Predicting cultural competence: Implications for practice and training.

Training and work experience with clients from diverse groups were examined among 266 recent PhDs in counseling and clinical psychology. Surveys were mailed to 600 participants who completed their graduate work between 1985 and 1987. Analyses examined which training variables predicted self-rated competence in providing services to various cultural groups. Results indicated that most therapists reported competence in working with diverse clients, but there was notable variability among ratings of therapists' self-perceived competence with different client groups. Exposure during training to working with clients from specific cultural groups was important in predicting therapists' current perceived competence. Most respondents reported accessing education and training experiences in providing services to diverse client groups. A small but troubling number of respondents reported seeing clients despite reporting low levels of competence with that client group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward reflective practice: A multicultural competence training model from a community mental health center.

Despite the importance of multicultural competence in clinical practice and training, there is a surprising dearth of innovative training models from fieldwork sites that would be replicable in other practicum settings. The authors illustrate a multicultural competence training model from a community mental health center that highlights the Guidelines on Multicultural Education, Training, Research, Practice, and Organization Change for Psychologists (American Psychological Association, 2003). The model focuses on providing multicultural training through two separate but linked training teams for the dual purposes of internal reflection and reflective practice. The authors conclude with a discussion of the implications of this training model for practice, research, and organizational change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual differences in adult decision-making competence.

The authors evaluated the reliability and validity of a set of 7 behavioral decision-making tasks, measuring different aspects of the decision-making process. The tasks were administered to individuals from diverse populations. Participants showed relatively consistent performance within and across the 7 tasks, which were then aggregated into an Adult Decision-Making Competence (A-DMC) index that showed good reliability. The validity of the 7 tasks and of overall A-DMC emerges in significant relationships with measures of socioeconomic status, cognitive ability, and decision-making styles. Participants who performed better on the A-DMC were less likely to report negative life events indicative of poor decision making, as measured by the Decision Outcomes Inventory. Significant predictive validity remains when controlling for demographic measures, measures of cognitive ability, and constructive decision-making styles. Thus, A-DMC appears to be a distinct construct relevant to adults' real-world decisions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of practice and some methodological considerations in training counseling interviewing skills.

Studied 3 areas of counseling interview training (the role of practice, the use of modeling, and evaluation procedures) in 51 university students from a counseling class. Ss were randomly assigned to 5 training conditions: (a) audiovisual model followed by practice, (b) audiovisual model followed by no practice, (c) written model followed by practice, (d) written model followed by no practice, and (e) a comparison training group. Ss' responses to an audiotape of structured interview segments were evaluated, and outcome measures were the frequencies of total and preferred use of open-ended questions, tacting response, and silence. The frequencies for both the total use and total preferred use of interviewing skills were significantly higher for Ss in the practice training condition than in the no-practice training condition regardless of the model. The effects of the research methodologies currently in use are dicussed in light of the results of this study. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Positive uncertainty: A new decision-making framework for counseling.

Changing one's mind will be an essential decision-making skill in the future. Keeping the mind open will be another. Positive uncertainty helps clients deal with ambiguity, accept inconsistency, and utilize the intuitive side of choosing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural competence and evidence-based practice in mental health services: A complementary perspective.

The need for cultural competence and the need for evidence-based practice in mental health services are major issues in contemporary discourse, especially in the psychological treatment of people of color. Although these 2 paradigms are complementary in nature, there is little cross-fertilization in the psychological literature. The present article illustrates the complementary nature of these 2 paradigms. A main point of convergence is related to the development of culturally adapted interventions in the move from efficacy research to effectiveness studies. The implications of cultural adaptations of empirically supported treatments for mental health services in terms of research and practice with ethnic/racial minority populations are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Race/ethnicity, color-blind racial attitudes, and multicultural counseling competence: The moderating effects of multicultural counseling training.

Increasing trainees' multicultural counseling competence (MCC) has been a hot topic in counseling. Scholars have identified predictors (e.g., race/ethnicity, color-blindness) of MCC, and educators provide multicultural training for trainees. Using a sample of 370 psychology trainees, this study examined whether multicultural training (a) moderated racial/ethnic differences on MCC and (b) changed the relationship between color-blindness and MCC. Results indicated a significant interaction effect of race/ethnicity (i.e., White vs. ethnic minority) and multicultural training on multicultural awareness, but not on multicultural knowledge. Specifically, at lower levels of training, racial/ethnic minority trainees had significantly higher multicultural awareness than their White counterparts; at higher levels of training, no significant difference was found. Described differently, more training significantly enhanced Whites' multicultural awareness, but did not enhance racial/ethnic minority trainees' awareness. Additionally, there was a significant interaction effect of color-blindness and multicultural training on multicultural knowledge, but not on multicultural awareness. The association between color-blindness and multicultural knowledge was stronger at higher levels of multicultural training than at lower levels of training. Alternatively, the effect of training on enhancing knowledge was stronger for those with lower color-blindness than for those with higher color-blindness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A competence paradigm for psychological practice.

A competence approach to clinical and preventive interventions is offered as an alternative to defect-based or cognitive-rationalist models. A competence paradigm is more securely rooted in modern evolutionary theory and receives strong empirical support from clinical psychology, preventive psychology, and developmental psychopathology. Psychology should become the science and practice of the identification and promotion of adaptationally significant competencies. By embedding individual problems in a sociopsychological matrix the construct can serve to rally psychologists around the goal of advocating for the personal empowerment of all individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developing a replicable career decision-making counseling procedure.

One approach to improving counseling is to identify particular client goals and to develop treatments with specified objectives, counseling components, and outcome measures that meet those goals. Following this approach, 18 volunteer counselors, with and without formal training, applied a specified career counseling treatment to 30 undergraduates. Analysis of pre- and posttreatment outcome measures indicated that clients significantly increased their knowledge of career decision making and planning and their satisfaction with their career choices, but not their ability to solve career problems. Of the 18 counselors, 15 achieved 60% or greater adherence to the specified treatment components with at least one client. Client feedback indicated that the counseling was particularly helpful for improving self-awareness and decision making but that additional components may need to be added to improve information seeking and goal specification. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Education and training in counseling psychology.

Suggests that employment settings are related to SES trends and discusses their combined impact on the training of counseling psychologists (CPs). Some training models are described, and doctoral programs are reviewed in terms of history, setting, and training emphases. Certification and licensing issues are considered, along with related issues such as retraining. The ever-changing identity of counseling psychology is presented as an obstacle to reaching a consensus as to what constitutes appropriate training for CPs. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of separate and combined overt and covert practice modes on counseling trainee competence and motivation.

Compared training programs that incorporated overt, covert, and combined overt–covert practice modes for their effects on developing counseling skills and confidence in training programs among 52 undergraduates. Ss were randomly assigned to 1 of the 3 treatment groups or to a wait-control condition. In simulated interviews, the combined practice group was superior to the control group on attending behaviors and empathy ratings. The overt practice group was also superior to the control group on attending behavior. Equal levels of trainee confidence were generated for all 3 treatment programs. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of a counseling intervention program for teaching career decision-making skills.

Developed a career decision-making model and program to provide a counseling intervention and teaching materials to aid students in improving their career maturity and decision-making skills. The model and program were piloted and evaluated to determine program effectiveness. 334 academic and nonacademic student groups were part of a quasi-experimental–control design to measure career maturity and decision making. Data indicate that students in the program significantly increased their Career Maturity Inventory scores, career maturity was significantly related to decision making, and more nonacademic program than academic groups increased their decision-making scores. Students reported they found the program useful in evaluating future career choices. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Program evaluation for organizational cultural competence in mental health practices.

Mental health practices that lack cultural competence prevent diverse clients from receiving the care they deserve. As providers and program administrators, psychologists currently have a responsibility to ensure high quality of care for diverse clients at the clinic level. This article deciphers extant empirical research, organizational theory, public policy literature, and best practices to identify which recommendations are most relevant for those in small mental health practices and clinics. The authors present 10 components for culturally appropriate care, ranging from policies and procedures to needs and satisfaction level of clients. This overview can be used to help evaluate and develop a mental health practice's ability to meet the needs of diverse clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developing a tool for measuring the decision-making competence of older adults.

The authors evaluated the reliability and validity of a tool for measuring older adults' decision-making competence (DMC). A sample of 205 younger adults (25–45 years), 208 young-older adults (65–74 years), and 198 old-older adults (75–97 years) made judgments and decisions related to health, finance, and nutrition. Reliable indices of comprehension, dimension weighting, and cognitive reflection were developed. Comparison of the performance of old-older and young-older adults was possible in this study, unlike previous research. As hypothesized, old-older adults performed more poorly than young-older adults; both groups of older adults performed more poorly than younger adults. Hierarchical regression analyses showed that a large amount of variance in decision performance across age groups (including mean trends) could be accounted for by social variables, health measures, basic cognitive skills, attitudinal measures, and numeracy. Structural equation modeling revealed significant pathways from 3 exogenous latent factors (crystallized intelligence, other cognitive abilities, and age) to the endogenous DMC latent factor. Further research is needed to validate the meaning of performance on these tasks for real-life decision making. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Continuing education in cultural competence for community mental health practitioners.

Continuing education in cultural competence is a key strategy for enhancing provider effectiveness in working with culturally diverse clients. In the mental health field, a majority of published works address training issues related to students in graduate programs. Few articles, however, discuss specific models or methods of continuing education for practitioners working in community-based settings. The authors present a case example of an interactive workshop in cultural competence for community mental health practitioners. They discuss key modules of this workshop, including (a) cultural competence and outreach principles, (b) cultural identity and worldview, (c) stereotyping and automatic thinking, (d) dynamics of difference, and (e) application exercises. Recommendations are offered for administrators, direct care staff, trainers, and researchers who may be interested in undertaking or participating in cultural competence continuing education efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapists' needs for training in counseling lesbians and gay men.

A survey of 112 therapists' attitudes, knowledge, concerns, and strategies in counseling lesbians and gay men clients revealed a strong need for therapist training. Although Ss showed generally liberal attitudes toward homosexuals, they admitted a lack of knowledge concerning lesbian and gay male lifestyles. Ss' major concerns in counseling gay clients were the maintenance of objectivity, countertransference, and lack of knowledge of homosexuality. It is recommended that training in counseling lesbian/gay clients become a standard feature of accredited training programs in clinical psychology, that competence in counseling lesbian/gay clients become a prerequisite for state licensure, and that the availability of continuing education regarding therapy for lesbian/gay clients continue for practicing clinical psychologists. (62 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lay mental health counseling: The effects of lay group counseling.

8 therapeutic groups of 10 hospitalized mental patients each were seen twice a wk. for a total of 24 sessions by 5 trained lay hospital personnel. 70 patients served as controls. The lay personnel, primarily attendants, had been trained by an approach integrating the didactic approach which emphasizes the shaping of therapist behavior with the experiential approach which focuses upon therapist development and "growth." Heavy training emphasis was placed upon research scales assessing process variables, which had been predictive of positive patient outcome, rather than any particular theoretical orientation. At the end of the 3-mo period, significant improvement was noted in the ward behavior of the treatment group when compared to the control group. (19 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assertion training for mental health paraprofessionals.

Provided 10 wks of assertion training to 8 mental hospital paraprofessionals who, in turn, served as either counselor or counselee in a microcounseling session with 8 paraprofessionals untrained in assertion training. The data were analyzed by a 2 * 2 completely randomized multivariate analysis of variance. Trained counselors were superior to untrained counselors on a set of counselor-effectiveness measures. Trained counselees differed from untrained counselees on a set of client behaviors. This effect was mediated by the training of the counselor. The problems of conducting scientifically valid research within an institution are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A training proposal to help mental health professionals clarify and manage implicit values in the counseling process.

A training model that will help therapists develop the ability to articulate and work with values implicit in the counseling process is presented, and research is reviewed that provides strong evidence that clients' values are influenced during the course of therapy by the therapist's values. In the proposed training, participants 1st translate various aspects of their therapeutic approach into value language. Second, they are provided with an ethical framework to facilitate the analysis of particular cases in terms of the therapist's multiple responsibilities, self-interests, and social vision. Finally, participants are introduced to the tool of levels of explanation, which may facilitate working with issues of religion and philosophy of life as these relate to client problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Home treatment in a private counseling practice.

Attempts to stimulate interest in home treatment by demonstrating its potential for producing novel and promising psychotherapeutic experience and reflections. The author maintains that while home treatment forces the practitioner to abandon many of the controls he/she can use in an office or laboratory, it also creates a gain that the laboratory cannot simulate—the presentation of the most direct materials of daily living. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)