Approaches for the Culturally-Competent Counselor to use with Offender Clients Sarah Littlebear, PhD, LPC Blue Ridge Judicial Circuit Cherokee County

Transcription

1 Approaches for the Culturally-Competent Counselor to use with Offender Clients Sarah Littlebear, PhD, LPC Blue Ridge Judicial Circuit Cherokee County Mental Health Court

2 The Drug Court Client What is the offender s age, gender, race, marital status, socioeconomic status etc? Is the offender employed, unemployed, in school? What does the family of the offender look like? What does the offender physically look like?

3 Counselor Competency The Association for Multicultural Counseling and Development (AMCD) established the multicultural counseling competencies: Counselors awareness of biases and own cultural values Counselors knowledge of clients worldviews Counselors implementation of culturally appropriate intervention strategies

4 Questions for Ourselves To what extent do we, as treatment providers to offenders, rate our multicultural competence? Does a difference exist in perceived multicultural competency on the basis of years of experience, education, ethnicity, or level of certification or licensure? Does the number of completed classes in multicultural counseling affect our perceived multicultural competence?

5 Counselor Multicultural Awareness Questions to facilitate with colleagues or in a supervision session: What does being a member of your racial group mean to you? What values and traditions do you associate with your racial group? How might your racial heritage influence your relationship with members of other racial groups? Lassiter & Chang (2006)

6 Cultural Knowledge The majority of materials to assist court personnel and others who work within this area are flawed. They provide information on characteristics of working with the offender population as a whole with focus on individual racial or ethnic groups. There is often a dichotomous view on working with these populations that focus on stable patterns. Warrier (2008)

7 Culturally-Appropriate Interventions must reflect Interventions the culture of the client. (Example: Latino population) Conventional Euro American approaches miss the cultural aspects of working with different minority groups. 1. Be a healthy role model for your client by modeling honest expression of your own life experiences and perceptions. 2. Provide client with feedback and openness. 3. Be direct with clients, but respond to negative emotions with positive regard, empathy, care. 4. Be confrontational with clients. 5. Interpret with honest self-disclosure. Torres-Rivera et al. (2004)

8 Motivational Interviewing Involves partner-like relationship between counselor and client Four Principles: Developing Discrepancy: May involve amplifying the discrepancy between a value and offending behavior and consequent prison sentence. Rolling with Resistance: No counter-resistance by therapist Expressing Empathy: Client-centered nature of MI Supporting Self-Efficacy: Fosters client s belief they have ability to change

9 Motivational Interviewing Generally used to facilitate change with the offender population. For populations who abuse substances, MI is an effective technique for retention. Leads to improvements in readiness to change. MI may have mixed results for substance using groups, but is not necessarily effective for clients with domestic violence issues. (McMurran, 2009)

10 Motivational Interviewing MI may be able to provide extrinsic motivation for offender clients (McMurran, 2009). This would be a great tool for various cultural backgrounds. Some upsides to MI in group formats include: meeting needs of larger group of clients and positive supports for peers. May work for individuals who do not identify treatment goals (Lincourt, Kuettel, & Bombardier, 2002).

11 Motivational Interviewing MI skills encourage resolving ambivalence, building motivation, fostering commitment to change, and making progress toward behavior change. MI uses open-ended questions, affirming, simple reflections, summaries, emphasizing control, and evocative questioning. MI has been particularly effective with minority groups and young people, but with mixed results with African-Americans. Inconclusive evidence of use with group-based settings. Austin, Williams, & Kilgour (2011)

12 Cognitive-Behavioral CBT has been found to be effective with juvenile and adult offenders; substance abusers and violent offenders; probationers, parolees, and prisoners. Used to improve social skills, means-ends problem-solving, critical and moral reasoning, cognitive style, self-control, impulse management, and self-efficacy. Programs are often used in small-group settings and use role-play, modeling, or demonstrations. In individual sessions, homework or experiments between sessions are given and recommended often.

13 Cognitive-Behavioral Some characteristics of distorted thinking: Immature or developmentally arrested thoughts. Inability to consider effects of one s behavior. Inability to manage feelings of anger. Mistaken belief of entitlement with inability to delay gratification while confusing needs and wants and ignoring others rights. Force and violence as means to achieve goals. Clark (2011)

14 Cognitive-Behavioral In a study of marijuana-dependent young adults (ages 18-25) where forms of CBT (plus contingency management) were used, African American males were significantly less likely to complete the treatment and post-treatment sections than White clients. Family-focused interventions were suggested for working toward retention for young African American males (Montgomery, Petry, & Carroll, 2012) CBT has been found effective for use with African American and Latino clients. CBT interventions have mixed reviews for use with depression in African American males; however, there has been significant reduction in panic disorder symptoms in African American females (Voss Horrell, 2008). **This is a very small snapshot of use of CBT with various cultural groups. There must be an effort to include minorities in research for treatment effectiveness.

15 Narrative Approach Offers a way to understand human experience in difficult circumstances. Personal storytelling that orders experience and constructs reality. Shaped by detailed, cultural, and context-specific schemas. Offenders are able to provide their personal accounts or autobiography. Describe past and criminal acts, lifestyle to peers and counselors. Can use this in group approach where other offenders are the audience and can detect cognitive distortions either verbally or through their body language. Use of intonation by narrator is common where voice is raised like a question when really making a statement. Waldram (2008)

16 Narrative Approach Taking charge of identity can be critical. Use of fantasy story could help with this. Be aware of any biases and privileged status when conducting narrative approach. Not intended to discourage those from a different background from engaging in narrative therapy with another background (Cohn, 2014). Encouraging client to find meaning. In group, includes listening for stories versus symptoms/information (Ricks, Kitchens, Goodrich, & Hancock, 2014).

17 Narrative Approach Client: I got locked up for having drugs on me at a traffic stop. Now, my life is ruined. Therapist: Put yourself back when all this was going on. What did that look like and mean to you? Client: Well, I was out of work at the time, and I met this girl who distracted me. Nobody knew what it was like to be the only transgender person around. I guess I thought the drugs were the way out of a bad situation

18 Conclusion In summary, remaining aware of your own cultural identity while working with other cultures is vital. Know your biases. Recognizing the therapeutic methods/techniques that work best with your clients is the key to successful work with offenders. Questions? Comments?

19 References Austin, K.P., Williams, M.M., Kilgour, G. (2011). The effectiveness of motivational interviewing with offenders: an outcome evaluation. New Zealand Journal of Psychology, 40 (1), Clark, P. (2011). Preventing future crime with cognitive behavioral therapy. American Jails, 1, Cohn, A.S. (2014). Romeo and Julius: A narrative therapy intervention for sexual-minority couples. Journal of Family Psychotherapy, 23, Lassiter, P.S. & Chang, C.Y. (2006). Perceived multicultural competency of certified substance abuse counselors. Journal of Addictions & Offender Counseling, 26, Lincourt, P., Kuettel, T.J., & Bombardier, C.H. (2002). Motivational interviewing in a group setting with mandated clients: A pilot study. Addictive Behaviors, 27, McMurran, M. (2009). Motivational interviewing with offenders: A systematic review. Legal and Criminological Psychology, 14, Montgomery, L., Petry, N.M., & Carroll, K.M. (2012). Moderating effects of race in clinical trial participation and outcomes among marijuana-dependent young adults. Drug and Alcohol Dependence, 126, Ricks, L., Kitchens, S., Goodrich, T., & Hancock, E. (2014). My story: The use of narrative therapy in individual and group counseling. Journal of Creativity in Mental Health, 9, Rivera-Torres, E., Wilbur, W.P., Phan, L.T., Maddux, C.D., & Roberts-Wilbur, J. (2004). Counseling Latinos with substance abuse problems. Journal of Addictions &Offender Counseling, 25, Voss Horrell, S.C. (2008). Effectiveness of cognitive-behavioral therapy with adult ethnic minority clients: A review. Professional Psychology: Research and Practice, 39 (2), Waldram, J.B. (2008). The narrative challenge to cognitive behavioral treatment of sexual offenders. Culture, Medicine, and Psychiatry, 32, Warrier, S. (2008). It s in their culture : fairness and cultural considerations in domestic violence. Family Court Review, 46 (3),