PS380 Unit 7 Cultural Humility Paper Example

She Asked Whether We Had Ever Worked With Native People: A PS380 Unit 7 Diversity and Cultural Humility Paper

[Student Name]

Purdue University Global

PS380: Clinical Psychology

Unit 7 Diversity and Cultural Humility Paper

[Instructor Name]

[Date]

The client, the clinic and its staff are composite; the competencies, studies and review cited are real.

The Question

Our clinic on Minnesota's Iron Range serves a mostly white population descended from Finnish, Slovenian, Italian and Scandinavian miners, but it also sees clients from nearby Ojibwe communities. In April a family physician referred a 52-year-old Ojibwe woman, whom I will call Darlene, for insomnia and grief after the sudden death of her younger brother. She works as an administrative assistant at a tribal health office, is married and has three adult children.

At her intake, before answering any of the standard questions, Darlene asked whether anyone at the clinic had ever worked with Native people. Dr. Lund, our psychologist, is a white woman of Norwegian descent who grew up in the area. She answered honestly that she had seen some Native clients but did not have special training, and asked Darlene what she would want her to understand.

This paper uses that moment to examine multicultural competence and cultural humility. It considers what Dr. Lund needs to know and do, how research suggests her stance affects treatment, and how to avoid both cultural blindness and stereotyping.

Multicultural Competence

Sue et al. (1992) proposed that culturally competent counselors need three kinds of competence. The first is awareness of their own cultural values, biases and assumptions, including how their background shapes what they see as normal or healthy. The second is knowledge of the client's worldview, including history, values and the effects of discrimination. The third is skill in using interventions that fit the client's culture. Their paper called on the profession to make these competencies part of training and practice standards, which later happened.

Applied to Darlene, each competence raises questions. On awareness, Dr. Lund's training emphasized individual autonomy, verbal processing of emotion and a fifty-minute office visit, assumptions that may not fit how Darlene understands grief. On knowledge, Dr. Lund should understand the history that shapes many Native families in the region, including boarding schools that separated children from their families and the long distrust of government and medical institutions that followed, while recognizing that Darlene's own history and beliefs are hers to describe. On skills, she should be prepared to adapt treatment, for example by including family or coordinating with traditional healing if Darlene wishes.

Knowing the history of boarding schools is necessary, but it does not tell Dr. Lund what Darlene believes about grief; only Darlene can do that.

Cultural Humility

Competence implies a body of knowledge that can be mastered. Hook et al. (2013) described cultural humility as a different stance: an orientation toward the client that is open to the client's cultural identity and the aspects most important to the client, combined with awareness of the limits of one's own understanding. They developed a scale for clients to rate their therapist's cultural humility. Across their studies, the higher a client scored the therapist on that scale, the stronger the client said their working relationship was, and the more the client reported having improved.

Dr. Lund's answer to Darlene's question was an example of cultural humility. She did not claim expertise she lacked, and she invited Darlene to teach her what mattered. Darlene later told me that the answer was why she came back for a second session. She had expected either a claim of expertise or a speech about Native culture.

Avoiding Two Errors

Gone and Trimble (2012) surveyed what is known about mental health among Native peoples of the United States, including Alaska Natives. They documented serious disparities, including high rates of substance use problems, suicide and trauma in many communities, along with limited access to culturally appropriate care. They also emphasized diversity: there are hundreds of tribal nations with distinct histories, languages and practices, and individuals vary widely in how they relate to tribal tradition, Christianity and mainstream American culture. They noted debates about whether standard treatments should be adapted for Native clients or whether culturally grounded approaches should be developed from within communities.

Their review points to two errors a clinician could make with Darlene. The first is cultural blindness: treating her grief exactly as Dr. Lund would treat any client's, ignoring that her family's mourning practices, her community's history of losses and her relationship to the clinic as an institution may all shape her experience. The second is stereotyping: assuming that, because she is Ojibwe, she follows traditional practices, distrusts Western medicine or wants a traditional healer involved.

Darlene's own answers showed why both errors would be harmful. She described attending both a Catholic funeral and a traditional ceremony for her brother. She said her family's way of grieving involved being together and not saying the dead person's name for a time, which made the clinic's standard grief questions uncomfortable. She also said she wanted help sleeping and did not want her treatment to be about her culture. The person in front of Dr. Lund was more specific than either a standard client or a cultural category.

Adapting Treatment

Based on Darlene's preferences, Dr. Lund agreed to several adaptations. She stopped asking Darlene to name her brother and used the term he instead. She offered to include Darlene's sister in some sessions, since grief in her family was shared. She focused the first phase of treatment on cognitive behavioral treatment for insomnia, which addressed Darlene's main request, and explained the approach in practical terms. She asked whether Darlene wanted the clinic to coordinate with anyone at the tribal health office, and accepted Darlene's answer that she did not, for privacy reasons.

Dr. Lund also took steps for herself. She arranged consultation with a Native psychologist in Duluth and enrolled in a training on historical trauma offered by a tribal college. These steps reflect the awareness and knowledge competencies, pursued without asking Darlene to be her teacher. Dr. Lund also reflected on her own reaction to the question at intake, which she admitted had made her defensive for a moment, and discussed it with her consultant.

Conclusion

Darlene's question at intake tested whether the clinic could see her as a person shaped by culture without reducing her to it. The multicultural competencies describe what Dr. Lund needs to develop, cultural humility describes the stance that made Darlene return, and Gone and Trimble's review explains why culture matters without dictating what it means for any one client. In practice, the answer to her question was not a credential but a willingness to ask and listen.

References

Gone, J. P., & Trimble, J. E. (2012). American Indian and Alaska Native mental health: Diverse perspectives on enduring disparities. Annual Review of Clinical Psychology, 8, 131-160. https://doi.org/10.1146/annurev-clinpsy-032511-143127

Hook, J. N., Davis, D. E., Owen, J., Worthington, E. L., Jr., & Utsey, S. O. (2013). Cultural humility: Measuring openness to culturally diverse clients. Journal of Counseling Psychology, 60(3), 353-366. https://doi.org/10.1037/a0032595

Sue, D. W., Arredondo, P., & McDavis, R. J. (1992). Multicultural counseling competencies and standards: A call to the profession. Journal of Counseling & Development, 70(4), 477-486. https://doi.org/10.1002/j.1556-6676.1992.tb01642.x