Practice Makes Perfect

One of my strengths is my ability to empathize with others, and this will, no doubt benefit my clients. Reflecting back on the extra question posed by Dr. S. in week one, empathizing with clients facilitates their ability to find, or perhaps, regain, meaning and purpose in life. If nothing else, empathy helps us to embrace the world of the client. To reinforce this strength, I subscribe to Levitt's (2001) position that active listening supports empathetic responses. I recall Toller's (1999) belief that, as counselors, we base our craft on "the understanding that it is through the experience of being listened to, accepted and truly heard by another person that we can begin to heal some of the pain and hurt of our human existence" (p. 48-49). Those words were poignant to me and continue to be a reminder of my purpose as a counselor. Remembering too, Gloria Steinem's (1992) idea that we all crave to be acknowledged, listened to, and validated, reminds me of the simplicity of counseling...simply listening and letting the client know I care will, at times, mean more than any specific technique I employ.

Certainly, after this class, I am well aware of my shortcomings as a counselor (which is, of course, not all bad) but perhaps my greatest concern is becoming too involved psychologically. In other words, failing to leave my work at the office. I recall considering this in one of my last classes and came to the understanding that I will have to practice self care, maybe even more than the average person. Because vicarious trauma is a normal effect of counseling, especially if the counselor has ongoing exposure to extremely traumatized clients, self care is essential. Trippany, White Cress, and Wilcoxon, 2004) claim that proactively maintaining a network of support as well as a balanced lifestyle helps to minimize burn-out and vicarious trauma. Personally, I believe maintaining spiritual awareness and taking an appropriate amount of respite and relief will help to address this problem.

This discussion asks for only one limitation and for this I am thankful. Not that it is so difficult to explore shortcomings, but it is rewarding to see growth, in others as well as in myself. Certainly it is wise to maintain an awareness of strengths and weaknesses; the strengths let us help others, and the limitations encourage us to ask for help. Perhaps this is one of the advantages of perceiving ourselves as scholar-practitioners - we continue to learn and practice.

That said, Lepkowski, Packman, Smaby, and Maddux (2009) suggest even though new counselors have a fairly accurate self-assessment of counseling skills, poorly skilled new counselors may overestimate their abilities. I would agree with these authors that, for the most part, people are not generally capable of judging their own competence accurately. Thankfully, we have many hours of supervision under which we'll have extra guidance and an external constructive judgment of our skills and abilities. All the more time to re-assess and keep in mind our roles as scholar-practitioners



Lepkowski, W. J., Packman, J., Smaby, M. H., & Maddux, C. (2009). Comparing self and expert assessments of counseling skills before and after skills training, and upon graduation. Education, 129(3), 363–371.

Levitt, D. H. (2001). Active listening and counselor self-efficacy: Emphasis on one microskill in beginning counselor training. Clinical Supervisor, 20(2), 101–115.

Steinem, G. (1992). Revolution from within: A book of self-esteem. Boston: Little, Brown.

Toller, P. (1999). Chapter 3: Learning to listen, learning to hear: A training approach. In P. Millner & B. Carolin (Eds.). Time to listen to children: Personal and professional communication (pp. 48-61). New York: Routledge.

Trippany, R. L., White Cress, V. E., & Wilcoxon, S. A. (2004). Preventing vicarious trauma: What counselors should know when working with trauma survivors. Journal of Counseling & Development, 82, 31-37.

Forward Movement

I thought it was particularly moving when Parham (Laureate Education, Inc., n.d.) spoke about marginalized people and the fact that they will always experience unjustified and unwarranted struggle. As counselors, we must become culturally competent enough to help individuals from diverse populations that are antithetic to our own cultures so that we may sustain movement and momentum in the lives of those who struggle. Counselors must be able to reach into the world of individuals whose beliefs and worldviews are so different than ours and effectively help them find liberation within the context of that struggle. It may be simply that by virtue of your therapeutic alliance with them, they will thrive. This is the importance of cultural competence.

As people become more aware of cultural differences and oppression of one culture over another, it will be important for counselors to be aware of the experiences of these people and understand how to effectively help them in a context that is of consequence to them. I think Miville's (Laureate Education, Inc., n.d.) words were wise when she said "listen when you don't understand and be patient with yourself".

Rather than developing an awareness of cultural contexts that dump entire races into new stereotypes, it is important to understand our clients and their personal experience of their culture. All Native Americans are not the same. All Hispanic/Latinos are not the same. Stacee Reicherzer (2012), who is a faculty member here at Walden recently wrote in her blog, "don't pretend you're culturally competent if you're not" (para.1). Instead of settling for textbook solutions such as those advised by Sue and Sue (2008), I will continue to question and learn from those around me who are different, I will question my own values and worldviews, and learn from the person sitting before me. I will ask questions and not assume I understand the Alaskan native because I read a chapter in a book.

As we become counselors it is important to understand our own world view, as well as the worldviews of diverse populations that differ from our own (Laureate Education, Inc., 2007). Additionally, we will need to work toward developing intervention strategies that are appropriate for culturally diverse clients and consider established systems and work toward necessary change within them.

As Hays (2008) suggests as therapists,

           we do not have the option of ignoring cultural influences. If we are to work effectively with
           people of diverse identities, we must learn to deal with difference and conflict in ways that do
           not simply reinforce dominant power structures but rather empower and show respect for one
           another (p. 218).


References:

Hays, P. A. (2008). Addressing cultural complexities in practice: Assessment, diagnosis, and therapy. (2nd ed.). Washington: American Psychological Association.

Laureate Education, Inc. (Executive Producer). (n.d.). The future of multicultural counseling. Baltimore: Author.

Laureate Education, Inc. (Executive Producer). (2007). The journey ahead. Baltimore: Author.

Reicherzer, S. (2012, May 7). Don't pretend you're culturally competent if you're not [Web blog post]. Retrieved August 18, 2012, from http://my.counseling.org/2012/05/07/dont-pretend-youre-culturally-competent-if-youre-not/

Sue, D. W., & Sue, D. (2008). Counseling the culturally diverse: Theory and practice. (5th ed.). New York: John Wiley & Sons.

Case Notes

For the purposes of this application, I have chosen to use the SOAP and DAP format for the family counseling session with Dr. Buckley (Laureate Education, Inc., 2010). For routine progress notes, either format works well to document the issues of counseling and progress made therein. Both notation formats have strengths and limitations but equally accomplish the essential task of recordkeeping in counseling.

SOAP Notes

Subjective

Father says he is concerned about his daughter's drinking and that his wife and daughter are drinking buddies. Mother says she and daughter are close friends and have a drink together occasionally. Mother says her husband treats her like a trophy so the world will see his success. Daughter says Father thinks she is a dancing monkey, and has no idea what she wants in her life. Father says he shows his love for his family by providing for them. He said part of his role is to tell his daughter what she wants, because she is too young to know for herself.

Objective

Proxemic behavior suggests mother and daughter allied against father (mother and daughter sit together, father sits alone. Mother and daughter use the word 'we' when talking about 'their' feelings. Father and Mother clearly on different sides of issues related to daughter. Mother is overly dependent on daughter for friendship and affection. Daughter likes Mom to be "cool" - she lets her drink, is open with her friends, and lets her do what she wants.

Assessment

The parents' relationship seems to have deteriorated over time; they share little to no affection and friendship. Father and daughter have an antagonistic relationship. Mother and

daughter are enmeshed in an unhealthy relationship. Mother seems overly dependent on daughter for emotional needs. Need to rule out daughter's alcohol abuse. Father has a fairly linear perspective on family life.

Plan

Strengthen parents relationship - date night once per week. Strengthen mother's sense of self and developing other friend relationships by becoming involved in something outside the home. Father and daughter will spend alone time together each week. Father will practice thinking about his role in the family differently-being a loving father rather than provider.

Benefit and Limitation of SOAP Notes

As long as counselors provide enough information, this notation format is an easy and efficient way of keeping records in a basic format that can be developed according to counselors' personal style of recordkeeping. Quinn and Gordon (2003) believe this format is widely used and understood by the majority of healthcare professionals, which is a benefit for the profession. Delitto and Snyder-Mackler (1995) believe the brevity of this format may preclude using it to assess progress, and emphasize the need to record adequate information.

DAP Notes

Data

The family comes to therapy because of daughter's drinking. Father is concerned about the drinking and also about the mother allowing the daughter to drink. Mother and daughter report having a close relationship, and mother and father report being distant. Mother and daughter believe the father uses them as trophies. Daughter expresses having a good relationship with her mother, but that her father does not know her or have any idea of who she is and what she wants. Father states he expresses his love by providing for his family.

Assessment

Parental relationship has deteriorated over time; mother and daughter became closer while the father became more distant from both the mother and daughter. Mother and daughter have become enmeshed and are somewhat estranged from Dad. Dad perceives his relationship to both in a fairly linear way and expresses his love in providing for the family rather than in overt emotional ways. He learned this role from his father. Daughter does some drinking with Mom and also with friends, so further investigation of her drinking behavior is warranted.

Plan

Have Mom get involved with a group or cause outside the home to strengthen her sense of self and extricate her from the enmeshed relationship with her daughter. Parents need to strengthen their relationship with a date night. Father and daughter need to have some alone time to create a relationship separate from mother. Dad needs to learn to think differently about roles he's learned regarding parenting, fatherhood and being a husband.

Benefit and Limitation of DAP format

This notation format is a quick and efficient way to keep information and track client progress. It can be accomplished in 10 minutes and between counseling sessions when necessary. One limitation is that although this type of notation is efficient and organized, it may tend to oversimplify the therapeutic process (Zuckerman, 2008).

Conclusion

Effective documentation in counseling protects counselors and helps them do a better job of monitoring client progress. Zuckerman (2006) believes finding a personally effective form of notation that will be used consistently helps keep counseling on track and protects both the client
and counselor in legal proceedings and other circumstances.

References

Delitto, A. & Snyder-Mackler, L. (1995). The diagnostic process: examples in orthopedic physical therapy. Physical therapy, 75:203-211.

Laureate Education, Inc. (Executive Producer). (2010). Techniques in counseling. Baltimore, MD: Author.

Quinn, L., & Gordon, J. (2003). Functional outcomes: Documentation for rehabilitation. St. Louis, Mo: Saunders.

Zuckerman, E. L. (2008). The paper office (4th ed.). New York, NY: Guilford Press.

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.

Recordkeeping

Recordkeeping is, in some way, the executive branch of counseling and its benefits are far-reaching for the client as well as the counselor. The ACA Code of Ethics (2005) requires counselors maintain client records that support the counselor's ability to monitor progress and provide ongoing adequate and organized service to the client. These records help the counselor maintain congruous and consistent direction within the therapy (Laureate Education, Inc., n.d.) Despenser (2004) states adequate recordkeeping according to appropriate policies helps the counselor keep a legal record of interactions with clients and their therapeutic progress. Keeping records also helps counselors keep track of therapies as well as interventional techniques, why they were implemented, and the effect they had on the client. Good recordkeeping works as a roadmap, of sorts, tracking clients' needs, the plan for their intervention, and their progress (Drogin, Connell, Foote, & Sturm, 2010). I suppose it is important to mention that if counselors fail to maintain adequate records, it can affect their right to protection in litigation as well as in mandated reporting, cause the imposition of penalties, and in some cases, the forfeiture of their license to practice (Remley & Herlihy, 2001).

A variety of circumstances underline the critical nature of recordkeeping: when counselors must report suspected child abuse or when dutifully warning others or protecting a client from themselves, counselors must present adequate records that substantiate their reasoning. Furthermore, when clients are involved in any type of legal proceedings, counselors may be required by law to submit portions or the entirety of records pertaining to the client. Each of these situations require appropriate recordkeeping. The one particular situation I will focus on for the purposes of this discussion, however, is if and when clients' records are legally subpoenaed.

In court-ordered circumstances, counselors may be legally obligated to provide documentation of detailed personal and sensitive information obtained during counseling, even when the counselor believes providing such information may not be in the client's best interest or may be detrimental to the client (ACA Code of Ethics, 2005). When counselors' ethical obligations conflict with legal ones, the counselor should remain committed to the ethical codes of the profession and take appropriate steps to mitigate the conflict. If the conflict defies resolution, they must fulfill their legal obligations (Committee on Legal Issues, American Psychological Association, 2006).

The counselor is obligated to provide the documentation although the obligation is limited to essential and pertinent information. Furthermore the counselor can try to prohibit or limit such disclosure when he or she believes releasing the information is harmful to the client. Counselors do, in fact, have an obligation to uphold legal requirements and government authority (ACA Code of Ethics, 2005). Seeking legal counsel is in the client's as well as the counselor's best interest in cases in which the court subpoenas the counselor's confidential documentation.

Understanding that my notes or any reports that come from counseling an individual, may end up as part of a lawsuit or some type of legal proceedings. Certainly part of informed consent should notify clients that anything they say, or the records kept on their behalf may, at some point, be evidentiary in a court of law. For the counselor, this may mean creating records that include limiting sensitive client information. Zuckerman (2008) recommends not including information from previous reports or the reports of other professionals. Furthermore, abridging notes and records can be helpful in sensitive situations, for example, when confidential information is subpoenaed. It is important to refrain from keeping confidential records that serves no purpose in therapeutic process. Including superfluous confidential information in the therapeutic environment is not beneficial for the client, and the first responsibility is to the client (Zuckerman, 2008).

I agree with Buckley in this week's video (Laureate Education, Inc., n.d.) when he states that he does not want to write his notes in fear of a lawyer of other institution reading them, but, on the other hand, counselors must understand the possibility exists that confidential information may be compromised in cases of litigation or other legal proceedings. Writing notes and keeping records with the legal system in mind will ultimately benefit the client as well as the counselor.


References:

American Counseling Association (ACA). (2005). 2005 ACA code of ethics [White Paper]. Retrieved from the ACA website: http://www.counseling.org/Files/FD.ashx?guid=ab7c1272-71c4-46cf-848cf98489937dda

Committee on Legal Issues, American Psychological Association. (2006). Strategies for private practitioners coping with subpoenas or compelled testimony for client records or test data. Professional Psychology: Research and Practice, 37(2), 215-222. doi: 10.1037/0735-7028.37.2.215

Despenser, S. (2004). Case notes in private practice. Counseling & Psychotherapy Journal, 15(6), 40–44.

Drogin, E. Y., Connell, M., Foote, W. E., & Sturm, C. A. (2010). The American Psychological Association's revised “record keeping guidelines”: Implications for the practitioner. Professional Psychology: Research and Practice, 41(3), 236-243. doi: 10.1037/a0019001

Laureate Education, Inc. (Producer). (n.d.). The Application of Ethical Guidelines and Laws To Record Keeping [Streaming Video]. Baltimore: Author.

Remley, T. P., & Herlihy, B. (2001). Chapter 6, Records, Subpoenas, and Technology. In Ethical, legal, and professional issues in counseling (pp. 129-163). Upper Saddle River, NJ: Merrill Prentice Hall.

Zuckerman, E. L. (2008). The paper office (4th ed.). New York, NY: Guilford Press.

The Complexity of Identity

The construct of social identity embraces the notion that the various identities of individuals are an integrated interrelatedness of many aspects of their subjective perceptions as well as their social identities (Sue & Sue, 2008). This complex web includes overlapping distinctions of race, ethnicity, religion, family, friendships, vocation, social group affiliations, and other circumstances that represent, for the most part, a diffuse perception of the self. Each affiliation and perception contributes to a unique worldview as well as a set of attitudes and beliefs in individuals and entire populations (Sue & Sue, 2008). Although these affiliations and perceptions create distinct separations, they also create opportunity for finding intersections between diverse individuals and populations (Laureate Education, Inc., n.d.). Perhaps John Kennedy (1961) described the greatest opportunity that comes from such diversity when he said, "what unites us is far greater than what divides us" (para. 13).

                                                            Diversity in America

Although statistics fail to explain the issues associated with diversity, they do graphically demonstrate the number of unique cultural contexts within the United States. The U.S. Census Bureau (2010) claims 72% of the population is White, 16% Hispanic/Latino origin, 13% Black, 4.8% Asian, .9% American Indian or Alaska Native, and .2% Native Hawaiian or other Pacific Islander. Considering the additional demographics of gender, socioeconomic status, sexual orientation, age, and household status, the diversity of America becomes readily apparent. Equally evident is the need to bridge the cultural gaps that cause separation and unrest between individuals and groups.

                                                        The ADDRESSING Format

Age: 54 years old with 4 generations of family on the Island of Maui; 3 adopted Hawaiian

daughters, 2 parents, and 3 grandparents. Mika is divorced.

Developmental Disabilities: None

Religion: Fundamentalist Christian

Ethnic and Racial Identity: Hawaiian

Socioeconomic Status: Hawaiian Low-Middle Class - with benefits of the Hawaiian Kingdom, given by the State of Hawaii to 100% Hawaiian citizens

Sexual Orientation: Heterosexual

Indigenous Heritage: Native Hawaiian

Gender: Male

                                                                       Identities

Kapuna perceives himself as a Christian, Father, and a Hawaiian. Of these aspects, he believes the most salient is his Christian identity, although the one he thinks about most is his identity as a father. He believes his religion influences his fatherhood, although he believes his Hawaiian heritage pervades his beliefs and attitudes, and affects him in ways he cannot articulate or even perceive. For example, two important Hawaiian cultural values are 'ohana (family) and lokahi (harmony) and these remain important in Kapuna's life, although he perceives them as mostly unconscious, albeit powerful, spiritual mechanisms. As many indigenous Hawaiians, he is happy living in the Islands. He is, however, aware of his lack of typical American motivation and his priorities that are decidedly Hawaiian and different from the American culture. He believes he could not survive on the mainland because he lacks the skills and education to obtain and keep gainful employment.

Christianity

Kapuna is a devout born-again Christian, and believes, above all, this is his most important
identity, although it is not the one he consciously thinks about the most. Most Hawaiians are Christian, although a few Hawaiians continue to practice traditional Hawaiian ritual although it is often in contradiction to Christianity. Traditional Hawaiian culture believed the land, ocean, water and sky were life's foundations and the source of the spirit, and they felt a deep spiritual connection to the earth. Gods and deities were embodied in all of these natural resources. Because Christianity is monotheistic, the Hawaiian lore became tales of the past and traditional ritual relegated to folklore. This creates a deep sadness in the Hawaiian culture. Hawaiians lost their spirituality and much of their culture when Christianity was heavily pressed upon them during the first contact of the haoles (White people.)

Kapuna has an accurate perspective on the Christianization of the Hawaiian people. When White people first came to Hawaii, they did not follow the laws of the Hawaiian Kapu system, although they were not punished by the gods (Silva, 2006). It became obvious to the Hawaiians that the laws of Kapu were not right. This new understanding left Hawaiians in somewhat of a cultural void that was filled by the Protestant Christian missionaries' teachings. They taught the Hawaiians their beliefs were not accurate and their belief in gods and deities was foolish (Silva, 2006). Although this instigated the loss of traditional Hawaiian culture, most Christian Hawaiians do not criticize Christianity because their worldview has been tainted by a new system of beliefs. It has, however, created a sad dichotomy for this minority population whose rich and colorful polytheistic religion and cultural history have been blanched by the White man's worldview.

Considering the pervasiveness of deep-rooted spirituality in the traditional Hawaiian worldview, the transition to an alternative belief system that eventually replaced their earth-centered beliefs had far reaching implications for the culture. Although most Hawaiians today consider their roots in Christianity, they continue to talk about the old Hawaiian systems, often with a decided sadness and sense of loss. As posited by Sue and Sue (2008), the belief systems founded on religious and spiritual beliefs are deeply interconnected with attitudes, beliefs, and emotional states, and have tremendous effects on well-being. The foundational change for Hawaiians represented a loss of generational influences and systemic beliefs that were all but erased in the religious and cultural transition. Koenig (2009) found when people become disconnected with their religious or spiritual beliefs, this disruption can contribute to pathology.

Hawaiian Heritage and Generational Influences

Kapuna is 54 years old, has lived on Maui his whole life, and is still surrounded by four generations of his Hawaiian 'ohana. Large and extended 'ohanas are an important part of Hawaiian life, and Kapuna is close to his many relatives (Mokuau, 1990). Traditionally, Hawaiian life was communal, and individual 'ohana members lived in close proximity to each other. When he was young, Kapuna had so many Aunties and Uncles, he cannot remember them all. Even in today's Hawaii, a little child might stop to ask a woman in a store for help referring to her as "Aunty". Family life remains a meaningful part of Hawaiian life (Mokuau, 1990). Unlike the typical American cultural perception of older adults, Hawaiians have fewer ageist perceptions and look toward their elders as a source of history, wisdom, and perspective (Mokuau, 1990). Kapuna's grandparents live with his parents and he and his six siblings contribute to their care, when necessary. According to McGuire, Klein, and Chen (2008) maintaining familial relationships in old age has a significant effect on longevity. Perhaps this idea correlates to Ryff and Singer's (1998) contention that having meaning and purpose in life contributes to psychological health and happiness. Although it may be overly simplistic to assume keeping older adults within the family environment will contribute to their health and longevity, there may be a direct relationship between the two. As an anecdotal response to this assumption, Kapuna's elderly grandparents as well as his parents have physical age-related challenges, but he reports they are happy and content, and love being close to their children, grandchildren, and great-grandchildren.

Similar to many Hawaiians, Kapuna experiences sadness when he considers the plight of the Hawaiian nation and struggles to accept the militarized takeover of the Kingdom. As many Hawaiians do, he believes the American government should return lands ceded to Hawaiian heirs of the Kingdom. Although he does not feel animosity toward White people or Americans, he believes the history of Hawaiians with White people is disturbing and the losses of the Hawaiian people are a tremendous burden on the contemporary Hawaiian culture. Traditionally, Hawaiians considered the land and its natural resources as sacred and a source of life, but Hawaiians have become Americanized and no longer have a kingdom. They are a people without a land. Without their spiritual traditions, they imitate American culture and often feel like misfits trying to fit into a culture that is not theirs.

Although Sue and Sue (2008) discussed Asian Americans and included Pacific Islanders in that group, the authors provided little to no accurate information specific to the Hawaiian population. The Hawaiian people are, however, a minority population and as posited by Dermer, Smith, and Barto (2010) have most likely been exposed to "the constant bombardment of negative attitudes from society" (p. 329). The experience of some Hawaiians who have integrated into the mainland American culture may be quite different from Kapuna's. He has travelled to mainland America and has always felt welcomed but he would not want to live there. Although Kapuna and all Hawaiians are a minority in the Hawaiian Islands, they continue to acknowledge it as the Kingdom of Hawaii, and by some legal standards, it is their land.

Fatherhood

Kapuna's role as a father fulfills a social expectation within his Hawaiian culture. He has three daughters ranging from age 17 to 23. One important idea he has tried to instill in his daughters is to wait to settle down and start a family. Traditionally, Hawaiians start families at younger ages than the average American teen, and Hawaiian children were expected to become adults earlier than the American norm. For many Hawaiians this idea has caused a cultural conflict. When Hawaiian girls become parents in their mid teenage years, they cannot keep up with the American norm of finishing high school and seeking higher education. Many Hawaiian girls wish to obtain an education, although receive conflicting messages from elder Hawaiian relatives. Hawaii is the only state that continues to uphold the legal age of consent at 14.Kapuna  recognizes the duality of messages to his daughters, even the ones they receive from Kapuna's extended family.

Kapuna's fatherhood is a source of pride for him. Fourteen years ago he adopted his three daughters, who were in the care of Child Protective Services because they were victims of abuse. Kapuna and his wife decided to adopt all three to keep the family together. This was a significant undertaking for two adults in their early 40s who had never had children. Because his children were sexually abused prior to their adoption, the family has been through years of counseling and many issues difficult for any family. He believes without his church affiliation, he might not have been able to contend with some of the more difficult family issues.

He spends the least time thinking about his Hawaiian heritage, although he believes his indigenous heritage is perhaps the most pervasive identity in ways of which he is not consciously aware. His actions, however, reflect his Hawaiian heritage daily. Kapuna  is a basket weaver by trade, and when he sits and weaves, he tells the island visitors jokes and stories about his native land. He feels as if the visitors view him as a Hawaiian, but he does not feel different from them in most ways.

                                                                        Worldview

Kapuna's worldview is less a perspective of a minority, but of a positive, forward looking Hawaiian American. His Christian religion is perhaps the strongest motivator of his attitudes and perspective. This affiliation, he posits, has helped him to feel like a part of something bigger. He is not usually conscious of his minority status, but when he is aware of it, it feels more like an honor rather than a status. He has never had to fight for acceptance or entitlement of a land that was taken from his people, although many of his fellow Hawaiians do fight to regain their lost Kingdom. He believes people love him for his Hawaiian heritage, and he is proud of his ability to relate to people.

Kapuna believes he is a good example of Hawaiians. He is happy to live on the land that was finally given to him from the Hawaiian Lands Act a few years ago. He is in touch with his a'ina (land) and although he is a devout Christian, he believes the spirit of the god Maui remains on the island. He believes as long as he is happy and grateful for what he has, he will continue to be blessed. As most Christians, he believes if he does what his religion recommends, he will remain happy and healthy and receive what he needs.

Bulhan (1985) posited the worldviews of all populations are filled with cultural assumptions, prejudice, and bias. Kapuna  believes his perceptions are accurate and good and if others followed the Hawaiian and Christian way of life, the world would be a better place. Stewart and Bennett (2006) claim people, as a general rule, measure others by their personal norms that are powerfully influenced by their culture, and they usually presume their culture is superior to others.Kapuna  is not free from making this type of assumption. He believes strongly that his belief in Christianity as well as his Hawaiian heritage could teach lessons all over the world.

Kapuna sees the world as a beautiful place, and is especially fond of Maui, his island of birth. He has never had to work too hard and he believes he has always had an abundance of resources for himself and his family. He was given a plot of land and his choice of homes built for him by the Hawaiian Homelands. Although the class structure of Hawaiians is different than mainland America's, he is probably lower middle class, yet enjoys the luxury of not working often because of his Hawaiian Homelands housing and the funding he and his wife received from the state to care for their children till they reached the age of majority. If one word, or phrase, in this case, could describe Kapuna, it would be happy-go-lucky. Living on Maui, and even when he visits the mainland, he is the picturesque barefoot Hawaiian boy (albeit, a fully grown one) with few cares, and an authentic connection to the ground below his feet.

                                                        The Complexity of Identity

Kapuna is an example of the complexity of identity, especially as a minority member in a larger culture that does not always accommodate or acknowledge the various differences in minority populations.Kapuna  is fortunate that he is able to establish himself as a friend to everyone he meets. He has never been threatened, nor does he menace those who are different from him. He is a father, Christian, brother, son, basket weaver, Hawaiian, and an American. He is all of these identities, although most of the time, he carries these identities below the threshold of his awareness. Kapuna  acknowledges his complex identity, and realizes because of it, his is able to will find more intersections between himself and other people (Laureate Education, Inc., n.d.).

Kapuna is never one single identity. He is a collage of all of them, each one overlapping the others. He is Christian, but he is a Hawaiian Christian. He is a father, but one heavily influenced by Hawaiian tradition and values. It is nearly impossible to separate these identities or determine where one converges with another. Kapuna perceives the world through a lens colored by the unique combination of his identities, and, for the most part, the complexity of this combination offers him the fluidity of relating to others. Discerning which of these identities reside at his core might be apparent at one time or another, although he believes he is an amalgamation of all of his identities. Each one mixes with the others, like paint on a palette, not one likely to be identified as its original hue. Kapuna demonstrates his self-acknowledged complex identity with a fluent ability to relate to others by finding commonalities within his multifaceted identity.

                                                                        Conclusion

People are diverse, hence, complex. The complexity of human identity creates a bounty of diverse perspectives, attitudes, and worldviews. Although such bounty can cause separation, anxiety and an innate fear of the unknown, it simultaneously introduces the possibility for a bridge that reaches toward likeness. Perhaps subscribing to Kennedy's (1961) or Kapuna's perspective does, in fact, preserve the opportunity that comes from diversity, when even the most miniscule similarities leverage the power of unification over division. If cultural differences pervade worldviews, then diverse worldviews present opportunities for unity, which according to Kennedy (1961), and Kapuna, is far greater than division.


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