Multicultural Competence: An Outcome or a Process?
My reflections on the question of whether competence, in this case multicultural competence, is an outcome or a process helps ground me and normalizes the struggles that are so apparent within our society. We have only to read the headlines, watch the academy awards or the post-super bowl news coverage, follow the presidential primary debates, or speak candidly with our colleagues to learn that, in particular, racism, sexism, and religism are alive and well, and suppressing the health of our communities. This is frustrating/incensing, scary/dangerous, and sad/downright depressing. It’s also incredibly draining to those who advocate for human rights and can seriously corrode feelings of hope for a society that embraces and celebrates diversity. Although intuitively, we have the sense that competence building is a process, I think it’s often implied that one can achieve some sort of cultural competence within the span of, let’s say, a five year graduate program. Even the word “competence” implies some sort of endpoint. The truth is, however, that competence is indeed a process that develops over a long period of time. Two areas of research that stress the process of competence development is the research on the Integrated Developmental Model of Supervision (IDM) by Cal Stoltenberg and Brian McNeill (2010) and Malcom’s Gladwell’s research review related to building expertise, which he describes in his book, Outliers (2008).
If the research is consulted on the matter, it is apparent that every mental health professional goes through periods of struggle in which they question their competence. As someone who is interested in professional development and finds a meaningful and rewarding calling supervising and scaffolding students in the fields of counseling and psychology, I want to first describe the research pertaining to the IDM. This model includes eight domains of competence. The two domains most pertinent to this article are the domains of Individual Differences and Intervention Skills, particularly because they relate most closely to developing multicultural competency in group psychotherapy. The IDM is organized by three over-riding structures, which identify areas in which individuals tend to struggle and grow. These areas are self-other awareness (which starts low and then gradually increases as one is exposed to a greater number of diversity and group psychotherapy experiences), motivation (which starts high, fluctuates as one realizes the overwhelming amount of information they have yet to learn or experience, and then increases again as one gains a level of expertise), and autonomy (which starts low and then increases as one requires less supervision over time). The process of this struggle is divided into three levels based on professional competence, ingeniously named Level 1, Level 2 and Level 3. Basically, a professional begins their career as a Level 1 practitioner and then, as expertise increases, so too does ones’ level. The highest level that can be achieved according to the model is Level 3i, which indicates a Level 3 therapist who is integrated across all domains.
My misunderstanding of the IDM in the early days, and I find that most of my supervisees also have this misunderstanding, was that one might reach Level 3 development in their third year of practice. Actually, the third year of practice is when one tends to get a whiff, catch a glimpse, or grasp an idea of how much they actually don’t know. It’s a humbling experience that messes with one’s motivation and thus, based on the information supplied by the IDM, solidly places the practitioner at a Level 2. To add complexity to the situation, this placement of practitioner skill is occurring throughout various areas within each domain. For instance, most practitioners remain at Level 1 in the domain of Intervention Skills for group psychotherapy for a good number of years because, since much of the early emphasis in training for this domain is in the realm of individual therapy, they have much less opportunity for practicing group psychotherapy. Regarding the question of how long it takes to reach competence in an area within a domain, for instance facilitating a support group for a particular special population (e.g., undocumented immigrants, international students from Iran, Lesbian parents), we turn to Malcolm Gladwell.
In his book, Outliers, Malcolm Gladwell explores the question of whether it is true that anyone can succeed. What he found is that one of the primary characteristics of people who achieve success—other than being in the right place at the right time—is a significant amount of hard work and practice. In fact, he argues that there is a formula for expertise that amounts to 10,000 hours of focused practice and he calls this the “10,000 Hour-Rule” based on a study by Anders Ericsson. This means that a Level 3 or competent therapist will have spent around 20 hours a week for 10 years learning and practicing a particular focus area within a particular domain (e.g., a support group for undocumented immigrants, or a support group for Iranian international students, or a support group for Lesbian parents). You get the idea. This information is not meant to be discouraging, rather to normalize the struggles that are apparent in our society and highlight the important work we do to educate ourselves and facilitate the development of cultural competence within ourselves and within our colleagues, supervisees, and clients. I think it also validates that the work we do requires time and that process is important—something all group psychotherapists know. Process is important.
So there you have it. Cultural competence in group psychotherapy is not something one generally achieves, rather developing cultural competence is a domain within many domains and is a long process that spans years and years and 10,000 hours of focused practice. Perhaps rather than feel hopeless that our world is in the state it is in, this information will provide a sense of grounding and patience for those Level 1 individuals out there, because we have all been there, and no one is really an expert in all aspects of cultural diversity. This article seeks to explore the implication that multicultural competence is an outcome and explicitly reframe multicultural competence as a process that continues, with mindful intention, throughout the span of our professional development.
As always, I welcome questions, concerns and ideas for future columns. Please email me at: firstname.lastname@example.org
Gladwell, M. (2008). Outliers: The story of success. New York, NY: Hachette Book Group, Inc.
Stoltenberg, C. D. and McNeill, B.W. (2010). IDM Supervision: An integrated developmental model for supervising counselor and therapists, third edition. New York, NY: Taylor & Francis Group.