Providing Cultural Competency Training in a Psychology Training - PowerPoint PPT Presentation

Providing Cultural Competency Training in a Psychology Training Program: A Paradigm Shift Orlando S ánchez, PhD Ren S tinson, PhD Thad S trom, PhD, ABPP Minneapolis VA Health Care S ystem

Acknowledgments u Wayne S iegel, PhD, ABPP u Workgroup members u J. Irene Harris, PhD u Rebecca S tinson, PhD u Kelly Moore, PhD u Julia Perry, PhD u S hani Ofrat, PhD u Kelly Moore, PhD u Bill Robiner, PhD, ABPP

Obj ectives This workshop is designed to help you: u Explain to others the multicultural sensitivity, awareness, and knowledge skills-based philosophy that has been adopted at the Minneapolis VA Psychology Training Program. u Describe at least one challenge faced and one strategy used to create a new diversity program philosophy for a psychology training program. u Design at least one multicultural skills-based diversity training activity to implement into your own training programs. u Describe to others the preliminary outcome data gathered from Minneapolis VA trainees in the Diversity S eminar.

Accreditation Context u For internship and residency, a program must demonstrate adherence to the S tandards of Accreditation (S oAs) related to individual and cultural diversity, which can be broadly thought to fall within the following areas: u Program Climate u Recruitment and Retention of Diverse S taff and Trainees u Attainment of Profession-wide competencies pertaining to Individual Culture and Diversity u Educational Activities that Promote the acquisition of profession-wide competencies

Relevant Background u Historically, this has been a value of the program. Prior efforts to meet S oAs have lead to: u S ervice line and facility diversity committees u On average 6-8 diversity related didactics yearly u Full day diversity seminar with other local accredited programs u Efforts to infuse diversity discussions within all didactics and within the supervision context

Challenges to this Approach u Less than positive feedback from trainees u Not skills focused u For some, approach is redundant to prior content learning u Focus on cultural group presentations feels ‘ siloed’ and doesn’ t generalize u S taff hesitations to “ say the wrong thing” often lead to little to no discussions

S teps Toward a New Approach u Discussions with other Training Directors and local diversity experts u Goals: u Move beyond knowledge-based approach to diversity training, and focus on skill acquisition and enhancement u Foster discussions within supervision contexts u Continue demonstrated value toward diversity and adherence to S oAs

S KILL-BAS ED MODEL Cult ural Knowledge Cultural Cult ural Cult ural Competency S ensit ivit y Awareness

S KILL-BAS ED MODEL  Cultural Awareness : change in attitude; reflects openness and flexibility – Connerley & Pedersen, 2005; Quappe & Cant at ore, 2005; Pope & Reynolds, 1997  Cultural Sensitivity (cultural humility): recognize differences and similarities without making value j udgments – Connerley & Pedersen, 2005; Lindsey, Robins, & Terrell, 2003; Pope & Reynolds, 1997 Participatory Third S ynergistic S tage Parochial S tage Ethnocentric S tage Culture S tage “ There are benefit s t o my way “ My way is t he only “ I know t heir way, but “ Our way” and ot her ways” way” mine is bet t er” No Awareness but -Hold -S ee weaknesses in our ability awareness No S ensitivity culture/ diversity in to provide services to diverse high esteem patients -Actively seek self- -Acceptance and respect examination -Explore (e.g., cultural -Actively advocate remedies) cultural sensitivity -Expansion of knowledge -Dynamic

SKILL-BASED MODEL  Cultural Awareness : change in attitude; reflects openness and flexibility – Connerley & Pedersen, 2005; Quappe & Cant atore, 2005, Pope & Reynolds, 1997  S upervision (ADDRES S ING Model)  Reflection exercises  Cultural immersion  Cultural Sensitivity (cultural humility): recognize differences and similarities without making value j udgments – Connerley & Pedersen, 2005; Lindsey, Robins, & Terrell, 2003; Pope & Reynolds, 1997  The skill of effective cross-cultural communication  The skill of effectively generating a cultural formulation  Cultural Knowledge : cultural characteristics, history, values, belief systems – Connerley & Pedersen, 2005; Lindsey, Robins, & Terrell, 2003; Pope & Reynolds, 1997  ht t p:/ / www.cult urecareconnect ion.org/ navigating/ mncountyprofiles.ht ml  Consult at ion  From t he pat ient  Theoret ical and empirical knowledge-base (Accult uration Theory & Ident it y Theory)

S yllabus

S yllabus Part 2

Attractive. Fresh minty breath. Neutral. Non-distracting smells. Nothing too strong. I don’t want them thinking Recently showered. CK One. about my breath (good or bad) while I’m talking with them. No perfumes since some clients may be sensitive to those things. Loud. Center of the party. Assertive Depends on the situation. More compassionate tone with clients. A bit more tone. Easy going. I laugh a lot and assertive tone in consultation with clients. Generally, I’m less loud than I am in loud. my personal life. Talk less listen more at work. I like hugs and hugging. High fives I was taught not to touch clients – boundary crossing. Though in some hospital are great! I don’t really do kisses on settings I have seen providers touch patients during therapy (e.g., bedside in a the cheek much – they make me medical unit). Personally, I don’t mind hugging clients, but because of how I was uncomfortable. taught I don’t do it. I have to give this one more thought. I like dressing stylish and comfortable. I feel much more pressure in professional settings to adhere to specific clothing and Usually Nike sport pants, white sneakers, grooming norms, which seem to be set by the dominant culture, and have more hoodie, and a flat-brim baseball cap. Some distinction between genders. I look more traditionally female at work – make-up, call it “urban” style and it helps me women’s dress pants and blouse. This isn’t how I would dress personally, but I feel identify with my cultural group. I don’t like I need to adhere to set norms. I want to feel authentic at work and I think I will wear much make-up. I don’t care much do my job better as a psychologist if colleagues and clients notice that I am about my hair. I don’t care much about comfortable in my own clothes (make-up, hair, shoes, etc.). what gender people perceive me in my personal life. I actually prefer that my I can’t hide my race (multi-racial), but I actually think it is less apparent at work appearance is more gender neutral. I also since I adhere to dominant culture norms for dress, hair, make-up – which have tattoos and like showing them off if I accentuate the white parts of my identity. can – gotta let them breathe!

• Where did you ideas and preferences for what are “appropriate” smells, sounds, touch, and sight in personal and professional life come from? • After completing this activity, what areas of stimulus value would you change (or experiment with changing) for your professional role? • Are there areas that you could change, but are not willing to change? Why? How will this impact your professional identity? • Are there areas that you cannot change? How does this impact your professional identity? • What impact does your stimulus value have on your relationships with patients? • What impact does it have on your relationship with colleagues?

Acculturation Case Example Practice Y ou have a 90-minut e ment al healt h int ake scheduled for next week. Per t he limit ed informat ion in t he chart you learn t hat t he pat ient ident ifies as a 28-year- old, Hispanic, Cat holic, t ransgender man. The vet eran st art ed using V A services t wo mont hs ago, and t here is only one visit document ed; from t he emergency depart ment . The ED not e st at es t hat t he vet eran’s first language is S panish, t hough it is not ed t hat t he pat ient is proficient in English. The vet eran present ed t o t he ED for a “ flare-up” of a chronic back pain problem and also not ed t rouble wit h memory at work. The ED doct or document ed t hat t he vet eran appeared anxious in t heir encount er. ED doct or suggest ed t hat vet eran would benefit from ment al healt h services, t hus t he referral t o your clinic for int ake. u CULTURAL PROFILE. Look up a cultural profile (or profiles) for this patient. What sections of the cultural profile seem most useful to you for this intake? Why? u http:/ / www.culturecareconnection.org/ navigating/ mncountyprofiles.html u Look at the list of Culturally Relevant Intake questions. List five questions you may not typically ask for an intake, but believe would be helpful to understand the role of acculturation in this case. Explain why each of your five questions may help you with this task. (e.g., Do you have a preferred gender pronoun? What t hings do you do t o maint ain connect ion wit h your family’s cult ure? What is your experience wit h ment al healt h care? ) u Before meeting the patient, who would you choose to consult with about this case? List five questions you would have prepared for this consultation meeting we a colleague. u Any other considerations or approaches?