your values, or your cultural experiences. I welcome your feedback.” ● For ongoing self-reflection, use a journal to jot down potential implicit biases and observations about rapport building. ● Inquire about what the patient felt would be helpful. Are there cultural practices or herbal remedies that they have already tried, and what was the result? Do religious, Final Thoughts on Cultural Humility A culturally humble approach is interactive, with counselors having an openness and willingness to learn. It is the acceptance that the counselors may have expertise in the psychological aspects of the patient’s care, but the patient/family has the expertise in their own health. Cultural humility is about accepting our limitations and increasing
cultural, or individual convictions affect the treatment choice? ● After the session, ask the patient if he or she felt understood, if he or she understands the process, and if there is anything else he or she would like to add to be better understood. ● Be an advocate. Recognize that your advocacy and allyship can help transform culture and norms in the workplace. Open a dialogue if you notice a practice or policy excluding cultural groups. our self-awareness of our biases and misperceptions. It is about committing to lifelong learning, self-reflection, and the willingness to learn from our patients about what is important to them and collaborating with them for the best possible care.
CASE STUDIES
Case 1: Leo White The White family is Black family that lives in the urban center of a midsize Northeastern city. John and Melinda White are the parents of three children: Leo, 13; Kate, 11; and Tabatha, 9. The family lives in a small two-bedroom apartment. The apartment is located in a community with many single-family houses converted into two, three, or more apartments. The landlords often attend only to the most egregious of needed repairs, leaving many homes in disrepair. The neighbors know and look after one another on the Whites’ street. However, neighboring streets have recently been subjected to gun violence. This violence has dramatically concerned the White family and their neighbors. John and Melinda White both have jobs in the service industry. John is a cook at a fast-food restaurant, and Melinda is a certified nursing assistant (CAN), providing home care for elderly clients. The Whites do not own a car and rely on the bus system in their city. As a result, John and Melinda must be up and out of the house by 5:00 a.m. to get to their jobs on time. They have put Leo in charge of ensuring he and his siblings get up, eat, and get out the door to school by 7:30 a.m. Leo takes his responsibilities seriously, getting up at 5:30 to make sure he is ready in enough time to help his younger sisters get up and ready for school and to ensure their safety on the way to school. Leo comes home right after school to make sure he is home with his sisters and to get dinner started, as his parents are unable to get home until 7:00 p.m. Leo helps his sisters with their homework and often does not start his homework until much later, causing him to stay up past midnight on many school nights. Leo recently fell asleep in class and has not performed well on tests. The school has called John and Melinda about Leo sleeping in class and having poor test scores. They are distraught with Leo’s recent performance on tests and have tried to talk to Leo about his recent poor performance. However, whenever his parents approach him, Leo says he has it under control and will take care of it and then goes to his room. The school scheduled a meeting with John and Melinda during the day, but they could not attend it because of their work schedules, and the school did not offer an alternative. The school assumed that the Whites were not invested in Leo’s education. The school counselor, Ms. Fields, is a White counselor from a middle-class background. She has met with Leo. Ms. Fields tried to talk to Leo, but he would barely speak to her and kept shrugging his shoulders, looking at
the floor when she tried to elicit reasons for his sleeping and poor test performance. The school counselor has seen kids like Leo before and assumes that school is not a priority at home for Leo; judging from his parent’s absence from the meeting, she feels her opinion is correct. She meets with Leo a few more times, but he refuses to answer questions about what he is doing with his time and with whom he is spending time. She tells Leo to schedule a session with her when he is ready to be more forthcoming. Leo never reschedules an appointment, and his performance continues to be poor for the rest of the year, resulting in his having to repeat math. Questions 1. How does the school’s approach to resolving Leo’s school problems reflect culturally embedded beliefs? 2. How might Ms. Fields’s culturally embedded beliefs have affected her interactions with Leo? 3. What should Ms. Fields have taken into account to practice cultural humility? 4. If you were the counselor, what would you do? Why? Discussion The school and the counselor seem to be making assumptions about Leo’s poor performance. As a result, Leo was left without help, which might have prevented him from failing math. The Whites might benefit from the school’s engaging in a dialogue with them regarding availability to meet; the school could offer to meet at the Whites’ home and could inquire about the overall situation at home. The counselor neglected to engage Leo as an equal partner in the counseling process, leaving it to him to speak up, and located the problem squarely within him. Had Ms. Fields considered the possible institutional and societal structures preventing Leo from doing his homework, she might have been more successful in advocating for him on various levels. Although it is unlikely Ms. Fields could have changed the Whites’ work schedules, she might have supported the school administrators or, perhaps, the teachers in the school to change some of their practices, allowing Leo the opportunity to succeed given the circumstances of his family life that are rooted in societal inequities. The counselor practicing within a culturally humble and social justice orientation would not locate the problem within the individual but would look to the environmental factors that contribute to the individual’s actions and reactions (Sue & Sue, 2016). In the case of Leo White, he is
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Book Code: PYTX1226
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