Cross-cultural training, also referred to as multicultural counseling competence training, denotes the process of instructing psychologists-in-training to work effectively across cultures in their practice and research activities. The term cross-cultural (or multicultural) has been defined in the counseling psychology literature in two distinct ways. One definition of cross-cultural is broad and inclusive of a wide variety of reference group identities (e.g., race, ethnicity, sexual orientation, social class). More traditional uses of the term, which emerged in the 1960s, were specific to different ethnicities, within and beyond the borders of the United States. On the basis of salience of race as a marker in the United States, many scholars during the 1980s and 1990s argued for a more specific definition of cross-cultural (multicultural) that focuses on domestic racial, ethnic, and linguistic minority groups. Because there has been increased attention to international issues in the field of counseling psychology during recent years (for instance, three of the five presidents of the Society for Counseling Psychology between 2003 and 2007 positioned counseling psychology in a global sphere), cross-cultural, for the purposes of this entry, refers to race and ethnicity within both domestic and international contexts.
The rapidly changing demographics of the U.S. domestic population and the transnational reach of counseling psychology make cross-cultural training increasingly critical in the overall education of applied psychologists. However, despite the importance the American Psychological Association (APA) has placed on cross-cultural training and the growing percentages of people of color in the United States served by applied psychologists, clients from diverse racial and ethnic backgrounds nonetheless continue to average fewer sessions, terminate more quickly, and utilize services less often than their non-Hispanic White counterparts. Racial and ethnic minority individuals oftentimes do not view counseling as addressing their needs, or perhaps untrained, culturally insensitive therapists leave too many minority clients feeling misunderstood. If clients are not considered within their sociocultural contexts as they understand and experience them, a host of potential negative implications might ensue with regard to case conceptualization (e.g., minimizing the importance of contextual factors), diagnosis (e.g., overpathologizing clients from different cultures on the basis of their different world-views), and treatment (e.g., difficulty establishing the therapeutic alliance, inappropriate interventions). Therapeutic services designed from a universalist framework—a theoretical approach based on White middle-class male values that assumes a set of universal laws of human functioning—may not be appropriate in contexts where diverse worldviews and cultural values prevail. On the other hand, counselors (of various ethnicities) who have received cross-cultural training and demonstrate adequate levels of multicultural competence and sensitivity generally will minimize mistakes made in cross-cultural counseling and thus provide better, more appropriate services to clients of various racial and ethnic backgrounds.
Changing demographics in the academy also call attention to the importance of cross-cultural sensitivity in university classrooms and other training settings (e.g., practica). Traditional forms of pedagogy that rely on the universalist approach are not relevant for many students of diverse racial and ethnic backgrounds. To recruit and retain graduate students from a variety of racial and ethnic backgrounds, training programs must make the curriculum relevant for these students. Although demographic trends reveal increasing numbers of domestic students of color in undergraduate psychology programs (25% in 2000), many do not enroll in graduate study, or they withdraw before obtaining their doctorates. The teaching and training of psychology must become culturally relevant and appropriate for students from diverse racial and ethnic backgrounds so that they can (a) feel respected and validated in academic environments, thus leading to greater rates of completion; (b) bring relevant knowledge, grounded in empirical research, back to their communities; and (c) transform the ways in which psychological services are provided to a wide range of people. Based on data collected by the APA Research Office in 2000, the immediate reality remains that the majority of psychologists in the workforce (91%) and psychologists-in-training (78%) are White, and many are apathetic or resistant to cross-cultural training. With regard to internationalization, increasing numbers of international students are enrolling in applied psychology graduate programs and are being hired in academic positions in the United States or abroad in their countries of origin.
Counseling psychologists of all ethnicities, races, and nationalities are well-positioned to be leaders in the area of cross-cultural training because the variety of skills that they possess are essential in this realm. Certainly, creating environments conducive to effective cross-cultural training is challenging. Educators not only need mastery of content knowledge but also must possess excellent group facilitation skills, demonstrate appropriate self-disclosure, employ theoretical models and empirical research to guide training, and skillfully manage intense emotions that might emerge during discussions of such affectively loaded topics as racism, ethnocentrism, and White privilege.
A long-standing history exists that deals with the constructs of culture and race in psychology. Initial conceptual and empirical work regarding cross-cultural psychology sought to identify equivalent individual variables across cultural groups; that is, the focus was to detect universal laws of human functioning, which perhaps only varied by context. Early attention to the notion of race in psychology often was based on models of biological inferiority and cultural deprivation paradigms, blatantly reflecting and reinforcing White supremacy. In a society as diverse as U.S. society, with a wide variety of worldviews and healing practices among different cultures, it would seem obvious that a universalist approach would be ineffective with clients from various racial and ethnic backgrounds. However, the field of psychology was unable to transcend the universalist approach and is still struggling to do so, perhaps due to institutional racism and White privilege.
The concept of cross-cultural training in psychology gained momentum alongside grassroots activism, such as the civil rights and other liberal movements for social change. It was not until Brown v. Board of Education of Topeka, when psychological research was accepted as evidence in federal courts, that the stage was set for improved attention to race in therapy. The advent of minority-focused psychological associations, such as the Association of Black Psychologists (1968), Asociacion Por La Raza (1970), Asian American Psychological Association (1972), and Society of Indian Psychologists (1975), provided further impetus for attention to cross-cultural training that transcended deficit paradigms. Concomitantly, the APA’s evolution with regard to racial issues has facilitated the development of cross-cultural training initiatives. For example, during the National Conference on Levels and Patterns of Professional Training in Psychology (widely known as the Vail Conference of 1973), leaders decided that diversity training would be included in all APA-accredited doctoral programs; however, this was not immediately enforced. Subsequently, structural changes in the APA, such as the development of the APA Office of Ethnic Minority Affairs in 1979, the Board of Ethnic Minority Affairs in 1980, and Division 45 (Society for the Psychological Study of Ethnic Minority Issues) in 1986, compelled greater attention to culturally relevant training issues.
Since early forms of the multicultural guidelines in the 1980s and the Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations in 1993, almost 20 years had passed before the APA Council of Representatives approved as APA policy the Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists in 2002. Guideline 3 specifically encourages psychologists “to employ the constructs of multiculturalism and diversity in psychological education” and emphasizes the importance of incorporating culturally relevant practice into undergraduate and graduate instruction, including research advisement and clinical supervision.
During the early 1980s, Derald Wing Sue and his colleagues pioneered the development of a tripartite model of cross-cultural, or multicultural, training. Sue’s model included three distinct yet interrelated areas multiculturally competent counselors should possess: (1) knowledge of the cultural values and worldviews of diverse populations, (2) awareness of one’s own cultural socialization and biases, and (3) skills for interventions with diverse client populations. The domains of knowledge, awareness, and skills have become widely accepted as the components of multicultural counseling competence and continue to be the prevailing training model today. Beginning in the 1990s Patricia Arredondo and her colleagues extended the tripartite model by delineating practical and specific training strategies, objectives, and techniques in each domain.
Since Sue’s early work, a growing body of research has documented the ways in which cross-cultural training is most effective. In a meta-analysis examining the findings of 30 years of published studies on multicultural training effectiveness (1973-2003), Timothy Smith and colleagues found that theoretically grounded training is twice as beneficial as training that is not based on theory. Several other key variables also were consistently predictive of higher levels of cross-cultural competence, such as advanced racial identity statuses, lower levels of racism, and greater levels of emotional empathy. These findings underscore the importance of trainee racial self-awareness as a critical aspect of cross-cultural training. Apparently, the one course method is not sufficient, and the most beneficial approach, according to Charles Ridley and colleagues, is one that integrates multicultural issues into every aspect of a training program.
P. Paul Heppner, in his 2005 Society for Counseling Psychology Presidential Address, emphasized that in an era of increasing globalization, the boundaries of counseling psychology will cross an even wider variety of countries and cultures, which further necessitates incorporating cross-cultural competence in training. He suggested a number of activities that could promote such competence: immersion experiences abroad, formal coursework, proficiency in languages other than English, cross-cultural textbooks and curricula, and learning opportunities with international students within U.S.-based training programs.
Greater specificity in the APA code of ethics and continued development of the Guidelines to explicitly outline the ways in which psychologists can effectively work with people from a variety of backgrounds is critical. Continued research is one way to accomplish this; empirically documenting what factors make cross-cultural training work best and for whom is crucial. Although training models are needed for trainees of all racial and ethnic backgrounds (those whose socialization and education are primarily U.S. based and those from other countries who complete graduate studies in U.S. colleges and universities), specific models are needed to help White graduate students overcome apathy, resistance, and ideologies grounded in White supremacist values (e.g., the perception of the superiority or universality of their worldviews). Minimum standards must be established to ensure that graduates possess the necessary knowledge, awareness, and skills to be effective in increasingly diverse domestic and global contexts. A challenge for the field of counseling psychology is to maintain its momentum on U.S.-based social justice initiatives while also attending to transnational issues.
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