CHAPTER13 CULTURALLY COMPETENT ASSESSMENT Introduction It is important to accurately assess, diagnose, and treat clients Cultural characteristics need to be taken into account Counselors are not objective and hold stereotypes and biases Therapist Variables Affecting Diagnosis Some common diagnostic errors include: Confirmatory strategy Attribution errors Judgmental heuristics Diagnostic overshadowing To guard against these, it is important for counselors to develop cultural competence (i.e., knowledge, awareness, and skills) Contextual and Collaborative Assessment A collaborative approach also endorses the client and counselor working together to construct an accurate definition of the problem The contextual viewpoint acknowledges that both the client and the counselor are embedded in systems such as family, work, and culture Collaborative Conceptualization Model Proceed using the following steps: Use both clinician skill and client perspective to understand the problem Collaborate and jointly define the problem Jointly formulate a hypothesis regarding the cause of the problem Jointly develop ways to confirm or disconfirm the hypothesis Test out the hypothesis using both the client and the counselor as evaluators If the conceptualization appears to be valid, develop a treatment plan If the hypothesis is not borne out, the counselor and client collect additional data and formulate new, testable hypotheses Collaborating on Intervention Strategies Intervention strategies should be based on research facilitating qualities possessed by counselors, client characteristics, and techniques Interventions should not be rigidly applied Consensus between counselor and client regarding course of therapy allows the therapeutic relationship to strengthen Client therefore develops confidence in the treatment as well as hope and optimism Culturally Sensitive Intake Interviews Identifying information: Other than demographic information and inquiries about cultural groups to which the client feels connected, also ask about primary language use in the home Presenting problem: Obtain his/her perception of the problem and be sure to consider issues such as prejudice or oppression History of presenting problem: Get a chronological account of the problem and understand how cultural issues might be related to the problem Psychosocial history: Be sure to assess social background, values and belief (questions for inquiry are presented in the chapter) Abuse history: Always ask questions around physical, sexual and emotional abuse history Culturally Sensitive Intake Interviews Strengths: Identify culturally relevant strengths such as pride in one’s identity or culture Medical history: Assess medical or physical conditions that may be related to psychological problems; inquire about indigenous healing practices Substance abuse history: Assess substance and alcohol use; ask questions about family history as well Risk of harm to self or others: Assess harm and ask questions about clients’ emotional state Implications for Clinical Practice Infuse cultural competence into assessment, diagnosis, and treatment Evaluate ones’ cultural competence Infuse cultural issues into intake interviews Do not stereotype clients or overgeneralize based on the information presented in the text Clients must be viewed in their totality, as unique individuals ... sure to assess social background, values and belief (questions for inquiry are presented in the chapter) Abuse history: Always ask questions around physical, sexual and emotional abuse history