Culturally Relevant Diagnosis
Axis I: 300.21 Panic Disorder with Agoraphobia
Axis II: V71.09 No Diagnosis
Axis III: None.
Axis IV: Has had three episodes of panic attacks, although has not had symptoms for one month. Since these episodes, she is afraid to leave the house. She reports she may lose her job if she continues to call in sick.
Axis V: Global Assessment of Functioning: 45 (reports agoraphobic tendencies.)
Age and Generational Influences: 37 years old; born in 1966 in Haiti. She is a firstborn child who lived with her paternal grandmother until she joined her parents at age 7.
Developmental Disabilities: none reported
Disabilities acquired later in life: none reported
Religion and spiritual orientation: raised Catholic but has since rejected Catholicism and now attends a nondenominational Christian church.
Ethnic and racial identity: born in Haiti; first language is Creole/French, but learned English when she emigrated to the United States. She has never applied for citizenship.
Socioeconomic status: not reported, but as a doctor, she is most likely middle to upper class.
Sexual Orientation: probably heterosexual since she is married to a male.
Indigenous Heritage: Haiti, emigrated to the United States at age 7.
National Origin: born in Haiti
Gender: female; oldest child; married with two children, a son and a daughter.
Major Issues in Culturally Competent Assessments
The bias in which most assessments are engulfed makes them a useful measurement of only a small percentage of diverse populations, although there are a few assessments that facilitate the bridging of wide cultural gaps in valid measuring tools (Laureate Education, Inc., 2007). Micro cultures within the United States as well as other cultures worldwide cannot be adequately or fairly measured by biased psychological assessments (Brualdi, 1996). Many measures are geared toward a Eurocentric worldview and when used on diverse populations create a distorted picture with a definitive bias. When assessing clients from diverse populations, it is essential to use measurements that consider the individual's underlying cultural context (Solomon, Greenberg, & Pyszczynski, 1991).
Affect of Major Issues on Counseling
Culture-bound values and norms influence the counselor's intervention as well as the client's capacity to perceive the process as therapeutic and appropriate. For the sake of effectiveness in counseling, the counselor must be aware of the client's cultural orientation and make a considerable effort to understand how to bridge any cultural gaps in communication (Hays, 2008). Counselors must use cultural sensitivity and competence in therapy, especially with clients from diverse populations. Without realizing, the counselor can pathologize misunderstood behavior and dissolve the therapeutic process. Assigning value to the client's issues as well as implementing any therapeutic intervention must use a somewhat relative approach that considers values and beliefs of consequence to the client's cultural context (Solomon, Greenberg, & Pyszczynski, 1991). Finding contextually relevant therapeutic designs and assessments can be arduous but the rewards contribute to the continued effort toward cultural competence and effective counseling (Laureate Education, Inc., 2007).
Brualdi, A. C. (1996). Multiple intelligences Gardner's theory (pp. 1-4, Publication No. RR93002002). Washington, DC: ERIC Clearinghouse on Assessment and Evaluation. (ERIC Document Reproduction Service No. ED410226)
Hays, P. A. (2008). Addressing cultural complexities in practice: Assessment, diagnosis, and therapy. (2nd ed.). Washington: American Psychological Association.
Laureate Education, Inc. (Executive Producer). (2007). Multicultural counseling. Baltimore: Author.
Solomon, S., Greenberg, J., & Pyszczynski, T. (1991). Advances in experimental social psychology. San Diego: Academic Press.
Sue, D. W., & Sue, D. (2008). Counseling the culturally diverse: Theory and practice (5th ed.). Hoboken, NJ: John Wiley & Sons, Inc.