Addressing professional competence problems in trainees: Some ethical considerations.

Psychologists working as graduate student educators and clinical supervisors often encounter trainees who manifest problems of professional competence. At times, faculty members and supervisors may experience role conflict, ambiguity, and anxiety about how to respond to trainee competence problems. Psychologists engaged in the education, training, and credentialing of trainees are ethically and professionally obligated to balance their developmental and gatekeeping roles with respect to trainees. A discussion of several systemic concerns related to psychology's approach to competence problems is presented along with 3 expert commentaries that further elucidate the core issues from the vantage point of education, training, and licensure. Several recommendations for enhancing cooperation and excellent practice among psychologists who train and credential are offered. (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)     

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)     

An acculturation model for ethics training: The ethics autobiography and beyond.

An integrated theme for ethics courses and workshops can be very valuable to psychologists engaged in ethics training. The model of ethical acculturation (M. M. Handelsman, M. C. Gottlieb, & S. Knapp, 2005) can serve as a framework for ethics training at undergraduate, graduate, and continuing education levels. The authors outline several advantages of focusing on the process of acculturating to the ethics of psychology rather than having students simply memorize ethics principles and standards. They discuss several pedagogical activities used to implement the acculturation theme and to help students become more active participants in their learning. Examples from student papers and course discussions highlight the ways these techniques aid in the teaching, learning, and assessment of learning in professional ethics training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural competence: A new way of thinking about integration in therapy.

This article, based on a keynote speech delivered to the 2009 conference of the Society for the Exploration of Psychotherapy Integration, offers a model for understanding cultural competence as a strategy for psychotherapy integration. Paradigms for what constitutes cultural competence in psychotherapy are explored, and the development of an epistemology of cultural competence that includes understandings of therapist bias and both therapist and client intersectionalities of identity are examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural and linguistic competence: Welcome challenges from successful diversification.

The increasing numbers of ethnically diverse professionals is filling a need for service provision in agencies that provide mental health services for a diverse clientele. However, the rapid shift in professional demographics provides a sharp generational contrast; these emerging psychologists are placed in potentially ethically charged positions before their careers truly begin as a result of the gap between institutional resources (materials and supervisors) and trainees' specialized needs. The lead article reviews a broad array of points to consider when a supervisee is providing services in the native language of the client and does not know that language. The three invited commentaries highlight (a) the role of language in emotion and subsequent implications for treatment and supervision, (b) the slow institutional development to meet the training needs of emerging therapists that will treat ethnically diverse clients, and (c) the importance of following decision-making models to inform ethical supervisory practice when there is a language mismatch. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When values of different cultures conflict: Ethical decision making in a multicultural context.

Can psychologists apply the same standards of moral conduct when treating patients from diverse cultural backgrounds as they do when treating European-American patients? The authors recommend options to exercise when patients from diverse backgrounds engage in behaviors that violate generally accepted Western standards of conduct. Psychologists need to determine if such a cultural conflict really exists, as many such conflicts are more apparent than real. If such a conflict does exist, the authors recommend analyzing the conflict from the perspective of soft universalism, which holds that all cultures share basic, universal values, although they may vary in how those values are expressed. The authors recommend a decision-making process based on principle-based ethics for guiding behavior when such conflicts occur. (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)     

Psychologists as change agents in chronic pain management practice: Cultural competence in the health care system.

Psychologists bring great value to health care systems, but our ethnocentrism regarding the medical community often limits our effectiveness as agents of change. Based on experience in developing pain management services within the Department of Veterans Affairs health care system, we discuss cultural issues as central to effective systems change and provide specific recommendations for psychologists aspiring to change organized health care systems, such as the Department of Veterans Affairs. Consideration is given to the misfit of the biomedical model to chronic pain, “physics envy” affecting the authority accorded psychology, and societal stigmatization of psychopathology. A process-based definition of cultural competence is recommended as improving on psychology's intrinsic group-based notion of culture in engaging the medical community. The systems thinking literature is sampled in summarizing practical recommendations that include identifying features of local medical culture and power dynamics between psychology and medicine that can be modified by engaging stakeholders in an interpersonally effective manner. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Community competence and violently acquired spinal cord injury: Employment as a peer role model.

Purpose: To understand how employment as a peer role model within a rehabilitation hospital affects the development of community competence among young men and women with violently acquired spinal cord injury (VASCI). Design: A mixed-method, multiple case study design was incorporated, in which 2 cases were selected for study, including 10 individuals who were currently employed as peer role models and 10 individuals who were not. Results: Results revealed several differences between the 2 cases, as peer role models demonstrated greater knowledge and use of community resources. Furthermore, results highlighted the processes by which these changes occurred, including that peer role models had more direct exposure to resources, engaged in the act of sharing resources with others, and experienced an increased connection to positive networks. Conclusions: Findings suggest that the experience of employment as a peer role model within a rehabilitation setting may facilitate connections between individuals with VASCI and the community supports and resources necessary for successful postinjury adjustment. Implications for future research and theory are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On supervision: Reflections of a Latino psychologist.

The clinical supervisory relationship can be used to help psychotherapy trainees develop a more integrated sense of a multicultural and professional self. In this paper, the author shares some of his own training experiences in supervision and their influence on his supervision style. Examples from supervisory sessions are given to demonstrate how issues of race, gender, class, and sexual orientation can be used to advance both the supervision and the treatment. Candid discussions around the transferential and countertransferential issues in the supervision and the treatment can improve the supervisee’s capacity to integrate cultural identity into the developing sense of professional self as a therapist. This process also contributes to the clinical understanding of the person being treated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)