(2010). Multidimensional Model for Developing Cultural Competence33 Figure 3. Effects of Asian American client adherence to Asian cultural values, session goal, and counselor emphasis of client expression oncareer counseling process. Journal of Counseling Psychology, 41, 149-154. This category only includes cookies that ensures basic functionalities and security features of the website. It is apparent the importance of crossing the lines in multi cultural competency, unless we prepare the children in the early stages of life to accept each other, the need for therapeutic care will continue to be a part of intensive training for professional multi cultural competent counselors. Journal of Counseling Psychology, 62(4), 568-578. doi:10.1037/cou0000106. Now in its 4 th edition, Counseling Psychology remains one of the leading, trusted introductory texts orienting students to this expansive and dynamic field. Owen, J., Tao, K., & Rodolfa, E. (2010). Meta-analyses of psychotherapy studies indicate that therapeutic alliance (Connors, Carroll, DiClemente, Longabaugh, & Donovan, 1997; Norcross, 2010) and empathy are good predictors of successful treatment outcome (Greenberg, Watson, Elliot, & Bohart, 2001). In addition to influencing perceptions of greater understanding and stronger therapeutic alliance, therapist MCC may also predict client satisfaction. (2003). Black female clients perceptions and attrition. The results also demonstrated that clients perception of a strong therapeutic alliance could have a mediating effect on the relationship between perception of microaggressions and psychotherapy outcomes. In a later study, Constantine (2007) examined the experience of African American clients (n= 40) with White therapists (n= 19) and found that clients perceptions of microaggressions in therapy, therapist MCC, and therapists general counseling competence were not significantly associated with client satisfaction. The existent trend of implementing mindfulness-based programs (MBPs) into public education came along with an increasing scientific record regarding the definitional construct of mindfulness, effects of various mindfulness-based interventions and their basic mechanisms. February 27, 2023 . A., Nadkarni, L. I., Henderson Metzger, L., & Rodolfa, E. R. (2010). American Psychological Association. Given the average premature. Multicultural counseling competencies: Lessons from assessment. Counseling the culturally diverse: Theory and practice (6th ed.). Psychotherapy relationships that work II. (2003). In B. L. Duncan, S. D. Miller, B. E. The heart and soul of change: Delivering what, (2nd ed., pp. In a study with 232 clients and 29 therapists, Owen, Imel, et al. Disadvantages in mental health care among African Americans. Deconstructing multicultural counseling competencies research: Comment on Owen, Leach, Wampold, and Rodolfa (2011). The overall disparities in mental healthcare have been associated with a lack of, Code of Ethics (2014) advise psychologists and counselors on the boundaries of. Scale. Worthington, R. L., & Dillon, F. R. (2011). 113-141). http://dx.doi.org/10.1037/0022-0167.54.4.351, Zilcha-Mano, S., & Errzuriz, P. (2015). American Psychological Association. b. vocational guidance counseling Culture is understood to be a. the same as race. In the SCTM, skills are divided into three stages . (2003). In the last couple of decades, "multicultural competence increasingly has been recognized as an essential component of ethical counseling . The tripartite model of MCT proposed by Sue, highlighted 3 key components of multicultural counseling competencies categorized as awareness, . Empathy. However, much of the empirical MCC literature includes studies with flaws in their methodologies (Ridley & Shaw-Ridley, 2011), measures with poor validity (Kitaoka, 2005), and an overreliance on analogue studies, college student populations, and indirect measures (Worthington & Dillon, 2011; Worthington et al., 2007). Worthington and colleagues (2007) noted that 24.7% of the studies in their meta-analysis of MCC research used analogue research (i.e., research in a laboratory setting meant to approximate reality), and 82.4% of studies that included client ratings of counselor MCCs included pseudo clients. In a meta-analysis of 20 independent samples,Tao, Owen, Pace, and Imel (2015)foundstrong and positive effects of client perceptions of therapist MCC on important psychotherapy processes (. The negative impact of therapist biases and discriminatory attitudes on the therapeutic relationship and treatment outcomes are documented in several studies (e.g., Constantine, 2007; Owen et al., 2014; Owen, Tao, & Rodolfa, 2010). Multicultural training, theoretical orientation, empathy, and. 2.1 A Tripartite Model of Multicultural Competencies. Author of Cultural Competence in Trauma Psychology. Great article! Clients of therapists who attended a culture sensitivity training attended more follow-up sessions and reported higher satisfaction with the therapeutic process compared to clients of therapists who did not attend a culture sensitivity training. Development and factor. Elliott, R., Bohart, A. C., Watson, J. C., & Greenberg, L. S. (2011). Toward culturally centered integrative care for addressing mental health disparities, Holden, K. B., & Xanthos, C. (2009). Wade, P., & Bernstein, B. L. (1991). The model is based on a 3 4 5 design that allows for the systematic identi-fication of cultural competence in several different combinations. (2017). Measurement and Evaluation in Counseling and Development, 36(3), 161-180. https://doi.org/10.1080/07481756.2003.11909740, Kim, B. S. K., Li, L. C., & Liang, T. H. (2002). Materials and Methods: This descriptive correlational study was performed on 230 emergency nurses in Tehran, Iran, in 2020 . 247-282). Similar to the definition of MCC, there are many conceptualizations of MCC. Constantine and Ladany (2000) found that social desirability attitudes are linked with the subscales of three of the four MCC measures they investigated. Development of the Multicultural Counseling Inventory. Empathy. Google Scholar. Disadvantages in mental health care among African, Journal of Health Care for the Poor and Underserved, 20, Kim, B. S. K., Cartwright, B. Y., Asay, P. A., & DAndrea, M. J. Empathy. Therapeutic alliance refers to the quality of relationship between the therapist and client, the therapists ability to engage the client and aid in effecting change in the client (Owen, Tao, Imel, Wampold, & Rodolfa, 2014). Counselor content orientation,counselor race, and Black womens cultural mistrust and self-disclosures. (1992). Owen et al. https://www.counseling.org/knowledge-center/ethics. A meta-analysis of multicultural. Smedley, B. D., Stith, A. Y., & Nelson, A. R. *Articulate your role as a counselor in becoming familiar with the characteristics and concerns of diverse populations and integrating culturally supported behaviors that promote optimal . As noted, Sue and colleagues (1992) conceptualization of MCCs include three dimensions: 1) beliefs and attitudes, 2) knowledge, and 3) skills (Sue et al., 1982, Sue et al., 1992). Ottavi, T. M., Pope-Davis, D. B., & Dings, J. G. (1994). Therapist-reported alliance: Is it really a predictor of outcome? Describe the key concepts of the Tripartite Model of Anxiety and Depression and how this model may lead to more effective interventions. They proposed that 1) culturally competent mental health providers are aware of their own beliefs, attitudes, values, and worldviews that might impact their work with their clients; 2) they have the knowledge of beliefs . As a result of these economic and cultural shifts, . Psychotherapy Bulletin, 53(4), 48-58. (1992) Personal Identity Model (PIM) with descriptive characteristics of the TM dimensions, the authors sought to give practitioners clear guidelines on how to implement multicultural counseling. zuriz, 2015; Zilcha-Mano et al., 2015). Tokyo, Japan. (2014) examined the therapeutic experiences of racial and ethnic minority clients (N= 120) at a university counseling center to explore whether experiences of microaggressions are being addressed in therapy. 2010 amendments to the 2002 Ethical Principlesof Psychologists and Code of Conduct. American Psychologist, 65, 493. The person-based model of cultural competency has been most widely recognized . However, the results of this study did indicate that higher perceptions of microaggressions were predictive of weaker therapeutic alliance and lower ratings of MCC and general counseling competence. In a later study, Constantine (2007) examined the experience of African American clients (. The state of multicultural counseling competencies research. As the acceptance of MCC has grown over the last three decades, there have been many conceptual and indirect empirical research on MCC (Ridley & Shaw-Ridley, 2011; Worthington et al., 2007). Washington, DC: American Psychological Association. Predictors of satisfaction with counseling: Racial and ethnic minority clients attitudes toward counseling and ratings of their counselors general and multicultural counseling competence. In J. G. Ponterotto. Journal of Personality Assessment, 73, 359-373. Moreover, clients perception of their counselors MCC predicted satisfaction beyond the variance previously accounted for by general counseling competencies (Constantine, 2002). While knowledge and awareness are important, it also is important to enhance skill development in counselors-in-training. Despite criticisms about the limitations of this model, (see Constantine and Ladany, Psychological Bulletin, 56, 81-105. Journal of Counseling & Development, 70, 143-150.http://dx.doi.org/10.1002/j.1556-6676.1991.tb01576.x, Dillon, F. R., Odera, L., Fons-Scheyd, A., Sheu, H.-B., Ebersole, R. C., & Spanierman, L. B. Models of multicultural counseling. The main goal for counselors is to recognize . Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. Mexican-American acculturation. A tripartite model of ego functioning: Values and clinical research applications. Given that clients from diverse racial and low socioeconomic backgrounds are the biggest consumers of mental health services in the U.S. and that the preponderance of evidence indicates worse outcomes for racial minority clients compared to White clients (Holden et al., 2014), there is surprisingly little research that examines the experiences of these clients in the MCC literature. These changes demand that counselors and therapists prepare to effectively serve the needs of these diverse populations. This theory includes three aspects of multicultural competency: knowledge, awareness, and skills. Gim, R. H., Atkinson, D. R., & Kim, S. J. Themes from the Difficult Dialogue Cultural Universality (etic) vs. However, clients ratings of therapeutic alliance mediated the relationship between clients perceptions of microaggressions in therapy and treatment outcomes. (1992). Journal of Counseling & Development, 20(2), 64-88.http://dx.doi.org/10.1002/j.2161-1912.1992.tb00563.x, Sue, D. W., Bernier, J. E., Durran, A., Feinberg, L., Pedersen, P., Smith, E. J., & Vasquez-Nuttall, E. (1982). We also use third-party cookies that help us analyze and understand how you use this website. Each individual has an own manner of connecting with the environment around them. Washington, DC: The National Academies Press. Norcross, J. C., & Lambert, M. J. The results indicated that clients perceptions of microaggression had a negative relationship with therapeutic alliance, even after controlling for clients psychological well-being, number of sessions, and therapist racial and ethnic identity. This association between clients ratings of therapist MCC and psychotherapy outcomes is supported by similar findings in the empirical literature, such as the association between therapist MCC and psychotherapy processes that include working alliance, empathy, genuineness, goal consensus and collaboration, and alliance-rupture repair (e.g., Elliott, Bohart, Watson, & Greenberg, 2011; Norcross & Lambert, 2011). This comprehensive overview of the entire field of counseling psychology surveys key professional practices and issues, interventions, science and research, and general basic concepts. The APA (2003) has provided guidelines for multicultural education, training, research, practice, and organizational change for psychologists. This association between clients ratings of therapist MCC and psychotherapy outcomes is supported by similar findings in the empirical literature, such as the association between therapist MCC and psychotherapy processes that include working alliance, empathy, genuineness, goal consensus and collaboration, and alliance-rupture repair (e.g., Elliott, Bohart, Watson, & Greenberg, 2011; Norcross & Lambert, 2011). Multicultural counseling. They found that 53% of clients reported experiencing racial and ethnic microaggressions from their therapists, and 76% of those clients reported that the microaggressions were not addressed as part of therapy. Cornish, J. (2011). multicultural case conceptualization ability in counselors. supervision goals for multicultural competency in psychology. Include one example of a gain in your self-awareness at each of the levels of the tripartite model of personal identity: individual, group and universal. measure of clients perceptions of therapists alliance activity. why is multicultural competence important? The role of ethnicity, cultural knowledge, and conventional techniques in counseling and psychotherapy. The strong correlations between therapist MCC and psychotherapy process suggest that the two processes might occur simultaneously. A dyadic study of multicultural counseling competence. Holden, K., McGregor, B., Thandi, P., Fresh, E., Sheats, K., Belton, A., & Satcher, D. (2014). Constantine also found that clients perceptions of their counselors MCCs mediated the relationship between their general counseling competence and treatment satisfaction (Constantine, 2002). http://dx.doi.org/10.1002/j.2161-1912.1992.tb00563.x. competencies research: A 20-year content analysis. Clients perceptions of their psychotherapists multicultural orientation. Multicultural Counseling and Development, 24, org.ezproxy.uky.edu/10.1002/j.2161-1912.1996.tb00288.x. Meta-analyses of psychotherapy studies indicate that therapeutic alliance (Connors, Carroll, DiClemente, Longabaugh, & Donovan, 1997; Norcross, 2010) and empathy are good predictors of successful treatment outcome (Greenberg, Watson, Elliot, & Bohart, 2001). Deconstructing multicultural counseling. Various Companies. In 2014, the U.S. population by race was represented by 62.2% of non-Latina/o Whites, while multiracial individuals and racial and ethnic minorities represented 37.8% (Colby & Ortman, 2014). Toward culturally centered integrative care for addressing mental health disparities among ethnic minorities. Ponterotto, J. G., Rieger, B. T., Barrett, A., Harris, G., Sparks, R., Sanchez, C. M., & Magids, D. (1996). In another study, Constantine (2001) found that counselors who reported higher levels of formal multicultural training rated higher on a self-report measure of empathy, and that counselors who had an integrative theoretical orientation were more likely to be rated higher on their multicultural case conceptualization ability. ethnicity and cultural sensitivity, and ratings of counselors. (2010). Multidimensional facets of cultural competence. One of the most important components of psychotherapy is therapeutic alliance. Characterizing depression and comorbid medical conditions in African American womenin a primary care setting. In addition to influencing perceptions of greater understanding and stronger therapeutic alliance, therapist MCC may also predict client satisfaction. These results are congruent with the Asian value of favoring immediate problem resolution early in therapy and anticipating emotional needs of others for interpersonal harmony (Sue & Sue, 2012). Administration and Policy in Mental Health and Mental Health Services Research, 31, 31-43. doi:10.1023/A:1026096123010, Greenberg, L. S., Watson, J. C., Elliot, R., & Bohart, A. C. (2001). Crossref. Writings on multicultural counseling competence usually imply that it exists for one of . Society for the Advancement of Psychotherapy uses, Personality Disorder & A Missed Clinical Turning Point, Counseling for Teens and Young Adults With an Autism Spectrum Diagnosis. Journal of Counseling Psychology, 58, 16-21. http://dx.doi.org/10.1037/ The definitions and dimensions of MCC continue to be defined and redefined, along with models counselors can use to develop their MCCs. One of the most widely used and most researched models (Worthington et al., 2007) of MCCs in the literature is the tripartite model (Sue et al., 1982; Sue et al., 1992). http://dx.doi.org/10.1037/0022-0167.39.4.515. Policy in Mental Health and Mental Health Services Research, 31. A. E., Schreier, B. If we dont learn about each other and how different we are culturally, it can be very difficult , I would believe, to be able to relate at the basic human level of compassion for one another, and reaching the basic human core. Projections of the size and composition of the U.S. population 2014 to 2060, . A., Nadkarni, L. I., Henderson Metzger, L., & Rodolfa, E. R. (2010). Journal of Counseling Psychology, 47(2), 155-164. doi:10.1037/0022-0167.47.2.155. Predictors of satisfaction with counseling: Racial and ethnic, minority clients attitudes toward counseling and ratings of their counselors general and, http://dx.doi.org/10.1037/0022-0167.49.2.255, Constantine, M. G. (2007). Sue and colleagues (1992) described the three dimensions of culturally competent counselors as: 1) being aware of their own values, beliefs, and worldviews, and limitations that might impact their work with a culturally different client; paying special attention to the impact ethnocentrism might have on their work with racially, ethnically, and otherwise culturally different clients; 2) making a genuine effort to understand the clients values, beliefs, and worldviews, and how those impact the clients life; the counselor approaches this in a nonjudgmental manner and accepts the clients worldviews as a valid way of life; 3) and possessing the skills and interventions necessary for working with the culturally different client, as well as practicing them in their work with the particular client (Sue et al. . Definitions of multicultural competence are based on the Tripartite Model of Multicultural Competency (Sue et al., 1982), which is divided into three areas: multicultural awareness, knowledge, and skills.According to this definition, counselors who have multicultural competence are aware of (a) their own cultural background, (b) their own potentially biased attitudes, (c) the cultural . competencies and psychotherapy process and outcome. 491 Words. Jessica Gonzalez, Sejal M. Barden, Julia Sharp Exploring client outcomes is a primary goal for counselors; however, gaps in empirical research exist related to the relationship between client outcomes, the working alliance, and counselor characteristics. These guidelines, ethical principles, and codes suggest that it is unethical for counselors and psychologists to provide services to culturally diverse populations if they have not had any education and training in multicultural competencies. . self-report multicultural counseling competence scales. Part I: Concepts and Theories. In terms of the rising definitional discourse in the interdisciplinary field of mindfulness, the "threefold model of . Dillon, F. R., Odera, L., Fons-Scheyd, A., Sheu, H.-B., Ebersole, R. C., & Spanierman, L. B. Although previous articles detailed guidelines of best cross-cultural practices, Arredondo et al. Multicultural competence, as defined by D. W. Sue (2001), is obtaining the awareness, knowledge, and skills to work with people of diverse backgrounds in an effective manner. Alliance in action: A new. Therapeutic alliance refers to the quality of relationship between the therapist and client, the therapists ability to engage the client and aid in effecting change in the client (Owen, Tao, Imel, Wampold, & Rodolfa, 2014). These guidelines, ethical principles, and codes suggest that it is unethical for counselors and psychologists to provide services to culturally diverse populations if they have not had any education and training in multicultural competencies. Journal of Counseling Psychology, 38, 9- 15. doi:10.1037/0022-0167.38.1.9, Worthington, R. L., & Dillon, F. R. (2011). Microaggressions and women in short-term psychotherapy: Initial evidence. education an awareness One of envelops the of most and a . One of the most important components of psychotherapy is therapeutic alliance. The therapeutic relationship. Psychotherapy: Theory, Research, Practice, Training, 38(4), 380-384. doi:10.1037/0033-3204.38.4.380, Holden, K., McGregor, B., Thandi, P., Fresh, E., Sheats, K., Belton, A., & Satcher, D. (2014). Although there has been growth in research and services on the health and mental health needs of racial and ethnic minorities, racial and ethnic minority populations in the U.S. suffer disproportionally from mental health disparities (Dillon et al., 2016; Holden et al., 2014;Smedley, Stith, & Nelson, 2003). Addressing racial andethnic microaggressions in therapy. (2012). (2014) examined the therapeutic experiences of racial and ethnic minority clients (. Asian-American acculturation, counselor. When they do seek mental health care, they are more likely to be underdiagnosed and undertreated for affective disorders, overdiagnosed and overtreated for psychotic disorders, and less likely to receive newer and more comprehensive care (Agency for Healthcare Research and Quality [, 2013; Greenberg & Rosenheck, 2003). Journal of CounselingPsychology, 63(1), 57-66. doi:10.1037/cou0000118, Elliott, R., Bohart, A. C., Watson, J. C., & Greenberg, L. S. (2011). The Clash of Civilization: Twenty Years On. SHANNONHOUSE, LAURA R., Ph.D. The Counseling Psychologist, 10(2), 45-52. doi:10.1177/0011000082102008. Journal of Counseling Psychology, 62(3), 337-350. doi: 10.1037/cou0000086, Thompson, C. E., Worthington, R., & Atkinson, D. R. (1994). Counseling . Multicultural Awareness, Knowledge, and Skills SurveyCounselor Edition. Therapist-reported alliance: Is it really a predictor of outcome? PubMed. Another critique of MCC measures is that some self-report measures of MCC might be assessing counselors self-efficacy in multicultural counseling instead of MCC (Constantine & Ladany, 2000; Ottavi, Pope-Davis, & Dings, 1994). This finding supports evidence from other empirical studies that found therapists are often inaccurate in their assessment of therapeutic alliance and treatment outcomes, suggesting the need for improvement in research, education, and training to enhance therapists ability to accurately assess therapeutic alliance and treatment progress. I am responding to your post as a 69 year old Afro-Caribbean female. In. (2012). a0022221. It has since evolved into a highly successful kind of addiction therapy. The three MCC measures are the Multicultural Counseling Inventory (MCI; Sodowsky, Taffe, Gutkin, & Wise, 1994), the Multicultural Awareness-Knowledge-and-Skills Survey (MAKSS; DAndrea, Daniels, & Heck, 1991; Kim, Cartwright, Asay, & DAndrea, 2003), and the modified self-report version of the Cross-Cultural Counseling Inventory-Revised (CCCI-R; LaFromboise, Coleman, & Hernandez, 1991). Shim, R. S., Baltrus, P., Bradford, L. D., Holden, K. B., Fresh, E., & Fuller, L. E. (2013). In the early 1920s, the counseling profession consisted primarily of a. mental health counseling. = 120) at a university counseling center to explore whether experiences of microaggressions are being addressed in therapy. Ratts, M. J., Singh, A. zen-therapy-transcending-the-sorrows-of-the-human-mind 2/12 Downloaded from tools.ijm.org on March 4, 2023 by guest contemporary children's animated lms, Sue and colleagues (1982) developed the tripartite model of MCCs that include attitudes and beliefs, knowledge, and skills. Multicultural counseling competencies and standards: A call to the profession. Sue, S. (1998). . Ottavi, T. M., Pope-Davis, D. B., & Dings, J. G. (1994). Some direct measures use specific MCC models to assess therapist MCC by focusing on the therapists skills and interventions, while indirect measures focus on concepts related to MCC, such as engaging in microaggressions or measuring cultural humility (Tao et al., 2015). As the MCC literature has grown over the last three decades, scholars have raised concerns about the limitations of the empirical studies in the current literature. In J. G. Ponterotto, Atkinson, D. R., & Matsushita, Y. J. Increases in diverse clientele have caused counselor education to enhance its focus on multicultural pedagogy, using the Tripartite Model (TM) to impart multicultural learning. Development and factor structure of the Cross-Cultural Counseling Inventory-Revised. Although the MCC tripartite framework continues to receive support and is implemented across a host of training programs . been the Tripartite Model of Multicultural Counseling Competency (MCC; see Sue, Bernier, Durran, Feinberg, Pedersen, Smith, & Vasquez-Nuttal, 1982). The main purpose of multicultural counseling is creating a positive and friendly environment, when counseling clients from an ethical or racial background or minority group. journal of employment counselingDecember2011Volume48 151 For the first step of the cultural accommodation process, we counselors need to examine which aspects of the counseling model or theory in question can be considered culture- general and be extended to other cultural groups beyond the dominant culture (e.g . Counseling the culturally diverse: Theory and practice (4th ed.). Multicultural Guidelines: An ecological Approach, to context, identity, and intersectionality, . competencies research: Comment on Owen, Leach, Wampold, and Rodolfa (2011). Counselor educators have Greenberg, L. S., Watson, J. C., Elliot, R., & Bohart, A. C. (2001). Some studies indicate that there is a positive relationship between multicultural competencies and therapy outcomes (Atkinson & Lowe, 1995; Ponterotto, Fuertes, & Chen, 2000), while others indicate a lack of association or weak relationship between therapists multicultural competencies and treatment outcome (Owen, Leach, et al., 2011; Tao et al., 2015). InD. Brown & R. W. Lent (Eds. l feel that we should impiement these techniques for children early in primary oelementary school. Measurement and Evaluation in Counseling and Development, 36, https://doi.org/10.1080/07481756.2003.11909740, Kim, B. S. K., Li, L. C., & Liang, T. H. (2002). In analogue studies with African American (Poston, Craine, & Atkinson, 1991; Thompson, Worthington, & Atkinson, 1994), Mexican American (Atkinson, Casas, & Abreu, 1992), Japanese American (Atkinson & Matsushita, 1991), and other Asian American clients (Gim, Atkinson, & Kim, 1991; Kim, Li, & Liang, 2002), MCC scholars have found that culturally congruent and culturally responsive verbalizations in therapy had a more positive impact on client outcomes compared to verbalizations that focus on the universality of human experiences. Cooper's tripartite characterization of global politics is tied to geography and the colonialist legacy (1999) differs from Cooper (2000), in that the former argues that the three governing principles of global politics coexist even in one society with varying. Hoboken, NJ: John Wiley & Sons. Additionally, outcome variables in MCC studies that investigate effectiveness of MCCs also use indirect measures. Systemic alliance in individual therapy: Factor analysis of the ITASSF and the relationship with therapy outcomes and termination status. 639-669). Client and therapistvariability in clients perceptions of their therapists multicultural competencies. Your email address will not be published. The tripartite model of multicultural counseling competency has activated organizational emphasis on improving counselor abilities to work with diverse clients. Atkinson, D. R., & Lowe, S. M. (1995). (1992). (2011) found that clients ratings of microaggressions had a negative relationship with treatment outcomes. counselor ethnicity, and perceived counselor credibility. The basic concepts and purposes of multicultural counseling include the following answers. Sue, S. (1998). American Psychological Association. Second, the concept of evolutionary structural-functionalism posited by M. Csikszentmihalyi (1993) as a framework for the Flow Theory will help explain the Having a multicultural focus when doing any type of work is important. Handbook of multicultural counseling competencies, DAndrea, M., Daniels, J., & Heck, R. (1991). Operationalization of the multicultural counseling competencies. The health disparities literature indicates that compared to White Americans, racial and ethnic minorities are less likely to have access to mental health services, less likely to utilize mental health services, more likely to receive lower quality mental health care, and less likely to retain treatment (Dillon et al., 2016; Holden et al., 2014).

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