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Cross Cultural Competency, Diversity, & Awareness: Ethical Boundariess
Cross Cultural Competency, Diversity, & Awareness: Ethical Boundariess

Section 3
Fears Treatment for Culturally Different Clients

Question 3 | Test | Table of Contents
Psychologist CEs, Counselor CEUs, Social Worker CEUs, MFT CEUs

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On the last track, we discussed the culturally different client’s Locus of Control, as well as the Locus of Responsibility. Your culturally different client may have either an Internal Locus of Control or an External Locus of Control. In counseling, your culturally different client may adopt either an Internal Locus of Responsibility or an External Locus of Responsibility.

On this track, we will discuss the ethical treatment of fear in culturally different clients who are coping with the five stages of identity development and the loci of control and responsibility discussed on the previous tracks.

Sound interesting?

Ethics - Case Study Analysis: Carlota's Anger & Fear
When Carlota (Car-lote’-ah), age 39 Hispanic, came to my office, she said that she was very unhappy. Carlota stated, "No one has ever really appreciated me. My father was abrasive, and my mother was just submissive to him. She really didn’t have a personality at all. She was so caught up in what my dad wanted, she didn’t notice me at all."

She explained that this situation growing up had created a lot of anger inside her. Carlota stated, "I just can’t get close to anyone. I’ve dated some men, but it just seems like there’s this invisible barrier. I’ve also tried to go out socially with some girlfriends, but we were never really that tight." Sound like a culturally different client of yours? Ethically how would you handle Carlota’s problems?

As you can see Carlota’s problem is not just her anger. I suspected that Carlota’s anger was actually rooted in another emotion. I asked Carlota, "When you try to comprehend the reasons for your anger, what do you come up with?" Carlota stated, "I know I have a hard time trusting people that aren’t Hispanic. It becomes a never-ending cycle. I want to get close to someone, but I’m sure I send signals indicating discomfort. So that person rejects me and I get mad. Then when another potential relationship comes along I’m all the more skeptical, so the cycle repeats itself."

I stated to Carlota, "I’m hearing you say that you are guided by your fears." Carlota looked surprised. She stated, "Fear? I always knew I was angry, but I didn’t think I was living in fear." It seemed to me that Carlota needed guidance in identifying fear. Do you agree?

As you are well aware, fear implies hesitancy, apprehension, and doubt. I have found that fear is an emotional governor that inhibits many culturally different and non-culturally different clients from living with full-throttle confidence.

However, as you are well aware fear is not always expressed in hesitancy, apprehension, and doubt. To help Carlota understand her fears, I decided to have her work through a couple of techniques. As I explain them, think of your client of a different culture. Would these techniques be ethically appropriate?

"Describing Fear" Technique
The first technique I asked Carlota to do was the "Describing Fear" technique. The "Describing Fear" technique is based on just one question. I handed Carlota a notebook and asked her to answer the question, "When you think of a fearful person, what mental image is most typical?"

Carlota began writing, "Someone unassertive, cowardly, shy." I stated to Carlota, "Most people identify fear in overtly weak characteristics like the ones you wrote. As you know, those qualities have strong elements of fear. However, fear is not one-dimensional. Fear can be expressed in any way that shows the inner insecurity that inhibits us from living in the healthy ways we know we should."

Ethics - "Subtle Fears" Technique
For the second exercise, which I call the "Subtle Fears" exercise, I asked Carlota to flip to a blank sheet in the notebook. I stated, "I’m going to list ten statements. I want you to give yourself a point for each statement that applies to you."

Subtle Fear Statements
I then read the following statements to Carlota:
1. I feel antsy or uncomfortable when I am not in control of things.
2. I have been told I don’t receive others’ feedback well.
3. There are parts of my personality no one knows about.
4. Sharing intimate feelings or personal thoughts with others is not natural for me.
5. Sometimes I use humor to avoid delicate subjects or I change topics quickly.
6. The moods of other people can have a strong effect on my moods.
7. I have a habit of letting my frustrations fester inwardly; I don’t let go of them easily.
8. I have been known to tell lies to cover up flaws or to keep from being accountable.
9. When someone is clearly angry, I habitually seek to "cover my flank."
10. I worry more about my public image than most people would suspect.

Carlota counted her tally marks and stated, "I have seven points." I explained to Carlota that each of the statements represented a subtle form of fear. I stated, "Having more than five points in the ‘Subtle Fears’ exercise usually may mean you struggle often with fear. That fear, in turn, brings frustration and anger into your world."

Do you have a client of a different culture who, like Carlota, is expressing his or her fear through anger? Ethically would your Carlota benefit from the "Describing Fear" technique? Or would your Carlota benefit more from the "Subtle Fears" exercise? From an ethical perspective, how might her cultural background influence the counseling process?

On this track, we have discussed the treatment of fear in culturally different clients.

On the next track, we will discuss discuss relevant processes and goals in counseling culturally different clients. We will also discuss Ivey and Authiur’s four conditions that may arise in counseling a client of a different culture. These four conditions are Appropriate Process and Appropriate Goals, Appropriate Process and Inappropriate Goals, Inappropriate Process and Appropriate Goals, and Inappropriate Process and Inappropriate Goals.

Peer-Reviewed Journal Article References:
Chavez-Korell, S., Rendón, A. D., Beer, J., Rodriguez, N., Garr, A. D., Pine, C. A., Farías, R., Larson, L., & Malcolm, E. (2012). Improving access and reducing barriers to depression treatment for Latino elders: Un Nuevo Amanecer (A New Dawn). Professional Psychology: Research and Practice, 43(3), 217–226.

Richins, M. T., Barreto, M., Karl, A., & Lawrence, N. (2021). Incidental fear reduces empathy for an out-group’s pain. Emotion, 21(3), 536–544.

Schwarzenthal, M., Schachner, M. K., van de Vijver, F. J. R., & Juang, L. P. (2018). Equal but different: Effects of equality/inclusion and cultural pluralism on intergroup outcomes in multiethnic classrooms. Cultural Diversity and Ethnic Minority Psychology, 24(2), 260–271.

Tormala, T. T., Patel, S. G., Soukup, E. E., & Clarke, A. V. (2018). Developing measurable cultural competence and cultural humility: An application of the cultural formulation. Training and Education in Professional Psychology, 12(1), 54–61.

Turner, E. A., & Llamas, J. D. (2017). The role of therapy fears, ethnic identity, and spirituality on access to mental health treatment among Latino college students. Psychological Services, 14(4), 524–530.

How is fear expressed in culturally different clients? To select and enter your answer go to Test.

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