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Article 24
Preparing Counselors of Color for Diverse Cultural Contexts
A Review of Multicultural Textbooks Used in CACREP-Accredited Programs
Abstract: This research analyzed the most widely used multicultural textbooks (MCTs) in CACREP-accredited programs for content that specifically addressed the cultural competence of counselors of color in training (COCITs). Due to current status of race relations in the United States, which includes racism, oppression, and violence that persons of color may experience, there needs to be unique training for COCITs that addresses possible emotional distress, biases, and ill-feelings toward Whites and other persons of color. Cultural competence is not only for White counselors-in-training, but also for COCITs; therefore, the authors hold that it is imperative to analyze MCTs for content that focuses on preparing COCITs. Twenty-two MCTs were reviewed and only five met criteria, albeit at varying degrees. Examples of content themes included the impact of internalized oppression, assimilation, and acculturation, as well as challenges related to voicing true feelings to White faculty and supervisors, and their cultural competence and skill level in handling COCITs preparation.
Keywords: cultural competence, counselors of color, multicultural textbook review, CACREP, training
The purpose of this research was to conduct a content analysis of multicultural textbooks (MCTs) in order to determine if textbook authors specifically addressed the process of cultural competence of counselors of color in training (COCITs). For this manuscript, cultural competence is defined as the ability of counselors and counselors-in- training to conduct psychotherapy while demonstrating competence as it relates to their cultural awareness and biases, cultural knowledge, and culturally appropriate interventions and skills with a range of culturally diverse clients. Cultural competence is an ongoing journey rather than a destination as culture is dynamic and ever changing; therefore, counselors and counselors-in-training are always in the process of becoming culturally competent (S. Sue, Zane, Hall, & Berger, 2009). The need for cultural competence training is not reserved for White counselors alone. In the past and present, persons of color have experienced discrimination, oppression, and violence, which has caused historical and intergenerational trauma (Evans-Campbell, 2008); anxiety, depression (Araújo & Borrell, 2006; Clark, Salas-Wright, Vaughn, & Whitfield, 2015; Gee, Spencer, Chen, Yip, & Takeuchi, 2007), substance abuse (Clark et al., 2015), hypertension, and increased stress (Araújo & Borrell, 2006). In as much as these outcomes may impact the process of cultural competence of COCITs, there may be a need for unique training for them as they counsel Whites and other persons of color (D. W. Sue & Sue, 2013).
Demographics in the United States and Within the Mental Health Field
As a nation, persons of color—including African Americans, Latin Americans, Asian Americans, and Native Americans—comprise approximately 37.4% of the population. European Americans account for about 62.1 of the population (U. S. Census Bureau, 2014). In the United States, persons of color account for only “19.2 percent of all psychiatrists; 5.1 percent of psychologists, 17.5 percent of social workers, 10.3 percent of counselors, and 7.8 percent of marriage and family therapists” (Substance Abuse and Mental Health Services Administration [SAMHSA], 2013, p. 8). However, with almost half of White adults with any mental health illness seeking mental health services, it is likely that mental health professionals of color will provide services for Whites as well as other persons of color. Estimates of any mental health service utilization within the past 12 months were similar among adults with any mental health illness, specifically White adults (46.3%), adults who reported multiple races (44.8%), and Native America or Alaska Native adults (41.6%). Further, estimates of mental health service used within 12 months were similar among African American (29.8%) and Latino (27.3%) adults with any mental health illness (SAMHSA, 2012). The client population suggests that training and education in cultural competence will be important due to the enduring disparity among mental health clinicians of color (SAMHSA, 2013).
Gaps in Multicultural Counseling Teaching and Training
As it relates to multiculturalism in counseling, “teaching and training were more directed at educating White trainees and counselors to their own biases and assumptions about human behavior” (D. W. Sue & Sue, 2013, p. 57). D. W. Sue and Sue (2013) operated from the assumption that “people of color knew much of the material on oppression, discrimination, and stereotyping” and therefore knew how harmful it was, so they would not perpetuate it to others.
Yet in the back of my mind, I knew that I was short changing my students of color by making this supposition. I knew that they also had biases and prejudices toward one another and that oftentimes their strong negative reactions toward White students (albeit often justified) could prevent their development toward cultural competence. (D. W. Sue & Sue, 2013, p. 58)
From an ethical perspective, counselors are called to do no harm, to avoid discriminatory practices, and to demonstrate multicultural competence in the practice of counseling (American Counseling Association, 2014). If COCITs harbor ill-feelings toward persons of color and Whites due to negative experiences, biases, stereotypes, and prejudices, and it is not addressed in their educational training, they may be ill-prepared to enter the profession (D. W. Sue & Sue, 2013). Understanding the racial climate of the United States and its effect on persons of color may give us an indication of what areas of cultural competence need to be addressed.
Framing the Issue
Race Relations in the United States
Throughout the years, racially charged clashes among persons in the United States—the Charleston church shooting (Kaplan, 2015), racist chants by University of Oklahoma fraternity members (Svrluga, 2015), the death of Antonio Zambrano-Montes, and the brutalization of Sureshbhai Patel (PBS NewsHour, 2015), and an 8-year-old Rosebud Sioux girl (Chen & Grether, 2015)—give us insight into race relations in the nation.
Furthermore, recent political polls indicate a shift in the public perception of racism and interracial relations in the United States. A 2013 Gallup poll stated that among various groups, there is a perception that relations are not good. These groups include relationships between Whites and Blacks, Asians and Whites, and Hispanics and Whites (Gallup, 2015). Further, a 2014 poll by the same organization revealed a sharp rise in the percentage of Americans who say race relations and racism are America’s biggest problem; these results jumped to 13% from a prior range reported from 1992 until 2014 at 0% to 5% (Gallup, 2015). Historical data indicates periods of recognized problems with racism reported at an all-time high of 52% in the 1960s with a steady decline until 1990 (McCarthy, 2014).
Effects of Discrimination, Oppression, and Prejudice on Persons of Color in America
As D. W. Sue and Sue (2013) expressed, persons of color experience discrimination, oppression, and biases from Whites and each other. Furthermore, research indicates that there is a relationship between the discriminatory experiences of African Americans, Asian Americans, Latin Americans, and Native Americans and poor mental health outcomes. For example, comorbid mental health disorders (depressive disorder and anxiety disorder) have been associated with self-reported accounts of discrimination among Asian Americans. Those reporting these events were more likely to have experienced one or more mental disorders in the past 12 months (Gee et al., 2007). Araújo and Borrell (2006) reviewed current empirical research articles associating discrimination with mental health outcomes illustrating the need for additional research on Latino populations. Indicators suggest that darker skin color is a predictor of higher levels of discrimination, resulting in increased reports of stress and depression. Therefore, it would appear that among persons of color, the recognition and acceptance of discrimination plays an important part in daily functioning. Carter and Reynolds (2011) theorized that among African Americans, the stress experienced associated with racism and can be perceived as race-related stress.
The discriminatory experiences of these populations may negatively influence emotional expression and negatively impact self-concept and self-esteem. The perceptual nature of these experiences may also sway daily functioning due to a perception of lack of control of one’s environment. These observations would include the experiences of counselors-in-training and counselors of color when assessing the racial realities for themselves and clients. Given the current research regarding negative outcomes of discrimination and the mental health well-being of persons of color, there is the potential for threat to the therapeutic relationship. If indeed these needs are not met for counselors of color and COCITs, it makes sense that many of these perceptions may be brought into the counseling relationship. The focus on multicultural competence is geared primarily towards non-persons of color. Therefore, the multicultural competencies related to one’s own experiences with discrimination as a counselor of color or COCIT are not addressed. For example, persons of color who have experienced these discriminatory events at the behest of non-persons of color, may demonstrate countertransference, moving them from the current therapeutic moment narrative (Comas-Diaz & Jacobsen, 1991). These reactions may also occur as a result of the COCIT’s and COC’s internalization of racial stereotypes, in which the stereotypes significantly impede proper interpretation of the client’s narrative (Chapman, 2006). Oliver and Wong (2003) enumerated findings that suggest that, in some contexts, Asian Americans may view Latin Americans and welfare recipients as having low intellectual capacity. They further found that African Americans and Latin Americans may consider relationships with Asian Americans to be problematic.
In the vast majority of cases, counselors who are grappling with their own discriminatory experiences have not had the opportunity to explore their own experiences with discrimination, oppression, and interracial relations with respect to multicultural competence preparation (D. W. Sue & Sue, 2013). It is therefore incumbent upon counselor educators to review the multicultural training of counselors of color in order to respect the dignity of all counselors of color, COCITs, and clients.
Cultural competence involves awareness of one’s own personal biases and values, knowledge about other cultures, and specific skills and techniques for clients (D. W. Sue, Arredondo, & McDavis, 1994). Due to the race relations in the United States, as well as possible ongoing discrimination and oppression that counselors of color may experience, counselor educators and supervisors should address their awareness of self, its impact on themselves and others, as well as their ability to counsel Whites and other persons of color.
Textbook Reviews
There have been various opinions about the impact of textbooks on the learner. Traditionally, textbooks have served as a reflection of the cultural values of a nation. Some have argued “textbook content is unfairly influenced by privileged groups within societies who attempt to prove a hegemonic view of power and control” (Heyneman, 2006, p. 35). Nonetheless, textbooks serve as tools of great power and influence (Heyneman, 2006). A review determines if the textbook provides what it purports and whether it meets the needs of the intended audience (Bazerman, 1995).
In this instance, the authors wished to review MCTs used in Council for Accreditation of Counseling and Related Educational Programs (CACREP)-accredited programs to determine if the texts provided content that specifically addressed the needs of COCITs. In an effort to better serve our diverse student population and select the best textbook for our courses, we searched for educational and research resources, specifically, textbooks to aid in COCITs’ cultural competence. The American Counseling Association and CACREP outline various areas of cultural competence counselors must strive to achieve. On a cursory glance, we found most textbooks appeared to target the development of counselors-in-training who were of European descent. They focused mostly on unearned privilege, unintentional racism, microagressions, etc. (e.g., D. W. Sue & Sue, 2013). These subjects, though important to understand for all counselors-in- training, do not address how COCITs can address ongoing racism and discrimination toward them, or their ill-feelings about Whites and other persons of color. As we begin our understanding of the specific nuances and methods of training and preparing COCIT for diverse cultural contexts, we wanted to explore how MCTs used by CACREP- accredited programs specifically address preparing counseling students of color. Toward this effort, we followed the leads of previous research by Brown, Goodwin, Hall, and Jackson-Lowman (1985), and Macgilliveray and Jennings (2008), who conducted interviews with editors, sales representatives, and instructors. Using the review criteria outlined by Brown et al. (1985), the principle investigator developed a textbook review survey for this evaluation. The following are the research questions addressed in this manuscript:
At what category—inclusion or exclusion—do each of the textbooks specifically cover issues related to the development of students of color’s cultural competence?
For those textbooks that do include information about preparing counselors of color for diverse cultural context, what is the specific content included and what type of content (e.g., experimental research, case studies, theory based) was it?
Method
Sample
Using the CACREP directory of programs (http://www.cacrep.org/directory/), the researchers noted all the departments/programs and institutions listed. There were 261 institutions listed. (Please note that institutions may have had two or more programs such as career, clinical mental health and school, etc.). Of the 261 institutions, we were able to determine what MCTs were being used at 234 (approximately 90%) institutions. Even after looking online and calling the institution bookstores, we were unable to get the MCTs used at 27 institutions. There was a total of 53 textbooks found to be used in counseling departments/programs at 234 institutions. Initial examination of textbook usage by institution indicated frequency of use. Researchers decided to only review MCTs that were used by three or more institutions. Some books used in multicultural courses were excluded because they were not textbooks (e.g., novels).
Procedure
Textbook reviews conducted by Brown et al. (1985) and Macgillivray and Jennings (2008) were the basis of our research methodology. Brown et al. examined psychology of women textbooks and their focus on the African American woman, and Macgillivray and Jennings (2008) conducted a content analysis and exploration of education textbooks for lesbian, gay, bisexual, and transgender content. Using the preceding research as inspiration, the principal researcher of this study developed the qualitative Multicultural Textbook Evaluation Tool (MTET). The 11-question tool was outlined so that the reviewer could systematically review the preface, table of contents, chapters, and subject index for content focusing specifically on the cultural competency and training of COCITs. The MTET was uploaded into SurveyGizmo and researchers used the online MTET to review the MCTs.
Part I of the MTET has six questions, which include the name of the reviewer, title of the textbook, authors, copyright date, edition, and purpose of the textbook. Part II (Questions 7, 8 and 9), the Inclusion/Exclusion section, includes 10 sub-questions that lead the reviewer systematically through the textbook via the preface, table of contents, chapters, and subject index to find content regarding preparing counselors of color for working with Whites and other persons of color. Brown et al. (1985) categorized books into integration, segregation, tokenism, and exclusion. Descriptions of the ratings adapted for this research are as follows:
Integration – This classification was utilized when content that specifically addressed COCITs’ and counselors of color’s cultural competence was found throughout the table of contents, subject index, and multiple chapters of the textbook.
Segregation – This referred to isolated content that specifically addressed COCITs’ and counselors of color’s cultural competence that was presented in a chapter or chapters that may be devoted exclusively to COCITs or counselors of color. There may be other cursory references to content elsewhere in the textbook.
Tokenism – This classification was utilized when content that specifically addressed COCITs’ and counselors of color’s development as cultural competence was found in sentences or paragraphs in a few places in the textbook.
Exclusion – This category indicated that there were no references that specifically addressed COCITs’ and counselors of color’s development as culturally competent mental health counselors.
A keyword list was developed by scanning indexes and tables of contents of the textbooks that included any phrase or word that we thought was associated with COCITs’ cultural competence and ability to work with Whites and other persons of color (Macgillivry & Jennings, 2008). The keywords were used to “mine” the information being sought (See Appendix A).
Part III of the MTET includes Question 10 with nine sub-questions focused on what specific content was included and where it was located in the text, and Question 11 focused on the types of content (i.e., experimental design, theoretical/empirical, or essay/ experiential/case studies) presented in the textbook concerning preparing counselors of color.
Scoring
Reviewers rated the textbooks using a scale from 0 to 3. If no content was found in the section mentioned in the question, the reviewer assigned a value of zero which meant COCITs content was excluded. If content existed, the reviewers assigned the value of 1 (Token), 2 (Segregation), or 3 (Integration), depending on the depth of the information provided. For Question 8, which consisted of 10 sub-questions, raters entered the total score, ranging from 0 to 30. In order to ensure that the score was correct, Question 9 asked raters to re-add the score for accuracy. For textbooks that scored 1 or more overall, the rater would complete the remaining questions.
In order to categorize the textbooks, the mean of the raters’ scores from Part II was calculated along with the standard deviation. Textbooks with a score of 23 to 30 points were categorized as Integrated, a score of 15 to 22 points was categorized as Segregated, a score of 7 to 14 was in the Token category, and a score of 0 to 6 was categorized as Exclusion.
Data Collection and Review
The data collection was done in four parts. The first part of the data collection involved collecting the list of the MCTs used by CACREP-accredited counseling programs. A list of counseling programs was obtained from the CACREP Web site and entered into an Excel spreadsheet. Using mainly the Internet, syllabi, and bookstores, two graduate students recorded the graduate-level multicultural counseling course names as well as the textbooks used. The initial request for the MCTs took place in September 2013 and was performed on a continuous basis for two semesters. For some institutions, the multicultural counseling course was offered on a rotating basis, so we had to wait until the semester the course was offered to learn which textbooks were being used. A separate Excel spreadsheet was created to tally the prevalence of a particular MCT. After two semesters, our inquiry yielded textbooks from 234 institutions (approximately 90%). After multiple attempts were made, we were unable to acquire MCT information for 27 institutions.
Once the information on the MCTs was recorded, along with their frequency of use, the research team, consisting of four doctoral-level counselor educators and one graduate student assistant affiliated with a predominantly African American university, met to plan the review of the MCTs. Textbooks were ordered from publishers and through interlibrary loan.
The second part involved the inter-rater reliability. Inter-rater reliability for our research group was established prior to analyzing the MCTs used for the study. All researchers engaged in a 3-week training period that included: 1) explanation of protocols (i.e., MTET) for scoring MCTs; 2) creating a decision tree to assist with the evaluation (See Figure 1); 3) individually scoring three MCTs not used in the review; 4) a discussion of researchers’ independent scores and evaluations; 5) calculating standard deviation; and 6) establishing an acceptable standard deviation (SD ≥ 2; R & D Systems, 2003).
Using the methods of Macgillivray and Jennings (2008) as a guide, we enhanced the internal validity, along with construct validity, by analyzing the texts independently. At least three reviewers examined each textbook. Throughout the process of reviewing, the principal investigator would regularly review the results entered into SurveyGizmo and noted any errors. The team would meet regularly to review inconsistencies and errors as well as construct, verify, and clarify our ratings and the definition of each category as themes emerged. At times, this meant that we would go through the textbooks together using the MTET to complete the aforementioned tasks. In keeping with Macgillivray and Jennings, “consistent with the constant comparison method, we sought to reach consensus on categories that accurately reflected our collaborative analyses of the text” (p. 177). Our goal was to reach a consensus through collaboration so that we would generate more accurate and detailed categories than if we had relied on the independent analyses alone.
The third part involved evaluating the MCT. Before the evaluation began, we screened MCTs for frequency of use and determined that textbooks being used by less than three institutions would not be reviewed. Based on our criteria, 22 MCTs were evaluated using the MTET on SurveyGizmo. These MCTs were reviewed by at least three of the researchers. Mean scores and standard deviation were calculated and rated either integrated, segregated, token, or exclusion.
The final part of the review included identification of content from MCTs that addressed the cultural competence of COCITs. The research team reviewed the COCIT content found in the MCTs. Themes from the content were determined and agreed upon by all four researchers.
Results
Textbook Categories
Textbooks were categorized into two major categories: inclusion or exclusion. The category of inclusion included three sub-categories: Integration, Segregation, and Tokenism. Of the 22 books reviewed, we found that four textbooks scored in the inclusion category, as they had contained information regarding COCITs specifically. Only one textbook, Explorations in Diversity: Examining Privilege and Oppression in a Multicultural Society by Anderson and Middleton (2010), was rated in the Integration sub-category (M = 25) as it had content addressing the cultural competence of COCITs throughout the textbook. D. W. Sue and Sue’s (2013) textbook, Counseling the Culturally Diverse: Theory and Practice, was rated in the Segregation sub-category (M = 21) as it had only one chapter dedicated to COCITs. Developing Multicultural Counseling Competence: A Systems Approach (Hays & Erford, 2014) and Culture and Identity: Life Stories for Counselors and Therapists (Thomas & Schwarzbaum, 2011) were scored an average of 7.7 and 7.2, respectively, and were therefore in the Token sub-category. The remaining 18 books were in the Exclusion category in that the material presented in the text did not specifically address the cultural competence of COCITs (See Appendix B).
Figure 1.1.
Decision tree for gathering multicultural content that prepares counselors for diverse cultural context.
Content Areas
The content found in the textbooks was closely related. Themes that emerged from our evaluation included (See Appendix C):
internalized oppression, assimilation, and acculturation impact biases, misunderstandings, and miscommunications between persons of color;
as an intervention, professors/supervisors work individually with COCIT to address biases and values;
A COCIT in the Immersion stage of racial identity, is unable find value in the experiences of other persons of color including her classmates and her professor due to her own biases and ways of seeing the world;
encouraging COCIT to be aware of their stereotypes, values, attitudes, and behaviors in respect to experiences of other persons of color and Whites;
COCIT’s feeling uncomfortable sharing their true feelings in front of White faculty without suffering with a bad grade due to the power differential;
the racial identity of the COCIT may influence his/her ability to objectively counsel and/or assess the needs of his/her client;
Counseling dyads are influence by the race of the counselor and the impact of internalized racism; and
the faculty member’s lack of cultural competence makes COCIT uncomfortable.
Discussion
The journey toward cultural competence is one all counseling students will travel; however, the pace and experiences that happen on that journey vary from student to student. Cultural competence is not only for White mental health professionals but also for counselors of color, COCITs, and women (D. W. Sue & Sue, 2013). Although the majority of mental health professionals are White (SAMHSA, 2013), there are various “racial” combinations in therapeutic relationships for which counselors need to be culturally prepared. “Multicultural counseling is composed of many dyadic combinations and not simply a [White-people of color] relationship” (Sue & Sue, 2013, p. ix). As counselor educators, supervisors, and trainers, we serve as facilitators of the cultural competence development of COCITs as well as counselors of color. As a part of that facilitation, we use textbooks, empirical research, and our experience in the field. Therefore, the purpose of this study was to explore how MCTs used by CACREP- accredited programs specifically address preparing counseling students of color.
Availability of Multicultural Textbooks for COCITs
Our findings indicate that the majority of the MCTs used do not contain content that addresses the cultural competence needs of COCITs. Five MCTs were categorized in the inclusion category. The textbook Explorations in Diversity: Examining Privilege and Oppression in a Multicultural Society (Anderson & Middleton, 2010) was the only text that integrated said material throughout the textbook. Three universities are using this text, which is 1.1% of the total number of universities. Although Counseling the Culturally Diverse: Theory and Practice (D. W. Sue & Sue, 2013) is the most widely used MCT at 41.7%, it was in the segregation category. While there are only a few textbooks that specifically address the cultural competence issues relevant to COCITs, faculty may be using supplementary materials to educate, supervise, and train COCITs, supervisees, and counselors of color.
Relevant Content in Textbooks Needed
Our study revealed that most of the MCTs that are being used in CACREP- accredited programs do not specifically address the development of cultural competence of COCITs. While the content in select textbooks included case studies and experiential learning, which included identity development, dealing with ill feelings toward Whites and other persons of color as well as processing discrimination, it is missing how to address the negative mental health outcomes of persons of color. Those mental health outcomes include historical and intergenerational trauma (Native Americans; Evans- Campbell, 2008); anxiety, substance abuse, and depression (African Americans; Clark et al., 2015); high blood pressure, depression, and increased stress (Latin Americans, Araújo & Borrell, 2006); and depressive disorder and anxiety disorder (Asian Americans, Gee et al., 2007). Like White privilege (Sue & Sue, 2013), negative mental health disorders can hinder the development of cultural competence.
The Gallup Poll (2015) indicated that nationally, some people believe that race relations between groups are somewhat bad or very bad. As a counselor, it is important to address our views about persons of different backgrounds or beliefs, as it may greatly impact the way we may relate to them. Textbook content should provide insight and activities to help oppressed groups work through past and current discrimination and prejudice so that they are able to counsel others. A few of the texts specifically discussed the racial identity stage of the COCIT as a potential barrier to cultural competence (D. W. Sue & Sue, 2013; Schwarzbaum, & Thomas, 2008; Thomas & Schwarzbaum, 2011).
Other barriers to COCITs’ development of cultural competence include faculty and supervisors’ own development (Robinson-Wood, 2012; D. Sue, 2010). This same content was included in a few of the MCTs in this study. Seward (2009) indicated that students in his study described
their multicultural courses as not being beneficial to their learning largely due to anticipated and experienced marginalization. Concern over people of color and themselves being marginalized appeared almost paralyzing to students’ ability to concentrate on their cultural development. In this way, the multi-layered problem of students protecting and advocating for people of color and self is complex. However, increased attention to lessen marginalization within classrooms provides a way to reduce oppression as a barrier to learning. (p. 137)
While we have focused on COCITs as a unit, we recognize that the experiences within groups and between groups can be unique, so content in textbooks should speak, at the very least, to the general areas of concern for each group as it relates to their cultural competence (i.e., mental health outcomes of discrimination on various racial groups or race relations between groups). The unique perspectives and experiences of students of color may cause conflicts or barriers to arise (Seward, 2009).
Limitations
As with any research, we experienced limitations as well. While much effort was spent in the collection of information regarding the specific textbooks used by the majority of CACREP-accredited programs, we were unable to collect the MCTs used in the counseling department/programs at 27 institutions. Some bookstore staff and professors never responded. At times, bookstore staff were unsure of textbooks being used. Further, we only analyzed textbooks used by three or more programs. Of those not reviewed, there could have been one that covered preparing counselors of color for diverse cultural contexts. Due to the volume and variation of textbooks used in CACREP- accredited programs, we did not read all of the textbooks cover-to-cover. It is possible that we missed content. We do believe that our method was designed to capture content if there was any. Every effort was made to have consistency of evaluation from reviewers; however, it is possible that some information was not interpreted in the same way across reviewers. Also, during the review process, various textbooks were updated, and it is possible that these updated texts have addressed our concerns stated in this research.
Implications for Future Research
As authors revise their MCTs, they should consider including more comprehensive and applicable material for all COCITs who are gaining cultural competence. For example, ideally, each chapter that focuses on different racial and ethnic groups should include the barriers and skills needed for not only Whites students but COCITs as well. The development of cultural competence content should be specific to Asian Americans, African Americans, Native Americans, Latin Americans, and other ethnic groups of color (e.g., immigrant counselors-in-training). Furthermore, in order to broaden the scope of content, more empirical research should be conducted to determine specific cultural competence needs for specific groups. MCT authors should also include more evidence-based approaches that would best address the needs of COCITs. Lastly, counselor educators, counselors, and supervisors who train and educate students should be vigilant of their own areas of cultural competence growth so that they may help COCITs navigate the journey towards cultural competence.
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Author Note: Special thanks goes to Lakesha Winley who was the original graduate student who collected some of the multicultural textbooks used.
Appendix A: Keywords
Affective cost of racism and discrimination
African American counselor
Asian American counselor
Biracial counselor
Cognitive cost of racism for persons of color
Counselor of color bias
Counselors of color
Cultural competence
Cultural values Discrimination
Healing from historical trauma
Ill feelings towards Whites and persons of color
Impact of oppression
Implications for practice
Interethnic relations
Interpersonal cost of racism for persons of color
Interracial bias
Interracial relations
Internalized oppression
Latino American counselor
Minority counselor
Minority group, counseling clients of another/own
Minority therapist
Minority, group counselors/therapists
Minority/minori ty group clients
Oppression
Over identification with client\racial animosity
Persons of color
Physical cost of racism for persons of color
Prejudice Racial identity
Racial identity development of counselors of color
Racial interaction theory (Helms)
Racism
Stage of racial identity
Supervision and counseling students of color
Therapist biases
Therapist of color
White therapist
Appendix B
Table 1
Rating of multicultural counseling textbooks used in CACREP-accredited programs (N = 22)
Name of Textbook (ed.), Year | Publisher | Authors | CACREP Programs Using Text | Mean Score (SD) | Sub-Category/ Category |
|---|---|---|---|---|---|
Explorations in Diversity: Examining Privilege and Oppression in a Multicultural Society (2nd ed.), 2010 | Cengage Learning | Anderson & Middleton | 3 | 25 (1.3) | Integrated |
Counseling the Culturally Diverse: Theory and Practice (6th ed.), 2012 | John Wiley & Sons, Inc.. | D. W. Sue & Sue | 111 | 21 (2) | Segregated |
Developing Multicultural Counseling Competency (2nd ed.), 2013 | Pearson | Hays & Erford | 22 | 7.7 (1.5) | Token |
Culture and Identity: Life Stories for Counselors and Therapists (2nd ed.), 2011 | Sage | Thomas & Schwarzbaum | 8 | 7.2 (1.5) | Token |
Dimensions of Multicultural Counseling: A Life Story Approach (1st ed.), 2008 | Sage | Schwarzbaum & Thomas | 4 | 7 (1.7) | Token |
Convergence of Race, Ethnicity, and Gender: Multiple Identities in Counseling (4th ed.), 2012 | Pearson | Robinson-Wood | 13 | 3.3 (1.4) | Exclusion |
Multicultural Counseling & Psychotherapy: A Lifespan Approach (5th ed.), 2011 | Merrill | Baruth & Manning | 13 | 3.3 (1.5) | Exclusion |
Handbook of Multicultural Counseling (3rd ed.), 2009 | Sage | Ponterotto, Casas, Suzuki, & Alexander | 3 | 1 (0.7) | Exclusion |
Culturally Alert Counseling: A Comprehensive Introduction (1st ed.), 2007 | Sage | McAuliffe | 18 | 1 (1) | Exclusion |
Microagressions in Everyday Life: Race, Gender, and Sexual Orientation (1st ed.), 2010 | Wiley | D. Sue | 3 | 0.5 (1) | Exclusion |
Cultural Diversity: A Primer for the Human Services (4th ed.), 2010 | Cengage Learning | Diller | 5 | 0.3 (0.6) | Exclusion |
Counseling Across Cultures (6th ed.), 2007 | Sage | Pedersen, Draguns, Lonner, & Trimble | 8 | 0 (0) | Exclusion |
Ethnicity and Family Therapy (3rd ed.), 2005 | The Guilford Press | McGoldrick, Giordano & Garcia-Preto | 5 | 0 (0) | Exclusion |
Introduction to Multicultural Counseling for Helping Professionals (3rd ed.), 2014 | Routledge | Blando, Lee, Orozco, & Shooshani | 3 | 0 (0) | Exclusion |
Counseling Multicultural and Diverse Populations (4th ed.), 2003 | Routledge | Vacc, DeVaney, & Brendel | 3 | 0 (0) | Exclusion |
Readings for Diversity & Social Justice (3rd ed.), 2013 | Routledge | Adams, Blumenfeld, Castaneda, & Hackman | 12 | 0 (0) | Exclusion |
Privilege Power and Difference (2nd ed.), 2006 | McGraw-Hill Publishing Company | Johnson | 7 | 0 (0) | Exclusion |
Addressing Cultural Complexities in Practice (2nd ed.), 2007 | American Psychological Assn. | P. Hays | 8 | 0 (0) | Exclusion |
Diversity in Counseling (2nd ed.), 2011 | Cengage Learning | Brammer | 4 | 0 (0) | Exclusion |
A Race Is a Nice Thing to Have (2nd ed.), 2007 | Microtraining Associates | Helms | 4 | 0 (0) | Exclusion |
Counseling and Diversity (1st ed.), 2011 | Cengage Learning | Choudhuri, Santiago- Rivera, & Garrett | 3 | 0 (0) | Exclusion |
Multicultural Issues in Counseling: New Approaches to Diversity (4th ed.), 2013 | American Counseling Assn | Lee | 6 | 0 (0) | Exclusion |
Note: Integrated: 30–23 points; Segregated: 22–15 points; Token: 14–7 points; Exclusion: 6–0 points
Appendix C
Content included in textbooks that addressed training counselors of color
Textbooks and Content Themes | Example(s) of Content (Type of Content Included) |
|---|---|
Anderson, S., & Middleton, V. (2010). Explorations in diversity: Examining privilege and oppression in a multicultural society (2nd ed.). Belmont, CA: Cengage Learning. Themes: Internalized oppression, assimilation, and acculturation impacts biases and misunderstandings and miscommunication between people of color. Professors/supervisors work individually with COCITs to address biases and values. | “In the Stories of Internalized Oppression, Assimilation and Acculturation, the authors (most of whom are people of color) present their stories about the impact of internalized oppression and the subtle nature of assimilation and acculturation in varying contexts. Choudhuri’s Oppression of the Spirit graciously offers the reader an opportunity to see the power of oppression in her interactions with Shania, who is institutionally classified as African American, but was culturally Native American. Choudhuri, an Asian Indian, also fails to rightly assess the background of Shania and the differences between herself and her client. Emotional chaos ensues for both their interactions with each other as well as with those outside their relationship. . . . Lichaw and Howell-Carter “Unmask Within-Group Prejudice” by exposing the sometimes subtle nature of assimilation and its impact on the relationship between a counselor of color and her supervisee. Much of the story addresses Mayra’s issues as a light-skinned African American woman examining the ideal of meritocracy and its distortion by racism and other “isms.” (pp. 171–172) (Case Studies and Intervention) |
Sue, D.W., & Sue, D. (2013). Counseling the culturally diverse: Theory and practice. New York, NY: J. Wiley. Themes: A COCIT in the Resistance and Immersion stage of racial identity1is unable to find value in the experiences of other people of color, including her classmates and her professor, due to her own biases and ways of seeing the world. Professors/ supervisors work individually with COCITs to address biases and values. Hays, D., & Erford, B. (2014). Developing multicultural counseling competence: A systems approach (2nd ed.). Boston, MA: Pearson. Themes: Encouraging COCIT to be aware of their stereotypes, values, attitudes and behaviors in respect to experiences of other people of color and Whites. | “I’ve been angry at Professor Sue for this whole semester. I wish that they would have had a Black professor teach the class. How could he possibly have given me a B- in the midterm [racial counseling lab course]? I’ll bet the White students got better grades. As a Black woman, I know racism firsthand. They [White students] don’t get it and still get better grades Why am I not getting an A in the course? I know why. It has to do with our role play last week. The class thought I should have been more empathetic with Sandy [Asian American female who played the role of a client]. They said I couldn’t relate to her and didn’t explore her feelings of discrimination as an Asian. Well, I did. But you can’t tell me that she suffers like Blacks do. I felt like saying good, now you know what it feels like!!!!” [Sue said,] It took much class time and several individual meetings to finally get the student to begin examining her reactions to fellow White students and her images and prejudices toward Asians and Asian Americans. [Sue] tried to focus the discussion on the meaning of her extreme reactions to majority group members and other minorities and on what significance it would have if they were her clients. (pp. 58–59) (Case Studies and Intervention) “Self-awareness of one’s own attitudes and behaviors regarding racism and racial privilege is the first step toward social change. Ridley (2005) outlined various factors that contribute to counselor racism. Counselors should reflect on these factors and reflect on how they might play into their counseling relationships. Although these factors were developed as guidelines for White counselors, counselors of color are also encouraged to reflect on them. They include the following:
(Experiential Learning [General thoughts from the author]) |
Robinson-Wood, T. (2012). The convergence of race, ethnicity, and gender: Multiple identities in counseling (4th ed.). New York, NY: Pearson. Themes: COCITs’ feeling uncomfortable speaking true feelings in front of White faculty without suffering with a bad grade due to the power differential. | “Despite being well prepared and qualified to teach, White professors may be viewed suspiciously by students and faculty across race and ethnic groups Students of color may feel the need to carefully weigh their word lest they offend their White professors and suffer from this power differential with an inferior grade.” (p. vii). (Experiential Learning [General thoughts from the author]) |
Schwarzbaum, S., & Thomas, A. (2008). Dimensions of multicultural counseling: A life story approach. Thousand Oaks, CA: Sage Publications. Thomas, A., & Schwarzbaum, S. (2011). Culture and identity: Life stories for counselors and therapists (2nd ed.). Thousand Oaks, CA: Sage Publications. Themes: The racial identity of the COCIT may influence his/her ability to objectively counsel and/or assess the needs of his/her client | “Counselors who are the same race as the client but at a different stage of identity development may experience anger over the client’s stories and may suggest problem-solving skills that promote assertiveness or sometimes aggression as a reaction to acts of oppression. Although endorsing active problem solving may be helpful to some clients, if the client is experiencing depression, he or she may need to resolve those feelings before moving to problem solving. Same-race therapists may also feel powerlessness and helplessness and may be unable to provide solutions as they are experiencing memories of their own experiences of oppression. Same-race clinicians may also experience over-identification with their clients and project their feelings onto the clients’ experiences. When therapists begin to over-identify with their clients, they lose the ability to feel and express empathy as they work to attempt to take care of their own emotions. At this point, clinicians often become frustrated when clients deny the emotional reaction that the clients are experiencing. Clinicians of the same race or ethnicity may have difficulty distinguishing between behaviors within the cultural norms and those that are pathological. Finally, same-race counselors may ignore pathological behaviors in an attempt to foster solidarity within the race. The example of the reactions to the Anita Hill trials exemplified these notions: Some African Americans were angry that Anita Hill decided to come forward with her accusations against Clarence Thomas, believing that it should have been kept private to protect and African American man. Many counselors, for example, may ignore signs of abuse to prevent another member of their race from entering the social services system.” (Schwarzbaum, & Thomas, 2008, p. 88; Thomas & Schwarzbaum, 2011, p. 29) (Experiential Learning [General thoughts from the author]) |
Baruth, L., & Manning, M. (2011). Multicultural counseling and psychotherapy (5th ed.) Upper Saddle River, NJ: Pearson. Themes: Encouraging COCITs to be aware of their stereotypes, values, attitudes, and behaviors in respect to experiences of other people of color and Whites. | “Stereotyping crosses cultural lines and deserves the attention of counseling professionals of all cultural backgrounds. Just as European American counselors might hold stereotypical perceptions about African American, Asian American, Asian American, Hispanic American and American Indian clients, counselors from theses cultural groups might also hold stereotypical perceptions about European American clients.” (p. 48) (Experiential Learning [General thoughts from the author]) |
Ponterotto, J. G., Casas, J. M., Suzuki, L. A., & Alexander, C. M. (2010). Handbook of multicultural counseling (3rd ed.). Thousand Oaks, CA: Sage Publications. Themes: Counseling dyads are influenced by the race of the counselor and the impact of internalized racism. | “I am aware that as a Latina psychotherapist, many of my clients of color choose to come to see me because of ethnic identity. Other people of color, with internalized racism, might choose to avoid seeing someone like me.” (p. 108) (Experiential Learning [General thoughts from the author]) |
Sue, D. (2010). Microagressions in everyday life: Race, gender, and sexual orientation. New York, NY: Wiley. Theme: COCITs feeling uncomfortable speaking true feelings in front of White faculty due to the faculty member’s lack of cultural competence. | Throughout the semester, the professor had sensed increasing resentment among his students of color over the course content (he could not understand the reasons) and he welcomed the opportunity to say something positive about their classroom contributions. (p. 4) The Black students in the class suffered a series of racial microaggressions that were unconsciously delivered by Professor Richardson. (p. 9) (Case Study) |
Notes: 1. A person in the Resistance and Immersion stage of the Racial/Cultural Identity Development Model is noted to endorse minority-held views entirely and rejects dominant ways of seeing the world, including values of society and culture. “The person seems dedicated to reacting against White society and rejects White social, cultural and institutional standards as having no personal validity” (D. W. Sue & Sue, 2013, p. 301).