Balancing of power suggests a respectful partnership with patients and families that values their self-knowledge and lived experiences alongside our expertise in our field. Finally, advocacy involves individuals moving beyond the
interpersonal to impact larger (i.e., institutional, structural) systems. Figure 1 shows the different components of cultural humility defined by Tervalon and Murray-Garcia.
Figure 1. The Five Rs of Cultural Humility
Note . Adapted from “Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education,” by Tervalon, M., et al.,1998. Journal of Health Care for the Poor and Underserved, 9(2), 117–125. THE U.S. AND DIMENSIONS OF DIVERSITY
Diversity is a multidimensional concept that refers to many aspects of an individual that combine to comprise an overall sense of self. The U.S. continues growing and becoming a country where all cultural groups are represented. The past several censuses have shown increased racial and ethnic diversity among the U.S. population. The latest Census Bureau estimates indicate that nearly 4 of 10 Americans identify with a race or ethnic group other than White and suggest that 2010 to 2020 will be the first in the nation’s history in which the White population declined in numbers. In 2019, most of the nation’s population under 16 identified as a racial or ethnic minority. This group, Latino or Hispanic and Black individuals, comprise nearly 40% of the population (Frey, 2020). Moreover, diversity occurs within a cultural and social context where variances within the general population are treated differently based on society’s social, political, and cultural constructs. Some dimensions of diversity include race, socioeconomic class, gender, sexual orientation (i.e., identifying as lesbian, gay, bisexual, transgender, queer/questioning [LGBTQ]), gender identification (i.e., identifying as transgender), and disability. Although this is not an exhaustive list of all elements of individual diversity, it does address many prominent diversities dimensions an individual may have and determine where that individual falls within the societal hierarchy. Dimensions of diversity also empower some members of society while oppressing and marginalizing other members of society (Sue & Sue, 2016). Counselors need to understand the effects of diversity on a client in multiple domains, including a client’s mental health and well-being. In some instances, a client’s identity constructs may be a source of great strength, and in other contexts, they may contribute to increased stress. For example, on a micro level, simply being different increases the threat of victimization and bullying (Tippett & Wolke, 2014). When individuals differ from the majority group, a concept referred to as “person– group dissimilarity” (Juvonen & Galvan, 2009, p. 300), they are at risk of victimization. For instance, being the only individual in a school, workplace, or community group who possesses a particular trait increases the risk of victimization,
regardless of the trait (e.g., race, religion, socioeconomic status, LGBTQ, appearance). Children with special needs and physical disabilities are consistently at an increased risk of victimization (Fegert et al., 2020). Adults who are members of a minority group suffer from higher rates of bullying (Lewis, Giga, & Hoel, 2011). Some minority workers have been shown to endure a bullying rate that is two to three times higher than that of their nonminority coworkers (Lewis et al., 2011). Namie, Christensen, and Phillips (2014) found that Hispanic Americans, African Americans, and Asian Americans all experienced higher rates of workplace bullying, both witnessing and targeting, than White Americans and that their group rates were each higher than the national average. As in school settings, differences of any type increase a person’s risk of being bullied or experiencing other forms of victimization. For decades, “social psychologists have repeatedly demonstrated that individuals who do not belong to the group are devalued.” They are more likely to be used as scapegoats in the workplace (Zapf & Einarsen, 2011, p. 188). Being isolated, bullied, or oppressed can negatively impact your mental health. Bullying and mental health are closely related. Victims of teenage bullying tend to go through severe emotional trauma. They often feel helpless, lonely, bitter, isolated, angry, frustrated, vulnerable, and anxious. Victims of depression from bullying often carry the after-effects deep into adulthood. They might have ongoing self-esteem issues, continue struggling to form lasting relationships, and start avoiding social interaction as much as possible. They often also find it difficult to trust others, impacting their personal and career relationships. Likewise, adult victims of workplace bullying, or community oppression, will show signs of severe stress (Warszewska-Makuch, 2020). In a study examining the effects of workplace bullying, findings reveal perceived bullying was associated with mental health problems, including psychological distress, depression, and burnout, and physical health problems, including insomnia and headache (Lever et al., 2019). They show that bullied staff took more sick leave. As such, the context of a client’s diversity elements may directly affect the client’s reasons for presenting to counseling in the first place.
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Book Code: PYTX1325
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