Unit 5 Evidence Based Counseling Discussion Questions

Unit 5 Evidence Based Counseling Discussion Questions

Instructions/Descriptions

Unit 5, Evidence, Based, Counseling, Discussion, Questions

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Jessica F

RE: Unit 5.1 DB: Evidence-Based Counseling

Evidence based practices are becoming more accepted in multi-cultural counseling according to Sue et al., (2019). Although EBP may be accepted there is still an emphasis on understanding the cultural aspects and individual aspects of an individual when coming up with assessments, treatment plans and outcomes. Sue et al., (2019) explains that conflicts often exist between the values in conventional therapy and the cultural values and beliefs of ethnic minorities. As professional counselors we must be aware of these aspects of evidence-based practices and understand how to access each client properly.

EBPs can be kept in mind when evaluating an individual but use of discernment will be essential as well. Taking into consideration all aspects of the individual; culture, values, beliefs, socioeconomic status, personality and many other aspects, will assist a counselor in deciding best practices. Tanaka-Matsumi (2022) explains that psychotherapy is a healing process with a common goal of reducing individuals’ distress in local contexts. Also stated by Tanaka-Matsumi (2022) that psychotherapy alleviates distress, facilitates adaptive coping, promotes more effective problem solving and decision making and takes place within the interactive cultural context of the therapist and the client. As stated by Sue et al., (2019) treatment plans are not always a one size fits all matter.

If a treatment for depression is empirically supported, it may still be unsuccessful with specific clients such as those of marginalized groups because of the difference in their values and beliefs. Many of these marginalized groups are known to be less likely to seek treatment as there are more negative attitudes towards mental health and therapy. These empirically supported treatments involve specific treatments for specific disorders without the consideration of those differences in beliefs and values. Some groups of people’s cause of depression can be the oppression they have faced within their cultural context so treating that depression will look very different. Sue et al., (2019) explains some ways to culturally adapt the empirically supported treatments; matching the language and racial or ethnic backgrounds of the client and therapist, incorporating cultural values in the specific treatment strategies, utilizing cultural sayings in treatment, and consideration to the environmental impact on individuals. Using these strategies along with your ability as a therapist to understand the individual will assist in choosing the right treatments and practices. It will be important to look at the strategies used for therapy as well as the outcomes when researching effective treatments for multi-cultural groups. How did the strategies coincide or reflect the values in that culture or reflect the consideration of past oppresions.

References

Sue, D.W., Sue, D., Neville, H.A., & Smith, L. (2019). Counseling the culturally diverse. John Wiley & Sons.

Tanaka-Matsumi, J. (2022). Counseling Across Cultures: A Half-Century Assessment. Journal of Cross-Cultural Psychology, 53(7/8), 957–975. https://doi-org.postu.idm.oclc.org/10.1177/00220221221111810

Christopher H

RE: Unit 5.1 DB: Evidence-Based Counseling

Class,

This writer believes that a counselor who practices MCT might be wary of evidence-based practices (EBP) because of the history of EBPs for not being culturally appropriate. Sue et al. (2019) discussed how the majority of EBP work relied upon theoretical claims of efficacy rather than practical or experiential evidence whereas the trend is moving more toward reliance upon the latter. Bigfoot and Schmidt (as cited in Sue et al., 2019) expressed that historical decisions by governments and government-funded agencies to rely on a one-size-fits-all approach to treating clients has led to mistrust in the system to provide more suitable treatments as well. Sue et al. added that the traditional approaches in many Western countries have also relied upon such standards of treatment. However, Morales and Norcross (as cited in Sue et al., 2019) noted that treatment based on cultural relevance is becoming more important to counselors.

As a counseling student, this writer would recommend that developing cultural competence, getting to understand each client’s personal influences, and establishing trustworthiness. In addition, finding approaches that are designed for specific cultures (since it will be practically impossible to suit each and every individual client exclusively) must occur in order to successfully combine MCT and evidence-based approaches. Sue et al. (2019) noted that this would be ideal but is not very practical. Therefore, with Sue et al. having much more experience than this writer, he would follow their sage advice. Sue et al. recommended that MCT counselors should take an EBP approach and tailor it to the client’s specific needs and condition such as personal traits, beliefs, and inclinations. Therefore, if a treatment for depression is empirically supported but unsuccessful for a marginalized Jewish American or multiracial client, the counselor would need to conduct research to find what has proven to currently work best. For example, when examining research/articles on a particular therapeutic approach for potential use with such a client, this writer would you look for evidence shared by researchers from the clients’ native countries (if possible) and try to employ their techniques or the most feasible aspects of those techniques because they are proven to work with clients of the same or similar cultural groups. However, in many cases, that may not work because of lack of advancements in some nations (Tiley & Kyriakopoulos, 2018). If that is the case, Chisholm et al. (as cited in Tiley & Kyriakopoulos, 2018) stated that utilizing more accessible resources such as government agencies, professional networks, social services, and family members for guidance and support may come next. This, at least, offers something instead of giving up too quickly and referring the client elsewhere.

-Chris

References

Sue, D.W., Sue, D., Neville, H. A., & Smith L. (2019). Counseling the culturally diverse. John Wiley & Sons.

Tiley, C. and Kyriakopoulos, M. (2018). Evidence-based practice in a multicultural world: Changing with the times. U.S. National Library of Medicine.

Christopher H

RE: Unit 5.2 DB: Case Study

Class,

This writer would start out with a Jewish client such as Etian by sharing the purpose of questions for Etian and explaining to him that understanding his cultural background is an important aspect of service to him. For example, this writer would explain that in order to provide culturally relevant evidence-based practice (EBP) techniques, having an understanding of what makes up Etian will be crucial since he came to this writer for support even though he is apprehensive about sharing details regarding his family. Tiley and Kyriakopoulos (2018) explained that EBP involves a combination of proven therapeutic techniques, professional knowledge, and relevance to the client’s inclinations. In addition, this writer would try to gather information about non-Jewish people in his life and how his religious convictions are impacted or impact interpersonal relationships. Also, this writer would want to know what Etian finds uncomfortable or frustrating in order to avoid reiteration of those elements during sessions. Knowing this information would be helpful for discovering what Etian is comfortable with so that this writer can use that intel to make Etian more at ease in sessions (i.e., capitalizing on what he enjoys about his time with non-Jewish individuals) in hopes that he will be more open to discussing his problems. One possibility for getting information from Etian could be a questionnaire during intake in which he could respond in a fashion such as a Likert scale and share what he is willing to share without the feeling of being interrogated or confronted assertively.

One challenge that is evident from Etian’s negative response to being asked for more details about his concerns is that he will (justly) expect the counselor to have a solid understanding of his Jewish cultural group; especially appreciating boundaries. This would be client-specific because he seems to want the counselor to be prepared to tailor service to his inclinations (personal and cultural) and counselor-specific because it requires cultural competence through meticulous research and fidelity. Sue et al. (2019) noted that it is important to recognize that being Jewish is not just a religious identity but is deeper than that and is a cultural group influenced by countless successes but also mistreatments. This challenge could stem from Etian’s Jewish heritage experience strong and violent persecution for thousands of years as well as with the past several decades (i.e., the Holocaust); all of which is likely fresh in his mind when listening to accounts shared by ancestors. Due to such maltreatment, Etian may not have much trust in a new person in his life such as a non-Jewish counselor who also happens to be a Christian. Though discussed two decades ago, Weinrach (as cited in Sue et al., 2019) shared that mental health counselors have often been recognized as not fully respecting Jewish clients. For that matter, another counselor-specific challenge will be to earn Etian’s trust.

One potential microaggression that can occur when counseling a Jewish American is that the client’s female partner is submissive or subservient. Mistakenly assuming and communicating as if this is true of all Jewish females can be offensive (even offensive to the male partner). Sue et al. (2019) noted that Jewish American relationships are trending more and more in favor of a democratic partnership. Another potential microaggression is communicating the assumption that Jewish American clients are as religiously strict as other more traditional Jewish groups. Sue et al. noted that Jewish Americans are typically proud of their heritage and their American side of life and integrate important elements of both. In addition, Schlosser (as cited in Sue et al., 2019) related how Jews go through life in various levels of recognition and adherence to their Jewish culture. To try to minimize the likelihood that such microaggressions will take place, counselors can be more thoughtful of their speech; check regularly for the client’s comfort with the working relationship; and even converse with the client’s cultural leaders for advice (i.e., especially a rabbi if the client has expressed a significant level of religious influence upon their life) (Sue et al., 2019).

If the client is more closed off and uncomfortable with the counselor than open and relaxed after a few sessions together, it may be time to make an appointment with the client’s rabbi. In this writer’s opinion, if there is hope that he can make progress with he client, termination/referral is the last option to take. Sue et al. (2019) stated that counselors ought to make attempts to fully appreciate the client’s influences (religious or otherwise). This writer would prefer obtaining the client’s permission to consult with the rabbi first and/or offering co-leadership with the rabbi to the client. The same would go for if the client regularly refers to the rabbi’s advice or other words of inspiration during sessions because, obviously, the client values the rabbi. If the client not only regularly refers to the rabbi’s guidance but also indicates that they seem to make progress with the rabbi or states that they prefer the rabbi over the counselor, this writer would still try to make an appointment with the rabbi (with client permission) and refer the client to the rabbi. In this case, there is probably no need to continue to struggle for the client’s acceptance and confidence.

-Chris

References

Sue, D.W., Sue, D., Neville, H. A., & Smith L. (2019). Counseling the culturally diverse. John Wiley & Sons.

Tiley, C. and Kyriakopoulos, M. (2018). Evidence-based practice in a multicultural world: Changing with the times. U.S. National Library of Medicine.

Sherline F

RE: Unit 5.2 DB: Case Study A

This writer would forsee some difficulties working with this Jewis American (Etian) as well as gain some opportunies to work together to help Etian work through some of his tough choices. Ethian is face with choosing between what he wants in his life that he has been keeping a secret for many years and then his family values on the other end.

The counselor would have to be aware or may want to know how import is religion or his faith is is to Etian udaism is not only a religion but also a cultural enity ; it is a community that practices the tenets of the Ortnodox Jewish religion. The Orthodox Jewish community like many others, is defined by more than just a set of beliefs; religion acts as a way of life (Flannelly, Stern, Costa, Weaver, & Koening, 2006). The counselor would want to be mindful of their own bias or ideas of the Jewish culture that can potentially come off with some microaggression tone base on false infmormation. The counselor can avoid this by asking a seris of questions, be willing to listen, phraphasing what they heard to make sure they understto what is being told to them and follow the client’s lead. (Sue et al 2019).

The counselor would definitely want to consider conducting a consultation or making a referal if the client insiste that they felt mor e comforable speaking with a Rabbi at any point of the session. The sounselor should always want to dind out more about ways they can help to advocate and assist the client and support them which may include referrals in the community or needing assistance with other resources outside of the agency.

References:

Anderson, G. (1999). Nondirectiveness in Prenatal Genetics: Patients Read Between the Lines. Nursing Ethics, 6(2), 126-136

ttps://www.proquest.com/docview/518823456/51C10488174B4B12PQ/16?accountid=39363

Sue, D, W. D. Neville, H. A & Smith, L (2019) Counseling the culturally Diverse(8th ed)O Wiley Professional Development

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Unit 5 Evidence Based Counseling Discussion Questions

Unit 5 Evidence Based Counseling Discussion Questions

Unit 5 Evidence Based Counseling Discussion Questions

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