Multicultural case conceptualization
Multicultural (MC) case conceptualization ability is the extent to which therapists/psychologists identify and integrate cultural factors into conceptualizations of the etiology and treatment of a client's presenting concerns (Constantine & Ladany, 2000).
Extent to which a therapist integrates ethnic or racial issues into two conceptualizations of a client's presenting concerns:
A. The first conceptualization needs to be based on beliefs about the factors contributing to the etiology of the client's difficulties;
B. The second conceptualization needs to be based on beliefs about what would be an effective treatment focus or plan in addressing the client's problems.
Two interrelated cognitive processes: differentiation and integration are examined to measure MC case conceptualization ability
i. Differentiation is defined as a counselor's ability to offer alternative interpretations or perspectives of a client's presenting problems and the nature of the treatment that could be provided. The higher the number of options presented in relation to a client's problems, the higher the degree of differentiation.
ii. Integration is characterized by a counselor's ability to formulate associations between and among differentiated interpretations.
By default, the more distinct ideas that are presented in a case conceptualization, the more differentiated the response. Moreover, a greater number of words in the context of a case conceptualization would not necessarily translate to higher integration scores because the hypothesized ideas must be linked. (For example, although a respondent may discuss issues related to a client's endogenous depression in multiple sentences in a case conceptualization, the response would count only as one idea).
The above was excerpted and modifed from:
Constantine, M. G. & Ladany, N. (2000). Self-report multicultural counseling competence scales: Their relation to social desirability attitudes and multicultural case conceptualization ability. Journal of Counseling Psychology, 47(2), 155-164.
Thursday, February 5, 2009
Multicultural Case Conceptualization 2: Evaluation Criteria
Possible criteria for evaluation of MC case conceptualization ability
0 = no differentiation, no integration, i.e., no indication of ethnic or racial issues in conceptualizing the client's problems.
1= low differentiation, no integration, i.e., one or more references to ethnic or racial issues in the conceptualization of the client's problems, with no connections made between two or more differentiated interpretations.
2= low differentiation, low integration, i.e., one or more references to ethnic or racial issues in the conceptualization of the client's problems, with one connection made between two or more differentiated interpretations.
3 = moderate differentiation, low integration, i.e., two or more references to ethnic or racial issues in the conceptualization of the client's problems, with one connection made between two or more differentiated interpretations.
4= moderate differentiation, moderate integration, i.e., two or more references to ethnic or racial issues in the conceptualization of the client's problems, with two connections made between two or more differentiated interpretations.
5 = high differentiation, high integration, i.e., three or more indications of ethnic or racial issues in conceptualizing the client's problems, with three or more connections made between differentiated interpretations.
The above was excerpted and modifed from:
Constantine, M. G. & Ladany, N. (2000). Self-report multicultural counseling competence scales: Their relation to social desirability attitudes and multicultural case conceptualization ability. Journal of Counseling Psychology, 47(2), 155-164.
NOTE: The original article only specified criteria for ratings of 0, 3, and 5. I tried to get the complete rating but have not heard back from the authors. I decided to add criteria for the other ratings.
0 = no differentiation, no integration, i.e., no indication of ethnic or racial issues in conceptualizing the client's problems.
1= low differentiation, no integration, i.e., one or more references to ethnic or racial issues in the conceptualization of the client's problems, with no connections made between two or more differentiated interpretations.
2= low differentiation, low integration, i.e., one or more references to ethnic or racial issues in the conceptualization of the client's problems, with one connection made between two or more differentiated interpretations.
3 = moderate differentiation, low integration, i.e., two or more references to ethnic or racial issues in the conceptualization of the client's problems, with one connection made between two or more differentiated interpretations.
4= moderate differentiation, moderate integration, i.e., two or more references to ethnic or racial issues in the conceptualization of the client's problems, with two connections made between two or more differentiated interpretations.
5 = high differentiation, high integration, i.e., three or more indications of ethnic or racial issues in conceptualizing the client's problems, with three or more connections made between differentiated interpretations.
The above was excerpted and modifed from:
Constantine, M. G. & Ladany, N. (2000). Self-report multicultural counseling competence scales: Their relation to social desirability attitudes and multicultural case conceptualization ability. Journal of Counseling Psychology, 47(2), 155-164.
NOTE: The original article only specified criteria for ratings of 0, 3, and 5. I tried to get the complete rating but have not heard back from the authors. I decided to add criteria for the other ratings.
MC Case Conceptualization 3: How to do it
How to do the MC case conceptualization:
I have broken down the process of developing a MC case conceptualization into different steps. While these steps impose artificial categories, I highly recommend that you follow these steps one-by-one to manage the complexity that develops when you incorporate MC factors. Following these steps will also facilitate increased understanding of the different diversity factors in the ADdRESSING model (by Hays, 2001) and the possible intersections between these factors.
1. Look at "conventional" ways (without integrating any MC factors) to conceptualize the etiology of the client problems.
2. Identify the different ADDRESSING factors that may be relevant in your case and may provide alternative interpretations to the etiology of the client’s problems. Use the attached list (from: Addressing Cultural Complexities in Practice: A Framework of Clinicians and Counselors Pamela A. Hays, 2001).
3. Look at Step 2- how do the different ADdRESSING factors interact/intersect? Develop interpretations that incorporate these interactions/intersections to conceptualize the etiology of her problems (this would be A& ii):
4. Develop a treatment plan using what you found in Step 3. Can you identify how incorporating ADdRESSING factors changes your treatment plan?
I have broken down the process of developing a MC case conceptualization into different steps. While these steps impose artificial categories, I highly recommend that you follow these steps one-by-one to manage the complexity that develops when you incorporate MC factors. Following these steps will also facilitate increased understanding of the different diversity factors in the ADdRESSING model (by Hays, 2001) and the possible intersections between these factors.
1. Look at "conventional" ways (without integrating any MC factors) to conceptualize the etiology of the client problems.
2. Identify the different ADDRESSING factors that may be relevant in your case and may provide alternative interpretations to the etiology of the client’s problems. Use the attached list (from: Addressing Cultural Complexities in Practice: A Framework of Clinicians and Counselors Pamela A. Hays, 2001).
3. Look at Step 2- how do the different ADdRESSING factors interact/intersect? Develop interpretations that incorporate these interactions/intersections to conceptualize the etiology of her problems (this would be A& ii):
4. Develop a treatment plan using what you found in Step 3. Can you identify how incorporating ADdRESSING factors changes your treatment plan?
| Cultural factors | Age and generational influences | Developmental and Acquired Disabilities | Religion and Spiritual Orientation | Ethnicity | Socioeconomic Status | Sexual Orientation | Indigenous Heritage | National Origin | Gender |
Tuesday, February 3, 2009
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