PSY 451 Week 5 Culturally Responsive Practice Example

Adapting the Group, Changing the Counselor: Culturally Responsive Practice at a Community Clinic

[Student Name]

University of Phoenix

PSY/451: Multicultural Psychology

Week 5 Assignment

[Instructor Name]

[Date]

The practicum student, clinic, group and clients are composites written for a model paper; research findings come from the sources listed.

Understanding culture matters little unless it changes practice. This final paper examines how a community clinic adapted a program for a specific group and how a helper's own stance shapes care, drawing together the course's themes through the end of Daniela's practicum.

The Need

The clinic's eight-week stress management group, based on cognitive behavioral techniques, had been offered in English for years. Spanish-speaking mothers referred to the group rarely enrolled, and those who came often dropped out by the third week. Exit conversations revealed several reasons: sessions met in the evening when childcare was hardest, examples centered on workplace stress rather than family and immigration stress, homework sheets assumed literacy in English and several women felt uncomfortable discussing family problems with men present.

A Framework for Competence

Sue et al. (1992) set out multicultural counseling competencies in three areas. Counselors need awareness of their own cultural values and biases, knowledge of the worldviews of culturally different clients and skills in developing appropriate intervention strategies. Each area includes beliefs and attitudes, knowledge and skills, and the authors called on the profession to adopt these standards in training and practice.

The adaptation required all three. Staff had to recognize their own assumptions, such as that evening groups suit everyone. They needed knowledge of the mothers' concerns, including immigration stress, family separation and work in low-wage jobs. And they needed skills to deliver the group in culturally appropriate ways.

What Research Says About Adaptation

Griner and Smith (2006) pooled 76 outcome studies of treatments tailored to clients' cultures. Adapted interventions produced moderately larger benefits than comparison conditions. Interventions delivered to groups of the same cultural background were more effective than those delivered to mixed groups, and for clients whose first language was not English, treatment in their own language worked about twice as well as treatment in English. The findings support adapting both content and delivery.

Guided by this evidence and by a planning group of four mothers who had attended earlier, the clinic made specific changes. Sessions moved to Saturday mornings with on-site childcare. A bilingual counselor and a community health worker, a promotora from the neighborhood, co-led in Spanish. Examples were rewritten around family stress, separation from relatives and worries about immigration status. Homework used pictures and audio recordings. Sessions opened with a shared snack and time for personal connection, reflecting the value many participants placed on warmth and trust, and the group was offered for women only.

The techniques stayed the same; what changed was the hour, the language, the examples and who was in the room.

The Counselor's Stance

Program changes are only part of the picture. Hook et al. (2013) built a short client-rated scale of how culturally humble a counselor seems, defined as an other-oriented stance marked by openness, respect and lack of superiority toward the client's cultural background. Across their samples, the more humble clients judged their counselors to be about culture, the stronger the bond they described with them, and that bond tracked progress in therapy.

For Daniela, cultural humility means not assuming she understands Spanish-speaking mothers because she shares their language and ethnicity. In the group, she asks rather than assumes, for example inviting each woman to say what family support looks like for her. One participant, a mother from Guatemala, explained that her experience differed sharply from that of Mexican participants, a reminder of variation within groups.

Who Shaped the Changes

The planning group of former participants proved more valuable than any manual. They pointed out that the word the counselors had chosen for "stress" sounded clinical and suggested a common everyday phrase instead. They recommended starting with practical topics, such as sleep and children's behavior, before personal history. And they warned that some women would not attend if the group were advertised as mental health treatment, so it was described as a mothers' wellness group. Each suggestion came from experience no staff member had.

Keeping the Core of the Treatment

Adaptation raises a fair question: if so much changes, is it still the same treatment? The clinic kept the core techniques, such as identifying stressful thoughts, practicing slow breathing and planning small pleasant activities, and changed how they were introduced, practiced and discussed. Research on adaptation supports this approach of preserving active ingredients while changing the surface and context.

Measuring Results

The clinic tracked enrollment, attendance and a stress measure validated in Spanish. In the first adapted cohort, twelve of fourteen women completed at least six of eight sessions, compared with about a third in earlier English groups, and stress scores dropped from the first to the last session. The clinic plans a follow-up at three months and will continue to involve former participants in revising the group, since a program adapted once and then frozen can drift out of step with the community it serves.

Limits

Adaptation can slide into stereotyping when a program treats a whole group as if every member needed the same thing. Ongoing input from participants and flexibility within the group reduce that risk. The adapted group also cannot address structural stressors, such as immigration policy or low wages, which require advocacy and referrals.

Daniela's Reflection

At the start of her practicum, Daniela believed that sharing an ethnicity with clients meant understanding them. Over the semester, a young Mexican American man who wanted privacy from his family, a refugee whose distress a screener missed, a Black client worn down by daily slights and a Guatemalan mother whose experience differed from her neighbors' each challenged that belief. She now sees culture as something to ask about with each person, her own lens as something to examine and adaptation as work done with communities rather than for them.

Conclusion

The clinic's adapted group shows culturally responsive practice at the program level, guided by competency standards and by evidence that adapted, native-language interventions work better. Cultural humility shows it at the level of the individual helper. Together, along with community involvement and outcome measurement, they turn multicultural psychology into better care.

References

Griner, D., & Smith, T. B. (2006). Culturally adapted mental health interventions: A meta-analytic review. Psychotherapy: Theory, Research, Practice, Training, 43(4), 531-548. https://doi.org/10.1037/0033-3204.43.4.531

Hook, J. N., Davis, D. E., Owen, J., Worthington, E. L., Jr., & Utsey, S. O. (2013). Cultural humility: Measuring openness to culturally diverse clients. Journal of Counseling Psychology, 60(3), 353-366. https://doi.org/10.1037/a0032595

Sue, D. W., Arredondo, P., & McDavis, R. J. (1992). Multicultural counseling competencies and standards: A call to the profession. Journal of Counseling & Development, 70(4), 477-486. https://doi.org/10.1002/j.1556-6676.1992.tb01642.x