Multicultural Aspects of Disabilities by Willie Bryan - Book Report/Review Example

Introduction In Multicultural Aspects of Disabilities (2007) Willie Bryan discusses the various ways that minorities have been oppressed in the United States. He notes that ethnic minorities have a history of discrimination within America, and that there are considerable historical factors that have shaped the behavior of minorities. Indeed, a number of writers indicate that limiting one’s understanding of disabilities to solely medical issues is too restricting. (Singh & Trusty 2002) As a result, the helping professional must be cognizant of the ways that the complex interaction of race, discrimination, and culture influence and affect the helping relationship. There is no monolithic cultural entity among which a people can be grouped; for instance, Bryan (pg. 90) writes, “there is no African American culture, Native American culture…However, there are African American cultures, etc.” As counseling practices are heavily rooted in Euro-American cultural norms, many minorities reject the foundational assumptions of these mental health treatments. Bryan notes that the rate of termination of counseling after one session is highest for minority patients. Indeed, such cultural bias has been argued to engender ‘white racism’ and ethnocentrism that further disrupt the counseling process. While there are considerable factors that divide clients and professionals from different ethnic backgrounds, Paniagua (as cited in Bryan 2007, pg. 99) states, “the factors which appear to have the most impact upon treatment outcome are counselor/helper sincerity and sensitivity.” Proceeding from these foundational elements, this essay investigates the cultural factors that counseling professionals must familiarize themselves with when working with African and Native American patients. African-Americans Background, Issues, and Misconceptions When considering the historical situation of African Americans within the United States it’s important to note that many of the modes of oppression exhibited during the slavery period have long-term psychological effects, many of which continue to affect African Americans. Therefore, while African Americans have been officially free for over a century, the effects of the slavery period continue to act as elements of oppression. For African Americans the leading cause of death is homicide and legal intervention. There are also correspondingly high numbers of African Americans in prison. African Americans typically experience lower levels of education as well. When considering disabilities, African Americans have been determined to have the highest rate of severe disabilities among on ethnic group. This seems to be a result of their socioeconomic position, lack of access to adequate health care, and their unskilled laborer status that causes them to work in more risky and labor intensive jobs. African Americans also experience major health issues at disproportionate levels to the dominant Euro-American culture. These health issues include hypertension, heart conditions, diabetes, and stroke. For instance, African American men have 40 percent greater heart conditions than the dominant culture, and women have 64% greater differences. The rate of strokes is even higher, as African American women have an 80% greater risk of stroke than Euro-American women. The predominant theory of the increased stress levels that result in these conditions is that African Americans experience stress as a result of tension caused by prejudice from the dominant culture. There are a number of specific historical dynamics that counseling professionals must familiarize themselves with when acting as helping professionals to African American patients. One of the major considerations helping professionals must make concerns the divergent dynamics of the family structure between African and Euro Americans. One of the stereotypes of the African American woman is that they are domineering. This image has surfaced as in many instances African American females are the main providers of family income. There are also a high number of African American families where the mother is the only parent in the household. While many attribute this fact to corresponding difficulties in American culture, Bryan points out that, due to the community structure, “Female-headed households can and most often are stable households” (pg. 144). Misconceptions are also rampant when considering the role of the African American father. In order to oppress males during the slavery period, slave masters engaged in techniques to psychologically degrade the African American male. This is where conceptions of the black male as “lazy, ignorant, and not worthy of trust” (Bryan, pg. 145) arose from. Furthermore, the stereotype of African American males as poor fathers is a misconception, and when given access to adequate economic resources to provide for their children, they have proved to be effective fathers. Traits of African American child rearing include strong kinship bonds (Hill 1972, as cited in Bryan 2007); other traits include authoritarianism, “positive attitudes towards child bearing…strong attention to non-verbal communication” (Bryan, pg. 146). Kinship bonds indicate that children are influenced heavily by people who are not members of their immediate family. Oftentimes friends of the family are referred to by children as aunt or uncle and even ‘play mother’. Many African American families are achievement oriented, and they encourage their children to attain education as a means of attaining a greater existence. The conception of African Americans as lazy is misguided, as they are similarly work oriented. African Americans also demonstrate considerable adaptation in family roles as the female is oftentimes the primary financial provider, while the male may have to take on increased household chores. Africans Americans are people oriented and learn to engage in non-verbal communication. African American’s are also authoritarian and don’t tolerate ‘back talking’. While childbearing out of marriage is not encouraged, when it does occur the child is accepted and not consider ‘illegitimate,’ as many Euro-American families might understand it. Assisting African-Americans The nature of the black American history attests to the dominant culture’s efforts to institute an oppressive view of black heritage. As a result, African Americans oftentimes have a conflicted view of their culture. It’s important for the counseling professional to recognize the patient’s cultural heritage and alter the therapeutic practice accordingly. Failure to do this has been recognized as one of the predominant reasons for the high cancelation rates among African American minorities. It’s important for the counselor to recognize the place of the African American on the self-hate – self-acceptance continuum. Derived from William Cross (1971 as cited in Bryan 2007) Bryan posits the Cross Model for the counseling professional to follow in aiding the African Americans. The first stage in the Cross Model is the pre-encounter stage. During this stage the counseling professional is encouraged to investigate the nature of the black individual’s perceptions of being black. The intention is to determine the patient’s level of self-acceptance. Questions relating to the patient’s perceived level of discrimination, and the types of discrimination they have received are helpful during this stage. The next stage is the encounter stage. This is the stage when the African American encounters direct discrimination, oftentimes resulting in their wanting a counselor of a similar race. The fourth stage is the immersion-emersion stage. During this stage the client moves from rejection of their blackness to acknowledgement that it must not be the defining characteristic of their life. Bryan writes, “if the Euro-American helper can withstand this stage and/or become involved with them when they are in the emersion phase, productive rehabilitation efforts can be made” (pg.152). During the internalization stage the client begins to internalize their concept of blackness and consider its ultimate value to their life. For the counseling professional, it’s important to recognize that once the patient has internalized their blackness they can then move to self-acceptance of himself and his disability. The final stage is the internalization-commitment stage, where the individual has gained self-acceptance and works to maintain it. This is important for the helping professional to recognize, as they can aid the patient in using their internalized identity to withstand undesirable life events. Another important factor for the helping professional to consider is the role expectations play in the counseling process. It’s very necessary that both the helper and the client have similar expectations. For instance, if the client is attempting to be classified as disabled to be eligible for disability benefits, when the counselor is attempting to prepare them for a job, there would be a significant conflict of expectations. It’s important that the counselor gain a thorough knowledge of the patient’s expectations. While the helper may experience resistance in this category, Bryan writes, “By being honest, understanding, and nonthreatening in his approach as well as being careful to explain the why’s and what for’s, the professional helper increases his chances of success” (pg.154). There are also cultural factors the counselor should become aware. For instance, many African Americans have a casual attitude towards time and may initially be late for appointments. While the helper need not tolerate such occurrences, it’s important to inform the individual of the importance of punctuality and not be offended during the first few visits. It’s also important to note the level of situational control the client believes they have over their life. For instance, if the client believes outside forces greatly shape their destiny, it’s important for the helper to empower the client to take greater personal responsibility over their life. Native Americans There are a number of categories where Native Americans have notably higher percentages of disorder than the rest of the United States population. Alcoholism is 465 percent greater, tuberculosis is 425 percent greater, accidents 184 percent greater, diabetes mellitus 166 percent greater, pneumonia and influenza 51 percent greater, suicide 46 percent greater, and homicide 39 percent greater. It’s noted that disability oftentimes results from these disorders. Indeed, Native Americans have the highest rate of disabilities among all races. The reasons for this are lifestyle related, including social isolation and economic depravity. While these issues aren’t entirely the fault of Native Americans, they can be rectified by a knowledgeable helper. Indians face a number of related set-backs that might indirectly attribute to their high disability rate. Considering education, Native American exhibit lower percentages of having obtained a high school education when compared with the rest of the population – 65.3% to 75.2% respectively. Similarly, Native Americans exhibit lower rates of people having obtained a Bachelor’s Degree, with 8.9% having a degree compared to 20.3% of the rest of the United States population. It’s also argued that Native Americans health care options have attributed to the disparate number of health care disorder. Traditionally Native American populations utilized Medicine Men – a practitioner that combined organic health treatments with religious faith in treating patients. Many modern practitioners of medicine argue that such professionals are insufficient in treating contemporary issues. While in the past such care-givers may have been adequate in supplying health options, as a result of increased migratory pressure and practices, interaction with Euro-Americans, and modern diseases, Native Americans have been increasingly receptive to modern medicine. Assisting Native Americans When the counseling professional engages in assistance with Native American patients it’s necessary for them to recognize their own previously held misconceptions, and to understand the Indian family dynamics. Most researchers acknowledge that Native Americans utilize an extended family-structure. Wager (1976, as cited in Bryan 2007) divides contemporary Native American families into “traditional-oriented, transitional, and American middle class” (pg. 238). It’s important for counselors to understand that research attests to the mother’s role in the family in recent years has been elevated near or even coresponsible with that of the father. While counseling professionals are encouraged to recognize the Cross Model in determining Native American cultural image, it’s important to have an adequate understand of what Native American constitutes. Choney (as cited in Bryan 2007) argues, “it is more important to consider Native Americans levels of acculturation rather than attempt to develop a theory or model of Indian identity” (pg. 239). The argument for this perspective is that Native Americans don’t experience a ‘Native American’ culture, but find identity through tribal affiliations; thus, perpetuating an understanding of a monolithic ‘Native American’ ethnicity is perpetuating a misguided stereotype. When assessing levels of acculturation the counseling professional should determine the patient’s tribal affiliation. Once the tribal affiliation has been determined the helper can make a number of determinations. These include: Does the person participate in tribal activities? What are some of the customs and beliefs of the tribe? What is the tribal language? When does the person speak the language? Does anyone in the family speak the language? What does being an Indian mean to him? It’s also important for the helping professional to recognize misguided perceptions. For instance, there is a stereotype of Indians as taciturn individuals. This understanding is false and, indeed, Native Americans exhibit a wide-range of communicative competencies. Similar to African Americans, Native Americans may be initially guarded in revealing information, so it’s important for the helper to be patient. Lengthy eye contact is also discouraged. Specific techniques for aiding Native Americans vary. When dealing with medicinal concerns, it may help to have medicine men, or more traditional healers present. As the extended family is very important in Native American life, incorporating them into the therapeutic process may have a beneficial outcome. Assessment testing is discouraged in many situations, as Native Americans divergent epistemology makes the assessment tools difficult to adapt. Finally, the helper must be cognizant that Native Americans often are the product of two cultures – their tribal affiliation and the dominant Euro-American culture; by recognizing this, the helper can be more in-tune with the problems the Native American patient faces. Conclusion In conclusion, while the importance of understanding different values of minority groups members of the dominant culture must also investigate their own belief system. Edson (1989 as cited by O’Conner 1993) states, “without critically analyzing the institutionalized beliefs of the dominant culture, which affect us all both consciously and unconsciously, we will inadequately address issues of multiculturalism so important today.” Ultimately, it’s clear that helping professionals must become aware of the sociopolitical ramifications affecting their patients. References Bryan, W. V/ (2007) Multicultural aspects of disabilities. (Second Edition). Charles C. Thomas publisher. Springfield Il. O'Connor, Susan (1993). Disability and the Multicultural Dialogue. http://thechp.syr.edu/multovw1.htm, March 2010  Singh Daya, Trusty Jerry. (2002) Multicultural counseling: context, theory, and practice. Nova Science Pub Inc Read More