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Clinical Supervision: Models, Role, Legal & Ethical, Cultural Competency, & Transference
Clinical Supervision: Models, Role, Legal & Ethical, Cultural Competency, & Transference

Section 39
Cultural Competency in Supervision

Question 39 | Test | Table of Contents | Supervision
Psychologist CEs, Counselor CEUs, Social Worker CEUs, MFT CEUs

Cultural Lenses and Process Orientation

This portion of the course will deal with cultural competency in supervision including cultural lenses and process orientation, irrational thoughts, four areas of clinical practice, four stages of cultural competence, supervisor responsibilities, tape recording sessions, integration of multicultural influences, and four steps to multicultural competence.

Regarding cultural diversity we will discuss stereotyping, aggressive behavior, deculturation, culture shock syndrome, three key microskills, racist attitudes, and the social microcosm.

Regarding cross-cultural practices we will discuss marginalist perspective, guilt, counseling belief systems, ethics, case study, and historic considerations.

Cultural Lenses and Process Orientation
Cultural competence is defined as the "therapist’s ability to treat people of diverse cultural backgrounds in ways that respect, value, and integrate their socio-cultural context". As you are aware, a supervisee’s cultural competence lies in the ability to move between his or her own "cultural lens" and that of the client. In other words, your supervisee’s cultural lense is how he or she views cultures and their differences. Your supervisee should also be able to use this information to understand the client in context. This idea is called process orientation. Process orientation means that the supervisee and client are able to maintain their own culture-specific frameworks, and both frameworks are respected and valued by the supervisee and client.

Irrational Thoughts
Regarding cultural diversity, have you found like I, that there are times when your supervisee’s training may be disrupted by his or her own irrational thoughts? By irrational thoughts, I mean for example, self-deprecation and/or performance anxiety. Take a minute to think about your last supervision session. Did your supervisee use any self-deprecating phrases? For a supervisee to have a certain level of performance anxiety during a session is normal. Based on your supervisee’s level of clinical experience, is his or her performance anxiety concerning cultural diversity problematic?

Four Areas of Clinical Practice
The ideas we have just discussed can be applied to four areas of clinical practice. These four areas are engagement, assessment, theory, and method. As you read these four concepts, consider how the concepts would apply in a supervisee-client relationship, especially if your supervisee is from a different culture.

Area #1: Engagement
In the engagement phase, the supervisee tries to understand what the client hopes to gain from therapy, as well as understanding the client’s perspective on the problem at hand. This understanding of the client’s perspective shows cultural competency of your supervisee. It is your supervisee’s responsibility, as a therapist, to validate his or her client’s definition of the problem as well as addressing the problem in therapy.

Engagement with a supervisee of a different culture
Just as the supervisee tries to understand what the client hopes to gain from therapy, as well as the client’s perspective of the problem; what steps do you take as a supervisor to understand the culturally different supervisee and what they hope to gain from their training with you? Also, could their perspective on the challenges of learning a therapy model be different from yours, based on cultural perspectives?

Area #2: Assessment
In the assessment phase, culturally competent assessment by your supervisee, as well as interpretation, should incorporate two sets of cultural norms: those of mainstream culture as well as those of the client’s culture.

Cultural Norms in the Supervision Session
Ask yourself, in your last supervision session, were there any assumptions you made by being or not being part of the mainstream culture?

Area #3: Theory
In addition to engagement and assessment, the third phase is the theory phase. This phase incorporates the client’s cultural reference point into an understanding of how therapy can assist with behavior change.

What is your supervisee’s cultural reference point for understanding how your training sessions can assist in behavior changes to become a better therapist?

Area #4: Method
Lastly, the method phase involves the supervisee’s ability to develop and adapt interventions that are consistent with the client’s cultural values and practices. This phase requires your supervisee to show openness to considering the possibility that his or her methods may be inconsistent with the client’s cultural context.

In the method phase, regarding the supervision relationship, how do you develop and adapt interventions that are consistent with your supervisee’s cultural values and practices? This phase requires you to show openness to considering the possibility that your methods may be inconsistent with your supervisee’s cultural background.

According to Ancis and Ladany (2001), individuals may belong to one of three possible demographic groups:
(1) a socially oppressed group,
(2) a socially privileged group, or
(3) both groups, in the case of multicultural identities.
Is it appropriate for you to be aware of the demographic heritage of your supervisee? Does your culturally different supervisee come from a group, he, she, or you would consider socially oppressed? Or, does your supervisee come from a group, he, she, or you would consider socially privileged? Or, does your supervisee consider themselves coming from both an oppressed group and or possibly a subculture that is socially privileged? An example of this would be a supervisee whom I worked with who was African American, however, her father was a doctor.

Four Stages of Cultural Competence Development
I have found that a supervisor’s cultural competence development in supervision occurs in four stages. These four stages are adaptation, incongruence, exploration, and integration. As you read each of these, ask yourself what is the current stage of your relationship with your supervisee?

#1 Adaptation Stage - Denying and Dismissing Culturally Related Concerns
The adaptation stage occurs when the supervisee has not yet adapted to the culturally different client. Both socially oppressed and socially privileged supervisors may actively deny and dismiss culturally related concerns regarding themselves, the supervisee, and the supervisee’s clients. As the supervisor, you may experience, but perhaps may be unwilling to admit,your anxiety in this phase when diversity issues are raised by the supervisee or client. Does your anxiety in this initial phase cause you to discount the role of cultural context and perhaps blaming the supervisee may occur.

#2 Incongruence Stage - Minimizing Diversity Concerns
In the incongruence stage, denial of oppression can be replaced by minimization and rationalization. In addition, both socially oppressed group and socially privileged group supervisors and trainees may experience dissonance, or conflict, between their previously held views and new information or experiences. In this stage you may, at most, address diversity concerns in supervision only minimally, and more often are unlikely to discuss diversity concerns at all. Supervisees in the incongruence stage may perceive the supervisor to be disinterested, and thus are unlikely to bring up cultural issues despite being aware of them.

Take a deep breath. Take an honest look inside. Recall your last supervision session with a culturally different supervisee. Could your supervisee possibly be viewing you as disinterested due to your minimizing, lack of discussion, lack of recognition, etc, of the cultural difference between the two of you?

#3 Exploration Stage - Creating a Balance
In addition to adaptation and incongruence, the third stage of cultural competence development is exploration. This stage involves active exploration of one’s own socially oppressed group or socially privileged group status. In the exploration stage, both socially oppressed group and socially privileged group supervisors are more likely to address diversity issues in supervision and attempt to actively facilitate supervisees’ multicultural awareness. In this stage you may also be open to exploring conceptualizations and interpretations based on cultural differences, and you may also begin self-exploration of cultural influences for the trainee. One risk in this stage is that cultural influences may be overemphasized, and you may have difficulty providing support for your supervisee in his or her own personal exploration. Supervisees at this phase may be interested in exploring multicultural issues but may also overemphasize culture at the expense and be out of balance.

So, where are you at, if you feel like you are in the exploration stage with your supervisee? If you are exploring cultural differences with your supervisee, to facilitate the supervisee’s multicultural awareness, in an effort to avoid minimizing are you overemphasizing cultural differences? Does your overemphasizing cultural differences create difficulty in providing support for your supervisee?

#4 Integration Stage - Challenging your Biases
The final stage of cultural competence development is integration.
When interacting with different groups, supervisors possess an understanding of the supervisee’s group as well as multicultural integrity, awareness, and proficiency.
In addition, they recognize and can accurately empathize with oppression when it occurs.
They may advocate against oppression and willingly use their privilege to promote equality.
The supervisor also is adept at facilitating multicultural development in their supervisees and may reach out to other socially oppressed group supervisors for mentoring.
Supervisees in this stage are often able to conceptualize their clients in a complex fashion that integrates the client’s multiple identities.
Most importantly, supervisees are able to challenge their own biases, explore how such biases affect their work with clients, and differentiate between their own personal issues and client-based concerns.

I have just listed six key points in the Integration Stage. Especially if you are supervising a culturally different supervisee, take a few minutes to re-read each point from the perspective of the supervisor-supervisee relationship. The more time you put into this course, the more you will get out of it.

Supervisor’s Cultural Self-Awareness

Supervisor Responsibilities
I have found, like you, that it is important for the supervisor to encourage discussion with their supervisee regarding diversity issues and multiculturalism in supervision. These discussions are important in the beginning of supervision to avoid misunderstandings and assumptions that may undermine the supervision process. Do you agree?

Failure to incorporate multicultural topics may contribute to a supervisee’s frustration and, ultimately, resistance in supervision. When a supervisor examines his or her own insight, attitudes, perceptions, and feelings, the supervisor will be able to better assist the supervisee as he or she engages in a similar process. What insights, attitudes, perceptions, and/or feelings do you have that you could use to help a supervisee with multicultural topics?

Please take one minute, meaning 60 full seconds, to think about each of the following questions. FOr most effective results and efficient use of your time, type your thoughts into a word document or, "old school" write them on a tablet.
1. What would you say are some insights that you have regarding cross cultural issues between your supervisee and a client he or she may be treating? ...and between yourself and your supervisee?
2. What attitudes come to mind regarding cultural issues that may affect your communication with your supervisee and/or clients they are treating?
3. To examine what multicultural perceptions that you have, break your cultural perceptions down into an examination of what you see, hear, or become aware of through your senses.
a. Here is food for thought. What do you see in your supervisee or a client that is of a different or even perhaps the same ethnicity as yourself? Just to make sure we are on the same page, ethnicity refers to the country of origin. Culture refers to the practices, beliefs, values, and norms that have been learned and shared. These cultural characteristics, as you are aware, affect thinking, decision-making, and actions within a particular ethnic group. Be honest. Visually, is there something about the appearance of your supervisee or a client they may be treating that causes you to form a prejudgment?
b. Regarding hearing, how does your supervisee or a client they are treating speak? Do you have any prejudgments about that?
c. Regarding other sensory awarenesses, like body awareness to tightness of breath, hand gestures, etc, could these be an unconscious signal to you of prejudging based on a cultural difference?

Tape Recording Sessions
To increase your supervisee’s sensory self-awareness, do you have your supervisee tape record his or her sessions with you? I suggest the supervisee review these tapes prior to each session. In this day and age of limited time, I find an easy way to "create time" is to play these tapes in the car.

Integration of Multicultural Influences in Supervision
When integrating diversity issues into supervision, it is, of course, goal for the supervisor is the development of culturally competent supervisees. This may seem like an obvious goal; but, the question is, how do you, as a supervisor, achieve this goal? As mentioned in the previous paragraphs regarding Supervisor Responsibilities, it is necessary for the supervisor to start with himself or herself. However, considering that cultural competency is an ongoing process, your role as a supervisor becomes to model the steps for your supervisee toward increasing his or her level of multicultural competence.

Question: How have you acted as a model for your supervisee? In your next session, how do you plan to act as a model for your supervisee?

Four Steps to Multicultural Competence
Have you found, like I, that to becoming multiculturally competent can take place in four layers or steps. See what you think about the four steps that I propose.

The four steps are,
(1) become aware of one’s own cultural background;
(2) be aware of and understand cultural biases that may interfere in therapy;
(3) learn about the history and culture of diverse groups; and,
(4) develop new skills.
Think of your supervisee who is learning about multicultural competence. Which of these four steps would be helpful for your supervisee in sessions with culturally diverse clients?

What are the Four Stages of Cultural Competence Development?
To select and enter your answer go to Test.

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