Counseling the Culturally Diverse. Laura Smith L.

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СКАЧАТЬ aware that the interpreter is a person within the therapeutic relationship; rather than a two‐person interaction, the relationship is likely to be experienced as a three‐person alliance. Clients may initially develop a stronger relationship with the interpreter than with the counselor.

       Provide extra time for the counseling session where possible.

       Ensure that the interpreter is in full understanding of the ethic of confidentiality.

       If you believe the interpreter is not fully translating the client's words or is interjecting their own beliefs, opinions, and assumptions, it is important to have a frank and open discussion about your observations.

       Be aware that interpreters may also experience intense emotions when traumatic events are discussed. Be alert for overidentification or countertransference. You may need to work closely with the interpreter, allowing them periodic debriefing sessions.

CLASS‐BOUND VALUES AND PERSPECTIVES

Diverse cultural perspectives and values can be reflected by diverse social class experiences as well as by racial‐ethnic diversity. Social class and classism have been identified as two of the most overlooked topics in psychology and mental health practice (APA Task Force on Socioeconomic Status, 2007). Statistics suggest that the income inequality gap—the gap between the poorest and the wealthiest Americans—is increasing, and the continuing escalation of wealth inequity in the United States is dramatic. The wealth gap between rich and poor families has grown steadily wider as more and more wealth trickles up to the top (and away from middle‐ and lower‐income families). The top 1% of wealthy Americans owned 200 times the wealth of the average American in 2020; in 1980, they had owned only 60 times as much (Smith & Reeves, 2020). In contrast, the net worth of middle‐income families actually decreased by 20% during that time, while lower‐income families sank even further, experiencing a loss of 45% (Horowitz et al., 2020).

      In the United States, 11.8% of citizens overall live in poverty (Tanzi & Saraiva, 2021). Segmented by race, the poverty rate for White Americans in 2019 was 9.0%, while for African Americans, it was over twice that at 21.2%. For Latinx people, the poverty rate was 17.2%, and for Asians and Pacific Islanders it was 9.7% (Semega et al., 2017). The highest U.S. poverty rates are found among American Indians at 24.2% (Kaiser Family Foundation, n.d.). These statistics underscore the intertwined nature of race with social class in the United States as the result of historic events such as the transatlantic slave trade, the seizing of lands from native people, and institutional barriers to wealth creation (Lui, Robles, Leondar‐Wright, Brewer, & Adamson, 2006).

      BY THE NUMBERS

      Year after year, economic statistics demonstrate the continuing U.S. racial wealth gap, a living legacy of the binding of wealth creation to race at the time of the nation's founding. At that time, only White people could legally accumulate wealth and property; African Americans, on the other hand, were property. For over two centuries, African Americans were not permitted to collect any of the income that resulted from their own labor; that money went instead into White pockets, to be accumulated and passed on to White heirs. What is the magnitude of the wealth gap today? In 2019, the median American White family had approximately $171,000 in net wealth, while the median African American family had approximately $17,000—or about one dime for every White dollar (Based on Broyles, 2019).

      THE DAMAGING IMPACT OF POVERTY

Research indicates that life in poverty is related to higher incidence of depression (Lorant et al., 2003), lower sense of control (Chen, Matthews, & Boyce, 2002), poorer physical health (Gallo & Matthews, 2003), and exclusion from the mainstream of society (Reed & Smith, 2014). When therapists come from middle‐ to upper‐class backgrounds, it can be difficult for them to relate to the circumstances and hardships affecting their client who lives in poverty. Certainly, most therapists would be expected to have sympathy for people in poverty and to know that they face material deprivations; however, many mental health professionals will not be aware of the additional stressors likely to confront clients who are excluded and stigmatized based on their poverty, nor do they fully appreciate how those stressors affect their clients’ daily lives (Smith, 2010).

      Life in poverty means surviving obstacles like low wages, unemployment, underemployment, little or no ownership of property or other wealth, and lack of reliable food reserves. Meeting even the most basic family needs is precarious, and the resources and opportunities that people at other income levels take for granted—such as safe housing, clean water, and adequate health care—cannot be taken for granted. Moreover, people living in poverty are subject to daily experiences of discrimination and bias. People at higher social class positions often (consciously or unconsciously) stereotype the poor as being lazy, inferior, drug‐abusing, or unintelligent, and frequently seek to distance themselves from the poor as a result (Lott, 2002). These stereotypes are manifestations of classist bias, and when people in poverty internalize society's widespread anti‐poor attitudes, feeling of self‐blame and inferiority can develop. Therapists who are not alert to the possibility of internalized classism may unwittingly attribute these feelings entirely to the individual or cultural characteristics of the client.

      THERAPEUTIC CLASS BIAS

      The existence of societal bias against people who are poor has been well documented (APA Task Force on Socioeconomic Status, 2007; Smith, 2013), and therapists, of course, are not immune to harboring these attitudes as well. For example, research has demonstrated that clinicians tend to perceive clients who live in poverty more unfavorably than more affluent clients (as, for example, being more dysfunctional and making poorer progress in therapy). In the area of diagnosis, it has been found that an attribution of mental illness is more likely when a person's history suggests a lower rather than a higher socioeconomic class origin (Liu et al., 2006). Many studies demonstrate that clinicians who are given identical clinical vignettes tend to make more negative prognostic statements and judgments of greater maladjustment when the individual is said to come from a poor or working‐class background rather than from the middle class (Lee & Temerlin, 1970; Smith, Mao, Perkins, & Ampuero, 2011; Stein, Green, & Stone, 1972).

      In addition, the culture‐bound characteristics of mental health practice as with regard to communities of color includes dimensions that are also relevant for social class experiences; the assumptions underlying therapeutic activities are permeated by middle‐class values that do not always apply to life in poverty. For example, appointments made weeks in advance with short, weekly, 50‐minute timeframes are not consistent with the necessity of surviving chaotic circumstances and seeking immediate solutions to pressing problems. Poor people have learned from experience that endless waits are associated with publicly‐funded medical clinics, police stations, and government agencies, where one can frequently wait hours for a 10‐ to 15‐minute appointment, and arriving promptly does little good. Therapists, however, rarely understand these aspects of life in poverty and may be quick to see late arrival as a sign of resistance or indifference (Schnitzer, 1996).

Similarly, with regard to conventional psychological practice, people from poor and working‐class backgrounds may view protracted therapeutic attempts to discover underlying intrapsychic problems as inappropriate or irrelevant. The harsh environment of poverty, where the future is uncertain and immediate needs must be prioritized, can make long‐range life planning difficult and even unrealistic. Because of the high cost of treatment in private practice, a low‐income client may be the first in their family to participate in therapy, and their expectations of therapy may be very different from those of their psychotherapists. For example, low‐income clients who are concerned with survival on a day‐to‐day basis may expect primarily СКАЧАТЬ