Examining the Association Between Self-Reported Multicultural Counseling Competencies and Demographic Variables Among Counselors

The authors examined the association between demographic variables and self-reported multicultural counseling competencies among counselors. A national sample of 220 counselors affiliated with university counseling centers participated in this investigation. Counselors responded to 40 Likert-type statements about multicultural awareness, knowledge, skills, and relationships. Results from a series of multivariate and univariate analyses indicated that Asian American and Hispanic counselors reported more multicultural knowledge than did White counselors, and African American, Asian American, and Hispanic counselors reported more competence in multicultural awareness and relationships than did White counselors. No effects were found for other demographic variables. Implications of these findings are discussed.     

Gay and bisexual male clients' perceptions of counseling: the role of perceived sexual orientation similarity and counselor universal-diverse orientation

A recurring question in multicultural counseling is whether client-counselor similarity on sociodemographic characteristics benefits counseling. A related issue is how counselor orientation to diversity relates to counseling process and outcome, both as a main effect and in interaction with counselor-client sociodemographic match. This cross-sectional study investigated these questions in relation to gay and bisexual male clients' counseling experiences by examining clients' perceived similarity to their counselor in sexual orientation, as well as counselors' self-reported orientation to diversity (assessed in terms of level of universal-diverse orientation [UDO]). Data were from 83 male-male client-counselor dyads recruited from lesbian/gay/bisexual-affirming counseling practices, where clients identified as gay or bisexual and counselors identified as gay, bisexual, or heterosexual. Counselor UDO was positively and uniquely associated with client ratings of the working alliance, session depth, and session smoothness. Perceived sexual orientation similarity was not directly related to any of the counseling-related criterion variables. Moreover, when counselors reported low levels of UDO, perceived similarity was negatively associated with the client-rated alliance and perceived improvement. Client religious commitment-a control variable in all analyses--was uniquely and negatively associated with client ratings of perceived improvement in counseling.     

Addressing Mental Health Disparities With Asian American Clients: Examining the Generalizability of the Common Factors Model

Although mental health disparities for Asian Americans are known, reasons for the disparities are not well understood within the counseling process. This study coded Asian American and White clients' reports of helpful counselor actions into empirically supported common factors to determine which within‐session processes might reduce mental health disparities for Asian American clients. Asian American clients' reports of helpful therapist actions did not differ from those of White clients, suggesting that disparities do not originate in differences in the foundational aspects of counseling. Implications for addressing disparities are discussed.     

Curriculum Evaluation and Assessment of Multicultural Genetic Counselor Education

Multicultural competence in genetic counseling integrates racial-cultural knowledge, awareness, and skills into clinical interventions and research practices. Researchers and educators often cite racial-cultural factors as obstacles for visible racial-cultural people seeking help. However, the professional's unfamiliarity of how his or her own racial-cultural group affiliations are influenced by the history of discrimination and oppression coupled with their lack of self-understanding of racial-cultural issues for him- or herself has also limited the effectiveness of genetic counseling. The purpose of this study is to evaluate the effectiveness of the Handbook of Cross-Cultural Genetic Counseling, a multicultural curriculum developed for genetic counselor education for increasing multicultural counseling competence. The multicultural curriculum was evaluated for its effectiveness of increasing multicultural counseling competence using a nonequivalent control group design. A participant's multicultural counseling competence was hypothesized to increase after being taught the curriculum. The curriculum was effective for increasing multicultural counseling competence. Additionally, achieved multicultural counseling competence was not influenced by when the curriculum was taught. Trend analyses measuring the longitudinal impact of the curriculum on multicultural competence were significant. Implications of the results are discussed.     

The Relationship Between Multicultural Counseling Training and the Evaluation of Culturally Sensitive and Culturally Insensitive Counselors

In a study, multicultural counseling training contributed significantly to the variance in ratings of a culturally sensitive counselor. No significant contribution was made to the variance in ratings of the culturally insensitive counselor. Possible explanations and implications of these results in multicultural counseling supervision are discussed.     

Client Adherence to Asian Cultural Values,Common Factors in Counseling,and Session Outcome With Asian American Clients at a University Counseling Center

Based on data from 61 Asian American clients at a university counseling center, the study found that client‐perceived match on client‐counselor belief about problem etiology was related to counselor credibility, empathy, and cross‐cultural competence; the client‐counselor working alliance; session depth; and the likelihood of the client recommending the counselor to another client. An interaction effect showed that both strong match on belief about problem etiology and high client expectation for counseling success were associated with strong client‐counselor working alliance.     

To switch or not to switch: Inviting bilingual clients to switch languages in psychotherapy

In the present study, we used an audio-analog design to test whether exposing bilingual participants to a therapist who invited a bilingual client to switch languages in a psychotherapy session would have a positive effect on participants’ perceptions of the therapist. We also explored whether participants’ sense of belonging to their ethnic group and to the larger US culture would enhance or attenuate this effect. Sixty-three bilingual Latino/a university students listened to one of two recordings of a simulated psychotherapy session with a bilingual Latina therapist and client. In one recording, the therapist invited the client to switch from English to Spanish when the client had trouble expressing complicated feelings; in the other, the therapist did not invite the client to switch. When listening, participants were asked to imagine themselves in the role of client and to rate the credibility and multicultural competence of the therapist, and the emotional bond they would anticipate with her. Contrary to expectation, only participants who expressed a greater sense of belonging to US culture rated the therapist who invited the client to switch as being more multiculturally competent. We discuss how these findings contribute to the literature on language switching and bilingualism in psychotherapy.     

Counselor Demographics,Ageist Attitudes,and Multicultural Counseling Competence Among Counselors and Counselor Trainees

The purpose of this study was to understand the relationship among counselors’ self‐reported multicultural counseling competence and their attitudes of the geriatric population. A statistically significant negative correlation was found between participants’ attitudes of the geriatric population and their self‐reported multicultural counseling competence. Implications for training and practice are provided.     

The Effects of Therapist Competence in Assigning Homework in Cognitive Therapy With Cluster C Personality Disorders: Results From a Randomized Controlled Trial

Therapist competence in assigning homework was used to predict mid- and posttreatment outcome for patients with Cluster C personality disorders in cognitive therapy (CT). Twenty-five patients that underwent 40 sessions of CT were taken from a randomized controlled trial (Svartberg, Stiles, & Seltzer, 2004). Therapist competence in assigning homework was rated by 2 independent raters assessing a session early in treatment (mostly Session 6) using the Cognitive Therapy Scale (CTS; Young & Beck, 1980). Higher ratings of therapist competence in assigning homework predicted a positive outcome at both mid- and posttreatment, even when controlling for initial symptom improvement. The results indicated that therapist competence in assigning homework is important for both symptom reduction and personality change in CT in the treatment of patients with Cluster C personality disorders.     

South Korean counselors’ perceived multicultural counseling competence: Relationship with openness to experience,perceived general counseling competence,and multicultural counseling education/practice

This study investigated variables related to the perceived multicultural counseling competence (MCC) of South Korean counselors. The relationship between perceived MCC and demographic information was explored, and effects of openness to experience, general counseling competence, and multicultural counseling education/practice on perceived MCC were examined.  Results revealed no relationship with demographic information and perceived MCC and significant effects of general counseling competence and multucultural counseling education/practice on perceived MCC. Implications for multicultural counseling training and future research are discussed.     

Contributions of Multicultural Counseling to Counselor Competence With Lesbian,Gay, and Bisexual Clients

This article outlines the contributions of multicultural counseling to 3 areas of counselor competence with lesbian, gay male, and bisexual male and female (LGB) clients: conceptualization of competence, counselor education, and assessment of counselor competence. The authors describe the foundations of multicultural counseling and extend the concepts to counselor competence with LGB clients. Este artículo resume las contribuciones de la consejería multicultural a tres campos de habilidad consejera con clientes homosexuales y hombres y mujeres bisexuales: la conceptualización de la competencia, educación del consejero, y evaluación de competencia para consejería. Los autores describen los fundamentos de la consejería multicultural y extienden estos conceptos a la competencia consejera con clientes homosexuales, lesbianas, y bisexuales.     

General and Multicultural Counseling Competency: Apples and Oranges?

This investigation tests the hypothesis that perceptions of general and multicultural counseling competence are distinct constructs. The findings question the validity of the assumption that general and multicultural counseling competence are separate constructs—particularly for certain clients. The implications of these findings for future research and counselor training are discussed.     

The factor structure underlying three self-report multicultural counseling competence scales

This study examined the extent to which 3 self-report multicultural scales were measuring the predominant 3-factor conceptualization of multicultural counseling competence as consisting of multicultural attitudes/beliefs, knowledge, and skills. Results of a confirmatory factor analysis revealed that the 3-factor model was not fully supported. An exploratory factor analysis identified a 2-factor structure (i.e., self-perceived multicultural counseling skills and multicultural counseling attitudes/beliefs) underlying these instruments. Implications of the findings for clinical practice, training, and research are discussed.     

Predictors of the change in self-stigma following a single session of group counseling

One of the major obstacles to seeking psychological help is the stigma associated with counseling and therapy. Self-stigma, the fear of losing self-respect or self-esteem as a result of seeking help, is an important factor in the help-seeking process. In the present study, college students meeting a clinical cutoff for psychological symptoms participated in 1 session of group counseling that either contained therapist self-disclosure or did not. In general, participants reported significantly less self-stigma following the session. Working alliance-bond and session depth significantly predicted the change in self-stigma. Furthermore, self-stigma (as well as bond, depth, psychological symptoms, and being female) predicted the intention to seek help following the session. Self-stigma and session depth also predicted interest in continuing with counseling. The therapist self-disclosure condition, however, had no effect on the change in self-stigma, intentions to seek help, or interest in continuing with group counseling.     

Forging the Link Between Multicultural Competence and Ethical Counseling Practice: A Historical Perspective

Recognition of multicultural competence as an essential component of ethical counseling practice is a growing trend. This article presents a historical perspective of salient events that have contributed to forging a link between multicultural competence and ethical behavior. Multicultural counseling is traced from its beginnings to its emergence at a position of prominence in the profession, along with the development of ethical guidelines over time. This time line depicts the infusion of multicultural considerations into ethical standards and provides a perspective for examining the current status of multicultural competence as an ethical mandate. Implications for the counseling profession are offered.     

Developing Multicultural Counseling Competence Through the Use of Portfolios

This investigation tested the ability of portfolios to stimulate the acquisition of multicultural counseling competence within counselors‐in‐training and compared portfolios with another method of competence development, case formulation. Results indicate that portfolios benefit the acquisition of multicultural counseling competence. Implications for training in multicultural counseling competence are discussed. Esta investigación probó la habilidad de portafolios para estimular la adquisición de competencia de terapia multicultural dentro de consejeros en instrucción y portafolios comparadas a otro método del desarrollo de la competencia, la formulación del caso. Los resultados indican que los portafolios benefician la adquisición de la competencia de terapia multicultural. Las implicaciones para entrenar en la competencia de terapia multicultural se discute.     

Relationship between orientation toward multicultural competence,multicultural competent behaviors,and working alliance: Examining a multigroup mediation model

In this study, the researchers examined the relationship among an orientation toward multicultural counseling competence, multicultural competent behaviors, and the working alliance from the perspective of 574 client participants across various therapeutic dyads. There was a positive relationship between clients’ perspectives on counselors’ multicultural orientation, counselors’ multicultural competent behavior, and working alliance. Multicultural competent behaviors mediated the relationship between an orientation toward multicultural competence and working alliance. However, the mediated effect was inconsistent across cross and similar racial/ethnic therapeutic dyads. Implications for counselors, limitations of the study, and future directions for research are provided.     

Religious Identity and Cultural Diversity: Exploring the Relationships Between Religious Identity,Sexism, Homophobia,and Multicultural Competence

In this article, the authors present the results from a national study investigating the relationships between religious identity, sexism, homophobia, and multicultural competence. Participants were 111 randomly sampled counseling professionals and graduate students. The results indicated a relationship between religious identity and various aspects of valuing cultural diversity, including sexism, homophobia, and multicultural competence. Implications of the role of religion and religious identity in counseling are discussed, and suggestions for future research are provided.     

A Novel Approach to the Assessment of Fidelity to a Cognitive Behavioral Therapy for PTSD Using Clinical Worksheets: A Proof of Concept With Cognitive Processing Therapy

Fidelity monitoring is a critical indicator of psychotherapy quality and is central to successful implementation. A major barrier to fidelity in routine care is the lack of feasible, scalable, and valid measurement strategies. A reliable, low-burden fidelity assessment would promote sustained implementation of cognitive behavioral therapies (CBTs). The current study examined fidelity measurement for cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) using clinical worksheets. External raters evaluated patient worksheets done as a part of treatment, both guided by the therapist and completed independently as homework. Results demonstrated that fidelity ratings from CPT session worksheets were feasible and efficient. Notably, they were strongly correlated with observer ratings of the fidelity of CPT strategies that were present on the worksheets. Agreement among ratings conducted by individuals with a range of experience with CPT was acceptable to high. There was not a main effect of therapist-guided, in-session worksheet ratings on PTSD symptom change. However, patient competence in completing worksheets independently was associated with greater PTSD symptom decline and in-session, therapist-guided worksheet completion was associated with larger symptom decreases among patients with high levels of competence. With further research and refinement, rating of worksheets may be an efficient way to examine therapist and patient skill in key CPT elements, and their interactions, compared to the gold standard of observer ratings of therapy video-recordings. Additional research is needed to determine if worksheets are an accurate and scalable alternative to gold standard observer ratings in settings in which time and resources are limited.