Culture, Context, Community and Mental Health Service

Delivery in a University Setting Presented by

Shelly P. Harrell, Ph.D.

Counseling and Psychological Services (CAPS)

July 17, 2013

My Connection to UCLA

• UCLA graduate student in the 1980s

• Practicum at UCLA Psychological Services 1985-86

• Dissertation topic was on the the role of minority student stressors in the academic performance and psychological well-being of Students of Color

• Visiting Professor in AAP’s Freshman and Transfer Summer Programs on and off since 1988 and every year since 2000

Overview of the Day

Beginning the Conversation Culture, Context, and Community Multicultural Competence Multicultural Psychology 101 The “PEaCE” Model Evidence Based Practice and Implications for

Intervention Multicultural Mental Health and the University

Setting Continuing the Conversation

“My humanity is bound up in yours, for we can only be human

together.” ~Bishop Desmond Tutu

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Beginning the Conversation

What are your thoughts

about the role of

culture in mental

health?

Walking the Talk?

• Does what we do in practice match what we say about the importance of multicultural issues?

• Belief in importance of multicultural competence outpaces behavior – McKitrick, D.S., & Li, T.S. (2008). Multicultural treatment. In Handbook of

Clinical Psychology, Vol. 1. Adults.

MY PRIMARY GOAL TODAY

Expand your awareness, knowledge, and skills related to

the consideration of culture, context, and community in your

work here at CAPS

The Centrality of Culture, Context, and Community in Multicultural Mental Health

APA Multicultural Guidelines (2003)

Approved as policy by the APA Council of Representatives

Addresses multicultural competence Professional practice

Research

Education and Training

Organizational Change

Important Cultural Awareness

Cultural Knowledge

Cultural Skills

First sentence of APA Multicultural Guidelines

“All individuals exist in social, political, historical and economic contexts and

psychologists are increasingly called upon to understand the influence of these contexts on individuals’ behavior.”

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Culture and Human Behavior

Human behavior is multiply determined and culture is one of those determinants

All behavior occurs in a cultural context – we see, experience, and interpret the world through a cultural lens

Culture provides a context for making meaning of the world and understanding one’s place in it

The cultural context provides norms for behavior and for social and interpersonal interactions

Definitions of Culture

“The patterns of behavior and thinking that people living in social groups learn, create, and share.” (Bodley, 2002, Microsoft Encarta)

“The vast structure of language, behavior, customs, knowledge, symbols, ideas, and values which provide a people with a general design for living and patterns for interpreting reality” (Nobles, 1978/2006, p. 71)

“Attitudes, values, beliefs, norms, and behaviors shared by a group but harbored differently by each specific unit within the group, communicated across generations, relatively stable but with the potential to change across time” (Matsumoto, 2000, p.24)

The material, social, and ideological adaptations of a group of people, which emerged in the service of collective adaptation to a particular sociohistorical context, and that are woven tightly into the fabric of daily life, relationships, and social structures (Harrell)

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Some Dimensions of Culture

Sense of self and space

Individualism / Collectivism continuum

Communication and language

Nature of relationships

Family roles and structure

Time and time consciousness

Values and norms

Beliefs and attitudes

Mental processes and learning style

Work style and practices

Dress and appearance

Food and eating habits

Art, Music, and aesthetic preference

Emotional expression

Public and private information

Coping and help-seeking behaviors

Definitions of health and illness

Culture can be demographically-based (e.g., ethnic culture, gay culture) or experientially-based (e.g., occupational culture, 12-step culture)

Individuals are exposed to and internalize multiple cultural influences which intersect in particular ways to create identity

Culture functions as an organizing and linking process between persons and contexts, as well as being manifested in the transactions between them

The inclusion of culture in the analysis of human experience, behavior, and transformation facilitates the identification of constructs, methods, and strategies that may enhance the effectiveness of applied work in diverse cultural contexts

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The Integrative and Foundational Role of Culture

A Conceptualization of Culture

CULTURE is conceptualized as an adaptative system that:

1) provides the superordinate context in which human experience, functioning, and transformation occur by

providing the fundamental and organizing foundation for interpreting and living in the world;

2) emerges from and influences the transactions between persons and environments;

3) is learned, expressed, and passed along through a vast network of shared material, social, and ideological

structures including ideas, values, beliefs, sensibilities, social roles, language, communication patterns, physical

artifacts, rituals, and symbols 15

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What is Context?

Contexts- the multiple and encapsulating environmental, interpersonal, societal, and historical conditions and circumstances within which we live, grow, and change

The Importance of Context

Central principle: Behavior cannot be understood outside of the settings and circumstances in which it occurs; EVERYTHING we do and become takes place in social contexts

Changing behavior involves not simply targeting the person, but also attending to the environment within which the behavior occurs

The idea of “people in context” is important in many fields within psychology

The Role of Context in Human Behavior

Behaviorism- Human behavior is shaped by the reinforcements and contingencies of the environment

Developmental Psychology: Bronfenbrenner’s Bioecological Theory of Human Development (aka Ecological Systems Theory) and Margaret Spencer’s Phenomenological Variant of Ecological Systems Theory (PVEST) Microsystems, Mesosystems, Exosystems, Macrosystems, Chronosystems / Process-

Person-Context-Time Model

Social Psychology: Kurt Lewin’s formula for understanding human behavior (Field Theory) B=f(P,E): Behavior is a function of person and environment interaction; Context Minimization Error

Interpersonal Neurobiology: “Mental events and human behaviors can be thought of as states that emerge from moment-to-moment interaction with the environment, rather than proceeding in a context-free fashion from preformed dispositions or causes. Inherently, a mind exists in context.” (Barrett, Mesquita, and Smith, 2010)

Health Psychology: George Engel’s Biopsychosocial Model of Health & Illness; Health and illness develop out of the complex relationships between biological, psychological, and social determinants

Functional Contextualism: A philosophy of science that guides modern behaviorism’s insistence that behavior must always be understood in relation to its historical and current context, the focus of study should be function rather than topography in order to understand and influence behavior, and the importance of contextual cues that determine the process of relational responding

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MORE… Community Psychology: Multiple Levels of Analysis Conceptual Framework

Individual, Microsystem, Organizational, Community, Macrosystem Multicultural Psychology: Centers the consideration of culture and human diversity in

understanding individual and group behavior Wade Nobles’ “Culturecology”; Celia Falicov’s Multidimensional-Ecosystemic-

Comparative Approach (MECA)

Feminist Psychology: Centrality of the dynamics of power and privilege, social location, and relational ways of being to the psychology of women

Constructivist/Narrative Psychology: Meanings of experience and events emerge from socially constructed narratives (stories) that are tied to our personal, social, temporal, political, and cultural contexts. These meanings influence identity and memory, as well as shape our understanding and interactions with others and in the world.

Existential Psychology: “The world…is the natural setting of, and field for, all my thoughts and all my explicit perceptions…Man is in the world and only in the world does he know himself.” –Maurice Merleau-Ponty

Humanistic Psychology: Roger’s necessary and sufficient conditions (“the soil”) for optimal development and functioning

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Importance of Ecological and Contextual Variables

Context affects conditions of living and access to societal resources

Context determines exposure to particular societal, sociocultural, and community narratives that define self, acceptable roles, as well as appropriate thoughts, feelings, and behaviors

Context impacts options for support and coping

Context influences opportunities for affirmation and validation of self and community

Unhealthy contexts can impede functioning and well-being, compromise or confuse personal and collective identity, and suppress or misdirect health-promoting behaviors.

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“The Building” Metaphor

Emerged while teaching Intercultural Laboratory to clinical psychology doctoral students during

the OJ Simpson Trial and Verdict

What is community?

Two Primary Types of Communities

Locality-based People, groups, and organizations who interact

primarily based on proximity, not necessarily by choice Examples: neighborhood, small town, city

Relational People, groups, and organizations whose connections

are based upon commonalities or identification and are not limited by place or geography

Examples: club, occupation, ethnicity

Four Types of Relational Communities

Identity community

Religion, race, ethnicity, sexual orientation

Common interest community

Social or recreational clubs, occupation

Task-oriented community

School, workplace

Collective power structure community

Labor unions, advocacy groups

Significance of Community

Sarason (1974) – A Psychological Sense of Community Loss or dilution of strong community connections is

the most destructive dynamic in people’s lives

Psychological well-being, quality of life, meaning and purpose, self-esteem and positive behaviors are strongly related to having a sense of belongingness, connection, and identification with something larger than oneself

Psychological Sense of Community Sarason (1974) & McMillan and Chavis (1986)

The emotional connection we have with our communities

Connection to a larger whole characterized by sharing an emotional bond or common condition

A feeling of belonging, identification, and security in relationship to a larger group

A sense of being “in this together”, that others “have my back” Feeling of belonging

Feeling that members matter to one another and to the group

Shared faith that members needs will be met through commitment to be

together

1967- Martin Luther King Jr.’s Invited Distinguished Address at APA

“The Role of the Behavioral Scientist in the Civil Rights Movement” Social responsibility – psychologists should be instruments for

social change Importance of focusing on context vs. individual pathology Appealed to psychologists to “tell it like it is” – disseminate

information on the “reality of Negro life” Calls for research into complex dynamics of “Negro” life

(within-group vs. comparative research) Understanding of urban riots Links economic conditions and discrimination to individual

behavior – called for structural changes Need to study and promote citizen leadership and social

action Promoted the idea of Creative Maladjustment

What is

Multicultural Competence (MC)

for Psychologists?

The demonstrated ability to consistently and carefully consider the cultural dimensions of Self, Other, and Context, and to engage

in ethical and culturally responsive behavior that reflects these considerations in all professional roles (i.e., assessment,

intervention, research, teaching, consultation, supervision, administration).

(S.P. Harrell, 1997, revised 2002 & 2006)

A Question for Contemplation

How is the killing of Trayvon Martin and trial of George Zimmerman

relevant to meeting the mental health needs of UCLA students?

Issues to Consider • Sociopolitical Issues

– Racism-related stress has been found to be associated with mental health and functional outcomes

• University Climate Issues – Experiences in the social climate (dorm, classroom, informal)

• Developmental Issues – The centrality of racial and ethnic identity development – Racial-ethnic socialization

• Relational Issues – Interactions with others – Social support and sense of community

• Psychological Issues – Anxiety – Stereotype threat (Claude Steele, Stanford University)

Multicultural Psychology 101 1. Terminology (Race, Ethnicity, and Culture) 2. The “Culture” of Psychology 3. Psychological Research and Cultural Diversity 4. Racial-Ethnic Socialization and Identity 5. The Sociopolitical and Sociohistorical Context 6. Immigration, Refugee, Colonized, Genocide, and Slavery Experiences 7. Acculturation, Assimilation, Biculturation, Alienation 8. Collectivism, Communalism, and the Interdependent Self 9. Worldview and Culture 10. Indigenous Psychologies 11. Intersectionality and Ecological Niche 12. The Lived Experience of People of Color 13. Stereotypes, Prejudice, Discrimination and Oppression 14. Racism-related Stress: episodic life events, chronic, microaggressions, vicarious, transgenerational 15. The Physical and Mental Health Effects of Racism 16. Internalized Racism and Colorism 17. White Privilege 18. Intergroup Relations and the Dynamics of Difference 19. Liberation Psychology and the role of Social Justice in Psychotherapeutic Interventions 20. Critical Consciousness 21. Multicultural Competence 22. EBPP and Cultural Diversity 23. Culture and Theoretical Orientation 24. Culturally-Adapted and Culturally-Centered Interventions 25. Language and Psychotherapy

Multiple dimensions of diversity

Intersectionality The overlapping and interactive dynamics of multiple

dimensions of diversity The effects of one diversity dimension in our lives is, in

part, dependent on one’s status on additional dimensions of diversity Being a man Being a Latino man Being a gay Latino man

Ecological niche the place where a one’s multiple contexts and cultural

locations converge

Privilege in a Clinical Context

What we miss or minimize

What we see as important or unimportant

Assumptions re: needs, wishes, meanings

Cultural empathy failures

Emotional responses (pity, guilt, irritation, defensiveness, boredom, disinterest)

DIFFERENCE

We are all

AT THE SAME TIME

Like ALL others

Like SOME others

Like NO others (paraphrased from Murray & Kluckhohn)

5 Ds of Difference (Harrell, 1990)

• Denial

• Defensiveness

• Distancing

• Devaluing

• Discovery

Implications for Multicultural Practice

Our clients live and develop in multiple cultural communities (communities of race/ethnicity, gender, religion, sexual orientation, social class, etc.)

Our clinical work must incorporate attention to the culture and context of these communities, as well as who we are in relation to the client’s cultural communities

Application of these ideas requires a unique journey with each client and each community with whom we work

The Need for a Model to Guide the Systematic Integration of Culture

and Context into our Work

“The struggle has always been inner, and is played out in outer terrains. Awareness of

our situation must come before inner changes, which in turn comes before

changes in society.” -Gloria Anzaldua

“Understanding of one’s existence as such is always an understanding of the world.”

–Martin Heidegger

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“PEaCE” Person-Environment-and-Culture

Experiential Model

Extends the idea of Person-Environment Transactions from Lewin’s Field Theory to explicitly include culture

Based on the idea that all of human experience occurs at the intersection of persons, culture, and contexts and that culture is a core element of both persons AND environments

The integrative Person-Environment-and-Culture Experiential (“PEaCE”) model starts with the role of culture and context in human experience.

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Primary Purposes in Developing the PEaCE Model

To provide a comprehensive, holistic, culture- and context- conscious meta-theoretical model that incorporates the multiple dimensions and contexts of human expression and experience

To identify and explicate core processes that can enhance our understanding of the development and optimization of positive outcomes for individuals, relationships, and communities

To provide a conceptual framework for the development and evaluation of evidence-based psychological interventions that emerge from cultural and contextual considerations

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PEaCE: The Experiential Emphasis

The PEaCE conceptual model seeks to provide an integrative conceptualization of “Lived Experience” that meaningfully incorporates culture and context incorporates the multiple determinants of and influences on the nature and quality of human experience

The emphasis is on how internal and external experience are in ongoing, dynamic, and culture-informed transaction to affect point-in-time outcomes with respect to functioning and well-being.

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Human Experience, Culture and Context

“[A] bare subject without a world never ‘is’.” -Martin Heidegger

Descriptions of human experience and behavior must reference the whole Person-Environment-and-Culture Transactional System in order to fully capture the dynamic process of the person as a living system that is embedded in and interdependent with multiple cultural and ecological systems

Emerging from these concepts is the theoretical position that a decontextualized “self” is meaningless; our existence is meaningful only in relationship (to others, to community, to culture, to physical settings, to ecological contexts, to nature, to God)

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Overview of PEaCE Point-in-Time Adaptational Outcomes (“A” Outcomes) for individuals, relationships and communities are expressed across multiple contexts of Well-Being (Physical, Psychological, Relational, Collective, Transcendent) and Distress, Dysfunction, and Disorder (DDDs). The Interconnected and Multidimensional (IaM) Person System (multiple Bio-Experiential “B” Processes) interacts with, is shaped by, and influences The Multilevel Social-Ecological (SEE) System (multiple Contextual “C” Processes) within the superordinate Multicultural System. These ongoing and constant Person-Environment-and-Culture (PEaC) Transactional Processes result in the degree and quality of the fit between co-occurring elements of the IaM Person, SEE, and Multicultural Systems. Ameliorative, Protective, and Transformative (APT) resources and processes (both natural and learned) emerge from these PEaC Transactions and can effect “A” outcomes. Degree of PEC Fit at any point in time is expressed through five Modalities of Daily Experience (MODEs: feeling, thinking, doing, connecting, and evolving).

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The 8 Core PEaCE Concepts 1. The Interconnected and Multidimensional (IaM) Person-System- “THE PERSON” -The 7 Bio-Experiential (“B”) Processes – “BEING & BECOMING” 2. The Multilevel Social-Ecological Environmental (SEE) System – “THE ENVIRONMENT” -The 8 Contextual (“C”) Processes–“CONDITIONS & CIRCUMSTANCES” 3. Culture- An organizing and foundational system from which persons and environments are shaped and

transformed, and that provides the fundamental frameworks for daily life as expressed through values, beliefs, behaviors, social roles and structures, etc.

4. Person-Environment-and-Culture Transactional Processes -The dynamic interrelations between and among person, cultural, and environmental processes

5. Person-Environment-and Culture (PEaC) Fit-The degree to which “B” and “C” Processes are experienced as congruent and complementary in a particular cultural context

6. Modalities of Daily Experience (MODEs)-The human experience and expression of PEaC Transactional Processes (Feeling, Thinking, Doing, Connecting, Transcending)

7. Ameliorative, Protective, and Transformative (APT) Processes & Resources-Natural or learned processes

and resources that emerge from PEaC Transactions and function to manage or change “B” and “C” processes and impact point-in-time outcomes

8. Human Experience, Adaptation, Relience, and Transformation (HEART) Point-in-Time Outcomes - “A” Outcomes – “ADAPTATION & AGENCY”: indicators of positive and negative outcomes for individuals, relationships, and communities; Well-Being: Physical, Psychological, Relational, Collective, Transcendent 46

The IaM Person System The Interconnected and Multidimensional Person System (IaM)

represents the ontological understanding of our “beingness” (human existence) and is grounded in the idea that we are simultaneously

~Biological Beings ~Cognitive Beings ~Emotional Beings ~Cultural Beings ~Psychological Beings ~Relational Beings ~Spiritual Beings

“B” Processes can be thought of as the dynamic and constantly

interacting elements of the IaM Person System Although we may sometimes feel these different elements as separate

aspects of ourselves, they are continuously interacting with each other and the environment

We cannot identify or describe any aspect of the IaM without considering the interdependence of all aspects of our beingness

Includes the idea of the whole being more than the sum of its parts and that the whole is contained within each of the parts

The IaM Person System does not exist in a vacuum Contextual and cultural processes influence how the “IaM” is

expressed, experienced, and developed

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The Multilevel Socioecological System

The Multilevel Social-Ecological Environmental (SEE) System represents the layered and embedded nature of the multiple contexts within which we experience our beingness

“C” (Contextual) Processes can be thought of as the dynamic and constantly interacting elements of the Multilevel Socioecological System

While eight critical contexts are identified in the model, it is important to remember that they operate concurrently and are in ongoing interaction with each other

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“BEING-IN-THE-WORLD”

Being-in-the-World, a humanistic-existential construct, is a way of thinking about the constant and ongoing relationship between the complex IaM Person System that exists and is transformed within the Multilevel SEE System

The two systems cannot exist independently– they are interdependent

The human “Being” is inseparable from the “World” in which s/he lives (Context)

The functioning of the different elements of the IaM Person System cannot be understood apart from each other nor apart from the layers of contexts in which we live

The contextual elements of the Multilevel Social-Ecological Environmental System are created, maintained, and changed by Persons

Contexts are impacted by the persons who comprise them

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Culture in the PEaCE Model CULTURE EMERGES FROM THE TRANSACTIONS BETWEEN PERSONS AND

CONTEXTS AND IS SIMULTANEIOUSLY REPRESENTED IN BOTH PERSONS AND CONTEXTS

Sociocultural Processes Reflect the transactions between culture and the multiple ecological contexts within which we develop,

live, and change The shared core elements of the cultural worldview, beliefs, customs, etc. General and commonly expressed cultural characteristics: Material culture, Social culture, Ideological

Culture Manifestations of culture that emerge from a group’s cultural context The essential elements of a culture’s way of life passed down from generation to generation Similar to Matsumoto’s “societal culture” Expressed as the SOCIOCULTURAL “C” Processes of the ENVIRONMENT

Psychocultural Processes Reflect the transactions between culture and the multiple and interconnected aspects of the person The unique ways that ecological culture is internalized and expressed by each individuals, families, and

groups The intentional choices that individuals makes regarding adopting and participating in particular cultural

values, customs, behaviors, etc. The meaning of culture to the individual Similar to Matsumoto’s “individual culture” Expressed as INTRACULTURAL “B” Processes of the PERSON

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APT Processes & Resources

Ameliorative, Protective, and Transformative (APT) Processes & Resources

• Natural or learned processes and resources that

reflect particular types of PEaC Transactions that

function to modify MODEs, B Processes, and/or C

Processes, thus creating new PEaC transactions that

ultimately modify Point-in-Time Outcomes

• Interventions can be developed to target problematic

PEaC transactions and decrease DDDs, as well as to

increase optimal functioning and positive well being

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Three Types of APT Processes & Resources

Ameliorative Processes Natural and learned processes with a primary goal or

effect of reducing distress and disconnectedness

Protective Processes Natural and learned processes that have the goal or

effect of increasing resilience, strengthening identity, and/or improving the ability to cope with life’s challenges

Transformative Processes Natural and learned processes that have the goal or

effect of facilitating thriving, positive growth, and optimal functioning

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PEaC Fit

PEaC fit is conceptualized as the degree of congruence and complementarity within and between

1) The bio-experiential processes and characteristics of the PERSON

2) The resonant worldview and ways of living rooted in CULTURE (within person AND context simultaneously)

3) The historically-influenced and currently manifested demands and resources of the social and physical CONTEXTS at multiple ecological levels of analysis

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APPLICATIONS

Evidence-Based Practice

APA’s Definition of Evidence Based Practice

for Psychologists (EBPP)

An integration of… The Best Available Research

Clinical Expertise In the context of:

• Patient Characteristics • Patient Culture

• Patient Preferences

Challenges to Evidence-Based Practice

There are problems in the operationalization and application of evidence-based practice What evidence is considered acceptable? Lack of distinction between evidence-based practice and empirically-

supported treatments such that the evidence is limited to the existence of ESTs for specific disorders

The foundation of ESTs are the randomized clinical trials (RCTs) conducted with largely homogeneous samples with respect to dimensions of diversity (e.g., ethnicity, acculturation, socioeconomic status, religion, sexual orientation, disability status, etc)

These problems are particularly concerning in regards to the trend towards the generation of lists of evidence-based treatments that are inappropriately imposed upon diverse communities that bear no resemblance to the samples in the RCT studies that established the intervention as “efficacious”

There has been some progress in the application of evidence-based psychological practice with culturally diverse, underserved, and marginalized populations, but this work is certainly in its infancy.

Terminology for Incorporating Culture

• Culturally-Sensitive • Culturally-Appropriate

• Culturally-Relevant • Culturally-Intentional • Culturally-Adaptive

• Culturally-Alert • Culturally-Responsive • Culturally-Competent

• Cultural Resonance (Trimble)

Culturally-Syntonic (Harrell, 2008)

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Why Culturally “Syntonic”? Syn – with or together

the Greek “suntonos”-- in harmony with – Collins English Dictionary

Emotionally in harmony with one’s environment -Collins English

Dictionary

Normally responsive and adaptive to the social or interpersonal environment -Merriam Webster’s Medical Dictionary

In emotional equilibrium and responsive to the environment –YourDictionary.com

Describes somebody who is normally attuned to the environment; used to describe behavior that does not conflict with somebody’s basic attitudes and beliefs –Microsoft Encarta College Dictionary

Characterized by a high degree of emotional responsiveness to the environment; Of or relating to two oscillating circuits having the same resonant frequency -American Heritage Dictionary

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Culturally-Syntonic Practice (CSP)

In the context of psychologically-informed interventions, culturally-syntonic practice involves:

Processes, activities, relationships, and experiential presence

that reflect attunement, harmony, and resonance

with relevant dimensions of collective cultural aspects (sociocultural processes) and their individual expressions (psychocultural processes),

such that engagement with, and the effectiveness of, interventions is enhanced and optimized. (Harrell, 2008/2011)

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More on a Culturally-Syntonic Approach

• Characterized by – activities, interactions, and perspectives

• that reflect consistency with and responsiveness to a person’s or group’s – relevant cultural contexts; – internalized cultural meanings, beliefs, values; and – manifested actions and behaviors

• such that there is a “fit” or resonance between the

practice and the relevant person-environment transactions

Culture and Context

in Psychotherapy

THERAPIST CLIENT

Dominant culture

Culture(s) of identity

Culture of psychotherapy

Dynamics of status, power and privilege

Environmental & sociopolitical context

Culture of Psychotherapy

Individual growth (“Find” and “Be” ME)

Autonomy and separation

Verbal and emotional expression

Generally rigid distinctions between physical and emotional functioning

Relative exclusion of spirituality

Linear approach to problem definition and solution

Analyzing the PEaCE Field

IaM Person System Analysis (B Processes)

Cultural-Ecological Profile (C Processes)

Multicultural Identities and Influences

PEaCE Transaction History and Current Status

Wellness Assessment (optional use of MWA instrument)

DDD Expressions (optional use of BADDD Scale)

ICHE Analysis

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Diversity Principles for Community Research and Action (Harrell & Bond, 2006)

Community Culture Descriptive

Informed Compassion

Community Context Analytic

Contextual Understanding

Self-in-Community Reflective

Empowered Humility

Informed Compassion

• Balanced integration of head and heart

• Seeking knowledge and awareness from a place of openness, respect, and caring

• Not distanced over-intellectualized position nor emotion-driven overidentified position

Contextualized Understanding

• Multiple levels of analysis

• Individual, Microsystem, Organizational, Identity Group, Macrosystem

• Temporal context

• Person and interactions among persons are a function of variables at all levels of analysis

• Decontextualized analysis risks oversimplified and superficial understanding

Empowered Humility

• Proactive engagement grounded in awareness of our vulnerabilities and limitations

• Acknowledgement of another’s right to self-determination

• Understanding that stronger connection and greater empowerment emerges from healthy humility that frees us to be open to see, hear, and learn in unanticipated ways– gives us confidence to walk in unfamiliar terrain and meet the “other” where s/he stands

Approaches to the Integration of Culture

Three approaches to the conceptualization and integration of culture into psychological research and practice

Culturally-Adapted - Start with presumably universal constructs, strategies and methods and then make cultural adaptations

Culturally-Centered - Start with constructs, strategies and methods that emerge from multicultural considerations and then integrate culturally-syntonic contributions from multiple traditions as appropriate

Culturally-Specific – Start with the specific ecological culture and design strategies that emerge from constructs relevant to that group

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Case Discussion and

Q & A