Multidimensional Cultural Competence Providing Too
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ASSOCIATE EDITORS
David L. Blustein, Boston College
Linda Forrest, Michigan State University
S. Alvin Leung, The Chinese University of Hong Kong
FORUM CO-EDITORS
Legacies and Traditions International Forum Around the Winter Roundtable
Nadya A. Fouad Frederick Leong Robert T. Carter
University of Wisconsin–Milwaukee The Ohio State University Columbia University
Nancy Downing Hansen Joseph G. Ponterotto
The Fielding Institute Fordham University
EDITORIAL ASSISTANT
Yu-Wei Wang, University of Missouri–Columbia
STUDENT ASSISTANTS
Meghan Davidson, Mathew P. Martens, Lisa Spanierman
University of Missouri–Columbia
EDITORIAL BOARD
José M. Abreu (2003) Mary Ann Hoffman (2001) Patricia McCarthy (2001)
University of Southern California University of Maryland University of Minnesota
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The Pennsylvania State University Boston College University of Utah
Y. Barry Chung (2002) Elizabeth A. Kincade (2001) Helen A. Neville (2001)
Georgia State University Indiana University of University of Missouri–Columbia
Madonna G. Constantine (2001) Pennsylvania Walker S. Carlos Poston, II (2001)
Teachers College, Kwong-Liem Karl Kwan (2002) University of Missouri–Kansas
Columbia University Purdue University City and the Mid-America Heart
Kathleen Davis (2002) Douglas H. Lamb (2001) Institute, St. Luke’s Hospital
University of Tennessee Illinois State University Loreto R. Prieto (2003)
Changming Duan (2002) Lisa Larson (2002) University of Akron
University of Missouri–Kansas City Iowa State University Kenneth G. Rice (2003)
Ann R. Fischer (2002) Madeleine Leveille (2002) Michigan State University
University of Akron Independent Practice Lawrence J. Schneider (2001)
James P. Guinee (2001) Owen Richard Lightsey, Jr. (2002) University of North Texas
University of Central Arkansas University of Memphis Roger L. Worthington (2003)
University of Missouri–Columbia
Division 17 Officers
For Sage Publications: Mark Gage, Rebecca Lucca, Corina Villeda, Angela Arnold, and Jennifer Trone
The Counseling
Volume 29, Number 6
Psychologist November 2001
I would like to highlight several points that Sue makes with which I concur
that are essential to developing cultural competence. It is imperative that
society, the profession of psychology as reflected in its professional associa-
tions, and educational institutions within which programs are housed support
and value cultural competence training. It is also essential for psychologists
and counselors as well as faculty members to personally understand the role
of culture in their personal development, training, and professional behavior.
Lastly, to build effective counseling relationships and to develop one’s racial
identity center on self-knowledge and motivation.
One important aspect of Sue’s model is his assertion that counselors and
psychologists learn about the cultures of racial/ethnic groups. I would like to
highlight the fact that knowledge of self would facilitate this, and I believe it
is essential for learning about others. Torres-Guzman and Carter (2000) put it
this way:
The goals of cultural education are not solely to create tolerance of diversity but
to change existing structures that perpetuate intolerance, oppression, and ineq-
uity. . . . The broader message is that our society needs to change drastically, but
that the paths toward those changes are multiple and must be undertaken in a
concerted, interactive way. By looking at self, one sees the other. We should
each take on the task of understanding self. But we come to see self through the
eyes of others, thus we must implicate ourselves in the development of the
other if we ourselves wish to develop. This is a call to all [irrespective of one’s
race or culture]. (p. 952)
tice but do not teach trainees that humans develop within a cultural context.
Even in programs in which such courses do exist, the course composes a
small fraction of the curriculum. Carter (1998) maintained, for instance, that
a 2-year master’s degree training program might require 60 credits or about
20 courses. At the doctoral level, it would be as many as 90 credits or some 30
courses. Of these, there may be 1 or 2 courses that have an explicit cultural
focus. It may also be the case that such courses are cognitive in content and
focus. Even when more cultural courses are offered, the traditional “Euro-
centric perspective” is still present in other courses.
The continued lack of application and commitment to cultural compe-
tence in our profession and training programs weakens our effectiveness as
helping professionals. The return to the past with an emphasis on integrative
self-exploration and development in which cognitive, affective, and behav-
ioral learning and skill development occur in our training of practicing pro-
fessionals and trainees could move us to value cultural competence.
It is not possible for training to matter unless our institutions and profes-
sion move from rhetoric to reality in their adoption of cultural competence as
an emerging and powerful force in psychology and education that enriches
our knowledge and ability to serve all people. As has been true of other move-
ments in psychology, there is resistance and doubt. My hope is that future
psychologists and counselors will look back to this time and note how the
reluctance to broaden our perspective on human development was a tempo-
rary phase in the field’s evolution.
REFERENCES
Carter, R. T. (1998). The influence of race and racial identity in psychotherapy: Toward a
racially inclusive model. New York: John Wiley.
Carter, R. T. (Ed.). (2000). Addressing cultural issues in organizations: Beyond the corporate
context. Thousand Oaks, CA: Sage.
Ridley, C. R., Mendoza, D. W., Kanitz, B. E., Angermeier, L., & Zenk, R. (1994). Cultural sensi-
tivity in cultural counseling: A perceptual schema model. Journal of Counseling Psychol-
ogy, 41, 125-136.
Sue, D. W. (2001). Multidimensional facets of cultural competence. The Counseling Psycholo-
gist, 29(6), 790-821.
Torres-Guzman, M., & Carter, R. T. (2000). Looking at self as the critical element for change in
cultural education: Pushing the seams of theory, research and practice. Part II. Teachers Col-
lege Record—Special Theme Issue Cultural Education, 102(4), 949-952.
· MAJOR CONTRIBUTION
Multidimensional Facets
of Cultural Competence
Derald Wing Sue
Teachers College, Columbia University
Calls for incorporating cultural competence in psychology have been hindered for a
number of reasons: belief in the universality of psychological laws and theories, the
invisibility of monocultural policies and practices, differences over defining cultural
competence, and the lack of a conceptual framework for organizing its multifaceted
dimensions. A proposed multidimensional model of cultural competence (MDCC) incor-
porates three primary dimensions: (a) racial and culture-specific attributes of compe-
tence, (b) components of cultural competence, and (c) foci of cultural competence. Based
on a 3 (Awareness, Knowledge, and Skills) ´ 4 (Individual, Professional, Organizational,
and Societal) ´ 5 (African American, Asian American, Latino/Hispanic American,
Native American, and European American) factorial combination, the MDCC allows for
the systematic identification of cultural competence in a number of different areas. Its
uses in education and training, practice, and research are discussed.
Calls for cultural competence in psychology are not new and have been
voiced by many psychologists and groups for more than two and half decades
(American Psychological Association, 1993; Arredondo et al., 1996; Coun-
cil of National Psychological Associations for the Advancement of Ethnic
Minorities, 2000; Cross, Bazron, Dennis, & Isaacs, 1989; Dulles Conference
Task Force, 1978; C. Hall, 1997; Korman, 1974; Marsella, 1998; President’s
Commission on Mental Health, 1978; Ridley, Mendoza, Kanitz, Angermeier, &
Zenk, 1994; D. W. Sue, Arredondo, & McDavis, 1992; D. W. Sue, Bingham,
Porche-Burke, & Vasquez, 1999; D. W. Sue et al., 1982; D. W. Sue, Carter,
et al., 1998). Yet, demands for integrating multicultural perspectives into the
profession have often resulted in resistance for several reasons: belief in the
universality of psychological laws and theories (Miller, 1999; D. W. Sue,
Carter, et al., 1998) and the invisibility of monoculturalism (D. W. Sue & Sue,
1999). Increasingly, however, psychologists are recognizing that psychologi-
cal concepts and theories are developed from a predominantly Euro-American
context and may be limited in application to the emerging racial and cultural
diversity in the United States (Kim & Berry, 1993; Marsella, 1998). Some
THE
Sue / COUNSELING
MULTIDIMENSIONAL
PSYCHOLOGIST
CULTURAL
/ November
COMPETENCE
2001
This article is based on a keynote address given at Teachers College, Columbia University
Roundtable, February 25, 2000. Correspondence concerning this article should be addressed to
Derald Wing Sue, Teachers College, Columbia University, 525 West 120th Street, New York,
NY 10027; e-mail: dwingsue@aol.com.
THE COUNSELING PSYCHOLOGIST, Vol. 29 No. 6, November 2001 790-821
© 2001 by the Division of Counseling Psychology.
790
Sue / MULTIDIMENSIONAL CULTURAL COMPETENCE 791
es
ut
ib
1 A ttr EUROPEAN AMERICAN
c ce
s ion cifi ten
en p e e NATIVE AMERICAN
m -S mp
Di ure Co
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C ul ura LATINO AMERICAN
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AFRICAN AMERICAN
SOCIETAL OF ATTITUDE/
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Dimension 3
ORGANIZATIONAL
PROFESSIONAL
INDIVIDUAL
Dimension 2
Components Of Cultural Competence
tural dimensions of human identity but notes the greater discomfort that
many psychologists experience in dealing with issues of race rather than
other sociodemographic differences (Carter, 1995). As a result, race becomes
less salient and allows us to avoid addressing problems of racial prejudice,
racial discrimination, and systemic racial oppression. This concern appears
to have great legitimacy. I have noted, for example, that when issues of race
are discussed in the classroom, a mental health agency, or some other public
forum, it is not uncommon for participants to refocus the dialogue on differ-
ences related to gender, socioeconomic status, or religious orientation. On
the other hand, many groups often rightly feel excluded from the multicul-
tural debate and find themselves in opposition to one another. Thus, enhanc-
ing multicultural understanding and sensitivity means balancing our under-
standing of the sociopolitical forces that dilute the importance of race and our
need to acknowledge the existence of other group identities related to culture,
ethnicity, social class, gender, and sexual orientation (D. W. Sue et al., 1999).
I have found the following tripartite framework useful in exploring and
understanding the formation of personal identity (see Figure 2).
The three concentric circles illustrated in Figure 2 denote universal,
group, and individual levels of personal identity. The universal level is best
Sue / MULTIDIMENSIONAL CULTURAL COMPETENCE 793
Universal Level:
Homo Sapiens
Co
m
m
o
Group Level:
n
s
lif e
Similarities and
ol
mb
ex
Differences
sy
pe
Gender Race
se
rie n
to u
ces
ty
Socioeconomic Sexual
Abili
Individual orientation
status
Level:
Uniqueness
Age • Genetic endowment Marital
• Nonshared status
experiences
Geographic Religious
t ie s
location preference
i la r i
im
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ica
Ethnicity Culture
ys
Se
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a
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ar Disability a
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B io
tion, are more fluid and changeable. Although culture and ethnicity are fairly
stable, some argue that they can also be fluid. Likewise, debate and contro-
versy surround the discussion about whether sexual orientation is fixed or
nonfixed. Despite their characterization, membership in these groups may
result in shared experiences and characteristics. They may serve as powerful
reference groups in the formation of worldviews. Figure 2 reveals that people
may belong to more than one cultural group (i.e., race, gender, and disabil-
ity), some group identities may be more salient than others (race over reli-
gious orientation), and the salience of cultural group identity may shift from
one to the other depending on the situation (disability among able bodied, but
sexual orientation among the disabled).
The individual level of identity is best summed up in the following state-
ment: “All individuals are, in some respects, like no other individuals.” Our
unique genetic endowment guarantees that no two individuals are identical.
Even identical twins, who theoretically share the same gene pool and are
raised in the same family, are exposed to not only shared but also many
nonshared experiences. Different experiences in school and with peers and
qualitative differences in how parents treat them will contribute to individual
uniqueness. Research indicates that psychological characteristics and behav-
ior are more affected by experiences specific to a child than by shared experi-
ences (Plomin, 1989; Rutter, 1991).
A holistic approach to understanding personal identity demands that we
recognize all three levels: individual (uniqueness—like no others), group
(shared cultural values and beliefs with reference groups), and universal
(common features of being human). Confusions occur in research and prac-
tice when social scientists fail to clarify or acknowledge the existence of
these multiple levels of personal identity. For example, psychological expla-
nations that acknowledge the importance of group influences such as gender,
race, culture, sexual orientation, socioeconomic class, and religious orienta-
tion lead to more accurate understanding of human psychology. Failure to do
so may skew research findings and lead to biased conclusions about human
behavior that are culture bound, class bound, and gender bound. Although the
concentric circles in Figure 2 might unintentionally suggest a clear boundary,
each level of identity must be viewed as permeable and ever changing in
salience. Likewise, even within a level of identity, multiple forces may be
operative. As mentioned earlier, the group level of identity reveals many ref-
erence groups, both fixed and nonfixed, that might affect our lives. Being an
elderly, gay, Latino male, for example, presents four potential reference groups
operating on the person. The complexity of human psychology is clear in this
diagram.
Unfortunately, psychology and specifically mental health professionals
have generally focused on the individual and universal levels of identity
Sue / MULTIDIMENSIONAL CULTURAL COMPETENCE 795
while placing less importance on the group level. There appears to be several
reasons for this orientation. First, our society arose from the concept of rug-
ged individualism, and we have traditionally valued autonomy, indepen-
dence, and uniqueness. In our culture, there is an assumption that individuals
are the basic building blocks of our society. Sayings such as “be your own
person,” “stand on your own two feet,” and “don’t depend on others but your-
self” reflect this value. Not only do psychology and education represent the
carriers of this value, but also the study of individual differences is most
exemplified in the individual intelligence-testing movement that pays hom-
age to individual uniqueness (Samuda, 1998). Second, the universal level is
consistent with the tradition and history of psychology where it has histori-
cally sought universal facts, principles, and laws in explaining human behav-
ior. Although an important quest, the nature of scientific inquiry has often
meant studying phenomena independently of the context in which human
behavior originates. Thus, therapeutic interventions from which research
findings are derived may lack external validity (S. Sue, 1999). Third, we have
historically neglected the study of identity at the group level for sociopolitical
and normative reasons. Issues of race, gender, sexual orientation, and disabil-
ity seem to touch “hot buttons” in all of us because they bring to light issues of
oppression and the unpleasantness of personal biases (Carter, 1995; Helms &
Richardson, 1997; D. W. Sue, Carter, et al., 1998). In addition, racial/ethnic
differences have frequently been interpreted from a deficit perspective and
have been equated with being abnormal or pathological (Guthrie, 1997; Lee,
1993; White & Parham, 1990). Yet, a discipline that hopes to understand the
human condition cannot neglect any level of our identity. Because group
identities such as race and ethnicity have historically occupied a tangential
role in psychology, the focus of my model on cultural competence operates
from a group perspective that is race based (Carter, 1995).
Accepting the premise that race, ethnicity, and culture are powerful vari-
ables in influencing how people think, make decisions, behave, and define
events, it is not far-fetched to conclude that such forces may also affect how
different groups define a “helping relationship” (Dumas et al., 1999; Fraga,
Atkinson, & Wampold, 2000; D. W. Sue & Sue, 1999). Multicultural psy-
chologists have noted, for example, that theories of counseling and psycho-
therapy represent different worldviews, each with its own values, biases, and
assumptions about human behavior (Ivey, Ivey, & Simek-Morgan, l997; Katz,
l985; D. W. Sue & Sue, l999). Given the fact that schools of counseling and
psychotherapy arise from Western-European contexts, the worldview they
espouse as reality may not be that shared by racial/ethnic minority groups in
the United States nor by those who reside in different countries (Parham,
White, & Ajamu, 1999). Each cultural/racial group may have its own differ-
ent interpretation of reality and offer a different perspective on the nature of
796 THE COUNSELING PSYCHOLOGIST / November 2001
teristic among many Latino groups (Comas-Diaz, 1990); and, among many
African Americans, multiple-role relationships are often associated with
greater probability of seeking help from the healer (Parham et al., 1999;
White & Parham, 1990).
Thus, it is highly possible that different racial/ethnic minority groups per-
ceive the competence of the helping professional differently from main-
stream client groups. If that is the case, culturally different clients may see a
clinician who exhibits primarily therapeutic skills associated with main-
stream therapies as having lower credibility. The important question to ask is
the following: “Do different racial/ethnic minority groups define cultural
competence differently from their Euro-American counterparts?” Anecdotal
observations, clinical case studies, conceptual analytical writings, and some
empirical studies seem to suggest an affirmative response to the question
(Fraga et al., 2000; McGoldrick, Giordano, & Pearce, 1996; Nwachuku &
Ivey, 1991; D. W. Sue & Sue, 1999; Wehrly, 1995). Yet, an equally important
question is the following: “Do different racial/ethnic minority groups define
cultural competence differently from one another?” For example, do African
American clients perceive therapeutic competence in the same way as their
Native American counterparts? The answers to these questions are important
because a helping professional’s therapeutic effectiveness is strongly linked
to how clients perceive the expertise of their clinicians. Although some stud-
ies have been conducted on culture-specific methods of intervention, there is
a noticeable lack of studies aimed at the multicultural competencies identi-
fied in the D. W. Sue et al. (1992) report and those currently being proposed
along the dimensions of awareness, knowledge, and skills. Fraga et al. (2000)
used a paired-comparison method to explore ethnic group preferences for the
31 multicultural competencies identified in the D. W. Sue et al. report. They
found significant preferences for many of the competencies that differenti-
ated Asian American, European American, and Hispanic/Latino groups.
There were similarities as well, lending support for both a culture-specific
(emic) and a culture-universal (etic) perception of cultural competence. As
shown in Figure 1, research into identifying culture-specific interventions for
the various racial/ethnic minority groups is sorely needed.
1. Aware and sensitive to own heritage 1. Has knowledge of own racial/cultural heritage 1. Seeks out educational, consultative, and
and valuing/respecting differences. and how it affects perceptions. multicultural training experiences.
2. Aware of own background/experiences 2. Possesses knowledge about racial identity 2. Seeks to understand self as racial/cultural
and biases and how they influence development. being.
psychological processes. Able to acknowledge own racist attitudes, beliefs, 3. Familiarizes self with relevant research on
3. Recognizes limits of competencies and feelings. racial/ethnic groups.
and expertise. 3. Knowledgeable about own social impact and 4. Involved with minority groups outside of
4. Comfortable with differences that exist communication styles. work role: community events, celebrations,
between themselves and others. 4. Knowledgeable about groups one works or neighbors, and so forth.
5. In touch with negative emotional interacts with. 5. Able to engage in a variety of verbal/nonverbal
reactions toward racial/ethnic groups 5. Understands how race/ethnicity affects personality helping styles.
and can be nonjudgmental. formation, vocational choices, psychological 6. Can exercise institutional intervention skills
6. Aware of stereotypes and preconceived disorders, and so forth. on behalf of clients.
notions. 6. Knows about sociopolitical influences, immigration, 7. Can seek consultation with traditional healers.
7. Respects religious and/or spiritual poverty, powerlessness, and so forth. 8. Can take responsibility to provide linguistic
beliefs of others. 7. Understands culture-bound, class-bound, and competence for clients.
8. Respects indigenous helping practices linguistic features of psychological help. 9. Has expertise in cultural aspects of assessment.
and community networks. 8. Knows the effects of institutional barriers. 10. Works to eliminate bias, prejudice, and
9. Values bilingualism. 9. Knows bias of assessment. discrimination.
10. Knowledgeable about minority family structures, 11. Educates clients in the nature of one’s practice.
community, and so forth.
11. Knows how discriminatory practices operate at a
community level.
knowledge, and skills will be used. Research may ultimately identify other
factors underlying cultural competence that may alter the MDCC.
Despite the numerous definitions of cultural competence, they often do
not help us answer two important questions: Why is cultural competence
desirable? and What specific outcomes are we seeking as we advocate for its
implementation? Answering these questions requires us to deconstruct the
values and assumptions inherent in cultural competence definitions. Two
representative definitions are revealing.
1. Helms and Richardson (1997) stated that multiculturalism “should refer to the
integration of dimensions of client cultures into pertinent counseling theories,
techniques, and practices with specific intent of providing clients of all
sociodemographic and psychodemographic variations with effective mental
health services” (p. 70).
In other words, their definition implies that the goal of cultural competence in
mental health is providing relevant treatment to all populations and that this
end is desirable.
2. The Society for the Psychological Study of Ethnic Minority Issues (Divi-
sion 45) and the Division of Counseling Psychology’s (Division 17) Commit-
tee on Multicultural Competencies have identified the following attributes as
central to the definition: (a) balances the extremes of universalism (etic) and
relativism (emic) by explaining behavior as a function of those culturally
learned perspectives that are unique to a particular group and to those common-
ground universals that are shared across groups; (b) on an individual level, the
acquisition of attitudes, knowledge, and skills needed to function effectively in
a pluralistic democratic society (ability to interact, negotiate, and communi-
cate with peoples from diverse backgrounds); and (c ) on a organizational/
societal level, developing new theories, practices, policies, and organizational
structures that are more responsive to all groups (D. W. Sue, Carter, et al.,
1998).
This definition extends the focus from the person/individual level to the orga-
nizational/system level. It, too, acknowledges the desirability of cultural
competence at all levels.
Although not directly stated, both definitions (and I believe those pro-
posed by others) are truly about social justice. For many psychologists, such a
statement may appear too political and/or unrelated to mental health. After
all, shouldn’t social justice be the goal of government and a democracy?
What does social justice have to do with mental health? Isn’t the goal of the
mental health system to provide beneficial treatments to client populations
Sue / MULTIDIMENSIONAL CULTURAL COMPETENCE 801
anced picture of any group requires that they spend time with healthy and
strong people of that culture. Third, they must supplement their factual
understanding with the experiential reality of the groups they hope to under-
stand. Finally, their lives must become a “have to” in being constantly vigi-
lant to manifestations of bias in both themselves and in people around them
(D. W. Sue, 1999). Although attending workshops and receiving continuing
education on multiculturalism are helpful, people must take responsibility to
initiate personal growth experiences in the real world. Thus, education and
training programs must somehow build learning experiences for trainees that
require personal growth through lived reality and experience (D. W. Sue et al.,
1999).
possess conscious and unconscious feelings of superiority and that their way
of doing things is the “best way.” Second, there is a belief in the inferiority of
all other groups’ cultural heritage, which extends to their customs, values,
traditions, and languages. Other societies or groups may be perceived as “less
developed,” “uncivilized,” “primitive,” or even “pathological.” The lifestyle
or ways of doing things by the group are considered inferior. Third, the domi-
nant group possesses the power to impose its standards and beliefs on the less
powerful group. This component of ethnocentric monoculturalism is very
important. All groups are to some extent ethnocentric; that is, they feel posi-
tively about their cultural heritage and way of life. Yet, if they do not possess
the power to impose their values on others, they hypothetically cannot
oppress. It is power or the unequal status relationship among groups that
defines ethnocentric monoculturalism (Jones, 1997). Fourth, the ethno-
centric values and beliefs are manifested in the programs, policies, practices,
structures, and institutions of the society. For example, chain-of-command
systems, training and educational systems, communication systems, man-
agement systems, and performance appraisal systems often dictate and con-
trol our lives. They attain “untouchable” and “godfather-like” status in an
organization. Because most systems are monocultural in nature and demand
compliance, racial/ethnic minorities and women may be oppressed. Fifth,
because people are all products of cultural conditioning, their values and
beliefs (worldview) represent an “invisible veil” that operates outside the
level of conscious awareness. As a result, people assume universality; every-
one, regardless of race, culture, ethnicity, or gender, shares the nature of real-
ity and truth. This assumption is erroneous but seldom questioned because it
is firmly ingrained in our worldview.
society are less visible but structured in such a manner as to uphold the cul-
tural heritage of one group over another (Ridley, 1995; D. W. Sue, Ivey, &
Pedersen, 1996; Wehrly, 1995). As a result, U.S. society has been severely
criticized as being ethnocentric, monocultural, and inherently biased against
racial/ethnic minorities, women, gays/lesbians, and other culturally different
groups (Carter, l995; Laird & Green, l996; Ridley, l995; D. W. Sue et al., l992).
Rather than educate or enlighten, rather than increase freedom and goodwill,
and rather than allow equal access and opportunity, the racial legacies of the
past and current societal practices continue to restrict, stereotype, oppress,
and damage the culturally different in our society.
3. A biased historical legacy. In his book Even the Rat Was White, Robert
Guthrie (1997) revealed the extreme bias of psychology and how the history
as told from the Euro-American perspective was and continues to be an
incomplete and inaccurate one. The title of his book strikes such a responsive
chord among persons of color because it asks a profound question: “Who
owns history?” The answer to this question in our society is clear. When the
contributions of various racial/ethnic groups are neglected and/or distorted in
social studies and history textbooks, when the contributions of one group are
glorified over another, and when children are socialized and educated to
accept and believe in the historical legacy of the dominant society, then we set
up conditions that contribute to ethnocentric monoculturalism and impose a
reality among the populace with major implications (Banks & Banks, 1995;
D. W. Sue & Sue, 1999).
Because of the invisibility of ethnocentric monoculturalism and how it
defines our reality, society is often unable to address or ameliorate basic
social problems. The perception that affirmative action programs are inher-
ently unfair by giving the advantage to minorities is based on the belief that
we have a level playing field for everyone and such programs “unfairly dis-
criminate against White Americans” (APA, 1997). Belief that we reside in a
democratic society means assumptions of a meritocracy in which achieve-
ment is based on individual effort alone.
The civil rights movement of the 1950s and 1960s resulted in a range of
policies and practices known as affirmative action that acknowledged the
reality that whole groups of individuals have been denied an equal opportu-
nity to pursue the meritocratic ideal. The goals of affirmative action are
(a) compensating for past injustices, (b) correcting present inequities, (c) pro-
moting multicultural competence, and (d) enhancing the presence of role
models (APA, 1999). Yet, if people’s reality leads them to conclude that past
injustices are adequately compensated, that they should not be “punished for
the sins of the past,” that present inequities are greatly exaggerated, that
Sue / MULTIDIMENSIONAL CULTURAL COMPETENCE 811
As indicated in Figure 1, each cell on the MDCC model targets the com-
ponents of cultural competence (awareness, knowledge, and skills), the foci
of analysis (individual, professional, organizational, or societal), and racial/
cultural group attributes (African American, Asian American, Latino/
Hispanic American, Native American, and European American). Several
examples illustrate how the MDCC model may help direct our attention to
specific areas for practice, education and training, and research.
812 THE COUNSELING PSYCHOLOGIST / November 2001
At the clinical level, it has been found that many racial/ethnic minorities
may underutilize traditional mental health facilities and often prematurely
terminate sessions when compared to their Euro-American counterparts
(Atkinson et al., 1998; Barney, 1994; Leong, Wagner, & Tata, 1995; Neigh-
bors, Caldwell, Thompson, & Jackson, 1994). Given the conclusion that all
groups may have similar rates of mental disorders and that racial minorities
may actually be under greater psychological stress than their White counter-
parts, these findings are puzzling and disturbing (Atkinson et al., 1998). The
reason for the disparity was originally conceptualized as residing either in the
culturally different client (incompatible value system) or in the traditionally
trained therapist who lacked appropriate cultural knowledge to be effective
(D. W. Sue & Sue, 1999). Research and training focused on the individual
level (see Figure 1, Dimension 3) where acquisition of knowledge by coun-
selors and therapists was seen as the key solution. The other two cultural
competency components of self-awareness and skills were given less empha-
sis because of several assumptions. It was often assumed that the process of
counseling was value neutral and that mental health practitioners were free of
biases when working with clients. In addition, it was believed that interven-
tion strategies had universal applications and could easily be adapted to fit the
needs of minority clients. Cultural competence, therefore, meant focusing on
the knowledge component of Dimension 2, at the individual foci of Dimen-
sion 3, and on the four major racial groups in Dimension 1. Thus, a large body
of knowledge began to accumulate on African Americans, Asian Americans,
Latino/Hispanic Americans, and Native Americans that became a part of
education and training programs. In my experience, many in-service and
graduate programs in the helping professions continue to conceptualize cul-
tural competence in this very narrow manner: acquiring racial/cultural infor-
mation. Although cultural knowledge may be a necessary condition to
becoming culturally competent, it is not a sufficient one.
Using the MDCC as a conceptual blueprint, however, allows us to view
the issue of underutilization from a broader perspective and enables us to sug-
gest multiple solutions. First, Dimension 3 forces us to expand our foci from
the individual perspective to those at the professional, organizational, and
societal levels. Second, Dimension 2 indicates that the components of cul-
tural competence are more than just cognitive knowledge but entail an aware-
ness of one’s own attitudes/beliefs related to race and differences as well as
culturally appropriate helping skills. Thus, the MDCC suggests several fac-
tors that account for the disparity in racial/ethnic minority group underutili-
zation of mental health services: (a) individual level—unintentional personal
Sue / MULTIDIMENSIONAL CULTURAL COMPETENCE 813
minority employees and believed that leadership training was the key to the
problem. They also entertained the possibility that White supervisors and
managers needed training in becoming more knowledgeable and sensitive to
the needs of the Asian American workforce.
Using the MDCC template to view the situation, it becomes clear that
one of the goals derived from Dimension 1 must be a consideration of racial/
culture–specific differences among the Asian American and Euro-American
workers in the workforce. For example, research reveals major differences
exist in communication styles between the two groups (D. W. Sue, 1991).
Traditional Asian Americans value subtlety and indirectness in approaching
problems, heavier reliance on contextual and nonverbal communications,
and restraint of strong feelings. These are in marked contrast to U.S. cultural
values of assertiveness; task orientation; directness; and being verbal, articu-
late, and forceful—qualities often associated with signs of leadership.
Beliefs that Asians do not make effective leaders or managers fail to recog-
nize that Asian countries define good leaders as people who work behind the
scenes, motivating the team, building consensus, and inducing cooperative
teamwork.
An organizational psychologist might approach the task by asking, “What
information about Asian Americans needs to be imparted to supervisors/
managers for them to move toward cultural competence at the personal
level?” Conversely, “What information about Euro-American leadership cri-
teria must be imparted to Asian American employees for them to move
toward cultural competence as well?” If our purpose in the world of work, for
example, is to facilitate the acquisition of cultural knowledge for White and
Asian American employees and upper management, then the type of strategic
intervention seems to be suggested by the model. The MDCC, however,
would not allow us to stop there. For example, it would expand our analysis to
two other components of cultural competence as areas of training as well: (a)
self-awareness of potential biases, prejudices, and stereotypes and (b) acqui-
sition of multicultural skills (communication or management styles).
More important, if Dimension 3 is used, it forces us to view the situation
on a larger organizational level. Is it possible that the company possesses a
monocultural orientation that creates systemic barriers to workers of color?
This question is important in light of our earlier assertion that cultural compe-
tence is often thwarted by monocultural rules, regulations, policies, prac-
tices, and structures that are unintentionally biased. In this case, the consul-
tant needs to seriously consider whether formal institutional policies and
practices may maintain an exclusion of minorities, create culture conflicts for
minority employees, lead to alienation, and result in retention and promotion
problems. In addition to other factors, my assessment revealed that the com-
pany’s performance appraisal system unfairly discriminated against Asian
Sue / MULTIDIMENSIONAL CULTURAL COMPETENCE 815
American employees. The criteria used by the company (seen in their job
description for upper management) strongly emphasized leadership qualities
as “assertive,” “visible,” “take charge,” “independent,” and “forceful.” Such
descriptors, as suggested earlier, are often culture bound. Many Asian
groups, for example, define leadership as the person who works effectively
behind the scenes by building group consensus and cooperation. Effective-
ness is measured by a team’s productivity, whereas Euro-American standards
often separate individual effort from group outcome. Although many organi-
zations may believe that their criteria are fair because they apply to everyone,
they fail to realize how certain policies and practices discriminate against cul-
turally different employees or groups in hiring, retention, and promotion
(organizational level). Thus, culturally competent knowledge would need to
be imparted to decision makers about Asian American values and behaviors
(individual level) and how institutional policies and programs may be cultur-
ally biased (organizational level). The solution may necessitate a change in
the performance appraisal system of the organization that represents inter-
vention at a systemic level.
The usefulness of the MDCC lies in its ability to raise similar questions
and issues concerning African American, Latino/Hispanic American, and
Native American employees on all three dimensions. Although many simi-
larities exist, factors unique to these racial/ethnic groups might also be
revealed (Dimension 1). The underrepresentation of African Americans in
upper management might be more a function of lack of mentoring programs
in a company (Dimension 3), whereas for Native Americans, it may be mis-
understanding reinforcement contingencies (Dimension 2) that motivate pro-
ductivity (overt public praise may not work as well as private praise). Although
these last few statements are gross oversimplifications, I hope they convey
how the MDCC may operate in practice.
CONCLUSIONS
awareness and knowledge. We tend to neglect the cells that focus on skill
development (Dimension 2) and those requiring intervention at the macro
levels (Dimension 3). The model is helpful for graduate training and research
because it points to neglected areas. Third, the model places the Euro-Ameri-
can group on an equal plane with others and conceivably begins the task of
recognizing that the invisible veil of Euro-American cultural standards must
be deconstructed. As long as we continue to view Euro-American standards
as normative, we unwittingly set up a hierarchy among the groups. Fourth,
the MDCC indicates that cultural competence for one group is not necessar-
ily the same for another group. The implications in the mental health field for
so-called empirically supported therapies (EST) based primarily on a Euro-
American population (G.C.N. Hall, in press) must be cautiously interpreted
with respect to minority groups. A critical analysis of EST studies reveals few
if any validated on minority populations (S. Sue, 1999). To assume universal-
ity of application to all groups is to make an unwarranted inferential leap.
Fifth, the model suggests that psychologists must play different roles to move
toward cultural competence. Simply concentrating on the traditional clinical
role ignores the importance of interventions at other levels. New helping
roles like consultant, advisor, change agent, facilitator of indigenous healing
systems, and so forth have been suggested as equally valuable (Atkinson et al.,
1993). Unfortunately, these alternative roles are often not perceived as the
domain of the helping professional, and graduate training programs lack cur-
riculum or fieldwork toward the development of them. Sixth, the model mini-
mizes potential misunderstandings and miscommunications likely to arise
when people do not clarify the different foci of cultural competence (Dimen-
sion 3) or whether they are conceptualizing at the individual, group, or uni-
versal levels of identity (Dimension 1) in which they do research, practice, or
training. Seventh, although the model emphasizes racial/ethnic minority
groups, it is potentially useful in the study of other marginalized groups as
well. For example, gender, sexual orientation, and ability/disability may be
substituted for a racial/cultural minority group dimension.
Finally, but more important, the path to cultural competence requires a
broad and integrated approach. Because psychology concentrates primarily
on the individual, it has been deficient in developing more systemic and
large-scale change strategies. Although the focus on the individual is impor-
tant, there are inherent limitations. Oftentimes, psychologists treat individu-
als who are the victims of failed systemic processes (cultural conditioning
and biased education). Intervention at the individual level is primarily reme-
dial when a strong need exists for preventive measures. Furthermore, the road
to cultural competence must recognize the interrelationship and interaction
of the multiple dimensions described in this article. Concentrating our efforts
at the individual level and neglecting the organizational one, for example, is
Sue / MULTIDIMENSIONAL CULTURAL COMPETENCE 817
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Sue / MULTIDIMENSIONAL CULTURAL COMPETENCE 821
Sue and his colleagues (1999) made the preceding statement in a summary
of progress made at the National Multicultural Conference and Summit held
in January 1999. Since then, the cultural competence of mental health practi-
tioners has continued to receive considerable attention. Counseling psychol-
ogy stands at the forefront of the conversation. We believe that the attention is
justifiable. In our opinion, the need for cultural competence is one of the most
important considerations facing applied psychology.
In his major contribution, Sue (2001 [this issue]) continued as the leading
voice on this topic. We are pleased to join the conversation and react to his
substantial effort. We feel it is our responsibility to hold Sue to his own high
bar of expectation for counseling psychology and for the APA. In reference to
their above declaration, we asked ourselves, How well can Sue’s model of
cultural competence help to “produce psychologists with the awareness,
THE
RidleyCOUNSELING
et al. / CRITICAL
PSYCHOLOGIST
ISSUES / November 2001
Correspondence concerning this article should be addressed to Charles R. Ridley, Department of
Counseling and Educational Psychology, W. W. Wright Education Building, Room 4020, Indi-
ana University, Bloomington, IN 47405-1006; e-mail: cridley@indiana.edu.
THE COUNSELING PSYCHOLOGIST, Vol. 29 No. 6, November 2001 822-832
© 2001 by the Division of Counseling Psychology.
822
Ridley et al. / CRITICAL ISSUES 823
most salient features of cultural competence tend to beg the questions, What
are the desired outcomes, and How can they be achieved?
An additional concern evoked by the current discussion pertains to the
evaluation of cultural competence. How do we currently evaluate cultural
competence, and is the current methodology adequate? Several measures
have been developed to capture clinicians’ abilities to function competently
with diverse clients. The most widely used instruments are based on the early
works published by Sue and his colleagues (1982; Sue, Arrendondo, &
McDavis, 1992) that emphasize the tripartite model of awareness/beliefs,
skills, and knowledge. Because the majority of these instruments rely on self-
report methods, an inherent social desirability confound is introduced. In
fact, this has been demonstrated in the literature and is part of the conundrum
(Constantine & Ladany, 2000; Ladany, Inman, Constantine, & Hofheinz,
1997; Pope-Davis & Dings, 1994). Obviously, a solution would benefit the
field.
Under the impact of the natural science paradigm, psychologists have main-
tained a value neutral posture and have remained preoccupied with the analysis
of variables and their interrelationships in a decontextualized manner. Conse-
quently, socio-historical and cultural factors that shape social reality have
largely been ignored. (p. 97)
Because of this effort to rigidly emulate the natural sciences, psychology has
largely failed to look “outside of the box” and realize its potential for, and rel-
evance to, achieving social justice in our society.
Sue (2001) noted that a statement about social justice might sound too
political or unrelated to mental health. Certainly, “any attempt to advance the
public interest is inherently political” (Smith, 1990, p. 530). The point is that
politics and psychology are not mutually exclusive, and treating them as such
thwarts societal progress. In addition, several psychologists have argued that
social justice, and specific instances of social injustice, is intricately related to
mental health (e.g., Martin-Baro, 1994; Thompson & Neville, 1999).
Although we support the inclusion of social justice in the conceptualiza-
tion of cultural competence, it would have been beneficial for Sue (2001) to
provide a clear definition of social justice and an explanation of how to work
toward it on a professional basis. He does list three examples of social justice
in the mental health delivery system: (a) providing equal access and opportu-
nity, (b) being inclusive, and (c) removing barriers to fair mental health ser-
vices. But how do these examples translate to specific actions individuals can
execute within their work environments? Clinicians may not know how to
navigate the organizational system in which they work or be in an optimal
position to do so. Clear suggestions are needed about how to infuse social jus-
tice interventions with other psychological activities. Examples include
making facilities handicapped accessible, offering a sliding fee scale, provid-
ing transportation vouchers, and employing bilingual clinicians.
Issues of Concern
1. Lack of a solid rationale for the model. In his introduction section, Sue
(2001) lamented, “What is sorely lacking is a conceptual framework that
would organize these dimensions into a meaningful whole” (p. 791). Al-
though other models may fall short of sufficiently capturing the dimensions
of cultural competence, in fact, several have been proposed and discussed in
828 THE COUNSELING PSYCHOLOGIST / November 2001
the literature (see Ponterotto, Fuertes, & Chen, 2000, for a review). Despite
the acknowledged merits of Sue’s new model, it is disconcerting that he
neglected to give credit to those models already developed. A cogent review
and critique of the strengths and limitations of extant models are necessary to
lay the foundation for the establishment of a new model. Otherwise, we have
no basis for determining why his model is needed or how it is an improvement
over existing models.
CONCLUSION
which this conversation has been built. We encourage our colleagues to join
in this endeavor.
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Multidimensional Cultural Competence:
Providing Tools for Transforming Psychology
Amy L. Reynolds
Buffalo State College
This comment on the major contribution addresses the conceptual richness and strengths
of the model; offers some possible extensions to enhance its application to counseling
psychology; and discusses its implications for practice, training, and research. Aca-
demic programs can use the multiple dimensions of cultural competence (MDCC) model
to assess their curriculum and policies and design new approaches to infusing multicul-
turalism. The conceptual framework of the MDCC also can be used to customize coun-
seling services to better meet the needs of a diverse client base. Future implications for
use of this model as a transformative tool for counseling psychology are also explored.
THE
Reynolds
COUNSELING
/ TOOLS FOR
PSYCHOLOGIST
TRANSFORMING
/ November
PSYCHOLOGY
2001
Correspondence concerning this article may be sent to Amy L. Reynolds, Counseling Center,
Porter Hall, Lower Level, 300 Elmwood Avenue, Buffalo, NY 14222; e-mail: reynolal@
BuffaloState.edu.
THE COUNSELING PSYCHOLOGIST, Vol. 29 No. 6, November 2001 833-841
© 2001 by the Division of Counseling Psychology.
833
834 THE COUNSELING PSYCHOLOGIST / November 2001
conceptual capabilities and application potential; and (c) discuss its implica-
tions for practice, training, and research in counseling psychology.
STRENGTHS
The virtues of the MDCC offered by Sue (2001) are both in the richness of
its underlying beliefs and philosophy and in the heuristic value of the concep-
tual model itself. Sue has proposed a dynamic, complex, yet very accessible
framework for deepening our understanding of multicultural competence
and creating more options for intervention. As always, Sue builds a strong
case for multicultural issues with a positive and powerful perspective,
embracing the centrality of race without diminishing the significance of other
social identities. His strong critique of the field of multicultural counseling
offers challenges and opportunities to the many psychologists committed to
making multiculturalism one of the cornerstones of counseling psychology.
Although Sue and others have attempted to offer multicultural counseling
theories or philosophies (Speight, Myers, Cox, & Highlen, 1991; Sue, Ivey, &
Pedersen, 1996), the field of multicultural counseling continues to lack a uni-
fying conceptual framework. The MDCC is an attempt to create solidarity in
the philosophy and action needed to transform psychology into a profession
that fully embraces multiculturalism at its roots. In reviewing this model,
there are two key conceptual strengths that build the foundation for MDCC:
(a) emphasis on the multidimensionality of identity and (b) attention to social
justice and advocacy issues.
Sue (2001) emphasized the importance of multidimensional identities; all
individuals belong to more than one cultural group (e.g., race, gender, class,
sexual orientation). Although some group identities may be more prominent
than others, all individuals are profoundly shaped by these social identities
regardless of whether they are a member of a dominant group (e.g., White or
male) or encounter prejudice or oppression (e.g., people of color and/or lesbi-
ans, gays, or bisexuals). Recognizing the multidimensionality of identity is
central to multicultural competence. Understanding the true complexity of
most individuals’ identities is a prerequisite to more fully appreciating their
daily experiences and challenges (Reynolds & Pope, 1991). Sue also high-
lighted the three levels of personal identity (individual, group, and universal)
as central to effective counseling research and practice. All individuals are
influenced by their individual experiences, their reference groups, and their
universal or human realities.
Beyond the obvious importance of this type of complex thinking in work-
ing with others, such complicated reasoning offers evidence of an even more
crucial multicultural competence that Sue (2001) implied but did not address
Reynolds / TOOLS FOR TRANSFORMING PSYCHOLOGY 835
stand clients and other professionals who may be culturally different from us.
Research about various racial/ethnic groups has been enriching the field of
psychology for decades, and such knowledge is essential to achieving multi-
cultural competence. Knowledge of the different racial/ethnic groups allows
us to rethink key issues such as dual relationships rather than continue to
nonreflectively engage the underlying assumptions and values of psychol-
ogy. The second dimension, components of cultural competence, is rooted in
one of the most commonly explored areas within the multicultural literature.
Sue (2001) emphasized the tripartite model of multicultural awareness,
knowledge, and skills first introduced by Sue et al. (1982). Many assessment
instruments and training models use this tripartite perspective as a basis for
their work. Finally, the third dimension, the foci of cultural competence, bor-
rows most heavily from the more recent addition to the multicultural counsel-
ing literature—multicultural organization development (Sue, 1995). By
expanding the use of cultural competence beyond the individual, Sue prac-
ticed what he preached—altering the foundational definitions and assump-
tions about the field.
book that extends and expands the illustrations offered by Sue is needed so
that Sue and others can suggest a range of solutions that exist for the many
challenges facing multicultural counseling. What are the unique issues that
exist for each of the racial groups, and how can the model be used to address
them? What are concrete interventions that can be used on the individual,
professional, organizational, and societal levels? Such case studies could
probably be gathered from actual training programs, professional associa-
tions, and direct service agencies and centers. Ideally, these cases could be
developed in the context of a conference where the goal was to systematically
and systemically address each of the barriers that Sue so effectively eluci-
dated. This is where the cutting-edge strategies and tools of multicultural
organization development can be applied to psychology and used to trans-
form the core structures and practices of the profession.
The third and maybe the most crucial issue to be addressed is how to move
from a vision and goal of transforming psychology to creating a unified and
strategic plan that seriously begins to address the core philosophical issues
that create barriers to infusing multiculturalism into psychology at every
level. Sue (2001) articulated that addressing social justice issues is central to
this transformation. Psychologists who address social policy issues have
been arguing this point for years; what we do in our individual offices is not
enough if it does not alter the social conditions that lead to sexual abuse,
addiction, or depression. Sue stated, “Multicultural counseling competence
must be about social justice—providing equal access and opportunity, being
inclusive, and removing individual and systemic barriers to fair mental health
services” (p. 801). By identifying and describing the various barriers that
exist, Sue provided opportunities for interventions. The next step is even
more challenging and involves the creation of a strategic plan that must be
broad based and inclusive. Multicultural psychologists, those of us whose
life work is invested in these issues, cannot put forth these solutions on our
own. We must work in coalitions with those in psychology who might not
agree with our views, who at times might work against us. This means build-
ing working coalitions within academic programs, professional associations,
and the workplace. Bernice Johnson Reagon (1983), in writing about coali-
tion building among feminist women, believed that it is in our best interest to
build alliances with those who are different from us. In fact, she, and others
such as Audre Lorde (1984), firmly believed that our survival is dependent on
our ability to build connections and coalitions with others. Reagon made a
distinction between doing coalition work and coming home. Coalition work
is about having challenging conversations and difficult dialogues that always
have the potential to create something new and exciting. It is not meant to be
easy. According to Reagon, if it feels comfortable, it is not true coalition
work. Coming home is going to multicultural conferences and workshops,
838 THE COUNSELING PSYCHOLOGIST / November 2001
surrounding ourselves with people who view the world like us. We all need to
do that on a regular basis so that we have the energy to do the really challeng-
ing work of building coalitions. Maybe, “the process of talking about and
working through differences is what can lead to individual and group trans-
formation” (Reynolds & Constantine, 2001, p. 15). Of course, talking is not
enough. To be effective, we need a strategic plan to address these issues, espe-
cially in the areas of practice and training within counseling psychology.
IMPLICATIONS FOR
PRACTICE AND TRAINING
There are important implications of Sue’s (2001) MDCC model for coun-
seling psychology practice and training. This model must move from a con-
ceptualization of the problems and potential solutions to a practical applica-
tion of how to use the model in academic programs and practice sites across
the country. With limited training in multicultural issues, organization devel-
opment perspectives, and other related literature, many faculty members,
therapists, and supervisors may have a difficult time implementing segments
of the MDCC. Ongoing efforts toward professional development and reedu-
cation of senior professionals in the area of multicultural competence are a
necessary and ongoing aspect of this process. Assessing and redesigning
counseling psychology training programs to more systematically address
multicultural issues are vital to the future of multicultural counseling.
Modifying academic programs is one of the most important aspects of a
plan to transform psychology (Reynolds, 1995, 1997). Because the MDCC
provides a conceptual rationale of the multicultural counseling competency
movement, it is an ideal tool for counseling psychology programs to use for
assessment of their multicultural change efforts. It is, as Sue (2001) articu-
lated, “a conceptual blueprint” (p. 812) that training programs will need to
individualize and apply to the particular needs of their faculty, students, and
curriculum. Creating a working group of students and faculty to study and
apply the MDCC to their program would be an ideal place for training pro-
grams to begin. These groups could systematically address the various
aspects of the cube model and use that information to create specific strate-
gies. For example, programs could identify how to infuse cultural knowledge
about various people of color groups throughout the curriculum. In ethics and
professional socialization courses, programs could read multicultural and
social policy literature and discuss psychologists’ role as advocates. Full
analysis of the barriers to cultural competence at the individual, professional,
organizational, and societal levels could occur in a variety of professional
training courses, including practicum courses where students could be asked
Reynolds / TOOLS FOR TRANSFORMING PSYCHOLOGY 839
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apy. Pacific Grove, CA: Brooks/Cole.
THE
Suzuki
COUNSELING
et al. / CULTURAL
PSYCHOLOGIST
COMPETENCE
/ November 2001
The Facets of Cultural Competence:
Searching Outside the Box
Lisa A. Suzuki
Mary B. McRae
Ellen L. Short
New York University
We are honored to write this reaction to Derald Sue’s (2001 [this issue])
eloquent treatise on the multiple facets of cultural competence. Sue is
uniquely qualified to challenge our traditional thinking in the multicultural
area given his long-standing expertise and commitment to the field of coun-
seling psychology. Based on his writing, Sue advocated a critical reexamina-
tion of the existing assumptions that for decades have formed the foundation
of psychology. This includes “belief in the universality of psychological laws
and theories, the invisibility of monocultural policies and practices, differ-
ences over defining cultural competence, and the lack of a conceptual frame-
work for organizing its multifaceted dimensions” (p. 790). His arguments
call for the linking of issues of social justice and sociopolitical concerns
along with individual and organizational levels of competence and aware-
ness. Our reaction focuses on the nature of his multidimensional model of
cultural competence (MDCC) and the complexities with respect to the “cube,”
the definition, and the measures of cultural competence. The comments rep-
resent additional challenges in the area in terms of the further integration of
power hierarchies as well as an elaboration on implications for training and
clinical practice. The multiple complexities of cultural competence must be
integrated into any model for it to reflect the realities faced by clinicians
Correspondence concerning this article should be addressed to Lisa A. Suzuki, New York Uni-
versity, 239 Greene Street, 4th Floor, New York, NY 10003-6674; e-mail: las1@nyu.edu.
THE COUNSELING PSYCHOLOGIST, Vol. 29 No. 6, November 2001 842-849
© 2001 by the Division of Counseling Psychology.
842
Suzuki et al. / CULTURAL COMPETENCE 843
dealing with diverse clientele. Thus, our title reflects to some extent the need
to search further, to go beyond the box theoretically posed by Sue.
Our comments regarding the MDCC focus on the discrepancies that exist
between the multifaceted figure and the cultural complexities discussed in
Sue’s (2001) narrative. Although we recognize that any visual representation
will be oversimplified in comparison to the explanatory detail contained in a
verbal narrative, nonetheless the figure does not adequately reflect Sue’s
arguments. In addition, there exists a great need for further elaboration of the
model in light of measures and operationalizing definitions.
reassures us that the methods are indeed applicable to other cultures: but what
we see is in fact, a construction of our own ethnocentric data-gathering proce-
dures—and what we do not see, we never worry about. (p. 120)
Thus, there are major difficulties in attempting to conduct research free of our
inherent biases. One notable psychologist put it as follows:
Thus, we are left with research findings that must be balanced to approximate
the true reality of the race and cultural phenomena we are attempting to study.
We cannot allow ourselves to be pulled into using convenient group labels.
Instead, we must retain in the background the complex contextual factors
(i.e., facets) that make up the reality of the diverse clientele we are attempting
to serve. As Sue (2001) indicated in his text, cultural group identity may shift
and the facets are permeable and dynamic depending in part on contextual
factors. As he stated, the “complexity of human psychology is clear in this
diagram”; we believe that it represents only the tip of the iceberg.
The measures. Although not a major focus of his article, Sue (2001) cited
the various measures that have been developed to assess cultural competence.
These instruments address facets of the MDCC. However, despite great
attempts that have been made to measure cultural competencies, the scales
remain limited in scope, relying on self-report, and provide little in the way of
specific behavioral outcomes. This is problematic given that we must infer
from the results important information regarding the individual examinee’s
competence. The accuracy of this practice remains to some extent question-
able and open to debate. The same problem exists for most measures in this
area. For example, acculturation measures have been criticized for being
“indirect measures of cultural values and beliefs,” relying solely on behav-
ioral indices such as language usage and place of birth (Betancourt & Lopez,
1993).
Sue’s (2001) focus on race and culture in his model forces us to consider
some very sensitive issues that are often unspoken in mixed racial cultural
groups. These include power, authority, authorization, and leadership among
members of particular groups, organizations, and society. For example, the
following questions represent areas that need to be understood within the cul-
tural competence framework discussed by Sue. How do race and culture
influence the role that one takes in a group, organization, or society? How are
the ways in which group members are authorized in their roles influenced by
race and culture? How are authority and leadership viewed by members of
one’s own group and others? Do members of certain groups take on the roles
of authority and leadership differently? How is power used and viewed by
members of different racial cultural groups? How do members of different
racial cultural groups engage in discussions about power and authority?
What are the experiences of power and privilege within and between groups?
Sue (2001) noted that the societal focus of cultural competence has the
“power to define reality.” He described “ethnocentric monoculturalism” and
a “Euro-American historical bias.” Imbedded within these concepts is the
assumption that there are limited quantities of power and resources. Thus, the
question of who should have power and control resources creates tension
between groups and forces them to identify with the group in power to define
846 THE COUNSELING PSYCHOLOGIST / November 2001
social reality and history (Reed & Noumair, 2000). This tension is dynamic
and involves awareness of the political pull to identify with the victim and the
victimizer or the oppressed and the oppressor. For example, in groups, orga-
nizations, and society, there can be competition between groups for who has
the most victimized status when there is a perception that resources have been
allocated for this group. Reed and Noumair (2000) called this perception the
“myth of redress,” indicating that there will be some redistribution of
resources and power to correct injury and oppression. One of the limitations
of this myth is that there is rarely adequate compensation for past injustices.
Thus, feelings of anger regarding insufficient compensation continue to per-
meate and affect real-life situations. As Sue noted, “if people’s reality leads
them to conclude that past injustices are adequately compensated”(p. 810),
then there is no need for further programmatic attempts (e.g., affirmative
action) for change.
In America, race has historically been labeled as a dichotomous variable,
with the lighter skin holding the positive value and the darker skin the nega-
tive value. We cannot escape the dynamic tension associated with racial atti-
tudes and stereotypes that influence thinking and behavior. Thus, as noted in
Sue’s (2001) model, developing awareness of attitudes, beliefs, and stereo-
types about race and culture is central. However, one of the complexities not
reflected in the MDCC is that whereas racial grouping may be defined by
physical and cultural characteristics, it may be issues of power that pull indi-
viduals into other groups. The reasons for identification with these groups
may be more salient than race and culture. For example, individuals may
physically look like they belong to one particular group, but ideologically
they may promote the social realities defined by the group with more power.
In addition, one of the consequences of power-defining-reality is that atti-
tudes, stereotypes, and beliefs are ascribed to different racial and cultural
groups. These shape the ways in which groups are treated in daily interac-
tions both within and between groups. Authority, authorization, and leader-
ship are connected to perceptions and stereotypes about race and culture.
Authority and authorization require that one’s power is legitimized or sanc-
tioned by others and self, making the process one of continued negotiation
between those with and without power (Berg & Smith, 1990). Members of
groups that are negatively stereotyped may not feel or experience themselves
as being fully authorized to take on certain roles of leadership in organiza-
tions. Fiske (1993) indicated that stereotypes operate in the service of control
by defining “how most people in the group supposedly behave, what they
allegedly prefer and where there competence supposedly lies” (p. 623).
There are two elements of concern with negative stereotypes: perceptions
of others and perceptions of oneself. Individuals may internalize negative and
positive attitudes and stereotypes ascribed to their racial group and act as if
Suzuki et al. / CULTURAL COMPETENCE 847
they are reality (as noted in racial identity theory). Developing awareness of
attitudes, stereotypes, and beliefs about which group holds power or author-
ity and why fosters increased understanding and appropriate skills to negoti-
ate these issues.
CONCLUSIONS
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·
THE
SueREJOINDER
/ COUNSELING
CULTURAL COMPETENCE
PSYCHOLOGIST / November 2001
The Superordinate
Nature of Cultural Competence
Derald Wing Sue
Teachers College, Columbia University
Correspondence concerning this article should be addressed to Derald Wing Sue, Teachers Col-
lege, Columbia University, 525 West 120th Street, New York, NY 10027; e-mail: dwingsue@
aol.com.
THE COUNSELING PSYCHOLOGIST, Vol. 29 No. 6, November 2001 850-857
© 2001 by the Division of Counseling Psychology.
850
Sue / CULTURAL COMPETENCE 851
sexual orientation, and other group identities in the United States are radi-
cally influenced by the Euro-American worldview (imposed reality).
In light of the three highly stimulating articles, I would like to continue the
dialogue by adding more fuel to the fire. Even though there are problems in
coming to an agreement concerning the definition of cultural competence,
many of us know incompetence when we see it; we recognize it by its horren-
dous outcomes or the human toll it takes on our culturally different clients.
For example, the purveyors of mental health services, counseling goals and
processes, and the education and training of psychologists have been
described in very unflattering terms for some time by multicultural special-
ists: (a) that counselors and therapists are insensitive to the needs of clients of
color and their communities; do not accept, respect, and understand cultural
differences; are arrogant and contemptuous; and have little understanding of
their prejudices (Thomas & Sillen, 1972); (b) culturally different clients who
need care frequently complain that they often feel abused, intimidated, and
harassed by nonminority personnel (President’s Commission on Mental
Health, 1978); (c) discriminatory practices in mental health delivery systems
are deeply embedded in the ways in which the services are organized—how
services are delivered to minority populations and their communities, in
diagnosis and treatment, in indicators of “dangerousness,” and in the type of
personnel occupying decision-making roles (Cross, Bazron, Dennis, &
Isaacs, 1989); and (d) mental health professionals continue to be trained in
programs in which ethnic issues are ignored, regarded as deficiencies, por-
trayed in stereotypic ways, or included as an afterthought (Meyers,
Echemedia, & Trimble, 1991, p. 5).
From my perspective, helping professionals have seldom functioned in a
culturally competent manner. They may have functioned in a monoculturally
competent manner with only a limited segment of the population, White
Euro-Americans, but even that is debatable. Strangely enough, the criticisms
of exclusion are often leveled at attempts to develop multicultural counseling
guidelines. Objections to multicultural standards have ranged from charac-
terizing them as focusing just on racial minorities and/or their exclusion of
other groups like women and gays/lesbians. The fallacies in this belief are
threefold: (a) Race, culture, and ethnicity are primarily a “minority thing”
and have little relevance to other populations (including White Euro-Ameri-
cans); (b) current standards of therapeutic practice are based on research that
makes them more valid; and (c) “good counseling is good counseling.”
Sue / CULTURAL COMPETENCE 855
First, it is clear that race, culture, and ethnicity are functions of each and
every one of us. It is not just a Black thing, an Asian American thing, a Latino/
Latina thing, or a Native American thing but a White thing as well. In her
book, Race Is a Nice Thing to Have, Helms (1992) addressed how race is
invisible to many White Americans because it serves as the default standard
in evaluating the world around them. That criticism also applies to other group
identities as well. Second, I seriously question the assumption that clinical
competence is empirically based. How much empirical support, for example,
is there for what I call the five therapeutic taboos: Counselors (a) do not give
advice, (b) do not self-disclose their thoughts and feelings, (c) should not
accept gifts from their clients, (d) should not enter into dual-role relation-
ships, and (e) should avoid bartering with clients. What sense do we make of
these admonitions in light of findings that indigenous helping practices con-
sider such behaviors and roles to be characteristics of healing and compe-
tency (Berman, 1979; Herring, 1999; Lee, 1996; Parham, 1997; Parham,
White, & Ajamu, 1999)?
I submit that much of current therapeutic practice taught in graduate pro-
grams is derived mainly from clinical experience with middle-class to upper
class White folks, not research. If we are honest with ourselves, we can only
conclude that much of our standards of professional competence (Eurocen-
tric) are derived primarily through folk wisdom and the values, belief sys-
tems, cultural assumptions, and the traditions of the larger society, not sci-
ence, as we would have our students believe. Thus, values of individualism,
psychological mindedness, and using “rational approaches” to problem solve
have much to do with how competence is defined. Furthermore, despite the
fact that our profession has advocated moving into the realm of empirically
supported treatments (EST), little evidence exists that they are applicable to
racial/ethnic minorities (Sue et al., 1999). A review of studies on EST reveals
few, if any, on racial minority populations, making assumptions of external
validity invalid when applied to people of color (Hall, in press; Sue, in press).
If we truly believe that standards of practice must be research based, might
we not also have to consider eliminating much of the current Euro-American
standards related to counseling/clinical competence? Yet, many of my col-
leagues continue to hold firmly to the belief that good counseling is good
counseling, thereby dismissing the centrality of culture in their definitions.
Thus, it is clear to me that the more superordinate and inclusive concept is
that of multicultural competence and not counseling competence. Elsewhere,
my colleagues and I (Sue et al., 1996) have proposed a theory of multicultural
counseling and therapy in the form of a metatheory. The multicultural theory
assumes that all helping systems are developed in a particular cultural context
and reflect different worldviews; that it includes European American, Asian,
African, Latin American, American Indian, and other indigenous healing
856 THE COUNSELING PSYCHOLOGIST / November 2001
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Suzuki, L. A., McRae, M. B., & Short, E. L. (2001). The facets of cultural competence:
Searching outside the box. The Counseling Psychologist, 29(6), 842-849.
Thomas, A., & Sillen, S. (1972). Racism and psychiatry. New York: Brunner/Mazel.
·
THE
Bichsel,
COUNSELING
Mallinckrodt
SPECIAL PSYCHOLOGIST
/ NATIVE AMERICAN
POPULATIONS / November
FORUMWOMEN 2001
Native American women (N = 218) living on a reservation were surveyed to assess their
preferences for counselor sex, ethnicity, cultural awareness, counseling style, and com-
mitment to Native American and Anglo-American cultures. Women generally preferred a
counselor with the following attributes: female, ethnically similar, culturally sensitive,
and used a nondirective counseling style. All these preferences, except for counseling
style, were generally stronger for personal versus vocational problems and were stron-
ger for women with high commitment to Native American culture. Written analogue por-
trayals depicted counselors in four combinations (Native American vs. Anglo, culturally
sensitive vs. insensitive). The Native American/sensitive counselor was rated highest,
with the Anglo/insensitive counselor rated lowest. The Anglo/sensitive counselor was
preferred to the Native/insensitive counselor by women who strongly identified with
Native American culture.
We gratefully acknowledge the cooperation of the Tribal Council of the Confederated Tribes of
the Warm Springs Reservation of Oregon, and we thank the women of the Warm Springs Reser-
vation for their participation in this research. This article is based on the dissertation research of
Ruth J. Bichsel, under the direction of Dr. Janet Moursund. Correspondence concerning this arti-
cle should be addressed to Ruth J. Bichsel, Ph.D., D.A.B.P.S., Lane Community College, Social
Science Department, 4000 East 30th Avenue, Eugene, OR 97405-0640; e-mail: bichselr@
lanecc.edu.
THE COUNSELING PSYCHOLOGIST, Vol. 29 No. 6, November 2001 858-881
© 2001 by the Division of Counseling Psychology.
858
Bichsel, Mallinckrodt / NATIVE AMERICAN WOMEN 859
(LaFromboise & Dixon, 1981), differing cultural views of the healing pro-
cess (Price & McNeill, 1992), and differing cultural values between Euro-
pean Americans and Native Americans (Bennett & BigFoot-Sipes, 1991;
LaFromboise, Trimble, & Mohatt, 1990). Some experts believe that much of
the mental health service provided by government agencies on reservations is
culturally insensitive, biased toward dominant cultural values, and may be
more destructive than helpful (LaFromboise & Rowe, 1983).
For any ethnic minority group, but perhaps especially for Native Ameri-
cans, a key element for engaging and retaining a client in counseling is a posi-
tive, mutually respectful therapeutic relationship in which both client and
counselor believe that the client will benefit (Atkinson, Thompson, & Grant,
1993; Gim, Atkinson, & Whiteley, 1990; LaFromboise & Howard-Pitney,
1995; McWhirter & Ryan, 1991; D. W. Sue & Sue, 1990b). A key element in
forming this type of positive relationship with Native American clients is the
counselor’s understanding of psychological aspects of the client’s cultural
experience (LaFromboise et al., 1993). Historically, Native Americans have
experienced grievous attempts to extinguish their tribal culture and language
and force them to adopt values of the dominant culture. The legacy of
imposed acculturation through, for example, the boarding school system,
forced separation of children from parents, and punishment for speaking the
tribal language (Garrett & Pichette, 2000; Little Soldier, 1985) has created
special psychological and emotional problems for many Native Americans
(Attneave, 1987; Morrissette, 1994). It is not surprising that many have a low
level of trust for White counselors (Herring, 1990a, 1990b; LaFromboise &
Dixon, 1981). Thus, the historical context and present experience of many
Native American clients require counselors to express positive attitudes,
knowledge, and respect for Native American culture as well as special sensi-
tivity to the unique stresses imposed by cultural conflicts to earn the trust of
Native American clients (LaFromboise et al., 1993; Trimble & LaFromboise,
1987).
Before proceeding, it is necessary to define important terms used through-
out this article. Acculturation has been described as a process of socialization
into an ethnic group other than one’s own, resulting from contact between
persons of two or more cultures. Acculturation involves cultural learning,
attitudinal change, and behavioral change (Casas & Pytluk, 1995). For
Native Americans, “acculturation refers to the degree to which the individual
accepts and adheres to both majority [White/Euro-American] and tribal cul-
tural values” (Choney, Berryhill-Paapke, & Robbins, 1995, p. 76, brackets in
original). A related term, bicultural competence, refers to the ability to inter-
act effectively with members of two cultures through one’s mastery of the
appropriate behaviors and knowledge of the culture-based expectations of
both cultures (LaFromboise & Rowe, 1983). Although there has been a
860 THE COUNSELING PSYCHOLOGIST / November 2001
the sum total of group members’ feelings about those values, symbols, and
common histories that identify them as a distinct group. . . . A person does not
belong to an ethnic group by choice; rather, he or she must be born into such a
group and becomes related to it through emotional and symbolic ties. (Smith,
1991, pp. 181-182)
Native American culture would form the most favorable impressions of the
culturally sensitive Native American counselor. We expected women with
high commitment to only Anglo culture to view the two Anglo counselors
most favorably, regardless of the counselors’ sensitivity. We formed no spe-
cific hypotheses regarding the complexities of how women with high or low
commitment to both cultures would perceive the counselors.
METHOD
Participants
Instruments
Cultural commitment. This measure was adapted for the present study
from single-item questions used in previous research (Johnson & Lashley,
1989; Price & McNeill, 1992; Sanchez & Atkinson, 1983) that conceptual-
ized cultural commitment in terms of two orthogonal factors of identification
with the “traditional” culture (in this case Native American) and the domi-
nant culture. Participants were asked to choose which one of the following
four phrases best described them: (a) “I have a strong commitment to both
Native American and Anglo-American cultures,” (b) “I have a strong com-
mitment to Native American culture and a weak commitment to Anglo-
American culture,” (c) “I have a strong commitment to Anglo-American cul-
ture and a weak commitment to Native American culture,” or (d) “I have a
weak commitment to both Native American and Anglo-American cultures.”
Following the example of Johnson and Lashley (1989), we included two
items to corroborate validity through asking about (a) degree of participation
in tribal activities and (b) proficiency in the tribal language. These items used
3-point scales (1 = not at all, 2 = somewhat, 3 = very). Because language
864 THE COUNSELING PSYCHOLOGIST / November 2001
was presented in written form and included three speaking turns each for cli-
ent and counselor. In this study, the four vignettes depicted combinations of
counselor ethnicity (Native American or Anglo-American) and sensitivity to
Native American culture (either moderately sensitive or fairly insensitive).
For example, in the vignettes depicting cultural sensitivity, the Anglo coun-
selor expresses empathy for the client’s experience of cultural isolation, and
the Native American counselor acknowledges the importance of showing
proper respect for one’s family members. In the vignettes depicting insensi-
tivity, the Anglo counselor admonishes the client for arriving late to the ses-
sion, and the Native American counselor fails to acknowledge the client’s
expressed concerns about not being respected by White coworkers.1 Respon-
dents were told that the client in each vignette was Native American and that
the counselor in each vignette lived near but not on the reservation. (The gen-
ders of counselor and client were deliberately left ambiguous.) A manipula-
tion check item presented after each vignette assessed perceptions of the
counselor’s “level of commitment to Native American culture” using a 10-
point unanchored scale.2 Three additional items asked for ratings of the coun-
selor’s competency, how comfortable the respondent would be if she or he
were to see this counselor, and how willing the respondent would be to see
this counselor. The 10-point scales for these items were anchored at the end
points with not at all competent versus very competent, not at all comfortable
versus very comfortable, and not at all willing versus very willing. These
three items were then summed to form a single index. Internal consistency
(coefficient alpha) ranged from .90 to .94 for the ratings.
Procedure
RESULTS
To test our first hypothesis about preferences for counselor sex, ethnicity,
cultural awareness, and counseling style, we created indices of these depen-
dent variables by combining single items from the MEPCCI. Our intention
was to create continuous measures likely to be more reliable than the single
items used by Wetsit (1992). The MEPCCI preference indicators for coun-
selor sex and ethnicity consisted of two components, a categorical choice
(“same,” “different,” or “does not matter”) and a 5-point scale to indicate the
strength of preference (1 = not important, 5 = very important). An index was
created for each item that reflected not only the basic preference but also the
importance attached to the preference. First, a valence coefficient of –1 was
assigned for the choice of different, +1 for same, and 0 for does not matter.
This coefficient was multiplied by the importance indicator, resulting in an
index that varied from –5 (very important to have a counselor of different eth-
nicity or sex) to 0 (this choice does not matter) to +5 (very important to have a
counselor of the same ethnicity or sex). Pairs of parallel items resulting from
ratings of the two vocational problems and the two personal problems were
then summed to yield an index that ranged from –10 to +10 for ratings of pref-
erence for counselor sex and ethnicity—with separate ratings for vocational
and personal problems. The third MEPCCI preference item asked about
counselor cultural awareness (either through the counselor belonging to the
respondents’ tribal group or having knowledge of the tribal culture). This
preference was scored on a 1 to 5 scale, summed across parallel items in the
two vocational and two personal problems to yield indices that varied from 0
(does not matter) to 10 (cultural awareness is very important). Regarding
counseling style, the choices works with me to determine options and lists
options and lets me decide were both given a valence of +1 because these both
described a fairly nondirective style, whereas tells me what to do was
assigned a valence of –1 to indicate a more directive style. The choice does
not matter was assigned a valence of 0. After multiplying the valence by the
importance attached to this choice (scored on a 1-5 scale) and summed across
the two vocational and two personal hypothetical problems, the resulting
index could range from –10 (strong preference for a directive counseling
style) to 0 (does not matter) to +10 (strong preference for a nondirective
counseling style). Note that assignments of valences were done only in our
statistical analyses, not in the materials presented to respondents.
Our second hypothesis stated that counseling preferences would depend
on whether the hypothetical presenting problem was personal or vocational.
868 THE COUNSELING PSYCHOLOGIST / November 2001
To test both of the first two hypotheses, the four indices described above were
analyzed with a mixed model multivariate analysis of variance (MANOVA),
with one between-participants factor (cultural commitment group); a within-
participants factor of problem type (vocational vs. personal); and a second
multivariate within-participants factor of preferences for (a) counselor sex,
(b) counselor ethnicity, (c) counselor cultural awareness, and (d) counselor
directive versus nondirective style. Because there were too few women who
indicated a weak commitment to both cultures (n = 12), they were excluded
from these analyses. Results shown in Table 1 indicate a significant main effect
for the between-participants factor of cultural commitment, F(2, 202) = 7.38,
p < .001, thus providing strong support for our first hypothesis. Results also
show strong support for our second hypothesis in that there was a significant
main effect for vocational versus personal problem type, F(1, 202) = 35.07,
p < .001, and a significant Cultural Commitment ´ Problem Type interaction,
F(2, 202) = 9.37, p < .001.
Univariate follow-up analysis suggested that the nature of the hypotheti-
cal problem was associated with women’s preferences for the sex, ethnicity,
and cultural awareness of their counselors but not counseling style. Compari-
son of the means in Table 1 shown in each pair of rows suggests that for
women with either a strong commitment to Native American culture or to
both cultures, their general preference for a counselor of the same ethnicity
and sex was stronger for a personal problem than for a vocational problem.
Regarding importance placed on cultural awareness, the picture is somewhat
mixed, with women in the “strong both” and “strong Anglo” groups attaching
higher importance to cultural awareness for personal problems than voca-
tional problems, whereas women in the “strong Native American” group
attached somewhat more importance to cultural awareness for vocational
problems. Note that because the ceiling score on this index was 10, these
scores indicate that all three groups had a fairly strong preference for coun-
selors with cultural awareness. Nevertheless, the strength of this preference
did vary depending on cultural commitment groups. All respondents pre-
ferred a nondirective counseling style, and the level of this preference was not
dependent on the nature of the counseling problem.
Scheffe follow-up comparisons between the three cultural commitment
groups are shown in the last column of Table 1. These comparisons suggest
that as hypothesized, preference for a counselor with high cultural awareness
and one of the same sex and ethnicity for personal problems was significantly
higher for women with high commitment to Native American culture or both
cultures, compared to women with a high commitment only to Anglo culture.
Interestingly, for vocational concerns there were also differences, in that
women with high commitment to Native American culture had even stronger
preferences for counselor cultural awareness and ethnicity than women with
TABLE 1: Cultural Commitment and Preference for Counselor Sex, Ethnicity, Cultural Awareness, and Counseling Style (n = 205)
Cultural Commitment
A: Strong B: Strong Native C: Strong
Both (n = 78) American (n = 103) Anglo (n = 24)
Counselor Preference by Problem Type M SD M SD M SD F Group Difference Scheffe Test
a
Preference for sex
Personal 3.10 4.45 4.70 4.69 0.23 0.87 10.96** B, A > C
Vocational 1.89 3.32 1.49 2.60 0.96 1.43 1.57 —
Preference for ethnicityb
Personal 3.89 3.49 4.11 3.77 0.18 0.85 13.86** B, A > C
Vocational 0.04 0.35 1.15 2.28 0.82 1.37 9.80** B>A
Preference for cultural awarenessc
Personal 7.73 1.61 7.74 1.23 6.64 0.95 7.65** A, B > C
Vocational 7.07 1.12 8.06 0.96 6.27 0.94 36.75** B>A>C
Preference for counseling styled
Personal 8.06 2.92 7.30 2.33 8.46 2.15 3.28*
Vocational 8.15 1.96 6.47 2.44 8.27 1.96 14.50** C, A > B
NOTE: Omnibus MANOVA results: Main effect for cultural commitment, F(2, 202) = 7.38, p < .001; main effect for problem type, F(1, 202) = 35.07, p < .001;
Cultural Commitment ´ Problem Type interaction, F(2, 202) = 9.37, p < .001.
a. Scores could range from –10 to +10, with higher scores indicating stronger preference for the same sex of counselor and increasing negative scores indicating
stronger preference for a male counselor. Effect of problem type, F(1, 202) = 9.10, p < .001.
b. Scores could range from –10 to +10, with higher scores indicating stronger preference for the same ethnicity of counselor and increasing negative scores indicat-
ing stronger preference for an Anglo counselor. Effect of problem type, F(1, 202) = 61.69, p < .0001.
c. Scores could range from 0 to +10, with higher scores indicating preference for greater cultural awareness; 0 indicates does not matter. Effect of problem type,
F(1, 202) = 4.47, p < .05.
d. Scores could range from –10 to +10, with higher scores indicating preference for less directive counseling style; 0 indicates does not matter, and increasing nega-
tive scores indicate preference for more directive style. Effect of problem type, F(1, 202) = 1.72, p = ns.
869
NOTE: Both = strong commitment to both cultures (n = 78); Native American = strong commitment to Native American culture, weak commitment to Anglo cul-
ture (n = 104); Anglo = strong commitment to Anglo culture, weak commitment to Native American culture (n = 24). Omnibus repeated-measures MANOVA
results: Main effect for cultural commitment, F(2, 203) = 21.36, p < .001; main effect for counselor, F(3, 201) = 140.14, p < .0001; Cultural Commitment ´ Coun-
selor Interaction, F(6, 404) = 10.51, p < .0001.
871
872 THE COUNSELING PSYCHOLOGIST / November 2001
DISCUSSION
ervation. The mean scores on this scale, which could range from –10 to +10,
indicated a strong preference for a nondirective style. Interestingly, women in
the two groups with a strong commitment to Anglo culture had the strongest
preference for a nondirective style. Perhaps, women with strong identifica-
tion only to Native American culture are accepting of a slightly less
nondirective style if it is combined with the nurturance, authority, and exper-
tise expected of a tribal elder (Johnson & Lashley, 1989).
Recall that the scale measuring preference for cultural awareness ranged
from 0 (does not matter) to 10 (strong preference). Means shown in Table 1
for women who identified with Native American culture were all greater than
7 on this scale, indicating that cultural awareness is a very important issue for
them. Unlike preferences for sex and ethnicity, preferences for a culturally
aware counselor were equally high for vocational as well as personal prob-
lems. These findings suggest that cultural awareness and cultural issues are
important in vocational problems as well as in personal problems, particu-
larly for women with a strong identification with Native American culture.
It is interesting to speculate about why the preferences for counselor sex
and ethnicity were apparently stronger for personal problems than vocational
problems. Helms (1995) has argued that an ethnic minority individual’s eth-
nic identity “status” can vary depending on context and environmental influ-
ences. For example, the social contexts of work, school, and family life
involve differing demands to which a person responds with different sets of
culturally relevant attitudes and behaviors. Perhaps participants in our study
believed that a Native American, female, culturally aware counselor would
have the best chance of helping them with the ethnic identity status they
assume in relating to their families. For women in our sample, vocational life
may require competence in, and identification with, the dominant culture to a
far greater extent than family life. Thus, some women may feel that a repre-
sentative of the dominant culture may have special expertise for providing
help with vocational problems. Our findings suggest that cultural awareness
is still important for women seeking help with a vocational problem but that
cultural awareness is even more important when the problem is personal.
Our third hypothesis involved predictions about how differing commit-
ment to Native American and Anglo culture would be associated with per-
ceptions of counselors who varied in cultural sensitivity and ethnicity. We
expected that women with high commitment to only Native American culture
would form the most favorable impressions of the culturally sensitive Native
American counselor (i.e., Counselor C). We expected women with high com-
mitment to only Anglo culture to view the two Anglo counselors (Coun-
selors A and D) most favorably, regardless of the counselors’ sensitivity.
Results partially supported our hypotheses. Perhaps, not surprisingly, the
Anglo counselor who demonstrated cultural insensitivity (i.e., Counselor D)
Bichsel, Mallinckrodt / NATIVE AMERICAN WOMEN 875
was rated lowest of all counselors by all three groups. Perhaps, also not sur-
prisingly, the Native American counselor who demonstrated cultural sensi-
tivity (Counselor C) was rated highest by all “both” groups with commitment
to Native American culture. However, comparison of Counselor A, the cul-
turally sensitive Anglo counselor, with Counselor B, the culturally insensi-
tive Native American counselor, is among the most interesting in this study
and has significant implications for counselor training and practice. Women
with a strong commitment to Anglo culture did not distinguish between these
two counselors. However, women with a strong commitment to Native
American culture (and not to Anglo culture) preferred the Anglo culturally
sensitive counselor to the Native American culturally insensitive counselor.
These findings underscore the importance of cultural sensitivity in counsel-
ing practice and suggest that especially for women who strongly value their
tribal culture, seeing a counselor who is sensitive to that culture is more
important to them than seeing a counselor who is a member of the culture but
does not appear to be sensitive to its values.
These findings are consistent with other studies that found both counselor
ethnicity and cultural sensitivity are important factors and interact with one
another as well as client characteristics in determining which counselor
potential clients prefer to see (Bennett & BigFoot-Sipes, 1991; BigFoot-
Sipes et al., 1992; LaFromboise et al., 1990). Perhaps women in our study
with high commitment to Native American culture, based on previous experi-
ence, did not expect much sensitivity from an Anglo counselor. Thus, Coun-
selor A who was Anglo and sensitive may have created a positive dissonance
that enhanced favorable ratings, whereas Counselor B who was Native
American and insensitive may have created negative dissonance by disap-
pointing expectations. The influence of positively or negatively confirmed
expectations on the counseling process might be a fruitful area for further
research.
LaFromboise et al. (1990) developed a five-level model of acculturation
for Native Americans based on varying degrees of cultural commitment and
assimilation. In this model, the traditional level is similar to the “strong
Native American” group in this study, with low commitment to the dominant
culture and strong commitment to Native American culture. The marginal
level corresponds to our “weak both” group, with low commitment to both
cultures. The bicultural level corresponds to our “strong both” group, with a
high commitment to both cultures. The assimilated level corresponds to our
“strong Anglo” group, with low commitment to Native American culture and
strong commitment to Anglo culture. The fifth level, pantraditional, is com-
posed of persons formerly at the assimilated level who seek out their tradi-
tional roots and embrace their tribal heritage. Thus, our “strong both” group
contained women that, according to the LaFromboise et al. model, could be
876 THE COUNSELING PSYCHOLOGIST / November 2001
NOTES
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·
THE
Carter,
COUNSELING
Davis / REORGANIZING
LEGACIES PSYCHOLOGIST
AND DIVISION
TRADITIONS/ November
17FORUM2001
Between 1992 and 1996, Division 17 of the American Psychological Association (APA)
was reorganized to respond to Executive Board- and member-perceived need for more
active and effective participation in APA and the field of psychology, enhanced member
involvement, and greater responsiveness on matters of concern to counseling psycholo-
gists. This article describes the process of the reorganization, including both docu-
mented historical events and interviews with key participants. It is intended to capture
the historical record and provide insight into the process of the restructuring as well as
the division’s governance and activities.
Correspondence concerning this article should be addressed to Jean A. Carter, 3 Washington Cir-
cle, Suite 205, Washington, DC 20037; e-mail: JCarterPhD@aol.com.
THE COUNSELING PSYCHOLOGIST, Vol. 29 No. 6, November 2001 882-906
© 2001 by the Division of Counseling Psychology.
882
Carter, Davis / REORGANIZING DIVISION 17 883
can be helpful to them in their professional lives. We hope that such an under-
standing will prompt individuals to become more involved in divisional gov-
ernance and activities.
The reorganization of the divisional structure was intended to encourage
more individual members to become active participants in Division 17 and to
enable more effective governance of the division by redistributing many
responsibilities and some authority. It was designed to permit greater respon-
siveness to member needs, to the APA, and to the broader field of psychology
and thus enhance the ability of Division 17 to take a proactive (rather than
reactive) stance on matters that are of concern to counseling psychologists.
The specifics of the reorganized structure are presented in the section titled
“Establishment and Refinement of a Concept” and in Appendix A.
PROLOGUE
The leaders of Division 17 through the 1970s and 1980s were employed
primarily by universities, and they were concerned that many counseling
psychologists who entered nonacademic practice settings might not be join-
ing or renewing their membership in the division (Huebner & Corazzini,
1984) or might be finding professional homes in other APA divisions (APA
Membership Services, personal communication, August 1994). However,
because counseling psychology reflects a distinctive perspective (Gelso &
Fretz, 1992), many of the counseling psychologists who identified with other
groups also continued to identify with the specialty (APA Membership Ser-
vices, personal communication, August 1994).
Division 17 responded to the expansion of members’interests by develop-
ing a proliferation of committees (e.g., Committee on Women, Committee on
Ethnic and Racial Diversity, Committee on Independent Practice) and numer-
ous special interest groups (SIGs). At the same time, the division maintained
the established traditional committees (e.g., Education and Training, Fellow-
ship, Membership, Professional Affairs, Program, Scientific Affairs) that
reflected divisional and APA interests. By 1990, there were 13 committees
and 20 SIGs, with the president monitoring these many groups and their
activities while simultaneously attempting to follow (and, in some cases, pro-
vide leadership for) developments at the national level. The president made
all committee appointments. The activities of the committees varied accord-
ing to the chairperson, and the involvement of members beyond the chair
largely depended on the effectiveness of the chair, who was usually in that
position for only 1 year.
The governance of the division had become sprawling and unwieldy, and
the ability of the division to be both attentive and responsive to the needs of
members and to issues of the association and the field was severely ham-
pered. Presidents of the division, burdened as they were by the organizational
structure and the demand to know about and attend to a tremendous range of
issues, continued to raise concerns about this structure, about the division’s
goals and responsibilities, and about how possible changes in the organiza-
tion might allow for more rapid and effective responding.
Concerned about the proliferation of committees, the need to increase
member involvement, and the need to move out of provincialism (e.g., focus
on counseling psychology identity issues), Presidents Naomi Meara (1988-
1989) and Michael Patton (1990-1991) engaged in a process of exploration
and consideration of mechanisms for improving the functioning of the divi-
sion. But, the roots of such exploration began much earlier, with President
Don Blocher’s appointment in 1981 of Tom Magoon, Lyle Schmidt, and
Naomi Meara to an ad hoc Committee on Structure and Function.
Carter, Davis / REORGANIZING DIVISION 17 885
Don [Blocher] was concerned that there were a number of issues, particularly
practice issues, on which we were not current because our style was laid back,
if not somewhat disorganized, and he thought we could benefit if we looked at
how things operated. We quickly became aware of several systemic factors—
we were a volunteer organization with no central office, all of our workers were
dispersed, and we had high turnover in leadership positions. We thought we
needed to look at better internal organization and we needed to recognize our
members and highlight their contributions. We made a list of suggestions, and
at Don’s invitation we went to the 1981 midyear meeting. Our report led to the
development of a handbook, containing the bylaws, which described each offi-
cer’s and committee chair’s responsibilities and other matters pertaining to the
structure and function of the division. In addition, we suggested having an
agenda book in advance of each meeting, an awards ceremony at the business
meeting, and so forth. These changes enabled the Executive Board to have
more organization and focus at its meetings.
I was beginning to worry about the vibrancy of the division during the time that
I was president. My presidential initiative of the regional conferences was an
attempt to address some of the same issues that the reorganization targeted.
What I saw was that there was only modest opportunity for involvement in the
division, mostly along interest lines.
What were the factors that motivated those of us to want to take a look at
restructuring? They were the lack of member involvement, the lack of opportu-
nities for involvement, the lack of shared and decentralized responsibility, and
the centralization of too much responsibility in the president. I think that the
organization that existed 10 years ago was not serving the profession and dis-
cipline of counseling psychology like it needed to be. These factors were an
impetus for what led to the Solomons Island retreat and the return to a set of
values—that was like going back to bedrock.
themes identified by the board included (a) active involvement in training; (b)
definition and implementation of the scientist-practitioner model; (c) atten-
tion to diversified roles and diversity among members; (d) professional
development; (e) structure and functions of Division 17; and (f) proactive,
political, and collegial relations (APA Division 17, 1993, p. 174). According
to the minutes of the 1992 midyear meeting,
Many of our desires for the future pertain to being active, intentional, and
proactive. . . . As in the past, our history has reflected growth and development.
The changing times may necessitate additional strategic planning and goal set-
ting. . . . Finally the discussion touched on power and the ability to control one’s
future and destiny. (APA Division 17, 1993, p. 174)
Although this exploration generated energy and enthusiasm for the division’s
potential, it also highlighted the frustration and roadblocks each president
and board had faced.
As the board moved to a discussion of the implementation phase of long-
range planning, it was clear that the most central issues were the structure and
function of Division 17, the need for strategic planning, the development of
both long-range and action goals, and the establishment of a mission state-
ment. The board concluded that “the action goals may or may not include
establishing a different divisional structure to reach those goals” (APA Divi-
sion 17, 1993, p. 174).
There were various options considered for addressing these issues. These
options included an ad hoc committee composed of past division leaders, a
committee representing various sectors of the membership, or a subcommit-
tee of the board. Finally, it was decided that these matters were of sufficient
import and magnitude that the members of the Executive Board should be the
ones responsible for conducting an in-depth evaluation of the future of the
division. Consequently, a planning retreat of the entire Executive Board was
scheduled for May 1992, at Solomons Island in Maryland. Puncky Heppner
and Jean Carter were appointed to serve as the agenda-planning team for the
retreat, with Jan Birk (president-elect) carrying the administrative responsi-
bility. This planning retreat began a complicated process that involved exten-
sive work on the part of a number of subsequent presidents and their Execu-
tive Boards who shared the responsibility for the implementation of the
reorganization plan.
Puncky and I agreed to undertake the planning of the agenda, and very soon it
dawned on us that we had accepted a huge job, as the success of the retreat
would depend on the agenda. We began a series of regular phone consultations
and, in mid-April, agreed to combine an agenda-planning meeting with the
PIPS [Project to Integrate Practice and Science] meeting that was already
scheduled for Madison, Wisconsin. We met in the airport in St. Louis and
began working even on the plane to Madison. We allowed an extra day for the
agenda planning and used every minute of it. We took full advantage of the
face-to-face meeting time and spent a full day working, thinking, and talking.
While talking through the issues, we realized that the structure would need to
change and that it would help the board in its retreat to have something to react
to, rather than having to start from scratch. So, we began designing structures,
organized in different ways to address different problems. The ideas came
quickly, but as we tried to draw the organizational structures—the way the dif-
ferent parts would relate to each other—too often it could not be done. And we
knew that if we could not draw it, it would not work so those ideas were
discarded.
Following the Madison meeting, many hours were spent developing drafts
of potential structures and other materials for the Executive Board’s reactions.
Our goals were to provide written materials and other supplies (e.g., portable
copy machine) that would enhance productivity.
I remember as Jean and I began talking and preparing the agenda for the retreat,
it hit us how significant and complex the problems were and subsequently the
complexity of planning the retreat. After considerable discussion, it occurred
to us that we would have to structure the retreat so as to facilitate discussion of
all of the issues within the group, as well as promote creative problem solving
to address the complexity and interrelationships within the issues. As we pro-
gressed in our planning, it also become clear to us that the problems facing the
division could not be handled with minor changes. In contrast, it seemed to us
that a major reorganization of the division was needed, but we did not know
whether others would agree with what seemed like our radical conclusion. In
retrospect, it is kind of funny for the two of us who were barely 40 to even con-
template a reorganization of the magnitude we envisioned as necessary. We
were so lucky to have the board we had at that time . . . knowledgeable of the
division, cooperative, good-spirited, supportive, and forward looking with a
strong desire to make things better, which included a willingness to take some
risks. It was a good thing we did not have an outside consultant (as was origi-
nally suggested), as the board members really knew the issues, the needs, the
problems, history, and the personalities.
CORNERSTONE OF A VISION
In May 1992, the members of the Executive Board (Bruce Fretz, president;
Jan Birk, president-elect; Mike Patton, past-president; Puncky Heppner, sec-
Carter, Davis / REORGANIZING DIVISION 17 889
retary; Kathy Davis, treasurer; Jo-Ida Hansen, Jim Hurst, and Helen Roehlke,
APA council representatives; and Linda Brooks, Jean Carter, and Chris
Courtois, members-at-large) arrived at Solomons Island to begin long-range
planning for the division. Everything was open to question, and new ideas
were to be proposed regarding the structure, function, and operation of the
division. A retreat provided the Executive Board with the opportunity to be
creative and the time to address issues in depth, a luxury rarely experienced
during the annual, regularly scheduled midyear or the APA convention meet-
ings. New and bold ideas were encouraged to be the norm rather than the
exception.
Board members started the retreat with different ideas about what was to
occur and what the outcome might be. Chris Courtois remembers having
been frustrated with the general conservatism of the Executive Board for a
number of years, but she felt these board members realized things needed to
change. The recognition and acceptance of divisional reorganization as the
outcome occurred at different times for each participant. Jim Hurst was look-
ing for a paradigm shift and admitted to sometimes feeling impatient with the
slow progress. Mike Patton recalls originally thinking that the focus of the
retreat was to be on strategic planning but realizing, by the 2nd day, that the
agenda had become a reorganization of the whole division. Jo-Ida Hansen,
who frequently admits to disliking change, was worried that the elimination
of numerous committees would result in fewer opportunities for members to
contribute their energies to the division. As a result, she questioned how some
of the more radical changes would be implemented and the impact the
changes would have on the membership-at-large. Even Bruce Fretz, whose
ideas began this process, did not fully realize the extent of what had been
accomplished until after returning home. So, what happened at Solomons
Island that fostered such sweeping changes?
After gathering on Saturday afternoon, the hard work began with a discus-
sion of the definition of counseling psychology, work on a mission statement
for the division, the problems and needs of members, and the functions
implied by the mission statement and member needs. Several major themes
emerged: (a) how to generate more interest in the division and opportunities
for involvement by people from various work settings and ethnic, gender, and
racial groups; (b) how to enhance the division’s ability to be more responsive
and more proactive in the field, profession, and in APA; and (c) how to facili-
tate the organization’s administrative functioning. The group quickly real-
ized that the current organization of the division did not provide an effective
structure and by Sunday morning was already prepared to move into small
groups to develop potential structures for the division.
The openness and willingness of all members to explore alternatives and
engage in constructive criticism led to a cohesiveness that would be difficult
890 THE COUNSELING PSYCHOLOGIST / November 2001
to emulate. One thing that stands out for Helen Roehlke was the working
spirit of the group; it was “a shared venture . . . a meeting of the minds.” How-
ever, that does not mean there was agreement on everything. For example,
Linda Brooks remembers being disgruntled that the board was spending so
much time on the details of reorganization and had not specifically identified
the goals or mission. Although the agreed upon values were reflected in the
reorganization plans, there was no clear picture of where we were going in the
whole process. To contribute collaboratively and reduce her concerns, Linda
volunteered to take the major responsibility for summarizing the themes,
issues, and goals and for writing a mission statement.
As Jim Hurst remembers,
I cannot remember anyone there who was casting cold water on ideas that
emerged. . . . Steps were taken to release ourselves from the burden of our past
structures . . . to free ourselves from how we had done things for so many years
and to envision what we wanted to happen in the future. I think that Bruce set
the parameters that way, and then, very frankly, the group worked together
superbly. There was a combination of thinkers there, ranging from those who
were able to articulate the vision, those who were able to restate and summarize
these visions, and those who were able to provide a foundation of reality. . . .
My own view is that there was an excellent chemistry that emerged. The mem-
bership of the division deserves credit for selecting those who provided leader-
ship for these transitions.
All 11 people present at the Solomons Island retreat shared the essential
values and goals for the division; however, several concerns were raised. One
was that officers in the division needed support for professional services,
such as copying, typing, and mailing. Individuals in independent practice
were typically disadvantaged in this regard, and in addition, such support was
becoming increasingly limited for those in academic and other organiza-
tional settings. Thus, to facilitate the involvement by a wider range of mem-
bers, the board considered the need to provide secretarial assistance for offi-
cers. Engaging a professional executive office to perform a variety of
necessary functions for the division was one of the options explored.
Another concern focused on how to enable the division to become more
proactive in policy development both in the profession and in APA. One
option discussed was to expand the responsibilities and duties of the mem-
bers-at-large. Although assigned by the president to significant projects from
time to time, and often consulted about matters of policy, the duties of the
members-at-large were not as well-defined as those of the other Executive
Board members. This sometimes led to differences in expectations about
responsibilities and contributions to the functioning of the division. Another
hindrance to proactive policy development and communication was that
Carter, Davis / REORGANIZING DIVISION 17 891
committee chairs were appointed to their positions for 1 year, so there was an
annual turnover in Division 17 representation to and communication with the
major APA boards and committees (e.g., Education and Training Board,
Board of Scientific Affairs, Board of Professional Affairs) and thus a lack of
continuity in divisional plans and projects in these important areas. So, the
members-at-large who could provide continuity were not involved in a
hands-on manner in important activities, and those who were involved (i.e.,
the committee chairs) served for a short time and often were not present dur-
ing Executive Board deliberations. Thus, it became clear that the organiza-
tion of the division at that time did not provide a structure that was conducive
to long-range planning, coherent leadership, or a proactive agenda.
After the 1st day, Jean Carter and Puncky Heppner evaluated what had
happened and what was decided and established a structure for the 2nd day.
In midmorning, the board members were asked to break into three work
groups identified by Puncky and Jean. Each group was charged with develop-
ing a tentative organizational mode—including a written organizational plan
and the underlying assumptions or values that were used to develop the pro-
posed structure to facilitate attaining the goals that had been discussed.
Each group came back to the meeting room with different, but not entirely
dissimilar, plans for restructuring the division. Each plan was presented and
discussed; then the board broke for lunch with an assignment: “Think about
the implications of each group’s proposal. Use this time to reflect and feel; try
to see proposals from different perspectives.”
Questions were raised about each of the proposals; most of the questions
reflected concerns about how the goals that had been identified earlier in the
process would be met within a specific structure or entity in the reorganiza-
tion plan. For example, a recurrent value was the importance of having
greater opportunity for suggestions and actions generated from the members,
as well as enhanced ability for the Executive Board to initiate action. There
was concern that the division had been merely responding in a reactive and
top-down manner to the initiatives of APA instead of representing the mem-
bership and implementing what they would like to have happen. To ensure
that both top-down and bottom-up strategies were included in division gover-
nance, Mike Patton suggested semiautonomous sections for the division (see
Appendix B).
The creation of four vice presidents, corresponding to the directorates in
APA, was an attempt to reduce the workload for the president and empower
more individuals to initiate actions relevant to the promotion of the counsel-
ing psychology agenda. These vice presidents, with their expertise in one of
the four areas (professional practice, science, education and training, public
interest and diversity), would be in a better position to evaluate proposals and
892 THE COUNSELING PSYCHOLOGIST / November 2001
ESTABLISHMENT AND
REFINEMENT OF A CONCEPT
The results of the June 1992 Executive Board elections ensured some con-
tinuity and some “new blood.” Linda Brooks and Jo-Ida Hansen returned to
the Executive Board as the newly elected treasurer and president-elect,
respectively. Lucia Gilbert, council representative, and Jim Spivack, mem-
ber-at-large, added different perspectives that were independent of those dis-
cussed at Solomons Island.
Carter, Davis / REORGANIZING DIVISION 17 893
In the fall, a special mailing describing the reorganization plan was sent to
the members. President Jan Birk asked for and received comments and reac-
tions to the proposed plan from approximately 50 members. Jan remembers
that most were positive and supportive of the Executive Board’s work. Other
members asked penetrating questions and offered suggestions. This feed-
back from the members was used to revise the original proposal during the
midyear meeting. To provide the time necessary to adequately address the
multitude of issues presented by the proposed reorganization before taking it
to the membership for a vote, President Birk extended the midyear meeting
by 1 day.
Looking back, Jan Birk (president, 1992-1993) recalls
that the process of putting the plan to paper required an incredible amount of
time and work by the members of the Executive Board(s) and they went
through the process admirably—in a style marked by utmost collaboration and
equanimity. When you consider the stress we were under to develop the plan,
solicit members’ input, fine tune the plan, and then effect approval of the rele-
vant bylaw changes, it was to everyone’s credit that our friendships not only
endured but solidified.
The following mission statement was printed in the Spring 1993 issue of
the Division 17 Newsletter. The points in the Statement reflect the values
shared at Solomons Island that gave form to the reorganization plan.
· Define, promote, and support the education and training of counseling psy-
chologists throughout the professional life span.
· Establish and maintain standards of professional service offered by counseling
psychologists.
· Promote the application of counseling psychology in the public interest.
(“Mission Statement,” 1993, p. 1)
The Executive Board now had the mandate to begin the arduous work of
implementing the new structure. Not many on the board realized the amount
of time, planning, and creative problem solving such a transition would
require. The new president, Jo-Ida Hansen, was ideal for the job, as she is a
very organized and detailed-oriented person—exactly what was needed at
this stage.
She recalls, “The huge task of implementation was very difficult, and it
matched what I expected. At the same time, I really appreciated the members’
ability to transcend personal agendas and compromise for the good of the
division.”
As Jo-Ida wrote in her fall President’s column (Hansen, 1993), “The two
most dramatic changes, perhaps, include (a) the expansion of our member-at-
large positions from three to four and their conversion to vice presidents, and
(b) the creation of Sections for the Division” (p. 1). Fortunately, in the 1991,
1992, and 1993 elections, the membership, in its wisdom, had elected three
members-at-large who had definite interests and expertise in three of the four
vice presidential areas: Rosie Bingham became vice president for diversity
and public interest; Jean Carter, vice president for professional practice; and
Jim Spivack, vice president for education and training. What to do about the
fourth vice president?
Because the necessary bylaw changes for the reorganization had not been
approved by the membership prior to the election of new officers (which
occurs routinely in the late spring), no slate for vice president for science had
been presented to the members. As a result, there was no one elected to
assume this key position after the reorganization plan was approved in
August 1993. At the same time, many scientists were feeling disenfranchised
and ignored by APA and had diverted their energies and professional affilia-
tions to the American Psychology Society. The Executive Board thought it
was crucial that the division retain its scientific base if we were to maintain
our identity as a scientist-practitioner specialty. A number of members who
had made numerous scholarly contributions were identified, and it was
decided that Jo-Ida Hansen would first ask Mike Patton to be the vice presi-
dent for scientific affairs. He agreed to serve, but there was a conflict with the
Division’s Bylaws, which allow past presidents only to be elected and serve
as a representative to APA Council. After consulting with the APA legal
counsel, it was decided that Mike would be able to act in the capacity of vice
president for scientific affairs if he were called coordinator of the science vice
presidency. An election for the newly created position of vice president for
896 THE COUNSELING PSYCHOLOGIST / November 2001
scientific affairs would occur the following spring; however, it was critical to
have someone in the position during this 1st year of transition.
Using the new structure, Jo-Ida Hansen created 13 STGs, usually com-
posed of three members of the Executive Board. These STGs were to help
address the transition and promote the underlying values in the mission state-
ment. Examples of the STGs were the Finance Committee Proposal STG (to
consider a new committee in the structure), the Membership Categories Pro-
posal STG (to examine the possibility of including people as division mem-
bers who are not members of APA), the Fellowship Criteria Proposal STG (to
develop new criteria that were more inclusive of the membership, not only the
scientists who published), and a number of STGs labeled Section-Formation
Working Groups. These latter STGs included, but were not limited to, Section
Finances, Section Membership, Section Organizational/Governance Struc-
ture, Section Division Support/Privileges, and Section Project Autonomy.
Every board member was on at least 2 STGs, and some members were on
more.
In accordance with the new structure and the goal to have more involve-
ment by members in the functions of the division, each of the vice presidents
was to have an advisory council. So, the new vice presidents, including the
coordinator of the science vice presidency, were asked to submit names for
the three positions on their advisory councils.
In January 1994, four agenda books arrived at every board member’s
office or home along with a very detailed time line for the 4 days (half days on
Thursday and Sunday) of the midyear meeting in Tampa. Everyone there
remembers certain highlights of the meeting, including the long hours for
meetings, the unbelievable amount of work accomplished, the imperative
break in the middle of the day for recuperation, Jo-Ida Hansen losing her
voice, the late dinners, and Jean Carter’s cookies. Others recall extensive dis-
cussions about specific issues. The two biggest organizational changes—
vice presidents and sections—required the most discussion, planning, and
problem solving. And not surprisingly, the issues were autonomy, responsi-
bility, and accountability.
There was considerable intense debate about the vice presidents’roles and
the extent to which they should operate autonomously in their areas of exper-
tise versus having the president or board sign off on their activities. Related to
this debate was a potential change in budgeting; should or could the vice pres-
idents be given discretionary budgets to better enable them to provide a
strong voice for counseling psychology and to respond rapidly in initiating
projects or attending important meetings or conferences? It was decided to
provide each vice president a budget. However, issues related to autonomy
continued to develop and to be debated.
Carter, Davis / REORGANIZING DIVISION 17 897
There was a long discussion about section autonomy. Most board mem-
bers wanted to give the sections as much autonomy as possible, whereas
some voiced the fear that without sufficient restrictions and accountability,
the sections could cause legal difficulties for the division. The results of these
discussions and the STG reports and decisions related to sections were com-
piled by Linda Forrest and Mike Patton and presented as “Guidelines for the
Governance and Operation of Sections” (also known as Section Guidelines)
at the next Executive Board meeting at the APA convention. By the 1994 con-
vention, 6 months later, the board had the fifth draft of these guidelines. After
Mike Patton’s 1-year term as the science coordinator ended, Linda Forrest
was given major responsibility for compiling the Section Guidelines. Little
did anyone know that there would be seven additional drafts before the guide-
lines were sent to the APA legal counsel for review in April 1995. Some of the
impetus for the multiple drafts arose out of a need for very detailed informa-
tion on how to form a section or SIG, how a section or SIG would govern
itself, and how each would relate to the division. Although the general guide-
lines in the newsletter (“President’s Column,” 1993) were followed, each
revision of the Section Guidelines raised a number of questions or issues that
then had to be clarified and made consistent with other parts of the guidelines.
The Section Guidelines were finally renamed “Rules and Procedures for the
Formation, Governance, and Operation of Sections” following the advice of
APA legal counsel in 1995.
Also at the 1994 midyear meeting, a discussion ensued that led to a minor
change from the original reorganization plan; rather than selecting one of the
four vice presidents for administrative reporting and information exchange
purposes, sections would report to the Executive Board. This change came as
a response to concerns raised by the groups that were asking to become sec-
tions. To them, reporting to only one vice president implied that they
“belonged” in that area, and many viewed their roles and goals to be congru-
ent with more than one vice president’s area. Although the intent had been an
administrative line only, a change was needed. This, of course, required yet
another change in the Section Guidelines.
Some of the standing committees were to be sunsetted at the 1994 APA
convention in August, 1 year after passage of the reorganization plan, and
they were eager to become sections or at least operate as sections-in-forma-
tion during the following year. Already, as of February 1994 at the midyear
meeting, three groups had their petitions approved to become sections-in-
formation. Two (Lesbian, Gay and Bisexual Awareness and Women) had
been standing committees, and one (Health) was a newly developed group.
Two others (Independent Practice, a former standing committee, and Voca-
tional Behavior and Career Development, a former SIG) were granted status
898 THE COUNSELING PSYCHOLOGIST / November 2001
and (c) reinvigorate the group and regain some energy for the final push while
reminding the board of the initial reasons for reorganization. The bylaws
were to be revised, sent to APA legal counsel for review, and voted on by the
membership at the annual business meeting during the 1995 APA
convention.
In addition to the changes associated with reorganization, a new member-
ship category, “Professional Affiliate,” was being proposed for those who
identified themselves as counseling psychologists or were affiliated with the
specialty but who were not members of APA. There were differing views on
the potential benefits and losses associated with this new membership cate-
gory. Some expressed the concern that if a large number of current members
chose to drop their APA memberships and become Professional Affiliates, it
could affect the division’s representation in the APA Council, as only APA
members are mailed ballots to allocate seats on the Council of Representa-
tives. Others thought that some distinguished members were considering
dropping or had dropped their APA memberships and the Professional Affili-
ate category would provide a means to keep these people and others involved
in the division. The new membership category was included in the proposed
changes to the bylaws that would require a vote of the membership at the
1995 annual convention.
Six groups had been recognized as sections-in-formation. Their bylaws
had to be reviewed for consistency with the division’s Rules and Procedures
for the Formation, Governance, and Operation of Sections and then given
section status by the board members.
At the 1995 Executive Board meetings at the APA convention in New
York, bylaws from three sections-in-formation (Health; Lesbian, Gay and
Bisexual Awareness; and Women) were approved. In addition, the Section on
Women became the first section in the division. After 3 years, the division
finally had one of the new structures for greater member involvement that
was conceived and conceptualized at Solomons Island.
Another momentous occasion at that convention was the passage of the
new Division 17 bylaws. After the years of work, members of the Executive
Board were apprehensive that there were so many changes in the bylaws that
the membership would not accept all of the changes at once. Contingency
plans had been developed. People in the audience attending the business
meeting said a collective expression of relief and disbelief crossed the faces
of all the officers on the podium when the revisions were approved without
dissent or comment.
The reorganization of Division 17 was in place, and all phases were being
implemented. Sarah Jordan of the APA Division Services Office is reputed to
have said that Division 17 was a model in how to implement the restructuring
Carter, Davis / REORGANIZING DIVISION 17 901
of a division in APA, and several other divisions have studied our process and
outcome as they consider reorganization.
Kathy Davis (1994-1995 president) said,
The things that impressed me the most were the hard work and amount of time
and energy expended as well as the dedication and commitment to the project.
The number of people involved in the reorganization was huge. Not only were
the Executive Board members during four or five administrations involved, but
there were all the members of the section steering committees who wrote their
bylaws and coordinated the elections of officers, the SIG coordinators who ver-
ified names on petitions or proposed membership lists, APA legal counsel who
reviewed division and section guidelines and bylaws, and so on. We involved a
lot of people!
Although the reorganization did not, and will not, prevent or solve all
issues in Division 17, we think the membership and its leaders are addressing
and meeting most of the goals identified at Solomons Island. We believe there
now exist a structure and means for those who wish to become involved in
Division 17 to do so. The importance of having an active and involved mem-
bership cannot be overstated. Counseling psychologists need an organization
that will attempt to represent all facets and the vast majority of the members
of the profession. As a profession, counseling psychologists cannot afford to
be fractionated on the bases of work settings, activities, or interests; the total
membership provides the direction and driving force of the new professional
and its organization, Division 17.
Jim Hurst’s (1987-1988 president and 1992-1995 and 1996-1999 council
representative) 10-year perspective speaks to the change that has occurred.
At the Executive Board meeting in Toronto [1996], I sat there and watched
Dorothy Nevill and then Jerry Stone, and I thought, “Holy Toledo!”—the lux-
ury of their being able to turn to a vice president for a report and the productiv-
ity that emerged under the vice-president’s leadership was marvelous. The new
structure may not be perfect, but given my perspective from 1988, the reorgani-
zation is as an enormous improvement in all of the ways that we hoped—with
involvement, with attention in various areas, the scientist-practitioner model,
diversity, and the involvement along each of those lines, and the sections,
STGs, and the SIGs. There is no way that the reorganization has solved all the
problems, but it is taking us in the direction to solve them. It provides us with a
structure, a vehicle by which we can address them more effectively. When
counseling psychologists get together, we are far more inclined to work
together cooperatively and productively.
902 THE COUNSELING PSYCHOLOGIST / November 2001
I think that we were no longer waiting to see the fruits of our labor; we were
actually beginning to see things happen. I felt really excited because it seemed
that we were able to determine that we had, in fact, addressed the issues that
concerned us at Solomons Island. The thing that was the most exciting aspect
for me, in addition to doing a much better job of recognizing and attending to
the needs of the various subpopulations in the division, was that we were actu-
ally providing opportunities for people to become involved in the division gov-
ernance at a much earlier point in their careers. Now there seem to be many
more people to share the responsibilities and the work [of the division]. The
other thing that has resulted, even though I am not sure we necessarily foresaw
that this would be such an important outcome, is our becoming involved and
forming liaisons with so many different relevant groups. I think that we have
made huge strides in terms of where and how our influence is felt.
APPENDIX A
1995 Organizational Structure of the
Division of Counseling Psychology (17)
PRESIDENT
E X E C U T I V E B O A R D
STANDING COMMITTEES
Awards & Recognition
Continuing Education & Regional Conferences
Elections Advisory Advisory Advisory Advisory
Fellowship Council Council Council Council
Finance
Hospitality Suite
Membership
Program
Nominations to APA Boards & Committees
PUBLICATIONS
The Counseling Psychologist
Newsletter
SECTIONS
SPECIAL INTEREST
GROUPS
SIG COORDINATOR
(SIGs)
APPENDIX B
Sections and Special Interest Groups
Sections
Definitions and purpose. Sections may be established by the Executive Board pro-
vided that (a) they represent an active and functionally unitary interest of a large group
of members (at least 50 voting members of the division); (b) their proposed purposes
and objectives are consistent with the purposes and objectives of the division and
American Psychological Association (APA); (c) they are formed with administrative
structures subject to Executive Board oversight and control; (d) they operate in a man-
ner consistent with applicable APA Bylaws and Rules and Division 17 Bylaws and
Rules and Procedures; and (e) the establishment of any new section is not inimical to
the welfare of APA, the division, or any division section already established. Sections
are organized to represent and further the educational, scientific, professional, and
public interest goals of division members. The division’s Executive Board may dis-
solve or issue sanctions against a section for cause by a two thirds vote following an
appropriate hearing. Procedures governing division sections are established by divi-
sion Executive Board.
APPENDIX C
Significant Events in Reorganizing the Division
REFERENCES
American Psychological Association. (1987). Model act for state licensure of psychologists.
American Psychologist, 42, 696-703.
906 THE COUNSELING PSYCHOLOGIST / November 2001
to
Volume 29
Authors:
ABREU, JOSÉ M., “Theory and Research on Stereotypes and Perceptual Bias: A Didactic Re-
source for Multicultural Counseling Trainers,” 487.
ANCIS, JULIE R., and DAWN M. SZYMANSKI, “Awareness of White Privilege Among White
Counseling Trainees,” 548.
ATKINSON, DONALD R., see Kim, B.S.K.
BAKER, DAVID B., “Counseling Psychology in Time and Place,” 404.
BAKER, DAVID B., and ROGER A. MYERS, “Albert S. Thompson: A Man of the World of
Work,” 308.
BAKER, DEBRA MOLLEN, see Ridley, C. R.
BARKHAM, MICHAEL, see Madill, A.
BICHSEL, RUTH J., and BRENT MALLINCKRODT, “Cultural Commitment and the Coun-
seling Preferences and Counselor Perceptions of Native American Women,” 858.
BLUSTEIN, DAVID L, “The Interface of Work and Relationships: Critical Knowledge for 21st
Century Psychology,” 179.
BLUSTEIN, DAVID L, LINDA D. FAMA, SARAH FINKELBERG WHITE, TIMOTHY U.
KETTERSON, BIANCA M. SCHAEFER, MICHELLE FRIEDMAN SCHWAM,
SELCUK ROGERS SIRIN, and MARIANNE SKAU, “A Qualitative Analysis of Coun-
seling Case Material: Listening to Our Clients,” 240.
BOWMAN, JASON, see Neimeyer, G. J.
CACHELIN, FARY M., see Striegel-Moore, R. H.
CARTER, JEAN A., “2000 Presidential Address: 90 Percent Perspiration, 10 Percent Inspira-
tion: Creating Change,” 148.
CARTER, JEAN A., and KATHLEEN L. DAVIS, “Revitalizing the Division: The Reorganiza-
tion of Division 17,” 882.
CARTER, ROBERT T., “Back to the Future in Cultural Competence Training,” 787.
CASAS, J. MANUEL, “Directions and Redirections in Chicano Psychology,” 128.
CHRISTOPHER-SISK, ERIN K., see Phillips, S. D.
DAVIS, KATHLEEN L., see Carter, J. A.
DAVIS, KATHLEEN L., “Naomi M. Meara: Toward the Common Good,” 336.
DAWIS, RENE V., “1999 Leona Tyler Award: Toward a Psychology of Values,” 458.
DORLAND, JEANNE M., and ANN R. FISCHER, “Gay, Lesbian, and Bisexual Individuals’
Perceptions: An Analogue Study,” 532.
DOUNCHIS, JENNIFER ZOLER, see Stein, R. I.
DUNBAR, EDWARD, “Counseling Practices to Ameliorate the Effects of Discrimination and
Hate Events: Toward a Systematic Approach to Assessment and Intervention,” 279.
FAMA, LINDA D., see Blustein, D. L.
FISCHER, ANN R., see Dorland, J. M.
FLUM, HANOCH, “Dialogues and Challenges: The Interface Between Work and Relationships
in Transition,” 259.
FOUAD, NADYA A., see Hansen, N. D.
GAO, YIHONG, “Directive Approach to Telephone Counseling in the People’s Republic of
China: Underlying Cultural Traditions and Transitions,” 435.
GLASSCOCK, JULIE M. JEFFREY, see Schultheiss, D.E.P.
GÓMEZ, SYLVIA P., see McNeill, B. W.
GÓMEZ, SYLVIA P., see Prieto, L. R.
GRAVINO, KRISTINE L., see Phillips, S. D.
HANSEN, NANCY DOWNING, and NADYA A. FOUAD, “Service, Scholarship, Serendipity,
and Students: Their Roles in the Lives of Three Prominent Counseling Psychologists,” 331.
HILL, CARRIE L., see Ridley, C. R.
HOTELLING, KATHY, “At Last! Counseling Psychology and Eating Disorders,” 733.
HURST, JAMES C., “Ursula Marie Delworth (1934-2000),” 454.
KASHUBECK-WEST, SUSAN, and LAURIE B. MINTZ, “Eating Disorders in Women: Etiol-
ogy, Assessment, and Treatment,” 627.
KASHUBECK-WEST, SUSAN, LAURIE B. MINTZ, and KENDRA J. SAUNDERS, “Assess-
ment of Eating Disorders in Women,” 662.
KETTERSON, TIMOTHY U., see Blustein, D. L.
KIM, BRYAN S. K., DONALD R. ATKINSON, and DAWN UMEMOTO, “Asian Cultural
Values and the Counseling Process: Current Knowledge and Directions for Future Re-
search,” 570.
KRESS, HELEN M., see Schultheiss, D.E.P.
LEWCZYK, CAROLINE M., see Stein, R. I.
MADILL, ANNA, SUE WIDDICOMBE, and MICHAEL BARKHAM, “The Potential of Con-
versation Analysis for Psychotherapy Research,” 413.
MALLINCKRODT, BRENT, see Bichsel, R. J.
MANZI, ALBERTA J., see Schultheiss, D.E.P.
MCNEILL, BRIAN W., see Prieto, L. R.
MCNEILL, BRIAN W., LORETO R. PRIETO, YOLANDA FLORES NIEMANN, MARC
PIZARRO, ELIZABETH M. VERA, and SYLVIA P. GÓMEZ, “Current Directions in
Chicana/o Psychology,” 5.
MCRAE, MARY B., see Suzuki, L. A.
912 THE COUNSELING PSYCHOLOGIST / November 2001
Division 17:
“American Psychological Association, Division 17—Counseling Psychology: 2000 Awards,”
156.
“The Council of Counseling Psychology Training Programs 2000 Award,” 155.
“Governance Members: 2000,” 157.
“In Appreciation,” 160.
“Minutes of the Annual Business Meeting,” 613.
“Minutes of the Annual Executive Board Meeting,” 604.
“Minutes of the Midyear Executive Board Meeting,” 162.
“1999 Leona Tyler Award: Toward a Psychology of Values,” Dawis, 458.
“Recognition of New Fellows and Counseling Psychology Diplomates,” 155.
“Student Affiliate Group,” 159.
“Treasurer’s Report,” 173.
“2000 Presidential Address: 90 Percent Perspiration, 10 Percent Inspiration: Creating Change,”
Carter, 148.
In Memoriam:
“Ursula Marie Delworth (1934-2000),” Hurst, 454.
International Forum:
“Directive Approach to Telephone Counseling in the People’s Republic of China: Underlying
Cultural Traditions and Transitions,” Gao, 435.
“The Potential of Conversation Analysis for Psychotherapy Research,” Madill et al., 413.
Major Contributions:
“Asian Cultural Values and the Counseling Process: Current Knowledge and Directions for Fu-
ture Research,” Kim et al., 570.
“Assessment of Eating Disorders in Women,” Kashubeck-West et al., 662.
“Awareness of White Privilege Among White Counseling Trainees,“ Ancis and Szymanski, 548.
“Chicana/o Ethnic Identity Research: Lessons for Researchers and Counselors,” Pizarro and
Vera, 91.
“Chicanas/os and Mental Health Services: An Overview of Utilization, Counselor Preference,
and Assessment Issues,” Prieto et al., 18.
“Cultural Mistrust and Mental Health Services for African Americans: A Review and Meta-
Analysis,” Whaley, 513.
“Current Directions in Chicana/o Psychology,” McNeill et al., 5.
“Eating Disorders in Women: Etiology, Assessment, and Treatment,” Kashubeck-West and
Mintz, 627.
“Etiology of Eating Disorders in Women,” Striegel-Moore and Cachelin, 635.
“Gay, Lesbian, and Bisexual Individuals’ Perceptions: An Analogue Study,” Dorland and
Fischer, 532.
“The Interface of Work and Relationships: Critical Knowledge for 21st Century Psychology,”
Blustein, 179.
“Lyle D. Schmidt: Opportunity and Sponsorship,” Meara, 358.
“Making Career Decisions in a Relational Context,” Phillips et al., 193.
“Multidimensional Facets of Cultural Competence,” Sue, 790.
“Naomi M. Meara: Toward the Common Good,” Davis, 336.
“A Qualitative Analysis of Counseling Case Material: Listening to Our Clients,” Blustein et al.,
240.
“Relational Influences in Career Development: A Qualitative Inquiry,” Schulthesis, et al., 214.
“Roger A. Myers: A Voice for Counseling Psychology,” Phillips, 383.
“Service, Scholarship, Serendipity, and Students: Their Roles in the Lives of Three Prominent
Counseling Psychologists,” Hansen and Fouad, 331.
“Social Identities in Contexts: An Ecological Model of Multicultural Counseling Psychology
Processes,” Neville and Mobley, 471.
“Stereotypes About Chicanas and Chicanos: Implications for Counseling,” Niemann, 55.
“Theory and Research on Stereotypes and Perceptual Bias: A Didactic Resource for Multicul-
tural Counseling Trainers,” Abreu, 487.
“Treatment of Eating Disorders in Women,” Stein et al., 695.
Professional Forum:
“Internship and Initial Job Placements in Counseling Psychology: A 26-Year Retrospective,”
Neimeyer et al., 763.
Reactions:
“Advancing the Study of Chicana/o Psychology,” Vasquez, 118.
“At Last! Counseling Psychology and Eating Disorders,” Hotelling, 733.
“Counseling Psychology in Time and Place,” Baker, 404.
“Critical Issues Concerning Cultural Competence,” Ridley et al., 822.
“Dialogues and Challenges: The Interface Between Work and Relationships in Transition,”
Flum, 259.
INDEX 915
Rejoinder:
“The Superordinate Nature of Cultural Competence,” Sue, 850.