Wednesday, August 22, 2012

Virtual Field Experience: Cognitive-Behavioral Therapy




Examples of the Effective Application of Competencies

Cultural Self-Awareness and Sensitivity to Cultural Heritage is Essential
The therapist understands that family of origin is important for his Hispanic/Latino client. He understands that in the client's culture, the man is often times the dominant partner and can expect his wife to be somewhat subservient. The therapist is also aware that his client is working toward Americanizing his role as a husband, especially since his wife is a White American and culturally different from him. The counselor perceives that perhaps the client is suppressing his natural cultural proclivity to act in a more traditional male role within his family. The counselor also understands the father's powerful influences, both generational and cultural, on his client

Applied Culturally-Appropriate Skills
The counselor, as he mentioned, was more prescriptive than he would have been with a White client in the same situation. As both therapists discuss, they believed this modification of the cognitive-behavioral therapy met his culturally affected expectations for therapy. I thought the counselor also did a good job of perceiving the affects of the client's gender which played a tremendous role in his issues, perhaps more than the cultural effects. Many White people have families like the client's and the issues he is contending with are at least as gender related as they are necessarily Hispanic/Latino issues.

Awareness of the Influence of Cultural Contexts and Experiences

The therapist is aware of the influence of the client's Hispanic/Latino heritage and the tendencies associated with it. As the therapist noted more than once, he thought being more prescriptive in his work with the client was appropriate because of his Hispanic/Latino background. He assumed that the client's cultural background would make him more responsive to the modified cognitive-behavioral techniques. The therapist also seemed to be keenly aware of the client's ideal of being more like a modern man rather than like his father who was arrogant, domineering, unfeeling, and self-centered. He thought the client's father's shortcomings were the effect of his Hispanic/Latino heritage, and believed his client was working toward a modernized American partnership with his wife. The counselor definitely understood the influence of the father on his client.

Therapist's Effectiveness in Cultural Competency

I thought the counselor was effective, especially in dealing with a client whose male gender leads him to express and experience emotions different than might a woman. The counselor seemed to understand his male role as a father and being the head of household (which is typical in the dynamics of many American families.) Since men are far less inclined to seek therapy for any issue, no matter how severe, this male counselor may have been effective simply by virtue of his gender and his ability to relate to the client. The counselor seemed to have adequate knowledge and information regarding Hispanic/Latino men. He also seemed to understand how ethnic differences could create a gap between the client and his wife. Although he did not necessarily address these, he seemed to understand perhaps there were more issues causing trouble in the relationship than were apparent to the client.

Furthermore, he seemed to understand the general characteristics of using a modified version of a Eurocentric psychological application, and modifying it in a way that was appropriate for the client's cultural context, which was his male gender and his Hispanic/Latino heritage. I appreciated the therapist's understanding of cognitive-behavioral therapy and how it perceives clients with the capacity to control thoughts and emotions and the ability to make changes in their environment (Hays, 1995). This was evident in his discussion with the client about him making a conscious effort to be a modern version of his father. The therapist validated the client's cognitive approach and his ability to accomplish that task.

Recommendations for Improvement

It would have been helpful to observe a cognitive-behavioral session in which the counselor implemented more culturally modified techniques. It was interesting to observe the session, although it was difficult to identify any modifications, except for the prescriptive aspect that was mentioned. I would not have recognized the modifications until the counselors discussed it, and because their discussion was limited, I was left with little to no in-depth understanding of the modifications. From my limited experience, the modification seemed applicable in many situations, not solely for counseling Hispanic/Latino clients.

I was somewhat concerned about gross assumptions because of the client's culture. According to the client, he had a selfish, arrogant, self-centered father. This is not necessarily indicative of a cultural affect, but of a self-centered man, father, and husband who is more inclined to serve himself before he takes care of the needs of his family. I understand there are cultural implications here, but I would certainly be careful to refrain from making assumptions simply because of his Hispanic/Latino heritage.


References

American Counseling Association (ACA). (n.d.). AMCD Multicultural Counseling Competencies. ACA Publications. Retrieved August 13, 2012, from http://www.counseling.org/publications

American Psychological Association (APA). (2002). Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists. APA. Retrieved August 12, 2012, from http://www.apa.org/pi/oema/resources/policy/multicultural-guidelines.aspx

Hays, P. A. (1995). Multicultural applications of cognitive-behavior therapy. Professional Psychology: Research and Practice, 26(3), 309-315. doi: 10.1037/0735-7028.26.3.309

Laureate Education, Inc. (Producer). (n.d.). Virtual Field Experience: Adaptation of CBT [Streaming Video]. Baltimore: Author.

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