceive themselves as biased. b. White identity theory was first developed to discount the idea that White identity exists. c. National surveys often ask White people questions about their racial identity. d. Being White makes it easier to assimilate into the dominant culture. Assessment and treatment It is important for healthcare professionals to approach every individual patient with a cognizance of the possible various intersecting identities within the patient, but without a stereotype of the patient based on preconceived notions of these intersecting identities (e.g., race, ethnicity, LGBTQ status). Implementing the practice of cultural humility may flummox healthcare professionals as they approach patients in a clinical setting (Schildkraut, 2017). The following example from Wyatt (n.d.) illuminates some key elements of providing patient care with cultural humility. An interracial couple, an African American father and a White mother, come into therapy because their child was kicked out of school for fighting and the father was called into child protective services for spanking the child. When they entered the office, the father was very angry and the mother was getting extremely upset, trying to calm him down. The White therapist suggested meeting with the father alone first. When he met with the father, rather than trying to silence his rage, he joined with him by stating, “It sounds like you’re furious with the situation that’s happened; you’re tired of it.” The father was able to calm down at that point, as the White therapist was allowing him to be angry in his presence and was acknowledging that there might be a reason for his anger. The therapist then asked the father if his disciplining method had anything to do with wanting to protect his child. The father responded that, yes, he was afraid his child, “a Black kid,” was at risk of going to prison if he was fighting at school. The father did not want that for his child and was frightened. By providing room for the father to express his rage and his fear, the therapist was able to make the clinical session more meaningful. Healthcare professionals who practice cultural humility also recognize that particular assessment tools and treatment protocols may not be appropriate for all patients. Historically, many therapeutic strategies employed in patient care were developed without empirically supported research with ethnic minorities (Sue & Sue, 2021). To this day, most evidence- based practices have not been tested with people of different ethnic and racial backgrounds, despite the evidence that using culturally adapted interventions significantly improves patient outcomes across a variety of conditions (Alegría et al., 2016). There is progress in some areas. For example, of 36 new programs added to the National Registry of Evidence-Based Programs and Practices of the Substance Abuse and Mental Health Services Administration (SAMHSA) since 2015, 14 were developed with ethnically and racially diverse patients. But only two of these programs include descriptions of culturally adapted treatment.
However, healthcare professionals should not rely solely on manualized treatment protocols to guide their interventions, as such an approach can fail to appreciate patients’ unique experiences and the effect of differing social environments. Rather, when employing a research- based therapeutic practice, healthcare professionals should adapt the approach in accordance with the patients’ values, experiences, and preferences while understanding the influence of the broader societal context (Sue & Sue, 2021). For example, consider that a combination of pharmacological and nonpharmacological treatment is recommended in well-researched, evidence- based guidelines as initial therapy for treating certain mental disorders. Some patients may have a preference for starting with nonpharmacological treatments, based on values or beliefs which hold negative connotations toward pharmaceuticals. Other patients may prefer pharmacological treatment as the first-line therapy and have no interest in cognitive or other nonpharmacological modalities, due to held beliefs which view psychotherapy in a negative manner. In either case, the practitioner must work to bridge the gap between research- based interventions and the patient’s personal belief system. Through facilitating a respectful partnership that allows patients to take the lead in narrating their experiences and in identifying personal treatment goals, healthcare professionals can create an environment that appreciates patients’ perspectives. Table 6 outlines important aspects of the multicultural perspective in clinical settings. The considerations outlined in Table 6 require healthcare professionals to balance many different facets of patients and their lived experiences. It is especially important in treatment to adhere to these guidelines, as doing so sets up a therapeutic environment in which healthcare professionals and patients are equal, while forcing healthcare professionals to consider the validity of various worldviews and the structural inequities that contribute to the problems and issues patients bring into therapeutic relationships.
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Book Code: PYFL4024
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