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Cross Cultural Equity, Cultural Diversity, the Marginalized, & Ethical Boundaries: Coping with the Challenges
Ethics and Cultural Diversity  continuing education social worker CEUs

Section 5
Cultural Perspectives in Counseling Hispanic Clients

Ethics CEU Question 5 | Ethics CE Test | Table of Contents
Social Worker CEUs, Psychologist CEs, Counselor CEUs, MFT CEUs

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In the last section, we discussed the case study of Gerald, an African American client. We considered this case in light of the aspects of African American culture like nonverbal behavior, humanism, and importance of family as discussed in the third section. We also discussed the ethical issues raised by the case.

In this section, we will discuss the cultural and historical perspectives in counseling culturally different clients who are Hispanic. We will also discuss the implications of these cultural and historical perspectives.

♦ History and Demographics
Obviously the term "Hispanic" has been used to replace the term "Latino" in recent years. "Hispanic" is used as a generic label to describe all people of Spanish origin and descent. Today, as you are well aware, there are more than 23.4 million Hispanics in the United States. This makes up approximately 9 percent of the total population.

I have found that typically Hispanics are a significantly undereducated group, with about 20 percent having completed five years of school or less. Additionally relative to the general population, Hispanics have high rates of unemployment. Employed Hispanics tend to have blue-collar jobs with high probabilities of abrupt termination. Approximately 22 percent of the Hispanic population is described as "low income."

I have found that although different subcultures emerged in the Hispanic culture based on geographic regions, there are many similarities between these subcultures to consider in counseling culturally different clients who are Hispanic. For example, as you may have guessed, a clear majority of Hispanics identify Spanish as the "mother tongue." In addition, across most Hispanic culture, sex roles and marriage are similar.

Regarding the family structure, Hispanics have a tradition of using the extended family structure for a stress resistant quality when it comes to emotional problems. As you may have noticed, this is commonly used as an argument to explain the Hispanic underutilization of mental health services. This will be illustrated further in the next section with the case study of Luisa (Loo-ease’-uh) and her family.

♦ Key Differences in Acculturation and Assimilation
In counseling the Hispanic client, I feel it is of ethical importance to consider the aspects of acculturation and assimilation. Acculturation, as you know, is the process of adopting the new ways of the dominant culture. Assimilation, on the other hand, refers to the extent to which an individual enters the dominant culture and becomes a part of that culture. As you can see, the key difference is "societal acceptance." Despite centuries of voluntary and involuntary acculturation, Hispanics in the United States have retained Spanish fluency and other traditions of Hispanic culture.

♦ Identifying Biculturalism
As a result, it makes sense to conceptualize culture group membership for Hispanics in the United States as a continuum, with one end representing those who are completely Hispanic, such as a new immigrant, and the opposite end representing those who are completely American, like someone completely acculturated to the general American culture. Obviously the majority of Hispanic clients fall at some intermediate point between the two extremes and are classified as "bicultural." Do you have a culturally different client who is Hispanic and retains values of both the Hispanic culture and the American culture? Might he or she be bicultural?

Clearly this bicultural classification may have a number of ethical implications for a therapist dealing with a culturally different client who is Hispanic. A bicultural Hispanic client may think, act, and feel more like an American than a Hispanic during treatment of a work or school problem. However this same bicultural Hispanic client may respond more like a Hispanic than an American in dealing with problems associated with home and family.

Make sense? Some bicultural clients may respond best, as a result, to bicultural counseling. Thus the important question is how to decide whether a Hispanic client is bicultural and whether that client would respond better to a bicultural counseling program. I have found that it is important to consider a variety of questions in determining whether a bicultural process would be appropriate for your Hispanic client. Is your client more Hispanic or American? What are his or her degrees of assimilation and acculturation? Is your client English or Spanish dominant?

♦ The Hispanic End of the Continuum
For a client that falls on the Hispanic end of the continuum, clearly no therapist can hope to initiate any type of intervention without Spanish fluency and awareness of Mexican culture. Cases with Hispanic clients who fall on the Hispanic end of the continuum require service delivery personnel who are bilingual and bicultural. In addition I have found that the extended family can be extremely helpful in the evaluation and treatment of the Hispanic client on the Hispanic end of the continuum.

Because the extended family often serves as a stress-reduction function for Hispanics, family-oriented treatment approaches may be beneficial. Finally you, as the therapist of a Hispanic client on the Hispanic end of the continuum, may want to construct a hierarchy of the needs of your client.

♦ The Middle of the Continuum
However if your client falls in the middle of the continuum, reflecting values of both the Hispanic culture and the American culture, a different bicultural approach may be appropriate. For a Hispanic client in the middle of the continuum, a therapist must be fluent in both English and Spanish. Ideally if you are counseling a Hispanic bicultural client, you should be able to switch from language to language with comfort. As you are probably aware, Hispanic clients in the middle of the continuum will often discuss different problems in different languages.

The Hispanic client may discuss family problems in Spanish, but use English to discuss problems related to work. As the therapist of a Hispanic client in the middle of the continuum, you also need to be sensitive to your client’s biculturality. In addition, like with the Hispanic client on the Hispanic end of the continuum, the family may be used as a stress-reduction function. This will be illustrated in the next section when we discuss the case of Luisa and her family.

♦ The American End of the Continuum
Finally a Hispanic client may fall on the American end of the continuum. Often, for Hispanic clients on the American end of the continuum, biological heritage is the only characteristic tying them to Hispanic values. As you are well aware, for these Hispanic clients on the American end of the continuum, models of counseling designed for Hispanics are often unnecessary and in some cases inappropriate. Hispanic clients falling on the American end of the continuum may be counseled as a typical American client would be.

Do you have a culturally different client who is Hispanic? Where does your Hispanic client fall on the Hispanic-American continuum? What ethical implications does this have on your counseling techniques? The ACA Code of Ethics states, "Counselors respect diversity and must not discriminate against clients because of age, color, culture, disability, ethnic group, gender, race, religion, sexual orientation, marital status, or socioeconomic status."

In this section, we have discussed the cultural and historical perspectives in counseling culturally different clients who are Hispanic. We discussed the implications of these cultural and historical perspectives.

In the next section, we will look at a specific case with a Hispanic client named Luisa and analyze the influences impacting that counseling experience.

Peer-Reviewed Journal Article References:
Burke, S. L., Naseh, M., Rodriguez, M. J., Burgess, A., & Loewenstein, D. (2019). Dementia-related neuropsychological testing considerations in non-Hispanic White and Latino/Hispanic populations. Psychology & Neuroscience, 12(2), 144–168.

Constantine, M. G. (2001). Predictors of observer ratings of multicultural counseling competence in Black, Latino, and White American trainees. Journal of Counseling Psychology, 48(4), 456–462.

Feldstein Ewing, S., Bryan, A. D., Dash, G. F., Lovejoy, T. I., Borsari, B., & Schmiege, S. J. (2021). Randomized controlled trial of motivational interviewing for alcohol and cannabis use within a predominantly Hispanic adolescent sample. Experimental and Clinical Psychopharmacology.

Hong, J. S., Peguero, A. A., & Espelage, D. L. (2018). Experiences in bullying and/or peer victimization of vulnerable, marginalized, and oppressed children and adolescents: An introduction to the special issue. American Journal of Orthopsychiatry, 88(4), 399–401.

Pérez-Rojas, A. E., Brown, R., Cervantes, A., Valente, T., & Pereira, S. R. (2019). "Alguien abrió la puerta:” The phenomenology of bilingual Latinx clients’ use of Spanish and English in psychotherapy. Psychotherapy, 56(2), 241–253.

Watson-Singleton, N. N., Lewis, J. A., & Dworkin, E. R. (2021). Toward a socially just diversity science: Using intersectional mixed methods research to center multiply marginalized Black, Indigenous, and People of Color (BIPOC). Cultural Diversity and Ethnic Minority Psychology.

What is the difference between an acculturated Hispanic client and an assimilated Hispanic client? To select and enter your answer go to Ethics CE Test.

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