Green describes that one critical challenge to effective treatment engagement and delivery is the cultural distance between clinician and client that often is displayed in the discrepancies in which each agent conceptualizes, labels and responds to the problem at hand. Green’s (1999) model of help seeking specifies the importance of understanding the client’s definition and conceptualization of their “problem”, which is idiosyncratically embedded within a cultural frame. ![]() We review each model briefly in relation to our argument for the application of a clinical tool that enhances culturally anchored clinician-client shared understanding. This emphasis on the development of a shared understanding has been highlighted by several models of cultural competent practice – Green’s (1999) help seeking behavior model, Sue’s (2006) concept of scientific mindedness, Lopez (1997)’s domain of engagement in his culturally competent process model, and the domain of shared understanding in Fischer, Jerome, and Atkinson’s (1998) model of multicultural competence. Of the numerous approaches to infusing a client’s cultural, ethnic and racial context within a therapeutic encounter, we focus on one central to client engagement- the development of a shared understanding of the client’s problems and treatment needs anchored in his/her individually defined conceptualization of culture. These findings reflect the limited availability of concrete strategies that incorporate conversations about culture, race and ethnicity into therapy in a tangible manner ( Cardemil & Battle, 2003) highlighting the need for a practical tools that facilitate the systematic integration of culture and context into the therapy process ( Cheung & Leung, 2008 Furness, 2005 Garran & Rozas, 2013).Ĭultural competence in engagement- the centrality of a shared understanding Maxie, Arnold & Stephenson, (2006) found that practicing clinicians often do not engage in discussions regarding cultural, ethnic and racial differences with clients. ![]() Empirical evidence suggests this, for example, Petrovich & Lowe (2005) found that abstract theoretical knowledge of cultural competence was less likely to be translated into practice skills for MSW students and alumni. In fact, scholars have argued that one of the biggest challenges to the field of cultural competence is the direct transfer of conceptual understandings of cultural competence to practice situations in which concrete skills are applied to address the complex cultural diversity of client backgrounds ( Boyle & Springer, 2001 Lum, 2011). Despite this, the articulation of these competencies has largely been philosophical and theoretical, resulting in an ideological struggle in the area of methodology and systematic training and skills. NASW, 2007 APA Multicultural Guidelines, 2003). Across disciplines, culturally congruent practice has been identified as fundamental to effective treatment engagement and delivery (e.g. This emphasis in integrating culture within the therapeutic context has been paramount to clinical practice. Thus, understanding the influence of culture is markedly important considering the profound effects it can have on the effective engagement and implementation of treatments for ethnically and racial diverse children and families ( Cavaleri, Gopalan, McKay, Messam & Elwyn, 2010). Further, the centrality of culture is particularly pronounced in the case of child and family treatments, because expectations and norms for child behavior and parenting practices are often culturally bound, thus requiring the clinician to be proficient in conceptualizing the case within a cultural frame and identifying treatment approaches that are culturally consonant ( Lau, 2006 Wintersteen, Mesinger, & Diamond, 2005). For ethnic minority clients, when culture is overlooked in the therapeutic process, misunderstandings may arise, stemming from conflicting worldviews, values and goals, resulting in client discomfort and poor treatment engagement and outcome (Huey & Pan, 2010). While several underlying causes of this engagement disparity among ethnic minority families exist, one explanation may be because conceptualizations of mental health problems and their prescribed interventions often fail to encompass cultural and ethnic factors, which results in the inability to engage ethnic minority families successfully ( Lau, 2006). ![]() ![]() Research continues to highlight a trend in which ethnic minority children and their families are less engaged in mental health services compared to European American families ( Garland et al., 2005 Freedenthal, 2007 Miller, Southam-Gerow & Allin, 2008).
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