As Chair of the Diversity Committee for Division 49, I wanted to focus my columns on building multicultural competency in group therapy practices with an emphasis on providing something useful to the practitioner. To set the stage, I’d like to review a bit of theory related to a particular debate in the late 1990s regarding the importance of emic (culturally specific) versus etic (culturally universal) factors related to multicultural competency. This debate was lively because around the same time mental health professionals were discovering that the medical model (treatment specific approach) did not do an adequate job of identifying what accounted for client change in psychotherapy. This was around the same time that Common Factors theory became quite popular. Common Factors theory research found that the factors that accounted for the greatest amount of client change in psychotherapy were actually those that were common or universal to the therapeutic relationship: client, therapist, and relational variables.
This finding probably did not surprise group therapists, particularly those who facilitated process oriented groups. It is the group interpersonal process, after all, that provides the curative factors resulting in the positive outcome of the individual. However, like physicists concluded when debating the wave versus the particle theory of light, and like biologists concluded when debating nature versus nurture, mental health researchers found that both emic and etic factors are important in client change or healing. I point this out because I think that we as group therapists may get a bit too comfortable with the etic side of the debate because, unless you are facilitating a culturally specific group such as “Estamos Unidas” (an outreach group for Chicana/Latina students offered by UC Irvine this Spring), you are likely to have a mix of folks with differing cultural backgrounds and beliefs, not to mention genders (the “a” on the end of Chicana/Latina indicates the group is for females), ethnicities, races, abilities, sexual orientations/gender identities, religious identities, ages, and socioeconomic/class statuses to name a few emic groupings. Although both types of groups would likely experience those 11 Therapeutic Factors identified by Irvin Yalom (Universality, Altruism, Instillation of Hope, Imparting Information, Developing Socializing Techniques, Interpersonal Learning, Cohesiveness, Catharsis, Existential Factors, Imitative Behavior, Self-Understanding, and the Corrective Recapitulation of the Primary Family Experience), it might be less clear in the mixed group how your emic skill-set might be useful.
In order to provide more clarity and, I admit, more encouragement to the practitioner to develop more multicultural awareness, knowledge, and skill about culturally specific issues, it might help to pose the following question: if the therapeutic effectiveness of group process comes from existential factors, which are those that are universal to all human experience, why apprise ourselves of human specific knowledge because how would this be useful? The answer actually lies within the question, which is: one of the existential challenges we all face is that we are “alone”, that is, that we are all individuals who are different. So while it is helpful for someone to learn “I’m not alone—all of us suffer at one point or another (‘I’m okay’)”, it is also helpful for someone to learn “I’m different so no wonder people respond to me in these ways/contexts—it’s not my imagination/I’m not crazy (‘I’m okay’)”. Therefore, I think group is a treatment where it’s important to emphasize both attachment/universality as well as separation/individuality because they are both an existential reality.
My goal in this column, as I noted earlier, is to provide something useful to the practitioner. Therefore, I encourage you to try a new intervention in one of your groups, the intent of which is to plant the seed and give permission for more multicultural discussions during the group process. That is, at the beginning of your group announce that you may be posing more cultural questions to the group so that members think more about how individual differences may play a role in their current experiences. Then ask both questions during the process: How are these struggles universal to all of you? How are these struggles specific to your particular cultural experience? These questions work in both heterogeneous and homogenous groups. If you don’t already ask these types of questions, I hope the answers you get increase your multicultural awareness and intrigue you enough to seek out more multicultural knowledge. It doesn’t have to be fancy, a simple intervention such as the one mentioned can really add to your multicultural skill set. By the way, if you haven’t already, check out the APA site regarding multicultural guidelines at: http://www.apa.org/pi/oema/resources/policy/multicultural-guidelines.aspx?item=7. As always, I welcome questions, concerns and ideas for future columns. Please email me at: firstname.lastname@example.org
Fischer, A.R., Jome, L.M., & Atkinson, D.R. (1998). Reconceptualizing Multicultural Counseling: Universal Healing Conditions in a Culturally Specific Context. The Counseling Psychologist, 26, 525-588.
University of California, Irvine Counseling Center (n.d.). Groups at UC Irvine Counseling Center [www page]. URL http:// http://www.counseling.uci.edu/Students/groups.aspx
Yalom, I., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York: Basic Books.