Strategies for Building Multicultural Competence in Mental Health and Educational Settings

One of the key elements of the American Psychological Association’s (APA, 2003) “Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists” is the notion of a cultural lens. The Multicultural Guidelines define culture as an embodiment of worldview, a complex of systems of values, beliefs, and resultant practices that shape the way individuals make meaning of the world. Using a visual metaphor, a cultural lens is then simply the field of vision that incorporates the landscape of culture. The Multicultural Guidelines invite psychologists to use a cultural lens, acknowledging the ways in which culture shapes their own lens, the multiple meanings that individuals may make about themselves and their contexts, and ways to be responsive and sensitive to such understandings of the world. Specifically, in terms of conducting research, Guideline 4 asks investigators to appreciate the importance of conducting culture-centered research and be sensitive to cultural issues regarding research focus, design, and methods. Aculturallens,bydefinition,isrootedinthesubjective,theinternal worldviewviewofaparticularpersonfromhisorherparticularlocation intheworld.Thissubjectivityofinternallyconstructedmeaning,asopposedtoapresumedexternallyobjectiverealitytrueforallpersonsin alltimesandcontexts,isthesociallyconstructedpositionofqualitative research.
OVERVIEW OF QUALITATIVE RESEARCH
The practice of qualitative inquiry covers a variety of research methods and approaches that operate from an interpretive paradigm, developingportrayals of a complex and dynamic reality (Glesne&Peshkin, 1992). Symbolic interactionism (Blumer, 1969), feminist inquiry (Olesen, 1994), grounded theory (Strauss & Corbin, 1990) action research, case studies, and ethnographies are examples of the plethora of approaches constituting qualitative inquiry (Bogdan &Biklen, 1992). Qualitative research strives to understand the epistemological nature of phenomena through the subjective experiences of the persons who are concerned with such phenomena. Essentially, it is the process of finding out what people think and feel impressionistically and narratively rather than quantifiably. As such, this methodology lends itself particularly well to understanding the experiences and worldviews of diverse persons. For instance, Gibson (2002) looked at the experience of African American grandmothers who were caregivers to grandchildren whose parents were not able to provide them with adequate care. This phenomenon of kinship care, culturally congruent in the African American community, needed a qualitative approach to explore a complex, sensitive, and contextually rich situation and capture the lived experience of this clinically significant group. Qualitative approaches are becoming increasingly popular as a methodology for conducting research in psychology (Ponterotto, 2002). Unlike many of the social sciences that have viewed humans as social beings, psychology typically considered humans as individuated selves in isolation (McLeod, 1996) and tended to link itself more closely with the natural sciences. Quantitative methods dominated the field, the gold standard of empiricism being the randomized control-trial experiment (Walsh-Bowers, 2002). Qualitative research methods were used primarily in clinical case studies to generate further understanding, and such research was usually presented in ways that implied objectivity and authoritative expertise on the part of the researcher. Walsh-Bowers (2002) used the qualitative approach of interviewing to investigate the experiences of psychology researchers with qualitative methods and found that a strong theme was the perceived difficulty of qualitative research being accepted within the canon of psychology, as well as the lack of adequate training in qualitative research. Despite these obstacles, over the past few decades, there has been an increasing realization that qualitative methods might be useful in answering particular kinds of questions (Rennie, 1996). The place of qualitative research may well be to generate discovery of phenomena rather than verification, because when there is little known about a field, qualitative inquiry is useful for generating themes that may be operationalized by later quantitative research (Heppner, Kivlighan, &Wampold, 1992). One way of comparing these methodologies and seeing the resultant gain is to examine two approaches to a single topic. Bracey, Bámaca, andUmaña-Taylor (2004) explored the relationship between self-esteem and ethnic identity development among biracial and monoracial adolescents through administering different measures to a large group of adolescents. They found that biracial adolescents had significantly lower selfesteem than Black adolescents but significantly higher than Asian adolescents. Biracial adolescents reported higher levels of ethnic identity than White adolescents, though lower than Black and Asian adolescents. The authors also found a significant positive relationship between selfesteem and ethnic identity. In a qualitative approach to the topic of biracial identity, Gillem, Cohn, and Throne (2001) used a case study method following two biracial youth to describe their identity development. Rather than deriving statistical significance from their findings, this approach allowed the generation of narrative examples of the complex process of racial identity development. Although each participant identified as Black, the paths they took were very different and had different meanings and consequences. Embracing Blackness for one individual meant feeling betrayed by White physical traits and experiencing rejection from other Blacks, resulting in his low self-esteem; for the other, it meant finally achieving high self-esteem and a refusal to reject any part of herself, including her positive relationship with her White parent. Both quantitative and qualitative approaches, therefore, generate useful information that is derived differently and can be applied differently. Whereas the first allows for generalizability, the second allows for deeper understanding of an issue in terms of context and complexity. Hill, Thompson, and Williams (1997) described a step-by-step process of conducting consensual qualitative research, a method of action research well-suited for studying complex clinical phenomena in counseling. Beyond coding therapist and client behaviors or creating scales to determine the strength of the working alliance, qualitative research can focus on the meanings such experiences hold for the client and the therapist as they naturally occur, discovering inductively what may guide the process. By focusing on the meaning of experience, qualitative research can be helpful in generating more ideas about what clients find helpful, useful, nonoppressive, and empowering, while taking into account the diversity of clients and the context of their interactions with counselors. The following set of studies demonstrates the building of a strong foundational basis through qualitative research. Thompson,Worthington,andAtkinson(1994)investigatedhowAfrican Americanwomencollegestudentsrespondedinsimulatedclientsessions toAfricanAmericanandEuropeanAmericancounselors who either madeapointofraisingracialissuesoravoidedthetopic.Sessionswerevideotapedandtheinteractionsqualitativelyanalyzed.Oneofthefindingsthatemergedwasthatthepseudo-clientsself-disclosedmoreintimatelywhenaskeddirectlyabouttheirexperiencesasBlackwomenona majorityWhitecampus.Extendingthatstudy,ThompsonandJenal(1994) focusedonthepseudo-clientsandfurtheranalyzedtheirinteractionswith theirrace-avoidantoruniversalisticcounselors.Theyfoundthatthe pseudo-clientswhoraisedissuesofracewerelikelytoeitherconcedeto theircounselor’suniversalisticresponsesortodisengagefromtheircounselor.Frequently,whenthepseudo-clientsweremetwithrace-neutralizing responsesonpresentingtheirracialissues,theywouldbecomeexasperated.Inessence,theclientsneededtonegotiatetheircounselor’sposture onrace.Continuingtobuildonthisthemefromtheperspectiveofthetherapists,Knox,Burkard,Johnson,Suzuki,andPonterotto(2003)used consensualqualitativeresearchtolookathowAfricanAmericanandEuropeanAmericanpsychologistsexperiencedandrespondedtoraceissues incross-racialtherapydyads.Thedatafromstructuredinterviewingof thepsychologistssuggestedthatalthoughparticipantsreportedsimilar trainingexperiences,ratesofpreparatory,supervisory,andcontinuing educationexperiencesthatrelatedtoraceandmulticulturalissueswere muchhigherfortheAfricanAmericantherapists.Notsurprisingly,therefore,EuropeanAmericantherapistsreportedgreaterdiscomfortabout addressingraceincross-racialtherapydyads. Aswellasinvestigatetherapistself-perceptionsandexperiencesaboutaddressingrace,qualitativeapproachescangiveusinformationaboutmulticulturaldevelopmentandsupervision(Fukuyama,1994),informus aboutidentitydevelopmentasmulticulturalpractitioners(Constantine, 1999),andilluminateprocessesofracism(Robinson&Ginter,1999).Ponterotto(1998)commentedthatqualitativeapproacheswerealsoparticularlywell-suitedformulticulturaltrainingresearchbecauseoftheneed forin-depthandhighlydescriptivestudiesthatcameoutofthegroundedtheorytradition.Whiletheory-drivenordeductiveapproaches flourish,thereisaneedtobalancethemwiththeory-developingorinductiveapproaches.
CULTURAL SENSITIVITY IN CONDUCTING QUALITATIVE RESEARCH
There are two different levels of cultural sensitivity to be accounted for in this research paradigm. On the first level is the foundational understanding that all qualitative research is informed by culture. Because all individuals, including the researcher, are cultural beings, the impetus, focus, and methods of the research will be shaped by the researcher’s worldview. Given this position, it is impossible to conduct culturally neutralqualitative research. Thus, all strategies are developed to identify, articulate, and manage subjectivity rather than to eliminate it. There are several important aspects of highlighting the cultural lens and participant perspectives which will be discussed in the following sections.
BRACKETING
The task of the researcher is to interrogate the cultural lens he or she brings to the research, explaining it to the reader so as to provide the reader with a direction from which to judge the research. This reflexivity (McLeod, 1996) in qualitative research defines the trustworthiness of the researcher. It also allows researchers to brackettheir own subjectivities to allow participant voices and meanings to be more clearly heard.
For example, when a European Canadian woman seeks to do research with women of color (Gerrard, 1995), it is critical to articulate why she chose to engage in such research as well as describe the conflicting tensions that her participants felt and her own positions on these issues. With less soul searching, but as much attention to detail, the authors of a study on African American and European American therapists’ experiences of addressing race in psychotherapy (Knox etal., 2003) described themselves in terms of their identities, positions, and experiences with multiculturalism. Obviously, this is very different from the quantitative research position, where the investigators are separate from their research and are subjects who report but are not scrutinized in turn. In qualitative research, the question is one of exploring and clarifying the boundaries of subjectivity rather than seeking to banish it. On a related note, Nevid and Sta Maria (1999) point out that it is important when working with participants from ethnic minority groups that have a long history of oppression to acknowledge cultural mistrust. A researcher needs to both account and prepare for the potentially mistrustful and hostile reactions and responses she or he may encounter and strategize means of building trust.
helpfultechniquetousetosensitizetheresearchertoculturalissues istheuseofthebracketinginterview(Fontana&Frey,2000).Priortoenteringthefieldtocollectdata,theresearcheristhoroughlyinterviewed byacolleague.Thefocusoftheinterviewisontheresearcher’ssubjectivityandbackground.Oneparticularstrategytodelineatethisistoask theresearcherquestionssimilartothosetheresearcherproposestoask participants.Becausequalitativeresearchersoftenbringidentitiesas wellasintrinsicexperiencesandperspectivestotheirresearch,thisprocessallowsthosephenomenologicalassumptionstobearticulatedand thensetasidesoastosensitizetheresearchertowhatmayemergefromtheparticipants.
SENSITIZINGRESEARCHQUESTIONS
Once the researcher has developed a coherent statement that explains his or her cultural location, it is time to apply a cultural lens to the research itself. Several areas are germane here that are peculiar to qualitative inquiry. On the one hand, qualitative research can be explicitly designed to be action research, focused on sociopolitical and historical problems of domination, alienation, and social struggle. For instance, Gerrard (1991) explored the intersections of racism and sexism in three stories of women of color experiencing counseling. Constantine (1999) analyzed the themes arising in 17 autobiographical narratives of racism generated by counselors. On the other hand, a research method that strives to capture the richness and complexity of experience may also be extremely intrusive and potentially harmful. It is necessary to tread cautiously when the focus of research is on areas of vulnerability, with the concurrent potential for impeding and doing harm to clients (McLeod, 1996). There are a number of resources available to researchers to sensitize them to the issues relevant to the population of interest. For instance, Stubben (2001) details some of the particular issues around American Indian and Alaskan Native family values and environments that a researcher must be sensitive to in conducting research with such populations. Examining areas of social identity such as race, gender, sexual orientation, or socioeconomic class, where the researcher is treading on sensitive ground mined by the experiences of oppression and discrimination, requires sensitivity. As an example, if the researcher wishes to study the experiences of Latinas, the questions designed to explore this issue will need to be asked only after building a trusting relationship. It will be important for the researcher to develop a coherent explanation of who is meant by the identity label “Latina.” Are participants approached on the basis of selfidentification, identification based on appearance, familial heritage, identified culture of origin, or perhaps familiarity with Spanish? This is where work done prior to entering the field is crucial so that the researcher is not caught completely off-guard by complexities about which he or she is unaware. Imagine the potential harm done by a naïve researcher, unaware of the implications, who expresses surprise that the Latina participant does not speak Spanish. The Latina participant needs to understand the researcher’s interest, believe that the experience of sharing will have ultimate positive value, and feel safe when she chooses to disclose. The consequences of the process undertaken by the researcher impact not only the participant’s safety but also the quality of the data. After all, a participant who is distrustful will either refuse to participate or will give shallow or misleading responses. The complexity and richness of her experience will be lost to the study.
PROTECTINGPARTICIPANTS
Beyond asking unsafe or potentially hurtful questions, ethical issues arise because anonymity is difficult to maintain in intimate samples where stories told are saturated with unique markers and changing too many such markers will drastically change the landscape of the narrative. Given the exploratory nature of the inquiry, risks are harder to determine in advance. Finally, the close contact between researcher and participant blurs traditional boundaries that separate researcher and subject (Grafanaki, 1996). Researchers must give careful attention to the protection of their participants. Beyond the requirements for the protection of human subjects, researchers must also consider the particular threats that can arise when someone speaks out about issues of culture or oppression. For instance, if a researcher is exploring the organizational system of a school, is it possible to sufficiently disguise the voices of the two African American teachers while retaining the integrity of their experience? If there are few people of color in the setting, simply changing the specific ethnic group identification will not create anonymity. Is there a possibility that members of the setting who read the research can not only identify the participants but also negatively target them for speaking out about racial matters? Researchers can use several strategies to protect their participants. Careful explanation to participants about the risks of participation encourages participants to give informed consent, as well as demonstrating respect for the participant’s ability to weigh risks and choose with deliberation. Developing multiple ways to protect anonymity, including inviting participants to choose pseudonyms, changing identifying details of location, and conducting interviews in neutral sites, is also helpful. Often, presenting participants with completed research reports allows them the option to comment, critique, and perhaps withdraw participation if the risks are too great. In presenting research, developing blended narratives that exemplify the emerging themes also reduces the presence of unique identifying markers.
TRIANGULATION
Triangulation is the combination of various methodologies in the study of the same phenomena (Patton, 1990). Taken from the term used in land surveying, it implies that taking bearings in two or more directions allows one to locate oneself more accurately at the intersection. Triangulation can take place in (1) data collection, using a variety of data sources; (2) investigators, using multiple investigators or evaluators; or (3) theories, by applying multiple perspectives to a single problem.
As pointed out by Halbrook and Ginsberg (1997), ethnographic transference and countertransference become significant issues to explore in conducting qualitative research. As foundational elements of analytic theories of psychotherapy, transference and countertransference originally referred to the client’s displacement of feelings and attitudes applicable to significant figures onto the analyst and vice versa (Reber, 1995). In the context of qualitative research, it refers to the displacement of such feelings and attitudes between the researcher and the participant. For instance, when a counselor begins interviewing participants who had been clients in counseling, many may respond to the investigator as a counselor rather than a researcher (Choudhuri, 2003). In turn, the boundaries of how the researcher responds to these participants may begin to blur as to whether a response is therapeutic or investigative. It is important that researchers explore and address these issues in multiple ways. As mentioned earlier, bracketing is important to articulate why the research became the focus of the researcher’s attention so as to be able to catch and filter the prevailing reactivities that may lead to ethnographic countertransference. During the course of the research, investigators may use multiple interviewers to gather data from different sorts of interview relationships. Therefore, the ways in which Vietnamese American participants are responding specifically to a Vietnamese American interviewer may be highlighted by the different content of the participant’s responses to African American and European American interviewers. Stephenson, Wolfe, Coughlan, and Koehn (1999) conducted two sets of qualitative interviews with older adults, changing the gender of the interviewer/participant pairing to have both cross-gender and same-gender interviews to assess the differences. They found that both the male and female participants focused on very different topics and content based on the interviewer’s gender. Having multiple interviewers allowed for this effect to be discovered and discussed. Another method of exploring these issues is the safety of multiple staggered interviews with the same participant, where the researcher can explore the content of previous interviews and remain alert to transferential phenomena, as well as bring it up to be explored with the participants. Sharing transcripts of interviews with participants for them to expand on, correct, or modify is another way of addressing these issues. The act of bringing the research toparticipants rather than simply getting it fromthem invites participants to become partners in the research, and often they will address the issues of authority and identity spontaneously. One of the advantages of qualitative research is the flexibility and creativity that can be used. For instance, Kim, Brenner, Liang, and Asay (2003), in their study of 1.5-generation Asian Americans, decided to use electronic mail as a way to safeguard their participants from shame andpossible loss of face as they described sensitive adaptation experiences. Given traditional Asian cultural values of restraint, the investigators believed that a face-to-face interview format would reduce forthright and comprehensive self-disclosure. On the other hand, Hendrix (1998), in researching college students’ perceptions of professor credibility by race, deliberately chose to be open with her identity as a Black woman researcher investigating student perceptions. Rather than having White confederates assist in interviewing White students, she chose to present to the reader her rationale for not doing so and then explore how both Black and White student interviewees responded to her.
SENSITIVEDATAANALYSIS
The point when the researcher leaves the field and begins making sense of the data is sometimes referred to as “data mining,” with a very real sense that the researcher is entering the overwhelming, claustrophobic, and dimly illuminated code mines (Glesne&Peshkin, 1992). This is the part of the journey where the researcher begins to make sense of the data and de facto applies a particular cultural lens to the material. The data, too, often consist of an intersubjective dialectical experience (Crossley, 1996): the record of conversations between researcher and participants, the record of observations by the researcher, or memos by the researcher articulating responses, reactions, and experiences in the fieldwork. Even texts and historical materials that may be part of the data have been purposefully selected. On this material, the researcher strives to impose some order and meaning. Methods to maintain cultural sensitivity and highlight multiple representations are necessary. Strategies include using inductive analysis, so that codes, categories, and themes come out of the data rather than being imposed. Starting with indigenous concepts and typologies (Patton, 1990), that is, verbal categories that were used by participants rather than asked by researchers, helps this process. For instance, if the researcher was studying children in a diverse sixth-grade classroom, starting to code by applying words used by the children and teachers rather than by the theoretical literature may open more possibilities of capturing the meaning of the diversity experience from the perspective of the participants. Triangulation is again important in data verification and validation. Many studies use teams of researchers to examine the data and code separately, before coming together to share their coding systems. In some cases, the primary researcher will code the data and then ask an external reader to review the codes assigned. Alternatively, a helpful set of participants may review preliminary findings and give feedback and critique of the data analysis. This testimonial validity, where the interpretation is

 
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