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Culturally Diverse Counseling

Culturally Diverse Counseling
Theory and Practice

  • Elsie Jones-Smith - Diplomate in Counseling Psychology, American Board of Professional Psychology

November 2018 | 672 pages | SAGE Publications, Inc
Culturally Diverse Counseling: Theory and Practice adopts a unique strengths-based approach in teaching students to focus on the positive attributes of individual clients and incorporate those strengths, along with other essential cultural considerations, into their diagnosis and treatment. With an emphasis on strengths as recommended in the 2017 multicultural guidelines set forth by the American Psychological Association (APA), this comprehensive text includes considerations for clinical practice with twelve groups, including older adults, immigrants and refugees, clients with disabilities, and multiracial clients. Each chapter includes practical guidelines for counselors, including opportunities for students to identify and curb their own implicit and explicit biases. A final chapter on social class, social justice, intersectionality, and privilege reminds readers of the various factors they must consider when working with clients of all backgrounds.
Chapter 1: Culturally Responsive Strengths-Based Therapy
Chapter Objectives  
The Profound Influence of Culture  
Our Brains Are Culturally Connected  
Affirming Each Person's Importance  
The Integration of Culturally Responsive and Strengths-Based Counseling/Therapy  
Brief History and Overview of the Multicultural Movement  
Mastering the Multicultural Counseling Competencies  
Ethical Issues and Multiculturalism  
The Evidence-Based Movement in Multicultural Counseling  
Beginning the Cultural Competence Journey  
Levels of Therapist Competence Development  
Clinical Skills Development: Cultural Awareness and Knowledge  
Major Barriers to Culturally Competent Counseling and Therapy  
Neuroscience, the Brain, and the Invisible Neural Barrier of the Racial/Ethnic Bias  
Summary of Key Points  
Discussion Questions and Exercises  
Chapter 2: Cultural Meaning Systems, Cultural Trust and Cultural Humility
Cultural Principles  
The Iceberg Concept of Culture  
Emic and Etic Perspectives on Culture  
Culture and Neuroscience  
Neuroscience and Cultural Differences between Western and Eastern Countries  
The Globalization of Culture  
Culture and the Process of Identity Development: The Tripartite Model  
The Ethnic Self: Ethnicity as a Schema  
Research on the Positive Benefits of a Cultural Identity  
Does One Have to Be of the Same Cultural/Racial/Ethnic Background to Counsel Clients Effectively?  
Assimilation, Marginalization, Acculturation and Acculturative Stress  
Culturally Responsive Counseling: Reaching Across Barriers  
Understanding Clients’ Cultural Stories  
Culturally Competent Clinical Knowledge  
Culturally Responsive Knowledge Skills for the Initial Interview  
Cultural Trust: Critical Issue in Culturally Diverse Counseling  
Cultural Empathy and Cultural Competence  
Levels of Culturally Competent Clinical Responding  
The Culturally Competent Skill of Counselor Cultural Humility  
Toward A Model for Evaluating Culturally Competent Clinical Skill Development of Therapists and Counselors  
Summary of Key Points  
Chapter 3: Neuroscience, Multiple Cultural Identities, and Cultural Strengths
Neuroscience, CACREP Standards and Major Counseling Associations  
Foundational Concepts in Neuroscience for Counselors  
The Brain  
Mapping the Cultural Architecture of the Brain  
Cultural Identity Formation and Neuroscience  
Brain Regions and Cultural Identity  
Some Important Findings in Cultural Neuroscience  
Cultural Identity and the Cultural Formulation Interview for DSM-5  
The Negativity Bias of the Brain: Findings in Neuroscience  
Is the Brain Hard-Wired to See the Glass Half Empty or Half Full?  
Mental Health from a Neuroscientific Perspective  
Neuroimaging Techniques and the Brain  
Neuroscience: Psychotherapy Changes Your Brain  
The Therapeutic Relationship from a Neuroscientific Perspective  
Neuroscience and the Culturally Responsive Counselor/Therapist  
Mirror Neurons and Counselors/Therapists  
What Happens When a Counselor/Therapist Focuses on a Client’s Negative Life Events?  
Neuroscience and Multiple Cultural Identities  
What Is a Multicultural Identity?  
The Need for Clinicians to Adopt a Multicultural Identity  
Summary of Key Points  
Chapter 4: Strengths-Based Development, Culture, and Clinical Practice
Culture, the Brain, and Strength Development  
The Neurobiology of Human Strengths Development  
Strengths and the Brain’s Pruning Process  
Relational Components of Strengths Development  
Attachment Theory and Strengths Development  
Bowlby’s Theory of Attachment: The Foundation for Understanding Individual Strengths Development  
Significance of Attachment Relationship and Strengths Development  
Strength Development and the Importance of a Trusted Relationship  
Strengths Development and Attention  
Attachment Patterns across Cultures  
Significance of Cultural Attachment, Migration, and Acculturation  
Strengths Development, the Narrative Process and the Mind  
Strengths as Dialogic Conversations with the Self  
Western and Eastern Views on Human Strengths: The Chinese Perspective  
How Do I Make Culturally Responsive Counseling Strengths-Based?  
The Philosophy of Strengths-Based Therapy  
Therapists’ Words—Either Positive or Negative—Matter During Counseling  
Cultural Mindsets  
Culturally Responsive Strengths-Based Practice  
Summary of Key Points  
Chapter 5: The Strengths-Based Counseling Model and Culturally Responsive Counseling
Neurocultural Dynamics: Cultural Consonance and Cultural Dissonance  
Strengths-Based Counseling and the Law of Neuroplasticity  
The Neuroscience of Belief  
The Power of Cultural Beliefs and Dying: A Comparison of Chinese Americans and White Americans  
Self-Limiting Beliefs  
The Revised Strengths-Based Counseling Model: New Concepts and Clinical Strategies  
Strengths-Based Counseling Techniques: Culturally Responsive Strengths-Based Therapist Communication  
Summary of Key Points  
Chapter 6: Culturally Responsive Assessment and the Cultural Formulation Interview
General Assessment Principles in Counseling  
Clinical Issues in Conducting a Qualitative, Culturally Responsive Assessment  
The DSM-5 and the Cultural Formulation Interview  
The Four Domains of the Cultural Formulation Interview  
Cultural Genograms: An Assessment Tool  
The Strengths-Based Counseling Model’s Assessment Process  
Summary of Key Points  
Chapter 7: Culturally Responsive Case Conceptualization and Treatment Planning
White Clinicians/Culturally Diverse Clients  
Cultural Bias and Disparities in Mental Health Service Delivery Systems  
Case Conceptualization: Some Generic Elements  
Culturally Responsive Case Conceptualization  
Case Conceptualization and the Cultural Formulation Interview  
Strengths-Based Case Conceptualization  
Strengths-Based Treatment Plans  
Culturally Responsive Strengths-Based Therapy Techniques  
Summary of Key Points  
Chapter 8: Culturally Responsive Therapy with African Americans
The African American Population: Some Basic Demographics  
The Overall Socioeconomic Status of African Americans  
Historical and Psychosocial Issues for Blacks: Oppression, Discrimination, And the Legacy of Slavery  
African American Population Mixed with Other Ethnic/Racial Groups: Microaggressions  
African Americans and Cultural Values  
Counseling/Psychotherapy Approaches for Working with African American Clients  
NTU: An Africentric Model for Counseling African Americans  
Summary of Key Points  
Chapter 9: Culturally Responsive Strengths-Based Therapy for American Indians, and Alaska Natives
Defining Group Membership  
Demographic and Population Statistics  
Who Is An “Authentic” or “Real Indian”?  
Socioeconomic Status  
Theory of Historical Trauma Among American Indians and Alaska Natives  
Racial/Ethnic Stereotype, Racism, and Microaggressions  
Family Structure: The Tribe as Family  
Cultural Identity  
Cultural Values  
Cultural Strengths  
Healing: The Circle and Medicine Wheel in Indian Life  
Counseling Applications of the Circle and Medicine Wheel  
Mental Health Challenges  
Counseling Approaches for American Indian and Alaska Natives  
Summary of Key Points  
Chapter 10: Culturally Response Therapy for Asian Americans, Native Hawaiians, and Pacific Islanders
Demographic and Population Statistics  
Historical Changes in the Asian Profile  
Intermarriage and the Asian American Population  
Socioeconomic Status of Asian Americans and Pacific Islanders  
Native Hawaiians and Other Pacific Islander: Socioeconomic Issues  
Asian Americans as the “Model Ethnic Minority”: Myth or Reality?  
Race/Ethnic Stereotypes, Racism, and Microaggressions  
Cultural Issues of Asian American and Pacific Islanders  
Family Hierarchial Structure, Family Values, and Parenting Styles  
Cultural Identity of Asian Americans: No One Identity Model for All  
Cultural Strengths and Contributions of Asian Americans  
Acculturation and Cultural Issues Affecting Mental Health  
Acculturation Level and Counseling  
Help-Seeking Attitudes of Asian Americans  
Mental Health and Asian Americans  
Mental Health of Native Hawaiians and Other Pacific Islanders  
Mental Illness and Substance Use Among Asian Americans and Pacific Islanders  
Asian Americans’ Expectations About Counseling  
Cultural Healing and Indigenous Practices  
Cultural Factors in Counseling Asian Americans  
Native Hawaiian Values and Cultural Healing Practices  
Summary of Key Points  
Chapter 11: Culturally Responsive Therapy for Latino/a Americans
Demographic and Population Statistics  
Overall Hispanic American Population  
Historical Changes to the Hispanic/Latino Demographic Profile  
Hispanic Subgroup Percentages  
The “Other Hispanics”  
Geographic Location of Hispanics in the United States  
Racial Identification for the Hispanic Population  
Subgroup Migration History of Some Major Hispanic/Latino Groups  
Mexican Americans  
Puerto Ricans  
Central Americans  
Immigration Status, Naturalization, and Pathways to Citizenship  
Socioeconomic Status of Latino Americans  
Racial/Ethnic Stereotypes, Racism, and Microaggressions  
Hispanic Americans’ Worldviews  
Communication Style of Hispanics/Latinos  
Hispanic/Latino American Cultural Values  
Acculturation Conflicts for Hispanic/Latino Americans  
Cultural Identity of Hispanic and Latino  
Hispanic/Latino Cultural Strengths  
Hispanic/Latino Physical and Mental Health Issues  
Counseling Approaches for Working with Hispanic/Latino Clients  
Case Study: SBT and the Juvenile Justice System  
Case Analysis Using the SBT Model: Enrique  
Summary of Key Points  
Chapter 12: Culturally Responsive Strengths-Based Therapy for Arab and Muslim Americans
Cultural Values and Worldview of Arabs and Muslims  
Mental Health Issues for Arab and Muslim Americans  
Counseling Arab and Muslim Americans  
Counseling Arab Americans: Some Recommendations  
Case Study: Nadia – Strengths-Based Therapy for Arabs and Muslims  
Summary of Key Points  
Chapter 13: Counseling White Americans of European Ancestry
Historical Perspectives and Immigration of White Europeans to the US  
Socioeconomic Status of White Americans  
The White Population, Intermarriage, and Multiple Race Identification  
Ethnic Group Saliency for White Americans  
Is an American Identity Synonymous with White Identity?  
Cultural Descriptions for White American Ethnic Groups  
Anglo or English Americans  
Italian Americans  
Jewish Americans: Cultural Values and Counseling Issues  
The White American Worldview  
Whiteness and White Privilege  
Models of White Racial Identity Development: Brief Historical Overview of White Racial Identity Models  
The Hardiman White Racial Identity Model  
The Helms Model of White Identity Development  
Criticism of the Helms Model of White Racial Identity  
Significance of the White Identity Models  
Research Findings and White Identity Development Models  
White Dialectics: The Promising Research of White Multicultural Scholars on White Identity Development  
White Americans and Mental Health Issues  
Counseling White Americans of European Ancestry  
Case Study: Strengths-Based Therapy Approach  
Summary of Key Points  
Chapter 14: Culturally Responsive Therapy for Women
Demographics of American Women  
Socioeconomic Status of U.S. Women  
Microaggressions against Women and Gender Inequality  
The Mental Health Issues of Women  
Women’s Strengths  
Counseling Approaches for Women: Feminist Therapy  
Dissatisfaction with Existing Psychological Theories  
Key Concepts of Feminist Therapy  
Gender Role Stereotyping Across Cultures  
The Social Construction of Gender  
Gender and Power Differentials  
Feminist Therapy Approaches  
Goals of Feminist Therapy  
The Role of Men in Feminist Therapy  
Techniques of Feminist Therapy  
Feminist Therapy and Multicultural Therapy  
Integration of Feminist Therapy with Other Approaches  
Case Study for Counseling Women  
Summary of Key Points  
Chapter 15: Culturally Responsive Counseling for LGBTQ Individuals
Demographic and LGBTQ Population Data  
Socioeconomic Status  
Discrimination and the Gay Rights Movement  
Homophobia Persists  
Microaggressions against LGBTQ People  
LGBTQ Identity Development  
Coming Out and Gender Identity Development for Gays, Lesbians, and Bisexuals  
Coming Out for People of Color: A “Tricultural Experience”  
LGBTQ Youth and Schools  
LGBTQ Families: Some Facts  
Mental Health Issues and the LGBTQ Community  
Top Ten Physical and Mental Health Concerns of LGBT College Students  
Strengths of LGBTQ Populations  
Counseling Members of the LGBLTQ Community  
Gay Affirmative Psychotherapy  
Reparative Therapy and Sexual Orientation Conversion Therapy  
Case Study: Sal and the SBT Model  
Summary of Key Points  
Chapter 16: Culturally Responsive Therapy for Individuals with Disabilities
Definition of Disability and the Americans with Disabilities Act (ADA)  
Demographics about People with Disabilities  
Socioeconomic Status  
Major Categories of Disabilities  
Some Invisible Disabilities  
Some Facts about People with Disabilities  
Models of Disability  
Disability as a Multicultural Issue  
Privilege and People with Disability  
Microaggressions toward People with Disabilities  
Spread: A Form of Ableism  
Interaction Strain and People with Disabilities  
Identity Development and People with Disabilities  
Experiencing a Disability Identity after Trauma  
Strengths of People with Disabilities  
Counseling Approaches for Individuals with Disabilities  
Counseling Issues and the Effects of Disability  
People with Disabilities and Risk for Abuse  
Family Counseling and People with Disabilities  
Disability Affirmative Therapy and Disability Orientation  
Olkin’s Model of Disability and Counseling Approach  
APA’s Guidelines for Assessment and Intervention for Individuals Who Have Disabilities  
Case Study: SBT and Elizabeth, A Young Teenager Suffering from a Car Accident  
Summary of Key Points  
Chapter 17: Culturally Responsive Counseling for Older Adults
Demographics for Older Adults  
Western and Eastern Cultural Views on Aging  
Microaggressions and the Older Adult  
Prevention of Chronic Physiological Disease  
Mental Health Issues of the Older Adult  
Alzheimer Disease and Other Cognitive Impairments  
Elder Abuse  
Substance Abuse and Older Adults  
Sexuality and the Older Adult  
The LGBTQ Older Adult  
The Strengths-Based Therapy Model and the Older Adult  
Phases of Strengths-Based Therapy and Older Adults  
Older Adults  
Case Study: Sarah  
Summary of Key Points  
Chapter 18: Culturally Responsive Therapy for Immigrants and Refugees
Mental Health Issues of Immigrants and Refugees  
Mental Health Issues and Pre-and Post-Migration  
Counseling and Therapy Models for Working with Refugees and PTSD  
Culturally Responsive Strengths-Based Therapy  
Case Study: Using a Culturally Responsive Strengths-Based Approach  
Summary of Key Points  
Chapter 19: Culturally Responsive Counseling for Multiracial People
Models of Multiracial/Ethnic Identity Development  
Competencies for Counseling Multiracial Individuals  
Psychotherapy with Multiracial/Ethnic People  
Culturally Responsive Strengths-Based Case Study: Simone  
Summary of Key Points  
Chapter 20: Social Class, Social Justice, Intersectionality, and Privilege
Social Class and Culturally Responsive Counseling  
The Neuroscience of Poverty and Social Class  
Effects of Toxic Stress and High Levels of Cortisol on Children  
Neuroscience, Social Class, and Empathy  
The Social Justice Movement in Counseling  
Intersectionality, Social Class, and Social Justice  
Internalized Oppression: Social Class, and Race/Ethnicity  
Privilege, Race, and Social Class  
Summary of Multidimensional Privileges in a Society  
Social Class and Cultural Strengths: Antidote for Internalized Oppression, and Stereotype Threat  
Summary of Key Points  


Instructor Resource Site

Visit to access the password-protected instructor resources that accompany this text.

  • A test bank provides a diverse range of pre-written options as well as the opportunity to edit any question and/or insert personalized questions to effectively assess students’ progress and understanding.
  • Editable, chapter-specific PowerPoint® slides offer complete flexibility for creating a multimedia presentation.

“Understanding cultural perspectives of our clients is a continuous challenge. Elsie Jones-Smith succinctly presents a multicultural strength-based model to ease the unique challenges in working with diverse clients. Empower yourself to empower your clients.”

Dr. Sorie Koroma
University of Massachusetts

“A transformational book regarding multicultural therapy.”

Tomasina L. Cook
Niagara University
Key features


  • Up-to-date content reflects the 2017 multicultural counseling guidelines set forth by the American Psychological Association (APA).
    • A brief summary of the guidelines is provided in Chapter 1.
    • A number of vignettes and case studies are presented from a strengths-based therapy framework recommended in the guidelines.
    • A focus on intersectionality of culturally diverse counseling emphasized in the guidelines is reflected throughout the book.
  • Boxes for cultural reflection throughout each chapter inspire students to think critically about multicultural issues.
  • Case studies in each chapter offer illustrations for working with clients.
  • Chapter-ending discussion questions offer instructors exercises for teaching culturally diverse issues.
  • A glossary of key terms at the end of each chapter defines terms likely to appear on licensing exams for counselors, psychologists, and social workers.

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ISBN: 9781483388267