Test Bank For Developing Multicultural Counseling Competence A Systems Approach, 4th edition Danica by ACADEMIAMILL

TEST BANK Developing Multicultural Counseling Competence A Systems Approach, 4th edition Danica G. Hays, Bradley T. Erford ISBN-10: 0137474148 ISBN-13: 9780137474141 Table of Contents

Chapter 1: The Culturally Competent Counselor

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 1: The Culturally Competent Counselor Chapter 1 Learning Outcome Quizzes Learning Outcome 1.1: Understand and apply key terms and concepts associated with multicultural counseling. [Q1] Which of the following correctly lists the three forces in counseling? 1. Reason, logic, and emotions 2. Psychodynamic, interpersonal, intrapersonal 3. Emotional, cognitive, and behavioral 4. Psychodynamic, behaviorism, existentialism/humanism [correct] [Feedback for Answer Choice 1] Although reason, logic, and emotions are important for counselors to consider when working with clients, these concepts are not known as the three forces in counseling. [Feedback for Answer Choice 2] Although psychodynamic conceptualization and intervention models are one of the three forces in counseling, interpersonal and intrapersonal factors are important to counseling but are not the other two forces in counseling. Generally speaking, interpersonal refers to interactions that occur between two or more people, whereas intrapersonal interactions occur within a single intervention. [Feedback for Answer Choice 3] Emotional, cognitive, and behavioral factors are explored in each of the three forces in counseling, but these factors alone are not commonly known as forces in counseling. [Feedback for Correct Answer 4] Psychodynamic, cognitive-behavioral, and humanistic-existential conceptualization and intervention models are supported as the three forces of counseling. [Q2] An arbitrary classification system of individuals based on physical characteristics is called: 1. ethnicity. 2. race. [correct] 3. ableism. 4. religion. [Feedback for Answer Choice 1] Although ethnicity is often related to race, ethnicity refers to common cultural values that cannot be seen in an individual’s physical appearance.

[Feedback for Correct Answer 2] Race is determined based on an individual’s physical characteristics and is considered arbitrary because individuals from different races can share common features and can be viewed on a continuum rather than as distinct categories. [Feedback for Answer Choice 3] Ableism refers to the tendency to favor individuals who do not have a physical or intellectual disability. [Feedback for Answer Choice 4] Religion is a set of commonly held spiritual beliefs and practices. [Q3] Which of the following is an ongoing, multidimensional process that maintains a hierarchical racial classification system? 1. Internalized racism 2. Racism [correct] 3. Culture 4. Cognitive costs [Feedback for Answer Choice 1] Internalized racism occurs when members of an oppressed group believe negative messages from the dominant culture. [Feedback for Correct Answer 2] Racism is an ongoing process in which certain races gain inherent privilege over others and, thus, maintains a hierarchical racial classification system. [Feedback for Answer Choice 3] Culture can refer to any set of commonly held values and beliefs. [Feedback for Answer Choice 4] Cognitive costs are mental burdens experienced by individuals and are not solely related to issues of race and class. [Q4] Which approach to multicultural awareness focuses on universal qualities that are generalizable to members of all cultural groups? 1. Etic [correct] 2. Emic 3. Within group 4. Between group

[Feedback for Correct Answer 1] An etic approach to multicultural conceptualization and awareness focuses on the general human experience and qualities that are relevant for all individuals, regardless of culture. [Feedback for Answer Choice 2] An emic approach to multicultural conceptualization and awareness focuses on cultural factors that are unique a specific cultural group or subgroup. [Feedback for Answer Choice 3] Within group is a research term that refers to variations that are found among people who belong to the same group. Groups can be determined based on a variety of factors, not just culture (e.g., age, height, geographic location). [Feedback for Answer Choice 4] Between group is a research term that refers to variations that are found among people who belong to different groups. Groups can be determined based on a variety of factors, not just culture (e.g., age, height, geographic location). Learning Outcome 1.2: Gain knowledge of U.S. demographic trends and how they influence counseling process and use. [Q1] According to a 2018 survey conducted by the U.S. Census Bureau, as Multiracial.

of Americans identify

1. 3.4% [correct] 2. 5.0% 3. 5.6% 4. 12.7% [Feedback for Correct Answer 1] According to a 2018 survey conducted by the U.S. Census Bureau, 3.4% of Americans identify as Multiracial. [Feedback for Answer Choice 2] According to a 2018 survey conducted by the U.S. Census Bureau, 5.0% of Americans identify as ‟other race.‖ [Feedback for Answer Choice 3] According to a 2018 survey conducted by the U.S. Census Bureau, 5.6% of Americans identify as being of Asian descent. [Feedback for Answer Choice 4] According to a 2018 survey conducted by the U.S. Census Bureau, 12.7% of Americans identify as Black.

[Q2] According to a 2018 survey conducted by the U.S. Census Bureau, as being of Hispanic or Latin descent.

of Americans identify

1. 12.7% 2. 15.0% 3. 18.3% [correct] 4. 27.5% [Feedback for Answer Choice 1] According to a 2018 survey conducted by the U.S. Census Bureau, 12.7% of Americans identify as Black. [Feedback for Answer Choice 2] According to U.S. Census Bureau (2020) projections, by 2060, the proportion of the U.S. who identify as Black will increase to 15%. [Feedback for Correct Answer 3] According to a 2018 survey conducted by the U.S. Census Bureau, 18.3% of Americans identify as being of Hispanic or Latin descent. [Feedback for Answer Choice 4] According to U.S. Census Bureau (2020) projections, by 2060, the proportion of the U.S. who identify as being of Hispanic or Latin descent will increase to 27.5%. [Q3] Which of the following terms is used to refer to individuals who move from place to place for economic reasons? 1. Refugee 2. Asylum seeker 3. Foreign national 4. Migrant [correct] [Feedback for Answer Choice 1] Refugees are those who are forced to flee their home country due to war or other violence or political persecution; they are given protections under international laws, conventions, and lifesaving support from aid agencies, and have the opportunity to become lawful permanent residents and eventually citizens. [Feedback for Answer Choice 2] Asylum seekers share characteristics with refugees, although they have not received a refugee status and accompanying protections and aid.

[Feedback for Answer Choice 3] The term foreign national is not defined in the U.S. Immigration and Nationality Act (INA). Instead, the term alien is used in American law to describe individuals who are not U.S. nationals. [Feedback for Correct Answer 4] Migrants are those who move from place to place, usually for economic reasons such as seasonal work. [Q4] The predominant racial group in the United States is which of the following? 1. White [correct] 2. Black/African 3. Asian 4. American Indian [Feedback for Correct Answer 1] Approximately 60% of individuals in the United States identify as non-Hispanic White, which makes White the predominant racial group in the United States. [Feedback for Answer Choice 2] Individuals who identify as Black/African are the largest minority group in the United States. [Feedback for Answer Choice 3] Fewer individuals in the United States identify as Asian than White. [Feedback for Answer Choice 4] Fewer individuals in the United States identify as American Indian than White. Learning Outcome 1.3: Articulate prevalence rates for common mental health concerns across multicultural populations. [Q1] In 2017, the estimated percentage of U.S. adults who reported any type of mental illness (i.e., mental, behavioral, or emotional disorder) for the previous year was: 1. 15.2% 2. 18.9% [correct] 3. 20.4% 4. 25.8% [Feedback for Answer Choice 1] 15.2% of U.S. adults of Latin or Latin American descent reported some type of mental illness for the previous year.

[Feedback for Correct Answer 2] 18.9% (46.6 million) of U.S. adults reported any type of mental illness (i.e., mental, behavioral, or emotional disorder) for the previous year.

[Feedback for Answer Choice 3] 20.4% of U.S. adults who identify as White reported some type of mental illness for the previous year. [Feedback for Answer Choice 4] 25.8% of U.S. young adults age 18–25 years reported some type of mental illness for the previous year. [Q2] In 2017, the estimated percentage of U.S. men who reported a Substance Use Disorder for the previous year was: 1. 1.8% 2. 5.3% 3. 11.5% [correct] 4. 14.3% [Feedback for Answer Choice 1] 1.8% of U.S. men reported PT SD for the previous year. [Feedback for Answer Choice 2] 5.3% of U.S. men reported Major Depression for the previous year. [Feedback for Correct Answer 3] 11.5% of U.S. men reported a Substance Use Disorder for the previous year. [Feedback for Answer Choice 4] 14.3% of U.S. men reported an Anxiety Disorder for the previous year. [Q3] In 2017, the estimated percentage of U.S. women who reported an Anxiety Disorder for the previous year was: 1. 5.2% 2. 6.4% 3. 8.7% 4. 23.4% [correct] [Feedback for Answer Choice 1] 5.2% of U.S. women reported PT SD for the previous year.

[Feedback for Answer Choice 2] 6.4% of U.S. women reported a Substance Use Disorder for the previous year. [Feedback for Answer Choice 3] 8.7% of U.S. women reported Major Depression for the previous year. [Feedback for Correct Answer 4] 23.4% of U.S. women reported an Anxiety Disorder for the previous year. [Q4] Which of the following practices is recommended to help counselors address race-related stress in counseling sessions? 1. Bracketing the client’s racial identity 2. Minimizing instances of race-related trauma and oppression 3. Supporting a client through race-related guilt [correct] 4. Helping clients conform to the majority culture [Feedback for Answer Choice 1] Counselors can better understand and empathize with clients if they acknowledge and explore clients’ racial identities and experiences. [Feedback for Answer Choice 2] Rather than minimizing the impact of oppression, counselors should explore race-related trauma with clients when applicable. [Feedback for Correct Answer 3] Counselors should help clients explore and process any guilt they might have related to their own racial identities. [Feedback for Answer Choice 4] Counselors should seek to affirm the unique perspectives and cultural values of clients. Encouraging clients to conform to the majority culture, rather than affirming their cultural identity, will likely compound the client’s level of race-related stress. Learning Outcome 1.4: Identify contextual factors that influence counseling use among multicultural populations. [Q1] Which of the following refers to a change in thoughts, values, and behaviors when a minority group comes into contact with a dominant culture? 1. Enculturation 2. Cultural identity development 3. Ethnic identity development 4. Acculturation [correct]

[Feedback for Answer Choice 1] Enculturation refers to the process of learning one’s own culture. [Feedback for Answer Choice 2] Cultural identity development is a broad term that does not necessarily refer to minority groups. [Feedback for Answer Choice 3] Ethnic identity development is a broad term that does not necessarily refer to minority groups. [Feedback for Correct Answer 4] Acculturation refers to a process in which individuals learn about a different culture. [Q2] Covert and overt behaviors based on cultural generalizations are called: 1. prejudice. 2. stereotypes. 3. discrimination. [correct] 4. values. [Feedback for Answer Choice 1] The term prejudice refers to a judgment placed on a group of people without proper evidence or knowledge. Prejudices can influence an individual’s behavior, but prejudice is not a behavior in itself. [Feedback for Answer Choice 2] Stereotypes are thoughts or beliefs toward an individual that are unfounded or otherwise unfair. Stereotypes can lead to unhelpful behaviors, but stereotypes are not behaviors in themselves. [Feedback for Correct Answer 3] Discrimination takes the form of unfair behaviors enacted by an individual toward another individual. Discriminatory behaviors might be easily identifiable (e.g., a hate crime) or difficult to identify (e.g., an employer hiring a less-qualified candidate because of his or her race). [Feedback for Answer Choice 4] An individual’s values can inform behaviors, but values are internal thoughts and beliefs rather than actions or behaviors. [Q3] Culturally diverse individuals might have a mistrust of the counseling profession as a result of which of the following? 1. Historical undertones of racism and other forms of oppression in the mental health fields [correct] 2. Insurance companies’ preferences for medical interventions 3. The ineffectiveness of counseling interventions

4. The recent push to promote and normalize counseling in Western culture [Feedback for Correct Answer 1] Although the profession’s ethical codes prohibit discrimination, certain populations have been oppressed by counselors (whether intentionally or unintentionally). [Feedback for Answer Choice 2] It can be debated whether insurance companies prefer medical procedures over mental health interventions, but this does not directly relate to the historical oppression of diverse individuals. [Feedback for Answer Choice 3] Counseling interventions have been proven to be effective in innumerable studies. [Feedback for Answer Choice 4] The social acceptability of attending to one’s mental health has increased in recent years, as more and more high-profile individuals—from diverse cultural backgrounds—have publicly shared their mental health struggles and have advocated for seeking help. [Q4] What are help-seeking behaviors in counseling? 1. Ways in which clients or students reach out for support [correct] 2. Ways in which clients communicate with their loved ones 3. Methods for creating outcomes in counseling 4. Business practices for independently licensed counselors [Feedback for Correct Answer 1] The term help-seeking behaviors refers to the ways in which groups of individuals typically access support from others. [Feedback for Answer Choice 2] Although individuals might ask their loved ones for help, the term help-seeking behaviors refers to the acquisition of formal support services. [Feedback for Answer Choice 3] Counselors are responsible for supporting clients toward their desired mental health outcomes, and help-seeking behaviors are enacted by clients to access counseling services. [Feedback for Answer Choice 4] Sound business practices are important for counselors to run successful agencies and practices, and typical help-seeking behaviors of clients might influence business practices, but business practices are not the same as help-seeking behaviors. Learning Outcome 1.5: Describe forms of communication and articulate how they relate to multicultural counseling.

[Q1] This term refers to the use of personal physical distance between counselor and client. 1. Proxemics [correct] 2. Kinesics 3. Paralanguage 4. Scope of practice [Feedback for Correct Answer 1] Proxemics refers to the use of personal physical distance between counselor and client. [Feedback for Answer Choice 2] Kinesics refers to the use of body movements, positions, and postures within counseling sessions. [Feedback for Answer Choice 3] Paralanguage refers to the verbal cues, other than words, used between counselor and client. [Feedback for Answer Choice 4] Scope of practice refers to the professional roles and permitted responsibilities associated with the practice of counseling. [Q2] The inclusion of diverse perspectives and context in the counseling process is known as: 1. interpersonal counseling. 2. culturally responsive counseling. [correct] 3. theoretical liberation. 4. problem solving. [Feedback for Answer Choice 1] Interpersonal counseling occurs between a counselor and one or more clients. Interpersonal counseling should include diverse perspectives, but that is not always the case if the counselor is not able to fully consider the client’s context. [Feedback for Correct Answer 2] Culturally responsive counseling includes diverse perspectives of others in the counseling relationship. Culturally responsive counseling allows each unique client to be viewed and understood within his or her individual context. [Feedback for Answer Choice 3] Although theoretical liberation is not a counseling-specific term, it sounds a bit like liberation psychology, in which oppressive sociopolitical structures are addressed. [Feedback for Answer Choice 4] Problem solving is an important component of many counseling interventions but this concept, in itself, does not directly address diversity and context.

[Q3] This term refers to the use of body movements, positions, and postures within counseling sessions. 1. Proxemics 2. Kinesics [correct] 3. Paralanguage 4. Scope of practice [Feedback for Answer Choice 1] Proxemics refers to the use of personal physical distance between counselor and client. [Feedback for Correct Answer 2] Kinesics refers to the use of body movements, positions, and postures within counseling sessions. [Feedback for Answer Choice 3] Paralanguage refers to the verbal cues, other than words, used between counselor and client. [Feedback for Answer Choice 4] Scope of practice refers to the professional roles and permitted responsibilities associated with the practice of counseling. [Q4] To build a therapeutic relationship with clients with marginalized identities, an increased use of on the part of the counselor is often necessary. 1. humor 2. silence 3. self-disclosure [correct] 4. self-deprecation [Feedback for Answer Choice 1] The clinical use of humor should only be utilized with clients after careful deliberation. Typically, counselors should integrate humor into later stages of counseling once a suitable therapeutic bond has been established. [Feedback for Answer Choice 2] At certain times, long periods of silence may be necessary. However, this approach may not be suitable for all cultural groups, as some clients may expect counselors to take a more active and directive approach to sessions. [Feedback for Correct Answer 3] Clients with marginalized identities commonly experience shame and stigma about discussing personal problems with a person outside one’s culture or family. An increased level of selfdisclosure on the part of the counselor is often a necessary and beneficial approach to overcoming cultural barriers to an open and honest communication with marginalized clients.

[Feedback for Answer Choice 4] Self-deprecation, like humor, should only be utilized with clients after careful deliberation. However, this approach is generally not appropriate for work with clients who view counselors as experts and authority figures. Learning Outcome 1.6: Articulate and apply components of the Multicultural and Social Justice Counseling Competency framework. [Q1] Counselors should be aware of and bracket their

during counseling sessions?

1. Status 2. Privilege 3. Power 4. Values [correct] [Feedback for Answer Choice 1] That status of a counselor may affect the ways in which they conceptualize clients. These factors should be acknowledged and accounted for by counselors. [Feedback for Answer Choice 2] Counselors might have power and privilege in society, and they might be exposed to others who have power and privilege in society. As such, counselors should conceptualize clients with an awareness of power dynamics within the counseling relationship, as well as in the lives of their clients. [Feedback for Answer Choice 3] Counselors have inherent power in the counseling relationship because clients are paying for their help, and counselors learn private information about their clients without divulging any of their own. Counselors should have an awareness of this reality and should strive to provide respectful and culturally responsive services. [Feedback for Correct Answer 4] Counselors should develop an awareness of their deeply held beliefs and strive to bracket their values within counseling sessions. [Q2] The ACA Advocacy Competencies include which of the following? 1. Acting on behalf of a client [correct] 2. Breaching confidentiality in order to advocate for a client 3. Taking clients to vote on election day 4. Providing access to technology-assisted services [Feedback for Correct Answer 1] Counselors are in a position of power for a variety of reasons. First, clients come to counselors for professional support and pay for these services. Additionally, counselors are respected

members of the mental health profession. Furthermore, counselors have a master’s degree and are educated on effective ways to support others in need. As such, the ACA Advocacy Competencies include counselors’ abilities and responsibilities to act on behalf of clients when relevant and appropriate. [Feedback for Answer Choice 2] Counselors may not breach client confidentiality in order to advocate for their clients. Advocacy should be done anonymously or with a properly signed release. [Feedback for Answer Choice 3] Counselors should maintain professional boundaries with clients. In some cases, it might be appropriate for counselors to take clients to vote, but this is not a common occurrence (and should be done with caution according to relevant laws and policies) and is not included in the A CA Advocacy Competencies. [Feedback for Answer Choice 4] Providing access to technology-assisted services is not included in the ACA Advocacy Competencies. However, counselors should make reasonable efforts to connect clients to relevant resources. [Q3] The promotion of equity for all in order to end oppression is: 1. impossible. 2. social justice. [correct] 3. supervision. 4. serious and foreseeable. [Feedback for Answer Choice 1] Although this is a lofty task, counselors are strengths-based and developmental professionals, and the counseling profession strives toward equity for all. [Feedback for Correct Answer 2] Social justice is the promotion of equity for all diverse individuals. Through social justice frameworks and initiatives, counselors hope to end oppression for all. [Feedback for Answer Choice 3] Although issues related to diversity and advocacy are often present in supervision, the supervision process serves as an educational gatekeeping tool rather than a tool specifically designed for promoting equity. [Feedback for Answer Choice 4] Counselors promote the safety of clients or other identified individuals if they are known to be in serious and foreseeable danger, but this is not directly tied to the promotion of equity and ending oppression.

[Q4] According to the Multicultural Counseling and Social Justice Competencies (MSJCC) framework, when a privileged counselor works with a marginalized client, the developmental domains should be attended to in the following order: 1. Attitudes and Beliefs, Knowledge, Skills, & Action [correct] 2. Attitudes and Beliefs, Skills, Knowledge, & Action 3. Knowledge, Attitudes and Beliefs, Skills, & Action 4. Knowledge, Skills, Attitudes and Beliefs, & Action [Feedback for Correct Answer 1] Regardless of the cultural backgrounds of the counselor and client, the order for attending to the four developmental domains does not change: Attitudes and Beliefs, Knowledge, Skills, & Action. [Feedback for Answer Choice 2] According to the MSJCC framework, counselors should be familiar with how their cultural identity plays out in their personal and professional experiences (knowledge) before engaging in skill development to communicate, apply, and assess their knowledge (skills). [Feedback for Answer Choice 3] According to the MSJCC framework, counselors should develop an awareness of their own worldview and combination of privileged and oppressed statuses (attitudes and beliefs) before moving on to address the domain of knowledge. [Feedback for Answer Choice 4] According to the MSJCC framework, counselors should first address their attitudes and beliefs before moving on to the domains of knowledge and skills. Learning Outcome 1.7: Demonstrate knowledge of ethical considerations in multicultural counseling. [Q1] Which of the following professional practices is promoted by the ACA Code of Ethics (2014)? 1. Connect privileged and marginalized clients with supportive individuals 2. Practice in a competent manner [correct] 3. Remove barriers that may impede the effectiveness of a school environment 4. Employ empowerment-based theories to address internalized oppression experienced by marginalized clients. [Feedback for Answer Choice 1] Counselors value diversity and promote equity for all individuals. However, the explicit guideline to connect privileged and marginalized clients with supportive individuals is outlined in the Multicultural Counseling and Social Justice Competencies (MSJCC) framework.

[Feedback for Correct Answer 2] Professional counselors are bound by the ACA Code of Ethics and practice with the ethical values of justice, fidelity, autonomy, beneficence, and nonmalfeasance. Counselors are responsible for ensuring that they are practicing in a competent and ethical manner. [Feedback for Answer Choice 3] According B.2.e of the ASCA Code of Ethics, school counselors should ―Collaborate with appropriate officials to remove barriers that may impede the effectiveness of the school or the school counseling program.‖ [Feedback for Answer Choice 4] Ethical counselors work to address issues or power and privilege with marginalized clients. However, the explicit guideline to employ empowerment-based theories to address internalized oppression experienced by marginalized clients is outlined in the Multicultural Counseling and Social Justice Competencies (MSJ CC) framework. [Q2] Section A of the ACA Code of Ethics (2014) addresses: 1. The Counseling Relationship [correct] 2. Professional Responsibility 3. Confidentiality and Privacy 4. Distance Counseling [Feedback for Correct Answer 1] Section A of the ACA Code of Ethics (2014) addresses The Counseling Relationship. [Feedback for Answer Choice 2] Section C of the ACA Code of Ethics (2014) addresses Professional Responsibility. [Feedback for Answer Choice 3] Section B of the ACA Code of Ethics (2014) addresses Confidentiality and Privacy. [Feedback for Answer Choice 4] Section H of the ACA Code of Ethics (2014) addresses Distance Counseling. [Q3] Section B of the ACA Code of Ethics (2014) addresses: 1. The Counseling Relationship 2. Professional Responsibility 3. Confidentiality and Privacy [correct] 4. Distance Counseling [Feedback for Answer Choice 1] Section A of the ACA Code of Ethics (2014) addresses The Counseling Relationship.

[Feedback for Answer Choice 2] Section C of the ACA Code of Ethics (2014) addresses Professional Responsibility. [Feedback for Correct Answer 3] Section B of the ACA Code of Ethics (2014) addresses Confidentiality and Privacy. [Feedback for Answer Choice 4] Section H of the ACA Code of Ethics (2014) addresses Distance Counseling.

[Q4] Section I.C of the AMHCA Code of Ethics and Multicultural Counseling Considerations (2020) addresses: 1. Counseling Process 2. Counselor-Client Relationship 3. Counselor Responsibility and Integrity [correct] 4. Relationship with Colleagues [Feedback for Answer Choice 1] Section I.B of the AMHCA Code of Ethics and Multicultural Counseling Considerations (2020) addresses Counseling Process. [Feedback for Answer Choice 2] Section I.A of the AMHCA Code of Ethics and Multicultural Counseling Considerations (2020) addresses Counselor-Client Relationship. [Feedback for Correct Answer 3] Section I.C of the AMHCA Code of Ethics and Multicultural Counseling Considerations (2020) addresses Counselor Responsibility and Integrity. [Feedback for Answer Choice 4] Section II.A of the AMHCA Code of Ethics and Multicultural Counseling Considerations (2020) addresses Relationship with Colleagues.

Chapter 1 Application Exercises Application Exercise 1.1: General Cultural Trends Learning Outcome 1.2: Gain knowledge of U.S. demographic trends and how they influence counseling process and use. [Q1] Keeping in mind that every individual has unique life experiences, what are some key cultural considerations discussed in the research presented in the text that counselors might explore or test when working with White clients and Black clients? [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Black individuals may value high levels of spirituality and collectivism.

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Black individuals may use expressive communication styles and value assertiveness when interacting with others.

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Black Individuals may choose to keep private matters within the family rather than communicating these with people in the community.

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White individuals may value individualism over collectivism.

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Self-reliance is a commonly held value in many White individuals.

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Family connections may be quite important for White individuals, and emotional expression within the family can be quite restrained or quite open.

[Q2] Keeping in mind that every individual has unique life experiences, what are some key cultural considerations discussed in the research presented in the text that counselors might explore or test when working with clients of Arab and Asian descent? [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Individuals of Arab descent may be collectivist in nature, and individuals might tend to stay very connected with their immediate families as they grow older.

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Arab individuals may value educational attainment for males and females, and physical appearance and religious affiliation can vary widely within the Arab community.

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Family is very important in many Asian cultures, and family needs are often placed before the needs of an individual.

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Gender roles may be strict in Asian cultures, and males may be primarily viewed as the breadwinners, whereas women may be viewed as caretakers.

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Education may be highly valued in many Asian cultures, and there is a wide variety of religious affiliations associated with Asian individuals.

[Q3] Keeping in mind that every individual has unique life experience, what are some key cultural considerations discussed in the research presented in the text that counselors might explore or test when working with Latina/o/x and Native American clients? [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Christianity is quite common in Latina/o/x culture, and gender-based roles in which men are breadwinners and women are nurturers may be promoted.

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Males may be given more freedom for sexual exploration and expression than females.

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Interpersonal relationships may be quite important in Latina/o/x cultures.

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Native American individuals may strive toward achieving harmony with nature and may place the needs of the group above their own individual needs.

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Humility and patience may be highly valued characteristics in the Native American culture, and Native American individuals may speak slowly and calmly to display their patience and respect for others.

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Native Americans may value the wisdom of elders and might turn toward nature for explanations of the physical world.

Application Exercise 1.2: Help-Seeking Behaviors Learning Outcome 1.4: Identify contextual factors that influence counseling use among multicultural populations. [Q1] Based on the research discussed in the text, what are some common help-seeking behaviors that may be associated with male clients in the United States? [Q1 MODEL RESPONSE] Your answer might include any of the following: 

Males in the United States might experience feelings of shame or guilt for seeking counseling.

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Men might minimize their problems or deny them altogether to avoid asking for help.

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Men who value higher levels of traditional masculinity might have more trouble seeking help.

[Q2] Based on the research discussed in the text, what are some common help-seeking behaviors that may be associated with Arab American clients?

[Q2 MODEL RESPONSE] Your answer might include any of the following: 

Arab American clients might view counseling as a Western concept, and individuals from generations that have been in the United States longer might be more open to counseling.

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Arab American clients might tend to manifest mental health symptoms physically, with presenting problems such as headaches or stomachaches.

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Arab Americans might feel more comfortable seeking help from medical professionals or clergy members.

[Q3] Based on the research discussed in the text, what are some common help-seeking behaviors that may be associated with Asian American clients? [Q3 MODEL RESPONSE] Your answer might include any of the following: 

Asian American individuals are three times less likely than White Americans to access mental health services.

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When Asian Americans do come to counseling, they are likely to terminate early.

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Asian American clients might seek help from health centers instead of counselors.

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Asian Americans might prefer mental health classes or online materials over counseling.

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Asian Americans who have greater English proficiency are more likely to use counseling services.

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Overall, a lack of knowledge about counseling may be a barrier for Asian American clients when seeking help.

Application Exercise 1.3: Are You Multiculturally Competent? Learning Outcome 1.6: Articulate and apply components of the Multicultural and Social Justice Counseling Competency framework. [Q1] What is multicultural counseling? [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Multicultural counseling is the practice of engaging in a counseling relationship with any person who is different from yourself.

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All counseling is multicultural counseling.

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No matter how similar, no two people are exactly the same.

[Q2] How will you know if you are a competent multicultural counselor? [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Multicultural counseling competence includes self-awareness, in which counselors have a firm understanding of their own complex identities.

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Multiculturally competent counselors are sensitive to issues of diversity and recognize the endless factors that make each individual unique.

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Multicultural counselors understand pluralistic values within and among diverse groups.

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Multiculturally competent counselors advocate for social justice.

[Q3] Explain the attitudes and beliefs, knowledge, and skills counselors need regarding their own cultural values and beliefs. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Counselors view themselves as cultural beings and appreciate the cultural differences of their clients.

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Counselors understand how their values inform their definitions of mental health and understand that others’ definitions of mental health will vary.

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Counselors understand how oppression has affected them and their clients.

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Counselors recognize their limits to competence and seek personal and professional growth and continued education to form an increasingly unoppressive identity.

[Q4] Explain the attitudes and beliefs, knowledge, and skills counselors need regarding their clients’ cultural values and beliefs. [Q4 MODEL RESPONSE] Your answer should include some of the following points: 

Counselors understand ways in which their own stereotypes and biases influence the counseling relationship and outcomes.

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Counselors understand that cultural backgrounds are often associated with oppression.

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Counselors engage in personal and professional immersion experiences to gain deeper insights into their clients’ lives.

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Counselors understand general mental health considerations for specific groups but also accept within-group variation.

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Counselors use culturally relevant approaches in the counseling process.

Chapter 1 Test Items Multiple Choice 1.

is NOT one of the first three forces of counseling. a. Psychodynamic b. Gestalt c. Behaviorism d. Humanistic/Existentialism

2. One reason the United States has become so diverse is due to a. aging trends. b. higher birth rates in some ethnic minority groups. c. immigration trends. d. All of the above. 3. Ethnicity, gender, sexual identity, and spirituality are examples of a. cultures. b. identities. c. subgroups of cultural groups. d. values. 4. Cultural identities of clients should be acknowledged in counseling because client cultural identities a. may differ from the counselor’s cultural identity. b. affect client experiences in counseling. c. Both a and b. d. None of the above. 5. The human experience of culture is mediated by a. biological events. b. historical events. c. political events. d. All of the above. 6. Ethnocentrism occurs when a. counselors project their values onto clients. b. counselors ignore how the client’s cultural values and beliefs may influence the client. c. counselors adhere to a narrow and rigid view of the world and other cultures. d. All of the above. 7. Cooperation, ―saving face,‖ and interdependence are examples of a. collectivistic values.

b. individualistic values. c. ethnocentric values. d. worldview. 8. Those people born during the Baby Boomer generation were born between the years of a. 1901–1924. b. 1925 –1942. c. 1946–1960. d. 1961–1981. 9. Socioeconomic status (SES) is defined by a. household income. b. education level. c. access to health care. d. All of the above. 10. In the model of acculturation, individuals reject the values and customs of both their own culture and the host culture. a. integration b. marginalization c. separation d. assimilation 11. Professional counselors who engage in advocacy efforts assume that there is a(n) a. common goal for advocacy among other professionals. b. power differential among U.S. individuals. c. unconscious and unearned power among all cultural groups. d. All of the above. 12. One way to deepen the level of understanding shared by a counselor and client is to use a. sympathy. b. metaphors. c. projection. d. kinesics. 13.

is NOT one of the hierarchical social relationship categories. a. Individualistic b. Lineal-hierarchical c. Collateral-individual d. Collateral-mutual

14.

may result when counselors cannot convey understanding to culturally and

linguistically different clients. a. Frustration b. Invalidation c. Both of the above. d. None of the above. 15. It is imperative that professional counselors interpret client presentation based on a. norms from within the client’s culture. b. norms from within the majority culture. c. what the professional counselor has researched about the client’s culture. d. All of the above. 16. To increase open communication, counselors should consistently a. take notes throughout sessions. b. check with clients to ensure they are accurately interpreting and understanding clients’ messages. c. write a synopsis of the session and ask the client to read it before the next session. d. record counseling sessions with the consent of the client. 17. As counselors work with clients who experience daily prejudice and discrimination, it is important that counselors examine a. clients’ emotions associated with these experiences. b. clients’ environmental stressors associated with stereotyping. c. their own prejudices. d. All of the above. 18. Biculturalism is a part of the model of acculturation. a. b. c. d. 19.

separation marginalization assimilation integration is a stressor that occurs across cultural identities.

a. Violence b. Trauma c. Both of the above. d. None of the above. 20. Developing multicultural counseling competency involves a a. psychodynamic approach. b. existential approach. c. systems approach. d. behavioral approach. 21. Increased levels of counselor awareness and knowledge of oppression has led to a(n)

a. focus on social justice and advocacy. b. decrease in minority groups attending counseling. c. focus on more effectively treating clients of the dominant group. d. All of the above. 22. When working with culturally diverse clients, it is essential to remember that there are more differences than differences. a. between-group; within-group b. within-group; between-group c. general; universal d. specific; universal 23. There is evidence that counselors may prejudice.

culturally diverse clients due to

a. misdiagnose b. underdiagnose c. overdiagnose d. All of the above. 24. A factor that might cause diverse clients to avoid counseling is a. inaccessibility of services. b. misdiagnosis. c. mistrust of the counseling profession. d. All of the above. 25. When considering both racial and ethnic minority group membership, which group represents the fastest growing population? a. Black/African Americans b. Hispanic/Latin Americans c. Asian Americans d. Both b and c. 26. The largest number of foreign-born individuals originate from a. Latin America. b. Europe. c. Asia. d. Africa. 27. The group with the highest median income is a. Hispanic/Latin Americans. b. White. c. Asian Americans. d. Black/African Americans. 28. ―Those living in poverty‖ is an example of a. universal b. group

culture.

c. individual d. None of the above. 29. Self-disclosure is an example of a. individualism. b. collectivism. c. universal culture. d. group culture. 30. ―I am in charge of creating success for myself‖ is an example of the

worldview.

a. internal locus of responsibility b. internal locus of control c. external locus of responsibility d. external locus of control 31. ―I believe what happens to me is based on my own doings‖ is an example of the worldview. a. b. c. d. 32.

internal locus of responsibility internal locus of control external locus of responsibility external locus of control is NOT an example of nonverbal communication.

a. Paralanguage b. Kinesics c. Proxemics d. Metaphor 33. Clients of diverse backgrounds may seek counseling because a. other services are inaccessible to them. b. counselors focus on within-group differences. c. there is social acceptance of counseling. d. None of the above. 34. Counselors engaging in community experiences to better understand a client of a cultural identity different from their own is an example of the aspect of multicultural counseling competency. a. b. c. d.

attitudes and beliefs knowledge skills advocacy 35. refers to changes in behavior, cognitions, values, language, cultural activities, personal relational styles, and beliefs as a cultural minority group encounters the dominant culture. a. Cultural encapsulation b. Acculturation c. Enculturation

d. Cultural identity 36. culture refers to commonalities shared by all cultures and humankind. a. Group b. Individual c. Universal d. Collectivist 37. The intrapersonal and interpersonal process in which individuals engage to build a clearer and more complex cultural identity is known as a. acculturation. b. ethnocentrism. c. ethnicity. d. cultural identity development. 38. A(n) perspective focuses on universal qualities common to all cultures and aspects of counseling that are generalizable across cultures, while the perspective involves viewing each client as an individual and evaluating the client using their cultural norms. a. b. c. d.

emic; etic etic; emic group; individual individual; group 39. is the arbitrary, socially constructed classification of individuals often based on physical distinctions. a. b. c. d.

Race Culture Ethnicity All of the above. 40. refers to the often unconscious and unearned power, access to resources, advantage, and social position based on cultural group memberships. a. Oppression b. Individualism c. Nationality d. Privilege 41. Which of the following factors may deter culturally diverse populations from participating in and completing counseling services? a. Attitudinal factors b. Structural factors c. Collectivist factors d. Both a and b 42. The type of nonverbal communication that includes body movements, positions, and postures is a. paralanguage.

b. proxemics. c. kinesics. d. eye contact. 43. refers to prematurely holding a belief or attitude without appropriate examination or consideration of actual data, while refers to covert and overt behaviors based on generalizations about individuals’ cultural group memberships. a. Prejudice; discrimination b. Discrimination; prejudice c. Stereotypes; prejudice d. Discrimination; stereotypes 44. In the model of acculturation, highly acculturated individuals identify solely with the new culture. a. b. c. d.

integration marginalization separation assimilation

Extended Response 1. 2.

Describe the factors that are contributing to an increasingly diverse U.S. society. Compare and contrast race, ethnicity, and ethnocentrism.

Describe the terms collectivism and individualism, along with the implications these concepts may have for counseling.

Describe Kluckhohn and Strodbeck’s theoretical model (1961) of worldview.

Compare and contrast the expression of emotions between Western and non-Western cultures.

Explain the different immigration patterns throughout U.S. history.

Describe the stressors related to acculturation among individuals of minority cultures.

Describe the factors that contribute to racial and ethnic minorities under-using counseling services and terminating counseling prematurely.

Explain the systems approach to becoming a multiculturally competent counselor.

10. Identify the four developmental domains proposed in the multicultural counseling and social justice competencies. 11. Discuss the etic and emic perspectives. Which perspective is supported by multicultural counseling literature? Why? 12. Describe and explain how attitudinal and structural factors deter culturally diverse populations from seeking counseling. 13. Explain and support the following statement: The way normality and abnormality are defined in counseling is culturally based. 14. Identify at least three barriers that culturally diverse clients encounter regarding the accessibility of counseling services. 15. Identify and describe the four main models of acculturation with which counselors should be familiar.

Chapter 1 Test Answer Key ANSWER KEY: Chapter 1 Test (Multiple Choice) 1. b 2. d 3. a 4. c 5. d 6. d 7. a 8. c 9. d 10. b 11. b 12. b 13. c 14. c 15. a 16. b 17. d 18. d 19. c 20. c 21. a 22. b 23. d 24. d 25. d 26. a 27. c 28. b 29. a 30. a 31. b 32. d

33. a 34. c 35. b 36. c 37. d 38. b 39. a 40. d 41. d 42. c 43. a 44. d

Chapter 2 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach 4th Edition Danica G. Hays University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

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ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents

Chapter 2: Cultural Identity Development

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 2: Cultural Identity Development Chapter 2 Learning Outcome Quizzes Learning Outcome 2.1: Describe and use racial and ethnic identity development models to guide work with people of color and White people. [Q1] Which of the following is included in Helms’s White Identity Model? 1. Conformity 2. Reintegration [correct] 3. Illegal behavior 4. Integrative Awareness [Feedback for Answer Choice 1] Conformity is included in Helms’s People-of-Color Identity Model. [Feedback for Correct Answer 2] Reintegration is a stage in Helms’s White Identity Model in which racial minorities are blamed for their problems. [Feedback for Answer Choice 3] Illegal behaviors are not directly addressed in Helms’s model. [Feedback for Answer Choice 4] Integrative Awareness is included in Helms’s People-of-Color Identity Model. [Q2] Which identity development model can be used to conceptualize counselors specifically? 1. Ponterotto’s Model of Cultural Identity Development [correct] 2. Phinney’s Model of Ethnic Identity 3. Downing and Roush’s Model of Feminist Identity 4. Cass’s Model of Sexual Identity [Feedback for Correct Answer 1] Ponterotto’s model of cultural identity was developed specifically for counselors in training. [Feedback for Answer Choice 2] Phinney’s model of ethnic identity was developed for adolescents. [Feedback for Answer Choice 3] Downing and Roush’s model of feminist identity was developed to support feminist therapy.

[Feedback for Answer Choice 4] Cass’s model of sexual identity was created for members of the LGBTQ community. [Q3] Regressive interactions in a counseling relationship are marked by which of the following? 1. Counselors with high levels of social power and high levels of cognitive complexity 2. Counselors with high levels of social power and low levels of cognitive complexity [correct] 3. Counselors with low levels of social power and low levels of cognitive complexity 4. Clients with low levels of social power and high levels of cognitive complexity [Feedback for Answer Choice 1] Counselors who have high levels of cognitive complexity can engage in deep and effective reasoning, which typically protects them and their clients from regressive behaviors. [Feedback for Correct Answer 2] Counselors who have low levels of cognitive complexity are not able to engage in intricate exploration of self and others, and when paired with high levels of social power, regressive counseling interactions are likely to be enacted. [Feedback for Answer Choice 3] Counselors with low levels of social power are not likely to engage in regressive interactions even if their reasoning is also limited. [Feedback for Answer Choice 4] Counselors with high levels of cognitive complexity can engage in deep self-exploration and understand others intricately. High levels of understanding, along with low levels of social power, protect counselors and clients from regressive interactions. [Q4] Which of the following is a complex process during which individuals determine which parts of certain ethnic groups belong to them? 1. Racial identity development 2. Ethnicity 3. Orthogonal cultural identity 4. Ethnic identity development [correct] [Feedback for Answer Choice 1] Racial identity development is related specifically to race, which is a physical/biological construct. [Feedback for Answer Choice 2] Ethnicity refers to a commonly held set of cultural beliefs, and this term does not specifically encompass one’s identity development in relation to this construct.

[Feedback for Answer Choice 3] An orthogonal cultural identity indicates that an individual identifies with parts of several cultures, but this term does not explain the process leading up to such an identity. [Feedback for Correct Answer 4] Ethnic identity development is a term used to describe the process by which an individual determines his or her own unique ethnic identity. Learning Outcome 2.2: Describe and apply gender identity development models in counseling. [Q1] Research suggests that adult males are socialized around: 1. Attire 2. Clothing 3. Hairstyles 4. Middle-class images [correct] [Feedback for Answer Choice 1] According to Halim et al. (2014), many young boys and girls are socialized around attire. [Feedback for Answer Choice 2] According to Halim et al. (2014), many young boys and girls are socialized around clothing. [Feedback for Answer Choice 3] According to Halim et al. (2014), many young boys and girls are socialized around hairstyles. [Feedback for Correct Answer 4] Research suggests that adult males are socialized around stereotyped notions of manhood that conform largely to White, middle-class, Christian, heterosexual images (Scott et al., 2012; Scott & Robinson, 2001). [Q2] A common benefit of social justice work for counselors includes increased: 1. Satisfaction [correct] 2. earnings 3. notoriety 4. self-importance [Feedback for Correct Answer 1] Counselors commonly experience personal satisfaction and growth when they help others. [Feedback for Answer Choice 2] Counselors engage in social justice work to advance important causes rather than to increase their earnings.

[Feedback for Answer Choice 3] Counselors engage in social justice work to advance important causes rather than to increase their notoriety. [Feedback for Answer Choice 4] Counselors engage in social justice work to draw attention to important issues that extend beyond themselves and their own interests. [Q3] Which of the following models is grounded in feminist theory and Black feminist scholarship and identifies 12 categories to consider in exploring experiences of transgender people of color? 1. The Key Model 2. Hoffman’s Model of Feminist Identity 3. De Vries Intersectional Model [correct] 4. Lev’s Transgender Emergence Model [Feedback for Answer Choice 1] The Key Model describes four types of gender identity attitudes for White males that are flexible and responsive to situations and experiences. [Feedback for Answer Choice 2] Hoffman proposed a theoretically inclusive model of women’s identity that identifies four distinct statuses. However, unlike De Vries, Hoffman’s model does not highlight the multidimensional aspects of transgender identity. [Feedback for Correct Answer 3] De Vries’s Intersectional Model is grounded in feminist theory and Black feminist scholarship and identifies 12 categories to consider in exploring experiences of transgender people of color. [Feedback for Answer Choice 4] Lev’s Transgender Emergence Model provides six developmental stages that describe what transgender individuals may negotiate as they come to terms with their own identity. [Q4] Movement toward empowerment, societal change, and activism is the final stage of which of the following Identity Models? 1. The Key Model 2. Hoffman Model 3. Devor’s Model 4. Downing and Roush Model [correct]

[Feedback for Answer Choice 1] The Key Model does not comprise stages; rather, it describes four types of gender identity attitudes for White males that are flexible and responsive to situations and experiences. [Feedback for Answer Choice 2] Synthesis of female identity is the final stage of Devor’s Model of Transsexual and Transgender Identity Formation. [Feedback for Answer Choice 3] Sense of pride in transgender or transsexual identity; commitment to transgender and transsexual identity advocacy. [Feedback for Correct Answer 4] Movement toward empowerment, societal change, and activism is the final stage of the Downing and Roush Model. Learning Outcome 2.3: Discuss and apply sexual identity development models in counseling. [Q1] One of the key traits associated with Stage 1 of the model developed by Weinberg et al. is: 1. Realization 2. Unsettled feelings [correct] 3. No or low levels of awareness 4. Awareness at individual and group levels [Feedback for Answer Choice 1] Realization is one of the key traits associated with Stage 1 of the model developed by Cass. [Feedback for Correct Answer 2] Unsettled feelings are one of the key traits associated with Stage 1 of the Model developed by Weinberg et al. [Feedback for Answer Choice 3] No or low levels of awareness is one of the key traits associated with Stage 1 of the model developed by Coleman. [Feedback for Answer Choice 4] Awareness at individual and group levels is one of the key traits associated with Stage 1 of the model developed by McCarn and Fassinger. [Q2] Identity Tolerance comprises Stage 3 of which of the following models? 1. Cass [correct] 2. Coleman 3. McCarn & Fassinger 4. Troiden

[Feedback for Correct Answer 1] Identity Tolerance comprises Stage 3 of The Cass Model. [Feedback for Answer Choice 2] Stage 3 of the Coleman Model is Exploration. [Feedback for Answer Choice 3] Stage 3 of the McCarn & Fassinger Model is Deeping Commitment. [Feedback for Answer Choice 4] Stage 3 of the Troiden Model is Identity Assumption. [Q3] The order of the development stages and the associated tasks proposed by the Cass Model are most like which of the following models? 1. Coleman 2. Brady & Busse [correct] 3. McCarn & Fassinger 4. Weinberg et al. [Feedback for Answer Choice 1] The first stage of the Coleman Model differs significantly from the Stage 1 of the Cass Model. Stage 1 of the Cass Model is Conscious Awareness, while Stage 1 of the Coleman Model reflects no or low levels of awareness. [Feedback for Correct Answer 2] The stages and tasks associated with the Brady and Busse Model most closely align with the Cass Model. Both models include many of the same tasks, which are also listed in the same developmental order. These overlapping developmental stages/tasks include identity comparison and tolerance, acceptance, pride, and synthesis. [Feedback for Answer Choice 3] The stages and tasks associated with the McCarn & Fassinger Model more closely align with the Troiden Model, than the Cass Model. [Feedback for Answer Choice 4] The first stage of the Coleman Model differs significantly from the Stage 1 of the Weinberg et al. Model. Stage 1 of the Cass Model is Conscious Awareness, while Stage 1 of the Weinberg et al. Model is Initial Confusion. [Q4] Deepening Commitment comprises Stage 3 of which of the following models? 1. Cass 2. Coleman 3. McCarn & Fassinger [correct]

4. Troiden

[Feedback for Answer Choice 1] Stage 3 of the Cass Model is Identity Tolerance. [Feedback for Answer Choice 2] Stage 3 of the Coleman Model is Exploration. [Feedback for Correct Answer 3] Deepening Commitment comprises Stage 3 of the McCarn & Fassinger Model. [Feedback for Answer Choice 4] Stage 3 of the Troiden Model is Identity Assumption. Learning Outcome 2.4: Describe and use spiritual identity development models in counseling. [Q1] Symbiosis is the first stage of which of the following Spiritual Identity Models? 1. Spero’s Development of Religious Transformations Model [correct] 2. Fowler’s Model of Faith Development 3. Genia’s Development of Growth Model 4. Poll and Smith’s Model of Spiritual Identity [Feedback for Correct Answer 1] Symbiosis is the first stage of Spero’s Development of Religious Transformations Model. [Feedback for Answer Choice 2] Stage 1 of Fowler’s Model of Faith Development is called Intuitive–Projective Faith. [Feedback for Answer Choice 3] Stage 1 of Genia’s Development of Growth Model is called Egocentric Faith. [Feedback for Answer Choice 4] Stage 1 of Poll and Smith’s Model of Spiritual Identity is called the Preawareness stage. [Q2] Which of the following proposes a non-linear model of spiritual identity development? 1. Spero’s Development of Religious Transformations Model 2. Fowler’s Model of Faith Development 3. Genia’s Development of Growth Model 4. Poll and Smith’s Model of Spiritual Identity [correct]

[Feedback for Answer Choice 1] Spero’s Development of Religious Transformations Model presents four linear stages that proceed through a person’s stages of growth and development over the life course. [Feedback for Answer Choice 2] Fowler’s Model of Faith Development presents six stages that are also liner and developmental is nature. [Feedback for Answer Choice 3] Genia’s Development of Growth Model presents five stages that are also liner and developmental is nature. [Feedback for Correct Answer 4] Movement through Poll and Smith’s Model is not linear but may involve doubling back or spiraling through various stages again and again from late childhood throughout the lifespan. [Q3] The fifth stage of Genia’s Development of Growth Model is called: 1. Reconstructed Internalized Faith stage 2. Dogmatic stage 3. Transitional Faith stage 4. Transcendent Faith stage [correct] [Feedback for Answer Choice 1] Reconstructed Internalized Faith is the fourth stage of Genia’s Development of Growth Model. [Feedback for Answer Choice 2] The Dogmatic stage is the second stage of Genia’s Development of Growth Model. [Feedback for Answer Choice 3] Transitional Faith is the third stage of Genia’s Development of Growth Model. [Feedback for Correct Answer 4] The fifth and final stage of Genia’s Development of Growth Model is called Transcendent Faith. [Q4] Which of the following is considered the foundational model of Spiritual Identity Development? 1. Spero’s Development of Religious Transformations Model [correct] 2. Fowler’s Model of Faith Development 3. Genia’s Development of Growth Model 4. Poll and Smith’s Model of Spiritual Identity

[Feedback for Correct Answer 1] Proposed in 1992, Spero’s Development of Religious Transformations Model is the oldest model of spiritual identity development. As such, it is considered a foundational model. [Feedback for Answer Choice 2] Proposed in 1995, Fowler’s Model of Faith Development is noted for its important scholarly contributions; however, it is not considered a foundational model. [Feedback for Answer Choice 3] Proposed in 1995, Genia’s Development of Growth Model is noted for its important scholarly contributions; however, it is not considered a foundational model. [Feedback for Answer Choice 4] Proposed in 2003, Poll and Smith’s Model of Spiritual Identity is also noted for its important scholarly contributions; however, it is not considered a foundational model. Learning Outcome 2.5: Identify scholarship and ethical considerations related to cultural identity development. [Q1] The phrase ―double pandemic‖ refers to the compounded impacts incurred due to COVID-19 and: 1. social isolation. 2. economic hardship. 3. race-based traumatic stress. [correct] 4. the loss of a loved one due to the pandemic. [Feedback for Answer Choice 1] While social isolation was widely experienced during the pandemic, this specific impact is not encapsulated by the phrase ―double pandemic.‖ [Feedback for Answer Choice 2] Economic hardship was widely experienced during the pandemic, but this specific impact is also not encapsulated by the phrase ―double pandemic.‖ [Feedback for Correct Answer 3] The phrase ―double pandemic‖ refers to the compounded impacts that marginalized populations incurred due to COVID-19 and race-based traumatic stress. [Feedback for Answer Choice 4] Many people also lost loved ones due to COVID-19; however, this specific impact is not encapsulated by the phrase ―double pandemic.‖ [Q2] According to (2020), people of color and marginalized populations statistically bore the brunt of the negative impacts related to world events. 1. Centers for Disease Control [CDC]

2. Johns Hopkins Medicine [correct] 3. Ratts et al. 4. Helms [Feedback for Answer Choice 1] In 2020, the Centers for Disease Control [CDC] asserted that the need for mental health care had become increasingly evident due to the economic strain, decreasing access to health care, drastic changes to ways of life, and complicated grief and loss associated with the COVID-19 pandemic. [Feedback for Correct Answer 2] According to Johns Hopkins Medicine (2020), people of color and marginalized populations statistically bore the brunt of the negative impacts related to world events. [Feedback for Answer Choice 3] Ratts et al. developed and published the Multicultural Counseling and Social Justice Competencies (MSJCC) in 2016. [Feedback for Answer Choice 4] While Helms has written extensively on issues related to race, her primary contributions to the profession pre-date the pandemic [e.g., Helms’s People-of-Color Identity Model (1995) and Helms’s White Identity Model (1995, 2017)]. [Q3] (2016) place(s) great emphasis on ethical practice, competency, and evidence-based practice. 1. Ratts et al. [correct] 2. Ponterotto 3. Gladding and Crockett 4. Willis and Neblett [Feedback for Correct Answer 1] Ratts et al. (2016) developed the Multicultural Counseling and Social Justice Competencies (M SJCC), which place great emphasis on ethical practice, competency, and evidence-based practice. [Feedback for Answer Choice 2] Ponterotto suggested a model of Cultural Identity Development in 1988, which was intended to be used specifically with White counselor trainees. [Feedback for Answer Choice 3] Gladding and Crockett published an article in 2019 on how spirituality informs perspectives and judgments, and provides meaning, mission, and purpose to life. [Feedback for Answer Choice 4] Willis and Neblett developed and published the Multidimensional Model of Racial Identity in 2020.

[Q4] To effectively practice multiculturally competent counseling, clinicians must older, foundational models with contemporary models. 1. improve 2. contrast 3. replace 4. integrate [correct] [Feedback for Answer Choice 1] The role of advancing, rather than improving, foundational models is typically carried out by researchers. [Feedback for Answer Choice 2] Simply contrasting the merits and relevance of foundational models with contemporary models is insufficient for effectively practicing multiculturally competent counseling. Clinicians must take the additional step of integrating best practices from each model to effectively tailor their approaches to the unique needs of each client. [Feedback for Answer Choice 3] Older models play a foundational role in informing the profession’s understanding and development of multicultural competence. As such, these models should be integrated into contemporary practices rather than being completely replaced. [Feedback for Correct Answer 4] Many of the foundational models and seminal research related to multicultural counseling may appear outdated but they remain relevant from both historical and current -day perspectives. Being mindful of foundational models while integrating newer and more contemporary models is essential for effective practice.

Chapter 2 Application Exercises Application Exercise 2.1: The Case of Lynsey and Scott Learning Outcome 2.1: Describe and use racial and ethnic identity development models to guide work with people of color and White people. [Q1] Lynsey and Scott have been married for 2 years, and they are experiencing marital problems. Specifically, they are fighting about finances and Scott’s use of alcohol. Scott’s mother has suggested that the couple should go to counseling, but neither Lynsey nor Scott wants to go. It is important to note that Lynsey identifies as a Black woman, and Scott identifies as a White American man. Why is it important to consider the racial/ethnic identities of the clients when thinking about the couple’s help-seeking behaviors? [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Help-seeking behaviors can vary based on a client’s culture.



Cultural differences associated with race and ethnicity can have mental health implications.



This couple might not access resources because of the mental health stigma found in both of their cultures.

[Q2] Lynsey and Scott have been married for 2 years, and they are experiencing marital problems. Specifically, they are fighting about finances and Scott’s use of alcohol. Scott’s mother has suggested that the couple should go to counseling, but neither Lynsey nor Scott wants to go. It is important to note that Lynsey identifies as a Black woman, and Scott identifies as a White American man. Based on the research discussed in the text, what help-seeking behaviors might Lynsey and Scott display based on their racial and ethnic cultures? [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

As a Black woman, Lynsey might believe that problems should be handled within the family. She might seek support from important people in her life, such as a family member or pastor, as opposed to a counselor.



As a White American man, Scott might perceive mental health services to be stigmatizing and might feel guilt or shame in asking for the help of a counselor.



Scott’s mom might have experience or education in mental health that led her to recommend a counselor.

[Q3] Lynsey and Scott have been married for 2 years, and they are experiencing marital problems. Specifically, they are fighting about finances and Scott’s use of alcohol. Scott’s mother has suggested that the couple should go to counseling, but neither Lynsey nor Scott wants to go. It is important to note that Lynsey identifies as a Black woman, and Scott identifies as a White

American man. If Lynsey and Scott do come to counseling, at what point should the counselor broach the subject of race/ethnicity with the couple? [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

To promote the best treatment outcomes, counselors should be willing to broach or explore difficult topics.



Counselors should conduct a multicultural assessment of the couple’s presenting problem and determine how or if issues related to race and/or ethnicity are relevant or important.



Counselors should ask the clients if they believe that race/ethnicity is an important part of their lives and presenting problems.



Counselors should implement culturally sound interventions according to the couple’s need.

Application Exercise 2.2: The Case of Travis Learning Outcome 2.4: Describe and use spiritual identity development models in counseling. [URL TITLE] Brainstorming Session

[Q1] Use Pearson eText Video Example 16.3 to answer the following question. Travis is concerned that since he has left his hometown, his spiritual and religious views have shifted from those held by his family. He is working with his counselor to brainstorm ways in which he can find congruence among his spiritual thoughts, feelings, and behaviors. What factors might have contributed to Travis’s recent shift in spirituality and religious practice? [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Travis was raised by a pastor, and his spiritual beliefs historically aligned with his religious practice.



It is possible that Travis’s spiritual beliefs have shifted and no longer align with the religious practices he was taught as a child.



It is possible that other life activities have gotten in the way of Travis exercising his religion how he would like.

[Q2] Use Pearson eText Video Example 16.3 to answer the following question. Travis is concerned that since he has left his hometown, his spiritual and religious views have shifted from those held by his family. He is working with his counselor to brainstorm ways in which he can find congruence among his spiritual thoughts, feelings, and behaviors. How would you explain Travis’s feelings of guilt about being hypocritical?

[Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Travis used to practice religious behaviors that aligned with the behaviors of his family, but he is no longer behaving as he was taught by his family.



Travis’s spiritual values and religious practices are currently dissonant.



Travis pretends as though his spiritual values and/or religious practices have not changed when he is around his family, which feels dishonest.

[Q3] Use Pearson eText Video Example 16.3 to answer the following question. Travis is concerned that since he has left his hometown, his spiritual and religious views have shifted from those held by his family. He is working with his counselor to brainstorm ways in which he can find congruence among his spiritual thoughts, feelings, and behaviors. What counseling considerations should you make when helping Travis work toward his goal of increasing communication with his family about his spiritual views and religious practices? [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

The counselor should validate the client’s feelings of guilt and hypocrisy.



The counselor should help the client more fully understand why he feels the need to express his spiritual/religious views with his family.



The counselor should help Travis gain a better understanding of his family’s views on spirituality and religion.



If Travis’s family ascribes to a rejectionist or exclusivist view of spirituality and religion, his changing views and behaviors might be judged or rejected by his family.



The counselor should help the client prepare coping skills and alternative resources if Travis’s family is not likely to accept his changing views and behaviors.

Application Exercise 2.3: Evaluating the State of Cultural Identity Development Research Learning Outcome 2.5: Identify scholarship and ethical considerations related to cultural identity development. [Q1] Discuss several recent events and considerations that could serve as important research areas for advancing counselor understanding of racial identity development.

[Q1 MODEL RESPONSE] Your answer should include some of the following points: 

The individual and societal effects of the current sociopolitical climate and recent cultural events (e.g., impact of police involved shootings, legal battles for civil rights, worldwide protests, among others).



Economic strain, decreasing access to healthcare, drastic changes to ways of life, and complicated grief and loss associated with the COVID-19 pandemic.



How major world events impacted the social and emotional health of people of color and marginalized populations.



The nature and effects of the ―double pandemic‖ on marginalized populations.

[Q2] Briefly discuss the barriers that have traditionally hindered scholarly research and publication in the areas of identity development and multiculturalism. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Cultural and multicultural research funding has been historically scarce.



Culturally sensitive researching tools, assessments, models, theories, and interventions for working with minoritized populations are lacking or non-existent.



Multicultural topics were typically published in culturally focused and/or sexual identityspecific journals, rather than in mainstream journals with widely circulated publications.

[Q3] Identify several aspects of cultural identity development that require updating and further investigation. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Racial trauma and post-traumatic stress



Immigrant identity development



Intersectional identity models



Xenophobia and the impact on the immigrant community



Eastern religious and spiritual identity development



Intersex identity development



Pansexual identity development

Chapter 2 Test Items Multiple Choice 1. Rules for social living are often defined within an individual’s a. b. c. d.

culture. race. level of acculturation. racial identity development status. 2. is the social process of becoming excluded from or existing outside of mainstream society or a given group. a. Immigration b. Emigration c. Acculturation d. Marginalization 3. Poston’s model of biracial identity includes all of the following stages EXCEPT a. achieved. b. personal identity. c. enmeshment/denial. d. appreciation. 4. Root’s (1998) ecological model of multiracial identity development suggests that identity development is a. linear. b. bidirectional. c. situational. d. achieved. 5. During Kerwin and Ponterotto’s preadolescence stage of multiracial identity development, individuals a. develop an intolerance for difference. b. take on multiple identities. c. recognize racial and cultural differences and similarities. d. become increasingly aware of group membership and social meanings. 6. The statement, ―I don’t tell racist jokes, but I admit I sometimes laugh. I don’t like that I do that‖ is indicative of the status of Helms’s White racial identity development model. a. Contact b. Disintegration c. Reintegration d. Pseudoindependence

7. The statement, ―I never owned slaves and neither did any of my relatives. I certainly don’t have any privileges because of my race. The bottom line is that if you work hard you get ahead‖ is indicative of the status of Helms’s White racial identity development model. a. Contact b. Disintegration c. Reintegration d. Pseudoindependence 8. The statement, ―I love that my child’s school is diverse. It is wonderful that all children can take advantage of the excellent educational standards and resources like those in our community‖ is indicative of the status of Helms’s White racial identity development model. a. Contact b. Disintegration c. Reintegration d. Pseudoindependence 9. The statement, ―If people would just get over race and stop using it as an excuse, the world would be a better place‖ is indicative of the status of the people of color racial identity development model. a. Conformity/Pre-Encounter b. Dissonance c. Immersion/Emersion d. Internalization 10. The statement, ―My identity has changed over time. As I learn more about who I am as a racial being, I choose to define myself differently‖ is indicative of the status of the people of color racial identity development model. a. Conformity/Pre-Encounter b. Dissonance c. Immersion/Emersion d. Internalization 11. The statement, ―I have always felt like an outsider. Maybe I am . . . not White enough to be considered White and not Black enough to be considered Black‖ is indicative of the status of the people of color racial identity development model. a. Conformity/Pre-Encounter b. Dissonance c. Immersion/Emersion d. Internalization 12. According to Ponterotto’s (1988) model, a White counselor trainee who feels strong allegiance to minority clients while also feeling negatively toward clients of her own race is

likely to be in the

stage of development.

a. Zealot-Defensive b. Enmeshment c. Integration d. Preexposure 13. The statement, ―I am angry at God for letting my mother die! How could a God who is supposed to love be so cruel?‖ is indicative of the stage of the Poll and Smith (2003) model of spiritual identity development. a. Pre-awareness b. Awakening c. Recognition d. Integration 14. The statement ―When I started this relationship I was clear about what I would and would not do. Now I am confused. I am acting so unlike myself that I do not even know who I am anymore. Who I am in my relationship is not who I am supposed to be!‖ is indicative of the stage of the Poll and Smith (2003) model of spiritual identity development. a. Pre-awareness b. Awakening c. Recognition d. Integration 15. The statement ―I just found out my boyfriend cheated on me. I cannot believe how much I gave to him over the course of our relationship. I thought that is what women are supposed to do. I can’t believe I ever felt that way. I feel betrayed and confused,‖ is indicative of which status of the Downing and Roush (1985) feminist identity model? a. Passive Acceptance b. Revelation c. Embeddedness-Emanation d. Synthesis 16. The statement ―I never believed I was sexist, but perhaps what I dismissed as harmless talk is offensive to the women in my office. Wow, I am sorry. What can I do?‖ is indicative of the type of the key model (Scott & Robinson, 2001). a. Claustrophobic b. Empirical c. Optimal d. Noncontact 17. Providing a client with reading material on racism in the workplace may be most appropriate and helpful for a client identified as the type of the key model. a. Claustrophobic

b. Empirical c. Optimal d. Noncontact 18. During the stage of the Troiden (1989) model of sexual identity development, individuals are most likely to become aware of same-sex attraction. a. Commitment b. Identity Assumption c. Identity Confusion d. Sensitization 19. Sexual identity development is influenced by a. race. b. gender. c. Both of the above. d. None of the above. 20. Helms (1995) describes interactions in which the parties share similar racial attitudes and assumptions as a. parallel. b. appropriate. c. progressive. d. simultaneous. 21. Culture is best defined as a. group classifications including race, ethnicity, gender, sexual orientation, and spirituality. b. values, beliefs, expectations, worldviews, and behaviors that provide norms and rules for social living. c. knowledge of values, beliefs, worldviews, and behaviors of a group. d. informal and formal rules for social living. 22. Culture identity involves a. identification with group classifications including those of race, ethnicity, gender, sexual orientation, and religious affiliation. b. a unidimensional construct of growth and development. c. understanding one’s use of communication patterns in formal and informal contexts. d. knowledge and acceptance of rules for living. 23. Race is a

construct.

a. biological and phenotypical b. psychological

c. social and emotional d. political and socioeconomic 24. Ethnicity is a/an a. identification with race classifications. b. identification with cultural groups. c. group classification in which members share origin and cultural heritage. d. construct shaped by emic and etic dimensions. 25. Changes in behavior, cognitions values, and beliefs that occur as a cultural minority group comes in contact with the dominant culture is known as a. oppression. b. enculturation. c. emersion. d. acculturation. 26.

is defined by the ideas, perceptions, values, and beliefs one holds about one’s environment. a. Culture b. Worldview c. Disposition d. Ethnicity

27. Movement through cultural identity development statuses is best described as a. cyclical. b. linear. c. predictable. d. chronological. 28.

is one of the thematic categories used in the expanded version of Cross’s Nigrescence model (e.g., by Cross & Vandier). a. Revelation b. Embeddedness c. Internalization d. Synthesis

29. Attitudes of low race salience or self-hatred may most clearly express the attitudes of individuals negotiating the stage of Cross’s model. a. pre-encounter b. encounter c. synthesis d. revelation

30. Helms’s people of color identity model includes all of the following statuses except a. integrative awareness. b. conformity. c. encounter. d. dissonance. 31. ―Race is not an issue in this country. We have a Black president‖ is a statement most indicative of the status of racial identity development. a. reintegration b. contact c. pseudo-independence d. immersion/emersion 32. According to Helms’s (1995) racial interaction theory, counselors working from interactions may be able to best help their clients. a. parallel b. progressive c. regressive d. compatible 33. During Poston’s (1990) stage, biracial individuals may feel guilt or disloyalty due to race group choices made previously. a. integration b. personal identity c. enmeshment/denial d. choice group categorization 34. In which stage of Hoffman’s (2006) model of feminist identity is a woman most likely to endorse traditional roles for all women? a. crisis b. pre-encounter c. synthesis d. unexamined female identity 35. McCarn and Fassinger’s (1996) model of sexual minority identity formation a. accounts for environmental contexts. b. does not account for environmental contexts. c. includes an identity confusion stage. d. does not begin with awareness. 36. A counselor working in a college counseling center may be most likely to encounter clients negotiating the stage of Fowler’s model of faith development.

a. individuative-reflective faith b. conjunctive faith c. intuitive-projective faith d. mythic-literal faith 37. According to the Poll and Smith (2003) model of spiritual identity development, development a. is linear in progression. b. occurs within the context of a particular religious tradition. c. varies based on client personality and experience. d. begins in adulthood. 38.

can be conceptualized as a complex process of moving from a state of racial unawareness and non-identification to one of awareness and self-identification. a. Ethnic identity development b. Racial identity development c. Culture identity development d. All of the above.

39. Ethnic identity development is a. a complex process. b. when individuals negotiate the degree that particular ethnicities belong to them. c. influenced partly by external evaluation. d. All of the above. 40. According to Helms’s racial interaction theory, harmony is obtainable in parallel interactions because a. the counselor and client share similar ego statuses that ascribe to similar racial attitudes and assumptions. b. the counselor and client are of the same race and/or ethnicity. c. the counselor and client have both reached the most advanced racial identity status. d. All of the above. 41.

are marked by differentiated social status of the participants, with the participant of higher social power exhibiting a less complex ego status. a. Progressive interactions b. Parallel interactions c. Regressive interactions d. Congruent interactions

42. All of the following stages are included in Cass’s homosexual identity formation model EXCEPT a. conscious awareness.

b. identity comparison. c. identity synthesis. d. identity acculturation. 43. Which of the following may be an appropriate way for a counselor to address a client’s spiritual identity in counseling? a. Helping clients identify and talk about personal spiritual experiences. b. Incorporating spirituality and the reliance on God in working toward counseling goals. c. Referring clients for further spiritual guidance and direction. d. All of the above. 44. According to Downing and Roush’s model of feminist identity, the stage focuses on action toward meaningful societal change and identification of personal goals of empowerment. a. acceptance b. active commitment c. synthesis d. revelation 45. Research suggests that individuals’ cultural identities take shape during and are necessary for the development of a healthy self-concept and cultural socialization. a. early childhood b. mid-adulthood c. adolescence d. middle childhood

Extended Response 1. Define, compare, and contrast racial identity development and ethnic identity development. 2. How might Helms’s racial interaction theory play out in group work with culturally diverse men and women focused on career transitions? Identify three specific ways in which the theory could be used to describe potential participant-to-participant and leader-to-participant interactions. 3. Explain the construct of status in relation to cultural identity. Why is this understanding significant? What implication does this have for counselors? Identify a brief counseling example that demonstrates this construct. 4. Given issues of the separation of church and state, should counselors who work in public schools address issues regarding students’ spirituality? Explain. 5. McCarn and Fassinger suggested that commitment to activism and public disclosures are not necessarily indicative of the most advanced statuses of identity development. They suggest that personal choice, environmental conditions, and the intersections of other cultural identities may affect these behaviors. What are your thoughts on these issues? How would your beliefs about commitment to activism and public disclosure affect your work with clients?

6. Do the Fowler, Park, or Poll and Smith models of spiritual identity development resonate with you? Explain. How may your current status of spiritual development affect your work with clients? If spiritual identity is not a part of your self-identity, how may this affect your work with a client who is deeply involved in a personal spiritual identity search? 7. Visible racial and ethnic groups must often negotiate internal and external processes regarding their cultural identity development. Explain this process and identify two implications for counselors working with this population. 8. As families move through the acculturation process, various family members may experience that process differently. Explain how this factor could differentially affect children and parents within a family. What counseling implications may result from this process? 9. Describe Helms’s racial interaction theory. How could this theory manifest in a school counseling scenario where high school students complain to the school counselor that a teacher is racist? What positionality may best benefit a school counselor in this scenario? Why? 10. Explain Helms’s pseudo-independence status of White identity development. Briefly describe one way an individual negotiating this status could present in a career counseling context. 11. Describe the statuses of Poston’s model of biracial identity development. 12. Identify the ego statuses of Helms’s people of color identity model, and briefly describe the characteristics of each status. 13. Describe the McCarn and Fassinger model of sexual minority identity formation. What is the primary difference between this model and the other previous models of sexual minority identity development? 14. Why is it important for counselors working in non-religious settings to understand spiritual identity development? Discuss one way spiritual identity development can be addressed in counseling. 15. Discuss at least three benefits of studying cultural identity development and reflecting upon one’s own development. What specific implications does this work have for counselors? 16. Identify how counselors can appropriately and sensitively address sexual identity in counseling.

Chapter 2 Test Answer Key ANSWER KEY: Chapter 2 Test (Multiple Choice) 1. a 2. d 3. a 4. c 5. d 6. b 7. c 8. d 9. a 10. d 11. b 12. a 13. b 14. c 15. b 16. b 17. b 18. d 19. c 20. a 21. b 22. a 23. d 24. c 25. d 26. b 27. a 28. d 29. a 30. c 31. b 32. b

33. c 34. d 35. a 36. a 37. c 38. b 39. d 40. a 41. c 42. d 43. d 44. b 45. c

Chapter 3 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach th 4 Edition

Danica G. Hays University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents

Chapter 3: Social Justice Counseling

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 3: Social Justice Counseling Chapter 3 Learning Outcome Quizzes Learning Outcome 3.1: Describe the key definitions and constructs of social justice counseling. [Q1] Individual factors of multiculturalism include which of the following? 1. School climate 2. Family dynamics 3. Sexual orientation [correct] 4. Social injustice [Feedback for Answer Choice 1] School climate is a community-based factor of multiculturalism that involves many people in addition to any one individual. [Feedback for Answer Choice 2] Family dynamics are created by all individuals in a family system. [Feedback for Correct Answer 3] Sexual orientation is an individual multicultural factor that is unique to each person. [Feedback for Answer Choice 4] Social injustice is an environmental factor of multiculturalism that involves many people in addition to any one individual. [Q2] Individuals with power and membership in the majority status experience which of the following? 1. Privilege [correct] 2. Secondary oppression 3. Social justice 4. Collectivism [Feedback for Correct Answer 1] Privilege describes inherent benefits that an individual might experience. [Feedback for Answer Choice 2] Individuals with privilege might engage in secondary oppression if they do not stand up for others who are oppressed. [Feedback for Answer Choice 3] Social justice refers to a movement toward equity for all.

[Feedback for Answer Choice 4] Collectivism refers to the idea that decisions—and thus what is deemed important—are based on the betterment of others, such as community or family members. Collectivism is a cultural value, rather than an experience associated with majority status. [Q3] Arguing on behalf of an individual or group is known as: 1. racism. 2. advocacy. [correct] 3. social justice. 4. litigation. [Feedback for Answer Choice 1] Racism is defined as behaviors that oppress other individuals rather than help them. As such, racism is not associated with individuals acting on others’ behalf. [Feedback for Correct Answer 2] Advocacy is the act of standing up for, or acting on behalf of, someone else. Individuals might advocate for individuals or groups of individuals who need assistance, are historically oppressed, or have less power in society. [Feedback for Answer Choice 3] Social justice is a movement in which individuals wish for all others to be treated with equity and respect. Advocacy is one way in which this movement can be supported, but social justice is not an action in itself. [Feedback for Answer Choice 4] Litigation is a term used in a court of law to determine who is at fault. Individuals might use advocacy in a court of law, but litigation is not necessarily associated with arguing on behalf of an individual. Rather, it encompasses a wide variety of legal action. [Q4] Social justice counseling can empower clients by: 1. encouraging them to conform to societal standards. 2. providing access to resources and opportunities. [correct] 3. ignoring power differentials within the counseling relationship. 4. encouraging them to forget about past experiences of oppression. [Feedback for Answer Choice 1] Counselors should uphold the ethical principles of autonomy and nonmalfeasance when working with clients. Counselors celebrate client diversity and work to eliminate oppression. As such, clients should not be encouraged to conform to societal standards if such standards do not align with clients’ worldviews.

[Feedback for Correct Answer 2] As social just advocates, counselors work to explore client needs and provide resources and opportunities for equitable treatment. [Feedback for Answer Choice 3] From an ethical and social justice perspective, counselors should maintain an awareness of power differentials in the counseling relationship and address such differentials when relevant and necessary. [Feedback for Answer Choice 4] From an ethical and social justice perspective, counselors should validate clients’ experiences of oppression and work to help clients make meaning of such experiences. Learning Outcome 3.2: Discuss historical events within the counseling profession related to social justice counseling. [Q1] Which of the following people served as President of the American Counseling Association from 1999 to 2000 and selected social justice and advocacy as the thematic focus of their presidential year? 1. Cortland Lee 2. Loretta Bradley [correct] 3. Tracy L. Robinson 4. Earl J. Ginter [Feedback for Answer Choice 1] Cortland Lee served as President of the American Counseling Association from 1997to 1998. Dr. Lee, along with Gary Walz, co-edited and published the seminal text, Social Action: A Mandate for Counselors, in 1998. [Feedback for Correct Answer 2] Loretta Bradley served as President of the American Counseling Association from 1999 to 2000 and selected social justice and advocacy as the thematic focus of her presidential year. [Feedback for Answer Choice 3] Tracy L. Robinson is not a past President of the American Counseling Associations. However, in 1999 she served as co-editor of a special issue of the Journal of Counseling & Development, dedicated to the topic of racism. [Feedback for Answer Choice 4] Earl J. Ginter is not a past President of the American Counseling Associations. However, in 1999 he served as co-editor of a special issue of the Journal of Counseling & Development, dedicated to the topic of racism. [Q2] 1992 marked an important year for the counseling profession’s advancement of social justice. What social justice milestone occurred during that year?

1. ACA endorsed the Advocacy Competencies developed by Lewis and colleagues. 2. The profession saw an increase in publications related to social justice issues in counseling. 3. Sue and colleagues published the multicultural competencies and standards. [correct] 4. ACA endorsed the revised Multicultural and Social Justice Counseling Competencies. [Feedback for Answer Choice 1] ACA endorsed the Advocacy Competencies developed by Lewis and colleagues in 2003. [Feedback for Answer Choice 2] The profession saw an increase in publications related to social justice issues in counseling from 2010 to 2011. [Feedback for Correct Answer 3] Sue and colleagues published the multicultural competencies and standards in 1992. [Feedback for Answer Choice 4] The revised Multicultural and Social Justice Counseling Competencies was endorsed by the AC A in 2016. [Q3] 2003 marked an important year for the counseling profession’s advancement of social justice. What social justice milestone occurred during that year? 1. ACA endorsed the Advocacy Competencies developed by Lewis and colleagues. [correct] 2. The profession saw an increase in publications related to social justice issues in counseling. 3. Sue and colleagues published the multicultural competencies and standards. 4. ACA endorsed the revised Multicultural and Social Justice Counseling Competencies. [Feedback for Correct Answer 1] ACA endorsed the Advocacy Competencies developed by Lewis and colleagues in 2003. [Feedback for Answer Choice 2] The profession saw an increase in publications related to social justice issues in counseling from 2010 to 2011. [Feedback for Answer Choice 3] Sue and colleagues published the multicultural competencies and standards in 1992. [Feedback for Answer Choice 4] The revised Multicultural and Social Justice Counseling Competencies was endorsed by the AC A in 2016. [Q4] The Council for the Accreditation of Counseling and Related Educational Programs (CACREP) first included the term multicultural in its standards in: 1. 1987

2. 1992 3. 1994 [correct] 4. 1998 [Feedback for Answer Choice 1] The Council for the Accreditation of Counseling and Related Educational Programs (CACREP) first included the term multicultural in its standards after 1987. [Feedback for Answer Choice 2] Sue and colleagues published the multicultural competencies and standards in 1992, but the term multicultural would not appear in the CACREP standards for two more years. [Feedback for Correct Answer 3] The Council for the Accreditation of Counseling and Related Educational Programs (CACREP) first included the term multicultural in its standards in 1994. [Feedback for Answer Choice 4] The Council for the Accreditation of Counseling and Related Educational Programs (CACREP) first included the term multicultural in its standards before 1998. Learning Outcome 3.3: Apply the ACA Advocacy Competencies to social justice counseling. [Q1] The multicultural counseling movement evolved to become the movement, which places a greater emphasis on the influence of environmental factors that affect the well-being of clients. 1. anti-racist 2. social justice [correct] 3. social action 4. environmental action [Feedback for Answer Choice 1] The term anti-racist refers to one approach to promoting social justice, but does not describe the next evolution of the multicultural counseling movement. [Feedback for Correct Answer 2] The multicultural counseling movement evolved to become the social justice movement, which places a greater emphasis on the influence of environmental factors that affect the well-being of clients. [Feedback for Answer Choice 3] The term social action falls under the umbrella of advocacy, which is an important component of social justice counseling. [Feedback for Answer Choice 4] Environmental action is not a counseling-specific term.

[Q2] Which of the following is one of the six domains of the ACA Advocacy Competencies? 1. Client Empowerment [correct] 2. Client Confidentiality 3. Personal Social Justice Compass 4. Strategic Plan for Change [Feedback for Correct Answer 1] Client Empowerment is one of the six domains of the ACA Advocacy Competencies. [Feedback for Answer Choice 2] Client Confidentiality is not one of the six domains of the ACA Advocacy Competencies. This consideration is an important component of the ACA Code of Ethics (2014). [Feedback for Answer Choice 3] Personal Social Justice Compass is not one of the six domains of the ACA Advocacy Competencies. According to Lee (2018), establishing a personal social justice compass is a key part of the process of becoming multiculturally literate. [Feedback for Answer Choice 4] Strategic Plan for Change is not one of the six domains of the ACA Advocacy Competencies. Lee and Rogers’s Counselor Advocacy (2009) recommends designing a vision and strategic plan for change as social advocacy intervention. [Q3] This document was developed in 2015 and further demonstrates the evolution of the multicultural counseling movement toward a social justice perspective: 1. ACA Code of Ethics 2. ACA Advocacy Competencies 3. Multicultural Counseling Competencies 4. Multicultural and Social Justice Counseling Competencies [correct] [Feedback for Answer Choice 1] The ACA Code of Ethics was revised and published in 2014. [Feedback for Answer Choice 2] The ACA Advocacy Competencies were developed in 2003 and updated in 2018. [Feedback for Answer Choice 3] The Multicultural Counseling Competencies were developed in 1992. [Feedback for Correct Answer 4] The Multicultural and Social Justice Counseling Competencies were developed in 2015 and further demonstrated the evolution of the multicultural counseling movement toward a social justice perspective.

[Q4] According to Lee’s (2018) five personal action steps, which of the following tasks is part of the process of becoming multiculturally literate? 1. Invite clients to teach you about their culture. 2. Consider past advocacy efforts. 3. Be open to new cultural experiences. [correct] 4. Adopt the MSJCC framework. [Feedback for Answer Choice 1] Clients are not responsible for increasing their counselor’s multicultural literacy. Counselors must take the initiative to educate themselves about the cultural values, traditions, and experiences of their clients. To this end, Lee (2018) recommends: reading newspapers and literature from other ethnic groups, being open to new cultural experiences, and experiencing various ethnic groups by traveling locally, nationally, and internationally. [Feedback for Answer Choice 2] Lee (2018) does not recommend considering past advocacy efforts. Instead, counselors are encouraged to explore their own privilege and reflect on how they have oppressed others in the past. [Feedback for Correct Answer 3] According to Lee (2018), openness to new cultural experiences is a key part of the process of becoming multiculturally literate. [Feedback for Answer Choice 4] While the MSJCC provide a useful framework for professional practice, this practice is not one of Lee’s (2018) five personal action steps. Instead, the author recommends developing your own personal agenda for social justice. Learning Outcome 3.4: Describe social justice counseling interventions using the three-tiered model of social advocacy. [Q1] Which of the following is part of the Three-Tiered Model of Social Advocacy? 1. Mindfulness 2. Client Services [correct] 3. Civic Engagement 4. Systemic Change Agent [Feedback for Answer Choice 1] Self-Awareness, rather than mindfulness, is the first tier of the Three-Tiered Model of Social Advocacy. [Feedback for Correct Answer 2] Client Services is the second tier of the Three-Tiered Model of Social Advocacy.

[Feedback for Answer Choice 3] Community Collaboration, not civic engagement, describes the third tier of the Three-Tiered Model of Social Advocacy. [Feedback for Answer Choice 4] Systemic Change Agent is a term used by the American School Counseling Association (ASCA) to describe one of the essential duties of school counselors. [Q2] Which of the following tasks is associated with the Client Services tier of the Three-Tiered Model of Social Advocacy? 1. Construct a cultural genogram 2. Empower disenfranchised clients [correct] 3. Design a vision and strategic plan for change 4. Negotiate with external agencies to provide better services for clients [Feedback for Answer Choice 1] Constructing a cultural genogram is a task associated with the Self-Awareness tier of the ThreeTiered Model of Social Advocacy. [Feedback for Correct Answer 2] Empowering disenfranchised clients is a task associated with the Client Services tier of the Three-Tiered Model of Social Advocacy. [Feedback for Answer Choice 3] Designing a vision and strategic plan for change is a task associated with the Community Collaboration tier of the Three-Tiered Model of Social Advocacy. [Feedback for Answer Choice 4] Negotiate with external agencies to provide better services for clients is a task associated with the Community Collaboration tier of the Three-Tiered Model of Social Advocacy. [Q3] Which of the following is one of the client advocacy roles outlined by the Three-Tiered Model of Social Advocacy? 1. Develop a strong professional identity 2. Advocate for insurance reimbursement 3. Educate public about the importance of the counseling profession 4. Become aware of one’s own cultural values and biases [correct] [Feedback for Answer Choice 1] Develop a strong professional identity is one of the professional advocacy roles outlined by the Three-Tiered Model of Social Advocacy.

[Feedback for Answer Choice 2] Advocate for insurance reimbursement is one of the professional advocacy roles outlined by the Three-Tiered Model of Social Advocacy. [Feedback for Answer Choice 3] Educate public about the importance of the counseling profession is one of the professional advocacy roles outlined by the Three-Tiered Model of Social Advocacy. [Feedback for Correct Answer 4] Become aware of one’s own cultural values and biases is one of the client advocacy roles outlined by the Three-Tiered Model of Social Advocacy. [Q4] Which of the following questions should be considered when conducting a cultural genogram? 1. Which memberships exert the strongest influence on your cultural identity? [correct] 2. Which memberships exert the strongest influence on your client’s cultural identity? 3. How do various social systems influence your client? 4. How can you leverage your cultural strengths to advocate for your client’s needs? [Feedback for Correct Answer 1] When conducting a cultural genogram, it is important for counselors to consider: Which memberships exert the strongest influence on your cultural identity? [Feedback for Answer Choice 2] The purpose of the cultural genogram, as described in the chapter, is for the counselor to gain a deeper awareness of how their own membership in privileged and oppressed groups either support or do not support the development of their various cultural identities. [Feedback for Answer Choice 3] In this particular example, the focus of the cultural genogram is on increasing the counselor’s self-awareness apart from a particular client’s social and cultural influences. [Feedback for Answer Choice 4] The emphasis of this exercise is on generating insight rather than action. Learning Outcome 3.5: Articulate the benefits and challenges of social justice counseling. [Q1] According to Lee (2018), which of the following is one of the three reasons that may prevent counselor trainees from engaging in social justice counseling? 1. The high intrapersonal and interpersonal costs for counselors [correct] 2. Lack of motivation and accountability 3. Some social justice initiatives are too aspirational 4. Resistance to dealing with oppression issues on behalf of the client

[Feedback for Correct Answer 1] Burnout, job loss, and harassment are some of the high intrapersonal and interpersonal costs that, according to Lee (2018), may prevent counselor trainees from engaging in social justice counseling. [Feedback for Answer Choice 2] While some counselor trainees may lack motivation or institutional accountability, these reasons were not identified by Lee (2018). [Feedback for Answer Choice 3] Lee (2018) does not cite social justice initiatives that are too aspirational as one of the three reasons. However, the author discovered that the incongruence between some social justice initiatives and traditional ethical standards may also prevent counselor trainees from engaging in social justice counseling. [Feedback for Answer Choice 4] Lee (2018) does not cite resistance to dealing with oppression issues on behalf of the client as one of the three reasons. However, the author noted that a lack of appropriate training in dealing with oppression issues on behalf of the client was listed as an obstacle to counselor trainees’ ability/willingness to engage in social justice counseling. [Q2] Scholars have written about the importance of incorporating multiculturalism and social justice counseling into all aspects of counseling. What is the primary limitation of the literature that has been published on this topic, to date? 1. Qualitative research is not generalizable 2. Existing publications lack clinical application 3. The majority of social justice publications are outdated 4. The majority of social justice publications have been conceptual in nature [correct] [Feedback for Answer Choice 1] While it is correct that qualitative research is not generalizable, minimal qualitative studies have been conducted on the importance of incorporating multiculturalism and social justice counseling into all aspects of counseling. Additionally, this method of inquiry is useful for identifying relevant topics for further study and, thus, cannot be considered a limitation. [Feedback for Answer Choice 2] Building on existing relevant research, scholars have written about the importance of incorporating multiculturalism and social justice counseling into all aspects of counseling. Many of these articles provide novel applications for clinical practice; however, the effectiveness of many of these recommendations have yet to be empirically validated. [Feedback for Answer Choice 3] The field has benefitted from many seminal social justice publications. While some of these articles and books are older in nature, on the whole, they continue to offer foundational insights and clinical utility for counselors striving to incorporate multiculturalism and social justice practices into their counseling.

[Feedback for Correct Answer 4] The primary limitation of the literature that has been published on incorporating multiculturalism and social justice practices into counseling, to date, is that the majority of the publications on this topic have been conceptual in nature. These articles provide helpful overviews of existing literature, emerging trends, novel clinical applications, and important recommendations for future research. However, these articles do not produce new empirical findings to inform and support evidence-based approaches to multicultural and social justice counseling practices. [Q3] Which of the following is one of the perceived benefits associated with integrating social justice initiatives in counseling, according to Hays et al. (2008). 1. growth 2. personal satisfaction 3. empowering others 4. increased awareness of self [correct] [Feedback for Answer Choice 1] Growth is one of the rewards and benefits of integrating social justice according to the research of Klar and Kasser (2009) and Lee (2018). [Feedback for Answer Choice 2] Personal satisfaction is also one of the rewards and benefits of integrating social justice according to the research of Klar and Kasser (2009) and Lee (2018). [Feedback for Answer Choice 3] Empowering others is another one of the rewards and benefits of integrating social justice according to the research of Klar and Kasser (2009) and Lee (2018). [Feedback for Correct Answer 4] According to Hays et al. (2008), increased awareness of self is one of the perceived benefits associated with integrating social justice initiatives in counseling. [Q4] Counselors can access which of the following websites to send letters to their representatives? 1. www.nationalhomeless.org/ 2. www.nami.org/ 3. www.votervoice.net/COUNSELING/Home [correct] 4. www.amnesty.org/ [Feedback for Answer Choice 1] This website is specifically for homeless individuals. Although many individuals who are homeless do have mental health needs, there is not a letter-writing tool on this website.

[Feedback for Answer Choice 2] This website is specifically related to mental health, but there is not a letter-writing tool on this website. [Feedback for Correct Answer 3] There is a letter-writing tool for counselors to contact their representatives on this website. [Feedback to Answer Choice 4] This website is specifically related to human rights, but there is not a letter-writing tool on this website. Learning Outcome 3.6: Describe current trends in research in social justice counseling. [Q1] Which of the following authors developed a new social justice model for counseling supervision with a focus on teaching actionable skills and on social justice outcomes as indicators of success? 1. Bayne and Branco (2018) 2. O’Hara and Cook (2018) 3. Hays (2020) 4. Dollarhide et al. (2021) [correct] [Feedback for Answer Choice 1] Bayne and Branco (2018) investigated the experiences of counselors of color who engage in broaching behaviors. [Feedback for Answer Choice 2] O’Hara and Cook (2018) investigated the harm that doctoral-level counseling students experienced with social class microaggressions in higher education. [Feedback for Answer Choice 3] Hays (2020) identified means for engaging in innovative research practices by applying principles rooted in Indigenous research methods and community-based participatory research. [Feedback for Correct Answer 4] Dollarhide et al. (2021) developed a new social justice model for counseling supervision with a focus on teaching actionable skills and on social justice outcomes as indicators of success. [Q2] Which of the following investigated the harm that doctoral-level counseling students experienced with social class microaggressions in higher education? 1. Bayne and Branco (2018) 2. O’Hara and Cook (2018) [correct] 3. Hays (2020) 4. Dollarhide et al. (2021)

[Feedback for Answer Choice 1] Bayne and Branco (2018) investigated the experiences of counselors of color who engage in broaching behaviors. [Feedback for Correct Answer 2] O’Hara and Cook (2018) investigated the harm that doctoral-level counseling students experienced with social class microaggressions in higher education. [Feedback for Answer Choice 3] Hays (2020) identified means for engaging in innovative research practices by applying principles rooted in Indigenous research methods and community-based participatory research. [Feedback for Answer Choice 4] Dollarhide et al. (2021) developed a new social justice model for counseling supervision with a focus on teaching actionable skills and on social justice outcomes as indicators of success. [Q3] Which professional association developed and adopted the Disability-Related Counseling Competencies in 2019? 1. American Counseling Association [correct] 2. American Mental Health Counselors Association 3. National Board for Certified Counselors 4. Counselors for Social Justice [Feedback for Correct Answer 1] The American Counseling Association adopted the Disability-Related Counseling Competencies in 2019. [Feedback for Answer Choice 2] American Mental Health Counselors Association has advocated for many important issues; however, it did author/adopt the Disability-Related Counseling Competencies. [Feedback for Answer Choice 3] The National Board for Certified Counselors has also written about and advocated for many important issues; however, it did author/adopt the Disability-Related Counseling Competencies. [Feedback for Answer Choice 4] Counselors for Social Justice has also advocated for many important issues; however, it did author/adopt the Disability-Related Counseling Competencies. [Q4] Which of the following authors applied a critical and social justice lens to their examination of broaching and acknowledged that not all experiences of broaching can be generalized across counselors? 1. Bayne and Branco (2018) [correct]

2. Cook and O’Hara (2020) 3. Hays (2020) 4. Dollarhide et al. (2021) [Feedback for Correct Answer 1] Bayne and Branco (2018) investigated the experiences of counselors of color who engage in broaching behaviors. [Feedback for Answer Choice 2] O’Hara and Cook (2018) investigated the harm that doctoral-level counseling students experienced with social class microaggressions in higher education. [Feedback for Answer Choice 3] Hays (2020) identified means for engaging in innovative research practices by applying principles rooted in Indigenous research methods and community-based participatory research. [Feedback for Answer Choice 4] Dollarhide et al. (2021) developed a new social justice model for counseling supervision with a focus on teaching actionable skills and on social justice outcomes as indicators of success.

Chapter 3 Application Exercises Application Exercise 3.1: Advocating for Social Justice Learning Outcome 3.1: Describe the key definitions and constructs of social justice counseling. [Q1] Social justice is an integral part of the counseling profession. Counselors are called to examine their own biases to identify ways in which their counseling practices might need to be adjusted. List several ways in which you have experienced privilege in your life. [Q1 MODEL RESPONSE] Your answer might include any of the following: 

Your race, ethnicity, gender, and age might add to your empowerment in society, or any of these might be a source of oppression for you.



Your socioeconomic status might be a source of power or oppression, but you have earned a bachelor’s degree and are pursuing a master’s, so that increases your power in society.



You have access to resources through your university, which adds to your power in society.

[Q2] What are some ways you have experienced oppression in your life? [Q2 MODEL RESPONSE] Your answer might include specific incidents that you can recall or ongoing patterns of oppression due to one or more statuses. Your experiences are real and valid. [Q3] Counselors have a responsibility to advocate for social justice. What are some ways in which counselors can advocate for social justice? [Q3 MODEL RESPONSE] Your answer should include some of the points: 

Counselors can become aware of the ways in which oppression can be manifested in society and the different ways this oppression can be experienced by individuals in society.



Counselors can participate in ongoing self-reflection regarding sources of privilege in their own lives.



Counselors can adjust therapeutic practices that might otherwise exploit or oppress a certain population.



Counselors can collaborate with historically oppressed groups in society in order to best support their clients.



Counselors can advocate for social change within the community.

Application Exercise 3.2: Power and Advocacy Learning Outcome 3.3: Apply the ACA Advocacy Competencies to social justice counseling. [Q1] Review the American Counseling Association (ACA) 2014 Code of Ethics for information regarding counselors’ responsibilities on issues of power and advocacy in the counseling relationship. Which specific codes in the ACA Code of Ethics address issues of power and responsibility in the counseling relationship? [Q1 MODEL RESPONSE] Your answer could include any of the following: 

A.7.a. ―When appropriate, counselors advocate at individual, group, institutional, and societal levels to address potential barriers and obstacles that inhibit access and/or the growth and development of clients.‖



A.7.b. ―Counselors obtain client consent prior to engaging in advocacy efforts on behalf of an identifiable client to improve the provision of services and to work toward removal of systemic barriers or obstacles that inhibit client access, growth, and development.‖



C.6.d.: ―Counselors do not exploit others in their professional relationships.‖



E.5.c.: ―Counselors recognize historical and social prejudices in the misdiagnosis and pathologizing of certain individuals and groups and strive to become aware of and address such biases in themselves and others.‖

[Q2] What is a specific advocacy item for which you are particularly passionate? [Q2 MODEL RESPONSE] Your answer might include any of the following: 

Social justice for individuals who belong to any racial/ethnic oppressed groups, the LGB T QIA community, women (of color), disabled individuals, people with low socioeconomic status.



Advocacy to reduce mental health stigma in the United States.



Advocacy to promote wellness initiatives in the United States.



Advocacy to increase access to mental health services for oppressed populations.

[Q3] How would you utilize the ACA Advocacy Competencies to pursue advocacy in an area in which you are passionate? [Q3 MODEL RESPONSE] Your answer might include any of the following: 

Supporting initiatives that empower clients or students.



Advocating on behalf of a client or student.



Collaborating with community entities.



Advocating for systemic change.



Providing the public with mental health and social justice information.



Advocating for social and political change.

Application Exercise 3.3: A Three-tiered Model of Social Advocacy Learning Outcome 3.4: Describe social justice counseling interventions using the three-tiered model of social advocacy. [Q1] List some of the individual factors that might be important to consider when conceptualizing a multicultural client. [Q1 MODEL RESPONSE] Your answer should include some of the following: 

Race



Ethnicity



Gender



Sexual orientation



Socioeconomic status



Spirituality



Disability



Identity development



Cognitive development



Biology



Genetics



Psychological needs

[Q2] List some of the family and community factors that might be important to consider when working to understand a client as a multiculturally competent counselor. [Q2 MODEL RESPONSE] Your answer should include some of the following: 

Family communication habits



Family values



Family roles and behaviors



Family race and ethnicity



School factors—classroom management, school climate, peer networks, teacher attitude, administrative policies



Community diversity



Public health services



Community resources and organizations



Economic opportunities



Legal resources

[Q3] Reflect on your personal experiences with individual, family, and community aspects of multiculturalism. What are some resources you might access to facilitate ongoing learning about your own culture and the culture of others? [Q3 MODEL RESPONSE] Your answer should include some of the following: 

Professors



Peers



Supervisors



Colleagues



Church



Community programs



Friends



Neighbors



Community members

Chapter 3 Test Items Multiple Choice 1.

Some scholars have argued that social justice counseling should be considered the fifth force in the counseling profession. The first four forces, in order, are the a. b. c. d.

psychodynamic, behavioral, humanistic, and multicultural forces. psychodynamic, behavioral, multicultural, and humanistic forces. psychodynamic, humanistic, behavioral, and multicultural forces. behavioral, psychodynamic, humanistic, and multicultural forces. refers to the act of arguing on behalf of an individual, group, idea, or issue in the pursuit of influencing outcomes. a. Social justice b. Social advocacy c. Social justice counseling d. Social revolution

refers to a belief in a just world that respects and protects human rights. a. Social justice b. Social advocacy c. Social justice counseling d. Social revolution

Social justice counseling refers to counseling that recognizes the impact of the mental health of individuals. a. oppression b. privilege c. discrimination d. All of the above

is NOT a goal of social justice counseling. a. Helping to empower people to advocate for themselves b. The belief that all people have a right to equitable treatment c. Ensuring that all people have the tools and resources for a ―good life‖ d. All of the above are goals of social justice counseling.

Oppression can be enacted by a. a heterosexual White male. b. a bisexual White female. c. a heterosexual Black male. d. All of the above.

When there is an imbalance of power,

exist(s).

a. oppression but not privilege b. oppression and privilege c. privilege but not oppression d. None of the above 8.

is defined as having control, choice, autonomy, and authority or influence over others. a. Privilege b. Empowerment c. Power d. Discrimination

is defined as having access, advantage, and a majority status. a. Privilege b. Empowerment c. Power d. Discrimination

10.

is the process by which those who are powerless and marginalized become aware of the power dynamics and develop the skills to gain control over their lives and work toward empowering others. a. Privilege b. Social Justice c. Power d. Empowerment

11.

has been identified as the primary cause of emotional disturbances. a. Sexism b. Racism c. Poverty d. Stress

12. Poor children compared with more economically advantaged children experience a. equal schooling. b. less violence. c. increased social support. d. None of the above. 13. One of the principal sources of stress is a. lower social support. b. lack of health care.

c. inferior education. d. poverty. 14.

is NOT a domain covered in the ACA Advocacy Competencies for counseling professionals. a. Client/student empowerment b. Community collaboration c. Social/political advocacy d. All of the above are domains of the ACA Advocacy Competencies.

15. A primary reason counselors do not engage in social justice counseling is a. the high intrapersonal costs for counselors. b. incongruence with theoretical orientation. c. a lack of training in dealing with oppression issues. d. All of the above. 16. Amy helps a client identify the external social, political, economic, and cultural factors that affect her life. This is an example from the ACA Advocacy Competency domain of a. Client/Student Empowerment. b. Client/Student Advocacy. c. Community Collaboration. d. Public Information. 17. After Hiroshi’s client informs him that she was denied an apartment lease due to her race, he refers his client to the free legal clinic available to university students. This is an example from the ACA Advocacy Competency domain of a. Client/Student Empowerment. b. Client/Student Advocacy. c. Community Collaboration. d. Social/Political Advocacy. 18. Oppression exists at the a. individual b. institutional c. cultural d. All of the above 19.

can influence privilege. a. Religion b. Education c. Family d. All of the above.

level.

limit racial, ethnic, and cultural minority people’s access to mental health care.

20.

a. Socioeconomic factors b. Language barriers c. Medical complication factors d. All of the above. 21. Experiences of oppression can lead to of Health and Human Services report.

according to a 2001 U.S. Department

a. depression b. substance Abuse c. low birth rates for women d. All of the above. 22. A White gay male a. holds privilege given his race and sex but is oppressed given his sexual orientation. b. shows how one can be both victim and perpetuator of oppression. c. Both of the above. d. None of the above. 23.

believed that the principles of psychology should be used to address social problems. a. Ellis b. Rogers c. Parsons d. Freud

24. In 2015 the ACA Multicultural Counseling Competencies were revised to become the a. Multicultural and Social Justice Counseling Competencies. b. Multicultural Counselor Educator Competencies. c. Social Justice Competencies. d. None of the above; the competencies were revised but retained the same name. 25. Counselors for Social Justice was chartered as a division of ACA in a. 1999. b. 2000. c. 2001. d. 2002. 26. Social injustice refers to a. punishment for not following norms. b. the unequal assignment of privilege.

c. unequal distribution of rewards and burdens. d. All of the above. 27.

involves the act of imposing on an individual or group an object, label, role, experience, or living condition that is unwanted and causes physical and psychological pain. a. Oppression by force b. Oppression by deprivation c. Internalized oppression d. Tertiary oppression

28. Secondary oppression involves a. oppression by force and oppression by deprivation. b. individuals benefiting from overt oppressive acts against others. c. internalized oppression. d. All of the above. 29. A female who buys into the message that males are more superior and that women should be subjugated may be experiencing a. oppression by force. b. primary oppression. c. secondary oppression. d. internalized oppression. 30.

occurs when social, political, economic, and other institutional entities and processes intentionally or unintentionally place barriers on development, wellness, dignity, and human potential. a. Privilege b. Imbalance c. Structural violence d. Internalized oppression

31. Which of the following components contribute to the concept of privilege? a. Power b. Access c. Majority status d. All of the above. 32. The goal of

involves equitable distribution of power.

a. empowerment b. social justice counseling c. power imbalances

d. All of the above. 33. A key aspect of empowerment involves , or the behaviors and attitudes that clients identify as beneficial in coping with stressful situations and adversity. a. resilience b. equity c. stress management d. distribution of power 34. All of the following are considered ―personal action steps‖ that counselors can take as social advocates EXCEPT a. exploring personal privilege. b. avoiding all biases. c. exploring the nature of oppression. d. becoming more multiculturally literate. 35. The of the ACA Advocacy Competencies consists of client/student empowerment and client/student advocacy. a. middle level b. macrolevel c. minor level d. microlevel 36. The of the ACA Advocacy Competencies consists of public information and social/political advocacy. a. middle level b. macrolevel c. minor level d. microlevel 37. According to the ACA Advocacy Competencies, the macrolevel of interventions may include lobbying at the level. a. local b. state c. national d. All of the above. 38.

are the three tiers of the three-tier model of social advocacy. a. Self-awareness, client services, and community collaboration b. Client-awareness, theoretical orientation, and community outreach c. Client/student empowerment, systems advocacy, and public information d. Worldview, counseling relationship, and counseling advocacy interventions

39. Which of the following is an example of the client services tier of the social advocacy model? a. Awareness of one’s own cultural values and biases. b. A strong professional counselor identity. c. Advocating for changes that help counselors provide high-quality services. d. Identifying and advocating for change in the community. 40.

involves working toward social change at the organizational and institutional level. a. Client services b. Self-awareness c. Community collaboration d. All of the above.

41. Which of the following reasons may prevent counselor trainees from engaging in social justice counseling? a. High intrapersonal and interpersonal costs. b. Lack of appropriate training in dealing with oppression. c. Concern for burnout, job loss, and harassment. d. All of the above. 42. Social justice counseling and literature.

are used interchangeably in the counseling

a. social justice b. advocacy counseling c. person-centered counseling d. All of the above. 43. All of the following are examples of empowerment EXCEPT a. validating a client’s anxiety with coming out to parents. b. normalizing a trauma survivor’s symptomology. c. using an etic perspective to ensure equal treatment for all clients. d. collaborating with others to address the lack of resources in a local school. 44.

believed that the principles of psychology should be used to address social problems. a. Ellis b. Rogers c. Parsons d. Freud

45. In 2015 the ACA Multicultural Counseling Competencies were revised to become the a. Multicultural and Social Justice Counseling Competencies. b. Multicultural Counselor Educator Competencies. c. Social Justice Competencies. d. None of the above; the competencies were revised but retained the same name.

Extended Response 1.

One of the goals of social justice counseling is to establish equal distribution of power and resources through advocacy to ensure that all people have the tools and resources for a ―good life.‖ Discuss what is included and not included in a ―good life.‖

Define and distinguish among the terms social advocacy, social justice, social injustice, and social justice counseling.

Identify at least two historical events that contributed to the growth of social justice counseling.

Pick one marginalized group (e.g., Black gay men, women, migrant workers) and give two examples of how you could advocate for this group and where these examples fall in the following six domains: 1) client empowerment, 2) client advocacy, 3) community collaboration, 4) systems advocacy, 5) public information, and 6) social/political advocacy.

How is a person’s conceptualization of privilege and oppression developed?

Does an inverse relationship exist between privilege and oppression? Why or why not?

Give examples for each of the four components of privilege: (a) power, (b) access, (c) advantage, and (d) status.

Discuss how social justice counseling principles fit into your current theoretical orientation. What aspects of social justice counseling fit well with your theoretical orientation? What aspects of social justice counseling may be incongruent with your theoretical orientation?

Define and give examples of the five components of empowerment.

10. What are some of the ethical challenges social justice counselors might face? For example, many counselors worry about imposing their own values on their clients. What are some of the benefits and consequences of such an action? Is imposing a counselor’s values ever justified? Why or why not? 11. Reflect on the following statement: ―Enjoying the pleasures of life can help sustain us in advocating for change.‖ What does that mean to you? What are some of the ―pleasures of life‖ that sustain you? How does this statement fit with the concept of burnout that many counselors face? 12. Discuss and give examples of oppression for the following groups: (a) Families that are homeless, (b) Interracial heterosexual couples, (c) White gay men, and (d) Latina straight women. 13. Discuss and give examples of privilege in the lives of the following groups: (a) White heterosexual men, (b) Asian straight men, (c) White older adult women, and (d) Latino gay men. 14. Explain Chang, Hays, and Milliken’s (2007) three-tiered model for advocacy. 15. Describe some of the challenges and benefits of social justice counseling.

Chapter 3 Test Answer Key ANSWER KEY: Chapter 3 Test (Multiple Choice) 1. a 2. b 3. a 4. d 5. d 6. d 7. b 8. c 9. a 10. d 11. d 12. d 13. d 14. d 15. d 16. a 17. b 18. d 19. d 20. d 21. d 22. c 23. b 24. a 25. c 26. d 27. a 28. b 29. d 30. c 31. d 32. b

33. a 34. b 35. d 36. b 37. d 38. a 39. c 40. c 41. d 42. b 43. c 44. b 45. a

Chapter 4 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach th 4 Edition

Danica G. Hays University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents Chapter 4: Racism and White Supremacy

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 4: Racism and White Supremacy Chapter 4 Learning Outcome Quizzes Learning Outcome 4.1: Articulate historical and contemporary expressions of race and racism. [Q1] Which of the following is a type of oppression? 1. Structural racism [correct] 2. Self-exploration 3. Social advocacy 4. Sexual identity [Feedback for Correct Answer 1] Structural racism is an ingrained form of oppression in which people with power act unfairly toward individuals with less power because of their physical features. [Feedback for Answer Choice 2] Through the process of self-exploration, clients might uncover ways in which they have been oppressed or have oppressed others, but self-exploration is not oppressive. [Feedback for Answer Choice 3] When issues of oppression are uncovered, counselors and clients should advocate as appropriate. Social advocacy works against oppression. [Feedback for Answer Choice 4] Although individuals with nonheterosexual identities have been oppressed historically, sexual identity in itself is not oppressive. Rather, cultural norms and values surrounding certain sexual identities can lead to oppression. [Q2] Self-devaluation and the lionization of White American culture as normal and preferable are indicators and consequences of racism. 1. cultural 2. internalized [correct] 3. individual 4. institutional [Feedback for Answer Choice 1] Cultural racism involves the belief that the cultural values and practices of individuals of White, European descent are superior to those of other racial groups.

[Feedback for Correct Answer 2] Internalized racism refers to members of marginalized groups believing and accepting, knowingly or unknowingly, negative social messages about their own racial and ethnic groups. Self-devaluation and the lionization of White American culture as normal and preferable are indicators and consequences of internalized racism. [Feedback for Answer Choice 3] Individual racism refers to personal attitudes and beliefs in White superiority and the inferiority of people of color, with physical differences among individuals used as an explanation of social, moral, and intellectual behavior. It involves adverse behavior by one individual or a small group of people. [Feedback for Answer Choice 4] Institutional racism is defined as ―differential access to the goods, services, and opportunities of society by race‖ (Jones, 2000, p. 1212). Institutional racism perpetuates political and social systems including the criminal justice system, schools, housing, health care, employment, among others. [Q3] Racial profiling is a prime example of racism, where individuals are targeted by law enforcement and community vigilantes based on race and ethnicity. 1. cultural 2. internalized 3. individual 4. institutional [correct] [Feedback for Answer Choice 1] Cultural racism involves the belief that the cultural values and practices of individuals of White, European descent are superior to those of other racial groups. [Feedback for Answer Choice 2] Internalized racism refers to members of marginalized groups believing and accepting, knowingly or unknowingly, negative social messages about their own racial and ethnic groups. Self-devaluation and the lionization of White American culture as normal and preferable are indicators and consequences of internalized racism. [Feedback for Answer Choice 3] Individual racism refers to personal attitudes and beliefs in White superiority and the inferiority of people of color, with physical differences among individuals used as an explanation of social, moral, and intellectual behavior. It involves adverse behavior by one individual or a small group of people. [Feedback for Correct Answer 4] Institutional racism is defined as ―differential access to the goods, services, and opportunities of society by race‖ (Jones, 2000, p. 1212). Institutional racism perpetuates political and social systems including the criminal justice system, schools, housing, health care, employment, among others. Racial profiling is a prime example of institutional racism where individuals are targeted by law enforcement and community vigilantes based on race and ethnicity.

[Q4] operates simultaneously on individual, group, and system levels and involves intentional and unintentional negative, erroneous, or stereotypical beliefs about race and the consequences of actions. 1. Racism [correct] 2. Racial worldview 3. Empathic isolation 4. Color-blind racial attitude [Feedback for Correct Answer 1] Racism operates simultaneously on individual, group, and system levels and involves intentional and unintentional negative, erroneous, or stereotypical beliefs about race and the consequences of actions (e.g., interpersonal behavior, public policy decisions). [Feedback for Answer Choice 2] The term racial worldview refers to how individuals and groups perceive and understand each other through this socially constructed prism that will be transmitted to succeeding generations. The process of racism engineers a racial worldview that is securely fastened to the cognitions of all members of a society, initially without their detection or protest. [Feedback for Answer Choice 3] Joe and colleagues (2018) coined the term empathic isolation to describe the emotional and social disconnect experienced among racial groups. [Feedback for Answer Choice 4] Color-blind racial attitude involves unawareness of racial privilege, institutional discrimination, or overt racial issues. Learning Outcome 4.2: Identify the cognitive, affective, interpersonal, and physical costs of racism for people of color. [Q1] White individuals who become aware of the concept of White privilege might experience which of the following consequences? 1. Happiness 2. Pride 3. Gratitude 4. Cognitive dissonance [correct] [Feedback for Answer Choice 1] It is not common for White individuals who learn about White privilege to be happy; they are more likely to feel confused, sad, or guilty.

[Feedback for Answer Choice 2] It is not common for individuals who learn about White privilege to feel proud because they might worry that some of their success was not directly due to their own hard work. [Feedback for Answer Choice 3] It is not common for White individuals who learn about White privilege to experience gratitude; they are more likely to feel confused, sad, or guilty. [Feedback for Correct Answer 4] It is common for White individuals to feel cognitive dissonance when learning about White privilege. [Q2] Frustration, irritation, and hostility— which are antecedents of anger— are examples of the costs of racism for people of color. 1. affective [correct] 2. cognitive 3. interpersonal 4. physical [Feedback for Correct Answer 1] Frustration, irritation, and hostility, which are antecedents of anger and, possibly, depression, are examples of the affective costs of racism for people of color. [Feedback for Answer Choice 2] The cognitive costs of racism for people of color include the mental energy and psychological processes (e.g., assessing, reflecting, questioning, interpreting) used to evaluate life incidents and experiences in which racism might be involved. A salient cognitive cost for people of color is internalized racism. [Feedback for Answer Choice 3] The interpersonal costs of racism for people of color include segregation, community displacement, and psychological disconnect. [Feedback for Answer Choice 4] The physical costs of racism for people of color include food insecurities linked to economic disparities fueled by systemic racism, health and health care disparities, among others. [Q3] According to the authors of this chapter, the costs of racism are perhaps the most visible and concrete of all the costs of racism described. 1. affective 2. cognitive 3. interpersonal [correct] 4. physical

[Feedback for Answer Choice 1] The affective costs of racism for people of color, such as frustration, irritation, hostility, anger, and depression may find outward expression or be internalized. Consequently, the affective costs of racism are not most visible and concrete of all the costs of racism described. [Feedback for Answer Choice 2] The cognitive costs of racism for people of color are less visible and include the mental energy and psychological processes (e.g., assessing, reflecting, questioning, interpreting) used to evaluate life incidents and experiences in which racism might be involved, as well as internalized racism. [Feedback for Correct Answer 3] The interpersonal costs of racism are perhaps the most visible and concrete of all the costs of racism described. The segregation of people by racial classification as a result of institutional racism presents a social, even physical, barrier to the establishment of meaningful relationships between people from different racial groups. [Feedback for Answer Choice 4] The authors of this chapter do not deem the physical costs of racism as the most visible and concrete of all the costs of racism described. [Q4] Which of the following groups highlights the U.S. Constitution as its guiding principle in providing equality and liberty for all? 1. Black Lives Matter 2. Congress of Racial Equality 3. National Council of La Raza 4. American Civil Liberties Union [correct] [Feedback for Answer Choice 1] The Black Lives Matter movement does not highlight the U.S. Constitution as its guiding principle. This group was developed as a grassroots effort to bring light to the killings and other recognized racial injustices in Black communities across America. [Feedback for Answer Choice 2] The Congress of Racial Equality has been working to promote the social, political, and economic well-being of minority populations since 1942. This group does not highlight the U.S. Constitution as its guiding principle in creating solutions to difficult problems that underprivileged individuals may face. [Feedback for Answer Choice 3] Established in 1968, the National Council of La Raza is directly involved with Latino communities and works toward the social, political, and economical progression of its people. This group does not highlight the U.S. Constitution as its guiding principle in serving as an advocacy sounding board for the betterment of Latinos in the United States.

[Feedback for Correct Answer 4] The American Civil Liberties Union has been a long-standing entity in the fight for justice for disenfranchised groups. This Union highlights the U.S. Constitution as its guiding principle in providing equality and liberty for all. ACLU causes include human rights, immigration rights, and racial rights. Learning Outcome 4.3: Define and provide examples of White supremacy. [Q1] is an ideology of racial segregation and racial purity, which emphasizes there are genetic and physical differences that naturally separate races. 1. White pride 2. White privilege 3. White nationalism [correct] 4. White supremacy [Feedback for Answer Choice 1] White pride is a byproduct of White privilege and White supremacy, rather than an ideology. [Feedback for Answer Choice 2] White privilege encompasses the positive ways that White people benefit from racism. Oftentimes, these benefits or privileges are unintentional and unconscious. [Feedback for Correct Answer 3] White nationalism is an ideology of racial segregation and racial purity, which emphasizes there are genetic and physical differences that naturally separate races (i.e., essentialism). Accordingly, White nationalism is a movement of discrimination toward racial/ethnic groups as well as other intersectional cultural identities. [Feedback for Answer Choice 4] White supremacy is a pervasive and often invisible force from which all White people, or those approximating Whiteness, benefit daily. It is typical that White supremacy is used interchangeably with White nationalism, which is inaccurate. It is important to remember, however, that White people support at varying degrees White supremacy that protects White privilege. [Q2] Endorsement of and related actions can be considered a continuum: from a sense of indifference or avoidance of race-based conversations, to a minimization of racism or promotion of color-blind views, to veiled racism. 1. White pride 2. White privilege 3. White nationalism 4. White supremacy [correct]

[Feedback for Answer Choice 1] White pride is a byproduct of White supremacy and, as such, is only indirectly related to the continuum of actions listed above. [Feedback for Answer Choice 2] White privilege encompasses the positive ways that White people benefit from racism. Oftentimes, these benefits or privileges are unintentional and unconscious. [Feedback for Answer Choice 3] White nationalism is an ideology of racial segregation and racial purity, which emphasizes there are genetic and physical differences that naturally separate races (i.e., essentialism). Accordingly, White nationalism is a movement of discrimination toward racial/ethnic groups as well as other intersectional cultural identities. [Feedback for Correct Answer 4] Endorsement of White supremacy and related actions can be considered a continuum: from a sense of indifference or avoidance of race-based conversations, to a minimization of racism or promotion of color-blind views, to veiled racism. [Q3] According to the authors of this chapter, how ideas of White superiority are produced.

is the most visible display of

1. White privilege 2. White nationalism [correct] 3. racial worldview 4. racial disparity [Feedback for Answer Choice 1] The authors of this chapter do not contend that White privilege is the most visible display of how ideas of White superiority are produced. [Feedback for Correct Answer 2] According to the authors of this chapter, White nationalism is the most visible display of how ideas of White superiority are produced. It is important to remember, however, that White people support at varying degrees White supremacy that protects White privilege. [Feedback for Answer Choice 3] The authors of this chapter do not contend that racial worldview is the most visible display of how ideas of White superiority are produced. [Feedback for Answer Choice 4] The authors of this chapter do not contend that racial disparity is the most visible display of how ideas of White superiority are produced.

[Q4] Tokenism and cultural appropriation are examples of: 1. racial indifference 2. color-blind views 3. minimizing racism 4. veiled racism [correct] [Feedback for Answer Choice 1] Tokenism and cultural appropriation are not examples of racial indifference. [Feedback for Answer Choice 2] Tokenism and cultural appropriation are not examples of color-blind views. [Feedback for Answer Choice 3] Tokenism and cultural appropriation are not examples of minimizing racism. [Feedback for Correct Answer 4] Tokenism and cultural appropriation are examples of veiled racism. Learning Outcome 4.4: Discuss White privilege in the U.S. context. [Q1] According to Peggy McIntosh (1988), the ability to avoid or ignore cultural contributions of other racial/ethnic groups is one of the advantages of: 1. White supremacy. 2. White privilege. [correct] 3. proxy privilege. 4. meritocracy. [Feedback for Answer Choice 1] Peggy McIntosh’s (1988) does not cite the ability to avoid or ignore cultural contributions of other racial/ethnic groups as one of the advantages of White supremacy. [Feedback for Correct Answer 2] Peggy McIntosh (1988) wrote the classic and highly cited work on White privilege wherein she described 46 conditions of unearned advantages of having White skin color, which include access to things representative of culture and the ability to avoid or ignore cultural contributions of other racial/ethnic groups. [Feedback for Answer Choice 3] Peggy McIntosh’s (1988) does not cite the ability to avoid or ignore cultural contributions of other racial/ethnic groups as one of the advantages of proxy privilege. [Feedback for Answer Choice 4]

Peggy McIntosh’s (1988) does not cite the ability to avoid or ignore cultural contributions of other racial/ethnic groups as one of the advantages of meritocracy. [Q2] According to Liu (2017), those with may be willing to support White supremacy in order to maintain some advantage for themselves, as they may see this in their personal best interests. 1. White fragility 2. proxy privilege [correct] 3. cultural tunnel vision 4. color-blind views [Feedback for Answer Choice 1] Liu’s (2017) writing predates the term White fragility, which was coined by Robin DiAngelo in her 2018 book, White fragility: Why it’s so hard for White people to talk about racism. [Feedback for Correct Answer 2] Some people enjoy what Liu (2017) terms proxy privilege, in that they benefit from the White supremacy framework given their physical and temporal proximity to White males. Consequently, those with proxy privilege may be willing to support White supremacy in order to maintain some advantage for themselves, as they may see this in their personal best interests. [Feedback for Answer Choice 3] The term cultural tunnel vision is used to describe instances when a counselor fails to view presenting problems from the client’s worldview and, instead, interprets them from the perspective of their own cultural socialization. [Feedback for Answer Choice 4] Liu (2017) does not write about color-blind views. [Q3] is difficult to dismantle, given that it is created and supported by . 1. White privilege, White supremacy. [correct] 2. White privilege, proxy privilege 3. White supremacy, White nationalism 4. White supremacy, proxy privilege [Feedback for Correct Answer 1] White supremacy is a pervasive and often invisible force from which all White people, or those approximating Whiteness, benefit daily. White privilege, then, would not exist without pervasive and intentional exclusionary practices that harm people of color. Thus, White privilege is difficult to dismantle, given that it is created and supported by White supremacy. [Feedback for Answer Choice 2]

White privilege is supported, but not created by, proxy privilege. [Feedback for Answer Choice 3] White supremacy is a pervasive and often invisible force from which all White people, or those approximating Whiteness, benefit daily; however, it was not created by White nationalism. [Feedback for Answer Choice 4] White supremacy is supported, but not created by, proxy privilege. [Q4] encompasses the positive— often, unintentional, and unconscious— ways that White people benefit from racism. 1. Color blindness 2. Reverse discrimination 3. White supremacy 4. White privilege [correct] [Feedback for Answer Choice 1] Color blindness involves unawareness of racial privilege, institutional discrimination, or overt racial issues. [Feedback for Answer Choice 2] Reverse discrimination refers to when White people deflect their role in perpetuating racism by focusing on times when they were discriminated against by people of color. [Feedback for Answer Choice 3] White supremacy refers to the presumption that White people are superior to people of color and, thus, deserve the better positions in society. [Feedback for Correct Answer 4] White privilege encompasses the positive ways that White people benefit from racism. Oftentimes, these benefits or privileges are unintentional and unconscious. Learning Outcome 4.5: Compare psychological responses to racism and White privilege. [Q1] refers to the internal need for White people to re-establish cognitive and affective equilibrium regarding their own Whiteness. 1. White guilt 2. White Savior 3. White fragility [correct] 4. Color blindness [Feedback for Answer Choice 1]

White guilt refers to a belief that White people bear a collective responsibility for the harm caused by the racism and discrimination experienced by people of color. [Feedback for Answer Choice 2] White savior refers to the desire a White person may have to ―save‖ people of color instead of working alongside them to challenge White supremacy. [Feedback for Correct Answer 3] White fragility refers to the internal need for White people to re-establish cognitive and affective equilibrium regarding their own Whiteness. DiAngelo (2018) described this state of racial equilibrium as a ―cocoon of racial comfort, centrality, superiority, entitlement, racial apathy, obliviousness‖ (p. 112). [Feedback for Answer Choice 4] Color blindness involves unawareness of racial privilege, institutional discrimination, or overt racial issues. [Q2] The view that segregation is based on individual, or outgroup choices reflects which of the four frames of color-blind racial ideology (CBRI) identified by Bonilla-Silva (2014)? 1. Cultural racism 2. Naturalization [correct] 3. Minimization of racism 4. Abstract liberalism [Feedback for Answer Choice 1] According to the four frames of CBRI identified by Bonilla-Silva (2014), cultural racism is reflected in attributing cultural deficits to communities of color and, consequently, their suffering is a result of these deficits. [Feedback for Correct Answer 2] According to the four frames of CBRI identified by Bonilla-Silva (2014), naturalism is reflected in the view that segregation is based on individual or outgroup choices. [Feedback for Answer Choice 3] According to the four frames of CBRI identified by Bonilla-Silva (2014), minimization of racism is reflected in the thinking of racism as a thing of the past. [Feedback for Answer Choice 4] According to the four frames of CBRI identified by Bonilla-Silva (2014), abstract liberalism is reflected in the notion that the United States provides equal opportunities which yield outcomes based on individualism and free choice. [Q3] According to Neville and colleagues (2013), using contemporary examples of people of color ―overcoming‖ discrimination (e.g., Barack Obama being elected and then re-elected) is an example of:

1. meritocracy. 2. reverse racism. 3. White fragility. 4. color blindness. [correct] [Feedback for Answer Choice 1] Neville and colleagues (2013) do not cite the use contemporary examples of people of color ―overcoming‖ discrimination as an example of meritocracy. [Feedback for Answer Choice 2] Neville and colleagues (2013) do not cite the use contemporary examples of people of color ―overcoming‖ discrimination as an example of reverse racism. [Feedback for Answer Choice 3] The above-mentioned article by Neville and colleagues (2013) predates the term White fragility, which was coined by Robin DiAngelo in her 2018 book, White fragility: Why it’s so hard for White people to talk about racism. [Feedback for Correct Answer 4] According to Neville and colleagues (2013), color blindness involves unawareness of racial privilege, institutional discrimination, or overt racial issues. For example, using contemporary examples of people of color ―overcoming‖ discrimination (e.g., Barack Obama being elected and then re-elected), White people will claim that racism is a thing of the past and thereby deny the existence of racial inequality and privilege. [Q4] According to Sue and colleagues (2019), Pathologizing Cultural Values/Communication Styles is one of the four forms of racial: 1. microaggressions. [correct] 2. macroaggressions. 3. superiority. 4. attitude. [Feedback for Correct Answer 1] According to Sue and colleagues (2019), there are four forms of racial microaggressions. The first form is referred to as Pathologizing Cultural Values/Communication Styles, such as appearances, practices, and views outside of the all-American standard may be considered abnormal or inappropriate. [Feedback for Answer Choice 2] Sue and colleagues (2019) did not propose four forms of racial microaggressions. [Feedback for Answer Choice 3] Sue and colleagues (2019) did not propose four forms of racial superiority.

[Feedback for Answer Choice 4] Sue and colleagues (2019) did not propose four forms of racial attitude. Learning Outcome 4.6: Develop a clear understanding of the cognitive, affective, interpersonal, and physical costs of racism for White people. [Q1] The prospect of losing friends or becoming disconnected from family is a particular challenge for White people that often prevents them from acknowledging racism and White privilege. This dilemma is associated with the costs of racism for White people. 1. affective 2. cognitive 3. interpersonal [correct] 4. physical [Feedback for Answer Choice 1] Losing friends or becoming disconnected from family are not examples of the affective costs of racism for White people. However, White people may experience affective costs as a byproduct of these events. [Feedback for Answer Choice 2] Losing friends or becoming disconnected from family are not examples of the cognitive costs of racism for White people. However, White people may experience cognitive costs as a byproduct of these events. [Feedback for Correct Answer 3] As White people address racism and racial privilege, they may lose relationships with other White people, including family members and friends, who are not engaged in social advocacy and personal growth. This dilemma is a particular challenge for White people that often prevents them from acknowledging racism and White privilege and is an example of the interpersonal costs of racism for White people. [Feedback for Answer Choice 4] Losing friends or becoming disconnected from family are not examples of the physical costs of racism for White people. [Q2] As White people acknowledge their racial privilege, they may become fearful of losing privileges to which they have become accustomed. This experience is associated with the costs of racism for White people. 1. affective [correct] 2. cognitive 3. interpersonal 4. physical

[Feedback for Correct Answer 1] As White people acknowledge their racial privilege, they may become fearful of losing privileges to which they have become accustomed. This experience is associated with the affective costs of racism for White people. [Feedback for Answer Choice 2] Fear of losing privileges to which a person has become accustomed is not associated with the cognitive costs of racism for White people. [Feedback for Answer Choice 3] Fear of losing privileges to which a person has become accustomed is not associated with the interpersonal costs of racism for White people. [Feedback for Answer Choice 4] Fear of losing privileges to which a person has become accustomed is not associated with the physical costs of racism for White people. [Q3] Inaccurate self-knowledge and a distorted view of self are associated with the costs of racism for White people. 1. affective 2. cognitive [correct] 3. interpersonal 4. physical [Feedback for Answer Choice 1] Inaccurate self-knowledge and a distorted view of self are not associated with the affective costs of racism for White people. [Feedback for Correct Answer 2] Inaccurate self-knowledge and a distorted view of self are associated with the cognitive costs of racism for White people. [Feedback for Answer Choice 3] Inaccurate self-knowledge and a distorted view of self are not associated with the interpersonal costs of racism for White people. [Feedback for Answer Choice 4] Inaccurate self-knowledge and a distorted view of self are not associated with the physical costs of racism for White people. [Q4] Lower White racial identity statuses, such as , serve to enhance opportunities and cultural preferences for White people and thus maintain the racial status quo. 1. Autonomy 2. Immersion–Emersion

3. Reintegration [correct] 4. Pseudoindependence [Feedback for Answer Choice 1] Autonomy is an example of a higher White status that views race as a complex construct that is often laden with misconceptions of minorities. [Feedback for Answer Choice 2] Immersion–Emersion is an example of a higher White status that views race as a complex construct that is often laden with misconceptions of minorities. [Feedback for Correct Answer 3] Lower White racial identity statuses, such as Reintegration, serve to enhance opportunities and cultural preferences for White people and thus maintain the racial status quo. [Feedback for Answer Choice 4] Pseudoindependence is an example of a higher White status that views race as a complex construct that is often laden with misconceptions of minorities. Learning Outcome 4.7: Identify current research trends and gaps related to racism, White supremacy, and White privilege. [Q1] noted a link between racism and depression and anxiety, life satisfaction, eating behavior, substance use, and quality of life. 1. Nelbett (2019) 2. Ratts and colleagues (2015) 3. Kirkinis and colleagues (2018) 4. Williams and colleagues (2018) [correct] [Feedback for Answer Choice 1] Scholars such as Nelbett (2019) have penned conceptual works to operationalize terms associated with racism, such as individual racism, structural racism, color-blindness, racial microaggressions, and internalized racism. [Feedback for Answer Choice 2] Ratts and colleagues (2015) developed guidelines to address racism and White privilege as counselors become culturally competent. [Feedback for Answer Choice 3] Systemic reviews of racism research conducted by Kirkinis and colleagues (2018) indicate that there is a significant positive relationship between racism and trauma, including post-traumatic stress disorder symptoms.

[Feedback for Correct Answer 4] Williams and colleagues (2018) conducted a systematic review examining research on independent racial groups and psychological stress. They noted a link between racism and depression and anxiety, life satisfaction, eating behavior, substance use, and quality of life. [Q2] developed guidelines to address racism and White privilege as counselors become culturally competent. 1. Nelbett (2019) 2. Ratts and colleagues (2015) [correct] 3. Kirkinis and colleagues (2018) 4. Williams and colleagues (2018) [Feedback for Answer Choice 1] Scholars such as Nelbett (2019) have penned conceptual works to operationalize terms associated with racism, such as individual racism, structural racism, color-blindness, racial microaggressions, and internalized racism. [Feedback for Correct Answer 2] Ratts and colleagues (2015) developed guidelines to address racism and White privilege as counselors become culturally competent. [Feedback for Answer Choice 3] Systemic reviews of racism research conducted by Kirkinis and colleagues (2018) indicate that there is a significant positive relationship between racism and trauma, including post-traumatic stress disorder symptoms. [Feedback for Answer Choice 4] Williams and colleagues (2018) conducted a systematic review examining research on independent racial groups and psychological stress. They noted a link between racism and depression and anxiety, life satisfaction, eating behavior, substance use, and quality of life. [Q3] Utilizing outreach and advocacy programs to address cultural and institutional racism is one of the practice recommendations outlined by for addressing the impact of individual racism. 1. Nelbett (2019) 2. Ratts and colleagues (2015) 3. Kirkinis and colleagues (2018) 4. Williams and colleagues (2018) [correct] [Feedback for Answer Choice 1] Scholars such as Nelbett (2019) have penned conceptual works to operationalize terms associated with racism, such as individual racism, structural racism, color-blindness, racial microaggressions, and internalized racism.

[Feedback for Answer Choice 2] Ratts and colleagues (2015) developed guidelines to address racism and White privilege as counselors become culturally competent. [Feedback for Answer Choice 3] Systemic reviews of racism research conducted by Kirkinis and colleagues (2018) indicate that there is a significant positive relationship between racism and trauma, including post-traumatic stress disorder symptoms. [Feedback for Correct Answer 4] Williams and colleagues (2018) conducted a systematic review examining research on independent racial groups and psychological stress. Based on this review, the authors presented eight categories of practice recommendations, which include outreach and advocacy programs to address cultural and institutional racism. [Q4] According to Crenshaw (1991), intersectionality refers to how the location of intersecting cultural identities creates different experiences for a phenomenon or construct based on different levels of power and status. 1. structural [correct] 2. political 3. geographical 4. representational [Feedback for Correct Answer 1] According to Crenshaw (1991), structural intersectionality refers to how the location of intersecting cultural identities creates different experiences for a phenomenon or construct based on different levels of power and status. [Feedback for Answer Choice 2] According to Crenshaw (1991), political intersectionality refers to how one social category is used politically to marginalize those who are disadvantaged in another category. [Feedback for Answer Choice 3] Geographical intersectionality is not a concept used by Crenshaw (1991). [Feedback for Answer Choice 4] According to Crenshaw (1991), representational intersectionality refers to how social categories that are culturally represented in media and other popular culture can disadvantage some at a particular location. Learning Outcome 4.8: Describe collaborative strategies to address racism within communities and other systems. [Q1] According to the authors of this chapter, before counselors can become antiracist using a systemic approach, they must seek to become a(n) .

1. ally [correct] 2. activist 3. advocate 4. White savior [Feedback for Correct Answer 1] Allies are individuals of dominant cultural statuses who both affirm the experiences of nondominant groups as well as actively work at the interpersonal and institutional levels to dismantle social injustice and systems of White supremacy. Before counselors can become antiracist using a systemic approach, they must seek to become an ally. [Feedback for Answer Choice 2] Counselors are accountable to ensuring people of color are treated equitably and do not seek recognition for doing so. This goal may eventually take on the form of activism. [Feedback for Answer Choice 3] Counselors are accountable to ensuring people of color are treated equitably and do not seek recognition for doing so. This goal may eventually take on the form of advocacy. [Feedback for Answer Choice 4] Counselors must avoid becoming a White savior, where they ―save‖ people of color instead of working alongside them to challenge White supremacy. [Q2] A counselor who maintains cultural tunnel vision and views client problems from the perspective of their own cultural socialization is an example of: 1. cultural myopia 2. ethnocentrism [correct] 3. reverse discrimination 4. victim blaming [Feedback for Answer Choice 1] Cultural myopia is not a counseling-specific term. [Feedback for Correct Answer 2] A counselor who maintains cultural tunnel vision and views client problems from the perspective of their own cultural socialization is an example of ethnocentrism. As a result, counselors may fail to view presenting problems from the client’s worldview and may minimize the role of racism and other forms of oppression in the client’s issues. [Feedback for Answer Choice 3] Reverse discrimination refers to when White people deflect their role in perpetuating racism by focusing on times when they were discriminated against by people of color.

[Feedback for Answer Choice 4] Victim blaming consists of labeling clients as the sole cause of their presenting issues or identifying as pathological or a form of resistance client behaviors in counseling that differ from the counselor’s expectations. Thus, counselors may exhibit racist attitudes and behaviors and ignore the potential effects of racism on client problems. [Q3] To broach the topic of racial , a counselor might ask the question: ―Has someone ever assumed that you were of a particular race but was wrong?‖ 1. assumptions 2. privilege 3. ambiguity 4. microaggressions [correct] [Feedback for Answer Choice 1] Counselors should avoid making assumptions about clients. The above-mentioned counselor question is intended to broach client experiences with racism and cultural insensitivity. [Feedback for Answer Choice 2] The appearance of some clients of color may be perceived as White, if their physical features approximate Whiteness, and may result in their experiencing some degree of White privilege. However, the above-mentioned counselor question is intended to broach client experiences with racism and not privilege. [Feedback for Answer Choice 3] The above-mentioned counselor question is intended to broach client experiences with racism and cultural insensitivity, rather than attempting to ascertain the client’s racial-ethic identity. [Feedback for Correct Answer 4] To broach the topic of racial microaggressions, a counselor might ask the question: ―Has someone ever assumed that you were of a particular race but was wrong?‖ [Q4] Sue and colleagues (2019) provided several microintervention strategies to address racial microaggressions. The objective to ―communicate your disagreement or disapproval toward the perpetrator in the moment‖ is associated with which of the following strategic goals? 1. Make the “invisible” visible 2. Educate the offender 3. Disarm the microaggression [correct] 4. Seek external reinforcement or support [Feedback for Answer Choice 1] Objectives associated with the goal to Make the “invisible” visible include: bring the microaggression to the person’s awareness to undermine the metacommunication; defend self or others who are targets of microaggressions to validate experiences in which the

microaggression is occurring; indicate to the perpetrator that they behaved or said something offensive to you or others; and/or force the perpetrator to consider the impact and meaning of what was said or done. [Feedback for Answer Choice 2] Objectives associated with the goal to Educate the offender include: engage in a one-on-one dialogue with the perpetrator to indicate how and what they have said is offensive to you and others; facilitate a conversation to explore the perpetrator’s biases; and/or encourage the perpetrator to explore the origins of their beliefs and attitudes toward targets while pointing out commonalities between the perpetrator and target. [Feedback for Correct Answer 3] Objectives associated with the goal to Disarm the microaggression include: instantly stop or deflect the microaggression by expressing disagreement; force the perpetrator to immediately consider what they have just said or done; and/or communicate your disagreement or disapproval toward the perpetrator in the moment. [Feedback for Answer Choice 4] Objectives associated with the goal to Seek external reinforcement or support include: partake in regular self-care to maintain wellness; check in with self and others to ensure optimal levels of functioning; and send a message to perpetrators at large that bigoted behavior will not be tolerated or accepted.

Chapter 4 Application Exercises Application Exercise 4.1: Understanding Race and the Levels of Racism Learning Outcome 4.1: Articulate historical and contemporary expressions of race and racism. [Q1] Explain the concept of racial worldview and discuss how the components of this classification system perpetuate racism. [Q1 MODEL RESPONSE] Your answer should include some of the points: 

A racial worldview is a defining cultural characteristic in that individuals and groups perceive and understand each other through this socially constructed prism that will be transmitted to succeeding generations.



The components of the system are individuals who are actively (e.g., lobbying to eliminate affirmative action policies) and passively (e.g., ignoring racist comments by a colleague) complicit in the reinforcement of racial worldview structures (e.g., prejudices, discrimination, racial inequities).



Racial worldview also perpetuates racism through intentional (e.g., voting, gentrification, employment practices) and unintentional (e.g., obliviousness to the absence of workplace diversity) actions.

[Q2] Briefly describe each of the three levels of racism identified by Jones (2000). [Q2 MODEL RESPONSE] Your answer should include the points: 

According to Jones (2000), the three levels of racism are: individual, institutional, and internalized.



Individual racism refers to personal attitudes and beliefs in White superiority and the inferiority of people of color.



Physical differences among individuals are used as an explanation of social, moral, and intellectual behavior.



Institutional racism is defined as ―differential access to the goods, services, and opportunities of society by race‖ (Jones, 2000, p. 1212).



Institutional racism perpetuates political and social systems including the criminal justice system, schools, housing, health care, employment, among others.



Internalized racism refers to members of marginalized groups believing and accepting, knowingly or unknowingly, negative social messages about their own racial and ethnic groups.

[Q3] Several academics have investigated the experiences of White students and faculty participating in conversations related to race, racism, and White privilege. Briefly discuss some of the salient feelings reported by the White participants in these studies (e.g., Chung et al., 2018; Sue, 2016, etc.). [Q3 MODEL RESPONSE] Your answer should include some of the points: 

Fear of appearing racist and/or realizing one’s racism.



Fear of confronting White privilege and taking responsibility to end racism.



Distrust, defensiveness, and other forms of resistance.

Application Exercise 4.2: The Various Costs of Racism Learning Outcome 4.2: Identify the cognitive, affective, interpersonal, and physical costs of racism for people of color. [Q1] Explain some of the cognitive costs associated with racism for people of color. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

People of color may discount the value of their individual, institutional, and cultural contributions to society and engage in self-hatred, due to internalized racism.



Denial of racial heritage or self-isolation from one’s racial group.



Introjecting ideals characteristic of White people and ignoring the values of one’s own group.



Reflecting on daily interactions, situations, and behaviors, which produce a general psychological vigilance in cross-racial interactions that taxes the mind, body, and spirit.



Generalized negative thinking as a result of experiences with racism can create additional costs, such as chronic anxiety, lowered self-esteem, a pessimistic outlook, and lack of motivation.

[Q2] Highlight some of the affective costs associated with racism for people of color. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Frustration



Irritation



Hostility



Anger



Depression



Somatization



Anxiety



Posttraumatic stress disorder



Heightened psychological distress



High blood pressure and other physical ailments

[Q3] Briefly describe some of the interpersonal costs associated with racism for people of color. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Ambivalence about developing relationships with members of the ―dominant group,‖ including White people.



Internalized racism may contribute to intergroup and intragroup relational discord among people of color.



Fear, suspicion, and distrust of others.



Community displacement



Psychological disconnect

Application Exercise 4.3: Exploring the Impact of Microaggression, Macroaggressions, and Color-Blind Racial Attitudes Learning Outcome 4.5: Compare psychological responses to racism and White privilege. [Q1] Briefly describe the impact that the Second-Class Citizen form of microaggressions can have on a person of color as described in Chapter 4. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

White people are given preferential treatment in stores, the workplace, politics, and the media.



People of color may feel invalidated.



Members of a particular group may be clustered together and viewed as having the same physical characteristics or actions.

[Q2] Highlight several examples that reflect a color-blind racial attitude as discussed in Chapter 4. [Q2 MODEL RESPONSE]

Your answer should include some of the following points: 

Unawareness of racial privilege, institutional discrimination, or overt racial issues.



Using contemporary examples of people of color ―overcoming‖ discrimination to argue that racism is a thing of the past.



Denying the existence of racial inequality and privilege.



Viewing the world as offering equal opportunity for all people.

[Q3] Discuss some of the negative clinical outcomes experienced by counselors who approach clients in a color-blind manner as discussed in Chapter 4. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

May have difficulty establishing a therapeutic alliance with racial and ethnic minorities.



They may also have greater interracial discomfort and resistance to discussing racial issues.



May experience increased engagement in racial microaggressions, increased prejudice, and racially based anger.



May demonstrate lower multicultural competencies and lower cultural empathy.

Chapter 4 Test Items Multiple Choice 1.

is an example of White privilege. a. Racial profiling b. Learning about different cultures in a history class c. Watching television shows and seeing White people portrayed in a positive manner d. Experiencing reverse discrimination

The disease concept of racism primarily refers to a. a distorted sense of self, reality, and racially different others. b. racial disparities in social and economic opportunities. c. educational opportunities based on racial privilege. d. None of the above.

Which of the following is NOT true about White racial identity development with respect to White privilege awareness? a. Individuals at lower racial identity statuses are less likely to work to eradicate racism. b. Whites experience psychosocial costs no matter which statuses are prominent. c. Negotiating White guilt is a major task of White racial identity development. d. Developing a non-racist identity is impossible no matter which statuses are prominent.

An individual who says, ―I was more qualified but they had to hire someone who was not White‖ is claiming as a natural defense. a. the myth of meritocracy. b. denial. c. reverse discrimination. d. projection.

Focusing only on racial dynamics in a counseling relationship refers to a. color consciousness. b. color blindness. c. projection. d. None of the above.

A contradictory position where racism is acknowledged in one setting but not another primarily refers to a(n) disposition. a. affective-impulsive b. rational c. liberal d. principled

Voicing racial slurs when discussing people of color primarily refers to a(n) disposition. a. affective-impulsive b. rational c. liberal d. principled

One of the key differences between the principled and principled-activistic dispositions involves a. understanding systemic examples of racism. b. support for policies that encourage racial integration. c. a sense of hope with social action that racism will be eliminated. d. expressing sadness for current U.S. racial dynamics.

Which of the following is LEAST likely to be a reason Whites fail to address their White privilege? a. Whites often have both privileged and oppressed statuses. b. Whites are not often engaged in multicultural counseling relationships. c. Whites may be uncomfortable with giving up privileges that they enjoy. d. Whites typically are surrounded by individuals and cultural values that seem normative for them.

10. Focusing on how people of color may be racist at times is what type of defense mechanism Whites might use to avoid acknowledging their White privilege? a. Reverse discrimination b. Projection c. Myth of meritocracy d. Color blindness 11.

are a result of genetic drift, isolation, and the interaction between geography and biology. a. Ethnic identities b. Nationalities c. Racial differences d. Demographic differences

12. Individuals often group people of the same race in groups of the same a. ethnicity. b. nationality. c. culture. d. dialect.

13. The Standards for the Classification of Federal Data on Race and Ethnicity were created to a. guide professional counseling practices. b. enforce civil rights laws. c. determine marginalized groups. d. All of the above. 14.

has NOT been used as a method for classifying race? a. Measuring skulls b. Examining blood quantum c. Scientific methods d. All of the above are methods that have been used for classifying race.

15.

is partly responsible for variation of physical characteristics among the same racial group. a. Nationality b. Ancestry c. Climate d. History

16.

were responsible for the justification of the concept of race and its associated ideologies of White superiority. a. Anthropologists b. Psychologists c. Politicians d. All of the above.

17. The use of

results in the socialization of a racial worldview for all its members.

a. racism b. racial classifications c. discrimination d. institutional racism 18. According to Jones, a. individual b. group c. institutional d. cultural

is NOT a level of racism.

19.

costs are probably the most visible and concrete of all the costs of racism. a. Cognitive b. Affective c. Interpersonal d. Physical

20. Which of the following is NOT a characteristic of White supremacy? a. It is often invisible to White people. b. White privilege does not have any intellectual or psychological costs to White people. c. White people can hold several myths that perpetuate White supremacy. d. Individuals who do not identify as White may have some degree of White privilege. 21. White racial development is greatly affected by a. interpersonal beliefs. b. cognitive impairments. c. White privilege. d. All of the above. 22. White individuals may define affirmative action as a. reverse discrimination. b. discrimination. c. inequality. d. a myth of meritocracy. 23. The first step to eradicating racism within clients’ lives is to a. advocate within the community. b. create community resources for the client. c. build rapport with the client. d. address racism within individual counseling sessions. 24. While exploring client problems of race-related stress, counselors should be sure to a. remain unbiased in conversation. b. be empathic. c. show empathy and self-disclose their own struggles when appropriate. d. open awareness of intentions with the client. 25. Counselors should work to build stronger coping mechanisms for clients by a. strengthening school and community resources. b. discussing currently employed coping mechanisms. c. discussing the counselors’ coping mechanisms. d. discussing the literature regarding coping mechanisms.

26. Institutional racism is closely related to and often used interchangeably with a. individual racism. b. internalized racism. c. structural racism. d. All of the above. 27.

refers to common ancestry, while commonalities (e.g., rituals, work ethic, values).

refers to cultural practices and

a. Ethnicity; race b. Race; ethnicity c. Culture; race d. Ethnicity; culture 28. Structural racism can be attributed to a. health inequities among racial minorities. b. disproportionate rates of suspension and expulsion for African American males compared to their White peers. c. disproportionate representation of children of color in the child welfare system. d. All of the above. 29.

is an ongoing, multidimensional, and dynamic process inherent to the development and maintenance of an institutionalized, hierarchical racial classification system. a. Ethnicity b. Cultural diversity c. Racism d. Discrimination

30.

refers to personal attitudes and beliefs in White superiority and the inferiority of people of color, with physical differences among individuals used as an explanation of social, moral, and intellectual behavior. a. Individual racism b. Institutional racism c. Internalized racism d. Systemic racism

31.

is defined as differential access to the goods, services, and opportunities of society by race. a. Individual racism b. Institutional racism c. Internalized racism d. Systemic racism

32. Members of marginalized groups believing and accepting, knowingly or unknowingly, negative social messages about their own racial and ethnic groups is referred to as a. individual racism. b. institutional racism. c. internalized racism. d. systemic racism. 33. California Proposition 227 (1998) a. sought to establish English as the only legitimate language in schools and workplaces. b. declared that police have the right to check the immigration status of any individual that they suspect may be illegally in the United States. c. enforced stricter laws on drug use and sales. d. found that Asian Americans were being paid far less than Whites in most occupations. 34. The Glass Ceiling Commission (1995) a. sought to establish English as the only legitimate language in schools and workplaces. b. declared that police have the right to check the immigration status of any individual that they suspect may be illegally in the United States. c. enforced stricter laws on drug use and sales. d. found that Asian Americans were being paid far less than Whites in most occupations. 35. The costs of racism include the mental energy and psychological processes used to evaluate life incidents and experiences where racism is potentially involved. a. affective b. cognitive c. interpersonal d. physical 36. The costs of racism refer to associated physical and physiological symptoms and consequences experienced by people of color (e.g., hypertension, chronic fatigue, preterm infants). a. affective b. cognitive c. interpersonal d. physical 37. Which of the following represents an effort to combat racism costs? a. Glass Ceiling Commission b. Black Lives Matter c. Zero-Tolerance d. All of the above.

38. The , which focuses on creating solutions to difficult problems that underprivileged individuals may face, has been working to promote the social, political, and economic well-being of minority populations since 1942. a. National Council of La Raza b. American Civil Liberties Union c. Congress of Racial Equality d. Black Lives Matter movement 39. Which of the following serves as an advocacy sounding board for the betterment of Latinos/as in the United States? a. National Council of La Raza b. American Civil Liberties Union c. Congress of Racial Equality d. Black Lives Matter movement 40.

is the belief that the superiority of White people justifies the disproportionate access to social and economic resources. a. White privilege b. White supremacy c. All Lives Matter d. Internalized racism

41. A common myth that White people hold that can perpetuate White privilege is a. Whiteness and White culture are desirable and universal. b. power affects everyone the same. c. guilt is a sufficient response to addressing racial privilege. d. All of the above are myths perpetuating White privilege. 42.

is/are brief and commonplace daily verbal, behavioral, and environmental indignities (intentional or unintentional) that communicate hostile, derogatory, negative racial slights and insults to the target person or group. a. Physical aggressions/attacks b. Discrimination c. Racial microaggressions d. Stereotypes

43. A key defense mechanism of Whites which helps maintain White privilege and alleviate dissonance and emotional discomfort is a. denial. b. empowerment. c. stereotypes. d. All of the above.

44.

is the notion that all individuals, regardless of racial makeup, can succeed if they try. a. Color blindness b. Reverse racism c. Myth of meritocracy d. Affirmative action

45. Whites demonstrating the psychological disposition engage in limited, stereotypical thinking about non-Whites and deny the existence of racism. a. affective-impulsive b. rational c. liberal d. principled

Extended Response 1.

Explain the Standards for the Classification of Federal Data on Race and Ethnicity and list the different racial and ethnic categories.

Describe how race and racism came about as social constructs.

Describe the methods used throughout history for classifying race.

Explain Jones’s three levels of racism.

Describe the cognitive, affective, interpersonal, and physical costs of racism. Provide an example of each.

Describe areas professional counselors should explore in individual counseling in order to eradicate racism.

Explain how professional counselors can help to build school and community resources for clients.

List and describe laws and policies that may have affected racism and White privilege throughout U.S. history.

Describe the economic and public health concerns minority groups face.

10. Provide examples of individual, institutional, and internalized racism. 11. Define White privilege and provide at least three examples of common unearned advantages experienced by White people. 12. Identify common myths that White people hold that can perpetuate White privilege. 13. Describe the term racial microaggression and identify the several forms of microaggressions that can occur. 14. Discuss color-blindness and the problems associated with the following assumption: ―I don’t see color.‖

Chapter 4 Test Answer Key ANSWER KEY: Chapter 4 Test (Multiple Choice) 1. c 2. a 3. d 4. c 5. a 6. b 7. a 8. c 9. b 10. a 11. c 12. a 13. b 14. d 15. b 16. d 17. b 18. b 19. c 20. b 21. c 22. a 23. d 24. c 25. a 26. c 27. b 28. d 29. c 30. a 31. b 32. c

33. a 34. d 35. b 36. d 37. b 38. c 39. a 40. b 41. d 42. c 43. a 44. c 45. a

Chapter 5 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach th 4 Edition

Danica G. Hays University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents Chapter 5: Gender and Sexism

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 5: Gender and Sexism Chapter 5 Learning Outcome Quizzes Learning Outcome 5.1: Define gender and sexism and the relationship to intersecting oppressions. [Q1] When babies are born, they are typically assigned a sex, male or female, based on a limited, binary view of sex characteristics and anatomy. This event is an example of gender: 1. role. 2. identity. 3. expression. 4. socialization. [correct] [Feedback for Answer Choice 1] Gender role refers to the cultural assumptions and expectations of how a person should behave, based on the sex they were assigned at birth. [Feedback for Answer Choice 2] Gender identity refers to an individual’s sense of their own gender. This self-concept may or may not align with the sex they were assigned at birth. [Feedback for Answer Choice 3] Gender expression refers to the public presentation of an individual’s gender identity. [Feedback for Correct Answer 4] Gender socialization begins from the moment humans are born and includes how people learn what gender they are, what gender others are, and what the so-called ―gender-appropriate‖ behavior entails. For instance, when babies are born, they are typically assigned a sex, male or female, based on a limited, binary view of sex characteristics and anatomy. [Q2] The system of cisgender privilege is related to the systemic mechanisms of 1. sexism [correct] 2. ageism 3. classism 4. male privilege [Feedback for Correct Answer 1] The system of cisgender privilege is related to the systemic mechanisms of sexism, wherein both women and men who are cisgender hold privilege but women and men who are trans do not and must acknowledge other intersecting systems and identities of privilege.

[Feedback for Answer Choice 2] Ageism is another form of oppression that may intersect with—but is still distinct from—the system of cisgender privilege. [Feedback for Answer Choice 3] Classism is another form of oppression that may intersect with—but is still distinct from—the system of cisgender privilege. [Feedback for Answer Choice 4] Male privilege refers to unearned rights and societal benefits afforded to men solely on the basis of their sex assignment. [Q3] Counselors should understand sexism within the specific sociocultural context in which it operates as noted by: 1. BIPOC 2. MSJCC [correct] 3. PFLAG 4. W PAT H SOC [Feedback for Answer Choice 1] BIPOC is an acronym for Black, Indigenous, and People of Color. This term denotes membership within several ethic groups but does not provide a clinical framework for understanding sexism. [Feedback for Correct Answer 2] Counselors should understand sexism within the specific sociocultural context in which it operates as noted by the American Counseling Association (ACA) Multicultural and Social Justice Counseling Competencies (MSJCC; Ratts et al., 2016). [Feedback for Answer Choice 3] PFLAG (formerly Parents, Families and Friends of Lesbians and Gays) is an organization that provides T NB-inclusive resources for caregivers and families but does not provide a clinical framework for counselors to understand sexism. [Feedback for Answer Choice 4] The seventh iteration of the World Professional Association of Transgender Health Standards of Care (W PAT H SOC, 2012) provides guidance for mental health professionals working with people who are TNB across the life span. However, this resource does not state that counselors should understand sexism within the specific sociocultural context in which it operates. [Q4] There may be a tendency for counselors and clients to on mental health in the United States. 1. minimize, sexism [correct] 2. exaggerate, sexism

the influences of

3. minimize, discrimination 4. exaggerate, discrimination [Feedback for Correct Answer 1] There may be a tendency for counselors and clients to minimize the influences of sexism on mental health in the United States. [Feedback for Answer Choice 2] Typically, counselors and clients tend to minimize, rather than exaggerate, the influences of sexism on mental health in the United States. [Feedback for Answer Choice 3] Counselors are acutely aware of the significance of discrimination in the lives of clients and strive to accurately acknowledge the influence of this issue. [Feedback for Answer Choice 4] Counselors strive to acknowledge the influence of discrimination accurately and appropriately on the mental health issues presented by clients. Learning Outcome 5.2: Articulate counseling considerations for cisgender and trans men and women and nonbinary people. [Q1] How might cisgender males in the United States commonly feel about counseling? 1. Counseling is a healthy preventative measure. 2. Receiving counseling services means that you are weak. [correct] 3. Counseling services are out of my reach. 4. Counseling is an important part of a wellness routine. [Feedback for Answer Choice 1] Although variation exists within every cultural group, cisgender males in the United States often feel as though professional counseling services are only for individuals who are weak or severely ill. As such, American cisgender males might not access counseling as a preventative measure. [Feedback for Correct Answer 2] Although variation exists within every cultural group, cisgender males in the United States often feel as though professional counseling services are only for individuals who cannot take care of themselves. [Feedback for Answer Choice 3] Although socioeconomic status influences help-seeking behaviors, cisgender males in the United States are likely to have access to counseling if they choose to use it because counselors are licensed in all 50 states, and counselors accept a wide variety of payment options.

[Feedback for Answer Choice 4] Cisgender males in the United States often feel as though professional counseling services are only for individuals who cannot take care of themselves. Consequently, counseling is not typically considered an important part of a wellness routine. [Q2] According to the ACA Multicultural and Social Justice Counseling Competencies (MSJCC; Ratts et al., 2016), the first and most important step when working with issues of gender among clients is developing: 1. skills. 2. actions. 3. knowledge. 4. awareness. [correct] [Feedback for Answer Choice 1] According to the MSJCC, the third step is developing the skills to work with gender and sexism in counseling as an outgrowth of self-reflection and knowledge. [Feedback for Answer Choice 2] According to the MSJCC, the fourth and final step is developing an action plan for identifying and reducing sexism both inside and outside of their counseling practice. [Feedback for Answer Choice 3] According to the MSJCC, the second step is developing knowledge that counselors need to effectively work with issues of gender and sexism. [Feedback for Correct Answer 4] According to the MSJCC, the first and most important step when working with issues of gender among clients is developing an awareness of your own assumptions, values, and biases regarding gender. This step also entails learning about your client’s worldview regarding issues of gender so that you can work effectively with clients. [Q3] According to the ACA Multicultural and Social Justice Counseling Competencies (MSJCC; Ratts et al., 2016), the fourth and final step when working with issues of gender among clients is developing: 1. skills. 2. actions. [correct] 3. awareness. 4. knowledge. [Feedback for Answer Choice 1] According to the MSJCC, the third step is developing the skills to work with gender and sexism in counseling as an outgrowth of self-reflection and knowledge.

[Feedback for Correct Answer 2] According to the MSJCC, the fourth and final step is developing an action plan for identifying and reducing sexism both inside and outside of their counseling practice. [Feedback for Answer Choice 3] According to the MSJCC, the first and most important step when working with issues of gender among clients is developing an awareness of your own assumptions, values, and biases regarding gender. [Feedback for Answer Choice 4] According to the MSJCC, the second step is developing knowledge that counselors need to effectively work with issues of gender and sexism. [Q4] There are certain factors to consider that may lead to more effective counseling processes and outcomes. Which of the following is one of the three factors that Kim and Park (2009) recommend considering? 1. gender socialization 2. gender stereotypes 3. client-counselor matching [correct] 4. same-race dyads [Feedback for Answer Choice 1] Research conducted by Bray (2018) and Seidler et al. (2018) indicates that gender socialization can influence the needs and level of engagement of women and men in counseling. [Feedback for Answer Choice 2] According to Fäldt and Kullberg (2012), certain problems or situations presented by a client that are not considered gender stereotypical (i.e., a cisgender or trans woman abusing a cisgender or trans man) could influence gendered perceptions of the client’s problem on the part of the counselor. [Feedback for Correct Answer 3] According to Kim and Park (2009), client-counselor matching is one of the three factors to consider that may lead to more effective counseling processes and outcomes. [Feedback for Answer Choice 4] According to Goode-Cross (2011), same-race dyads allow for the client and counselor to establish rapport more quickly, yet it is debatable whether this factor makes a difference in treatment outcomes. Learning Outcome 5.3: Identify historical events that have shaped gender and sexism. [Q1] Women’s roles began to expand beyond the traditional ones of wife, mother, and homemaker during which of the following times? 1. World War I

2. World War II [correct] 3. Korean War 4. Vietnam War [Feedback for Answer Choice 1] Women’s roles did not expand beyond the traditional ones of wife, mother, and homemaker prior to WWII . [Feedback for Correct Answer 2] In preparation for the large draft of men in the United States who entered the military during World War II ( WWII ), women entered the workforce in unprecedented numbers. During this time, women’s roles expanded beyond the traditional ones of wife, mother, and homemaker, and the new roles were endorsed by the U.S. government. [Feedback for Answer Choice 3] White women returned ―home‖ to resume their domestic duties at the end of WWII , when men came back to the United States. This trend persisted through the Korean War. [Feedback for Answer Choice 4] Once again, women’s roles began to expand beyond the traditional ones of wife, mother, and homemaker during the Vietnam War. However, this shift first began earlier. [Q2] This term, coined by Alice Walker in 1983, offers a theoretical framework to address the intersections of identity for BIPOC women: 1. Womanism [correct] 2. The Feminine Mystique 3. Rosie the Riveter 4. Intersectionality [Feedback for Correct Answer 1] The term Womanism, coined by Alice Walker in 1983, offers a theoretical framework to address the intersections of identity for BIPOC women. Womanism is also considered a social change perspective that is rooted in the everyday experiences of women of African and African American descent. [Feedback for Answer Choice 2] Betty Friedan wrote the book, The Feminine Mystique, to reveal women’s relegation to the domestic sphere at the expense of their mental and physical well-being. [Feedback for Answer Choice 3] ―Rosie the Riveter‖ was a WWII advertisement, which was laden with the gender and cultural messages of the time. In this governmental propaganda advertisement, the image of a White, middle-class woman with the words ―We can do it!‖ was used to recruit over 18 million women into the labor force to help drive the war industry.

[Feedback for Answer Choice 4] Intersectionality, a term coined by Kimberlé Crenshaw (1989), is a way to conceptualize a person or group of people based on their social categories, identities, and sources of oppression. [Q3] Which ―wave‖ of feminism was successful in obtaining the right to vote for women and proposed the Equal Rights Amendment? 1. First Wave 2. Second Wave [correct] 3. Third Wave 4. Fourth Wave [Feedback for Answer Choice 1] The first wave of feminism, which focused primarily on suffrage and suffrage-related issues, was not successful in obtaining the right to vote for women. [Feedback for Correct Answer 2] This second wave was successful in obtaining the right to vote for women (the 19th Amendment) and proposed the Equal Rights Amendment, which advocated ending all laws that discriminated against White women (e.g., laws dealing with property rights and jury service). [Feedback for Answer Choice 3] Baumgardner and Richards (2000) described the third wave of feminism as focusing on issues of ―sexual harassment, domestic abuse, the wage gap . . . and . . . modern problems of . . . equal access to the Internet and technology, HIV/AIDS, child sexual abuse, self-mutilation, globalization, eating disorders, and body image‖ (p. 21). [Feedback for Answer Choice 4] The fourth wave of feminism has reached back into earlier waves in some ways—challenging the roots of patriarchy and sexism—while also expanding gender and sexual possibilities and ways of being. [Q4] Which of the following theories has been critiqued for neglecting the experiences of women whose lives are also affected by racism, heterosexism, and other interlocking oppressions? 1. Multiculturalism 2. Intersectionality 3. Womanism 4. Feminism [correct] [Feedback for Answer Choice 1] Multiculturalism is not limited to assessing and addressing client issues related to gender. As such, multicultural counseling approaches consider the various identities and experiences of each client.

[Feedback for Answer Choice 2] Many new studies have begun to incorporate more intersectional understandings of feminist theory and now may be a theoretical gateway into understanding the complexity of intersecting identities for women of color. [Feedback for Answer Choice 3] Many new studies have begun to incorporate more intersectional understandings of womanist theory and now may be a theoretical gateway into understanding the complexity of intersecting identities for women of color. [Feedback for Correct Answer 4] Some researchers believe that feminism fails to meet the specific needs of BIPOC cis and trans women, and they consider it a Eurocentric theory because it privileges the experiences of White women over the experiences of these others. Addressing inequity from a gender-only framework, they say, neglects the experiences of women whose lives are also affected by racism, heterosexism, and other interlocking oppressions. Learning Outcome 5.4: Define gender and sexism and the relationship to intersecting identities. [Q1] It is important to recognize that much of the research base within counselor education programs has tended to analyze cultural variables such as race and gender: 1. as overlapping identities. 2. in relation to sexual identity. 3. in isolation from one another. [correct] 4. in a comprehensive manner. [Feedback for Answer Choice 1] Much of the research base within counselor education programs has tended to analyze cultural variables such as race and gender in isolation from one another rather than as overlapping identities. [Feedback for Answer Choice 2] The research base within counselor education programs has tended to analyze cultural variables in isolation from one another. Sexual identity is another such variable. [Feedback for Correct Answer 3] Much of the research base within counselor education programs has tended to analyze cultural variables such as race and gender in isolation from one another rather than as overlapping identities. [Feedback for Answer Choice 4] Much of the research base within counselor education programs has compartmentalized race and gender into single identity categories, thus, limiting the profession’s understanding of people with multiple stigmatized identities.

[Q2] Which of the following terms was coined by Kim (2020) to underscore how racism and sexism are combined to form a system of oppression uniquely experienced by women of color? 1. Gendered Racism [correct] 2. Racialized Sexism 3. The Feminine Mystique 4. Myth of the Black Superwoman [Feedback for Correct Answer 1] The term gendered racism was coined by Kim (2020) to underscore how racism and sexism are combined to form a system of oppression uniquely experienced by women of color. [Feedback for Answer Choice 2] Hooks and Mesa-Bains (2006) coined the term racialized sexism to underscore how racism and sexism are combined to form a system of oppression uniquely experienced by women of color. [Feedback for Answer Choice 3] Betty Friedan wrote the book, The Feminine Mystique, to reveal women’s relegation to the domestic sphere at the expense of their mental and physical well-being. [Feedback for Answer Choice 4] In 1978, Michelle Wallace wrote Black Macho and the Myth of the Superwoman to detail how the assumption of the strong, Black woman can be detrimental to Black women’s health and mental well-being. [Q3] According to a 2015 study conducted by the U.S. Census Bureau, below the poverty line.

of Black families live

1. 8.6% 2. 18.2% 3. 26% [correct] 4. 27% [Feedback for Answer Choice 1] According to a 2015 study conducted by the U.S. Census Bureau, 8.6% of White families live below the poverty line. [Feedback for Answer Choice 2] According to the U.S. Census Bureau (2015), 18.2% of households in 1960 were managed by single mothers. [Feedback for Correct Answer 3] According to a 2015 study conducted by the U.S. Census Bureau, 26% of Black families live below the poverty line.

[Feedback for Answer Choice 4] According to a 2015 study conducted by the U.S. Census Bureau, 27% of households in 2012 were managed by single mothers, compared with 18.2% in 1960. [Q4] One of the landmark works on women’s trauma experiences and treatment is Judith Herman’s (1997) Trauma and Recovery. Which stage of Herman’s model consists of counselors helping trauma survivors reconnect with their sense of self and with important relationships in their lives? 1. First Stage 2. Second Stage 3. Fourth Stage 4. Final Stage [correct] [Feedback for Answer Choice 1] The first stage of Herman’s Trauma and Recovery model entails ensuring that survivors are safe from their abusers and free of stressors (e.g., alcohol misuse, financial stress) that may make it challenging to heal from sexual violence. [Feedback for Answer Choice 2] The second stage of Herman’s Trauma and Recovery model makes their trauma meaningful by reviewing the details of their experience and acknowledging associated feelings. [Feedback for Answer Choice 3] Herman’s Trauma and Recovery model outlines three stages that are vital for recovery from sexual abuse. [Feedback for Correct Answer 4] The third and final stage of Herman’s Trauma and Recovery model consists of counselors helping trauma survivors reconnect with their sense of self and with important relationships in their lives. Learning Outcome 5.5: Describe counseling interventions with cisgender and trans men and women and nonbinary people. [Q1] Wester et al. (2010) recommend which of the following theories as a useful clinical framework for understanding the gendered experiences of clients and for identifying how counselors can support clients who may still be in conflict about their gender identity? 1. GRC [correct] 2. MSJCCs 3. ALGBT IC 4. ACA Code of Ethics

[Feedback for Correct Answer 1] Wester et al. (2010) suggested that GRC theory could provide counselors a framework for understanding the gendered experiences of clients, particularly those who identify as transgender, and for identifying how counselors can support clients who may still be in conflict about their gender identity. [Feedback for Answer Choice 2] According to Wester et al. (2010), GRC focuses on the messages constructed by society that determine one’s gender expression and that can be used by counselors to understand the complex experiences of clients. Once these components are assessed, counselors can then implement the ACA MSJ CC (Ratts et al., 2016). [Feedback for Answer Choice 3] The Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling (ALGBT IC) Transgender Committee developed the American Counseling Association Competencies for Counseling with Transgender Clients (2010). However, this resource does not constitute a theoretical framework. [Feedback for Answer Choice 4] The ACA Code of Ethics states that counselors have an ethical responsibility to continually educate themselves and to become culturally competent practitioners. However, it does not provide counselors with a clinical framework for understanding the gendered experiences of clients and for identifying how counselors can support clients who may still be in conflict about their gender identity. [Q2] The authors of this chapter recommend several strategies adapted from the ACA’s Multicultural and Social Justice Competencies. Which of the following reflects one of the authors’ recommendations? 1. Delineate salient client identities. 2. Teach self-empowerment skills to clients. [correct] 3. Identify internal barriers that affect client development. 4. Disregard counselor privilege and oppression experiences. [Feedback for Answer Choice 1] The authors of this chapter recommend exploring salient intersectional identities with gender for cisgender and T NB clients. Since these identities intersect with one another, it is not helpful to separate them and/or view them in isolation. [Feedback for Correct Answer 2] The authors of this chapter recommend teaching self-empowerment skills to clients who are cisgender and T NB. [Feedback for Answer Choice 3] The authors of this chapter recommend helping clients who are cisgender and T NB identify external— rather than internal— barriers that affect their development.

[Feedback for Answer Choice 4] The authors of this chapter recommend that counselors reflect on their own experiences with privilege and oppression related to gender and sexism. These reflections are valuable to the counseling process and should not be disregarded. [Q3] Singh and colleague (2011) conducted a study on South Asian survivors of child sexual abuse. Which of the following is one of the resilience strategies respondents shared? 1. social support 2. positive family responses 3. connection with community [correct] 4. working with a counselor of South Asian descent [Feedback for Answer Choice 1] Boss (2010) proposed that social support is an important aspect of developing resilience. According to the findings of Singh and colleague (2011), respondents shared the consistent message that social activism was among their resilience strategies. [Feedback for Answer Choice 2] Boss (2010) proposed that positive family responses are an important aspect of developing resilience. [Feedback for Correct Answer 3] According to the findings of Singh and colleague (2011), respondents shared the consistent message that connection with community was among their resilience strategies. [Feedback for Answer Choice 4] Working with a counselor of South Asian descent was not one of the resilience strategies respondents shared with Singh and colleague (2011). [Q4] Boysen (2010) contends that multiculturally competent counselors recognize that exists and are aware of how that reality can harm the counseling relationship, including impairing their ability to support clients from diverse backgrounds. 1. bias [correct] 2. ineptitude 3. ignorance 4. incompetence [Feedback for Correct Answer 1] Boysen (2010) contends that multiculturally competent counselors recognize that bias exists and are aware of how that bias can harm the counseling relationship, including impairing their ability to support clients from diverse backgrounds.

[Feedback for Answer Choice 2] Boysen (2010) does not emphasizes the importance of recognizing the existence of ineptitude. Rather, Boysen contends that even the most competent counselor should remain cautious of implicit bias. [Feedback for Answer Choice 3] Boysen (2010) emphasizes the importance of recognizing the existence of bias. [Feedback for Answer Choice 4] Boysen (2010) does not emphasize the importance of recognizing the existence of incompetence. Rather, Boysen contends that even the most competent counselor should remain cautious of implicit bias in order to ensure that automatic responses from learned societal messages do not perpetuate the social status quo. Learning Outcome 5.6: Identify areas of future research to engage in culturally response counseling practice with cisgender and trans men and women and nonbinary individuals. [Q1] Although issues of gender have been studied for a long time in the helping professions, much of this research has focused on cisgender and White clients. Research on cisgender women has perpetuated which of the following perspectives of cisgender men and women? 1. Complex 2. Nontraditional 3. Heteronormative [correct] 4. Multidimensional [Feedback for Answer Choice 1] Research on cisgender women has perpetuated limited perspectives of cisgender men and women, which are linked to the concept of a gender binary (i.e., there are two genders in which men should be masculine and women should be feminine). [Feedback for Answer Choice 2] Research on cisgender women has perpetuated traditional and Eurocentric perspectives of cisgender men and women. [Feedback for Correct Answer 3] Research on cisgender women has perpetuated heteronormative perspectives of cisgender men and women. [Feedback for Answer Choice 4] Scholarship on cisgender women has contributed to disadvantaging TNB individuals by failing to include them in research and/or producing biased research based on a gender binary. Thus, to advance clinical practice, there is much to be learned about the intersections of a broad, multidimensional conceptualization of gender and sexism with other oppressions and identities.

[Q2] According to Hyde and colleagues (2019), clinical practice is shaped by perceptions of a gender and lead to in diagnosis and treatment, as well as shaping treatment of those who seek treatment specific to gender issues. 1. binary, biased [correct] 2. spectrum, accurate 3. expression, biased 4. expression, accurate [Feedback for Correct Answer 1] Hyde and colleagues (2019) note that beginning in the 1930s the concept of psychological masculinity-femininity developed and was linked to the concept of a gender binary (i.e., there are two genders in which men should be masculine and women should be feminine). Clinical practice is shaped by perceptions of a gender binary, and reproduced stereotypes that lead to bias in diagnosis and treatment, as well as shaping treatment of those who seek treatment specific to gender issues. [Feedback for Answer Choice 2] According to Hyde and colleagues (2019), clinical practice is shaped by perceptions of a gender binary and lead to bias in diagnosis and treatment, as well as shaping treatment of those who seek treatment specific to gender issues. [Feedback for Answer Choice 3] According to Hyde and colleagues (2019), clinical practice is shaped by perceptions of a gender binary and not gender expression. These perceptions are responsible for reproducing stereotypes that lead to bias in diagnosis and treatment. [Feedback for Answer Choice 4] According to Hyde and colleagues (2019), clinical practice is shaped by perceptions of a gender binary and not gender expression. These perceptions produce bias which, in turn, inhibit accurate diagnosis and treatment. [Q3] Within the context of a research study, asking questions such as ―What is your gender?‖ ―How do you currently identify?‖ and ―What category were you assigned to at birth?‖ are examples of what type of questions? 1. Research 2. Required 3. Forced choice 4. Open-ended [correct] [Feedback for Answer Choice 1] A research question is an overarching question that guides a scholarly investigation (e.g., How does workplace harassment impact T NB expression?). The above-mentioned questions would be used to collect demographic data of research participants.

[Feedback for Answer Choice 2] Participating in a research study—along with self-reporting demographic data—is strictly voluntary and cannot be required. [Feedback for Answer Choice 3] Multiple choice questions are examples of forced choice, since only one of the answers available are correct. [Feedback for Correct Answer 4] ―What is your gender?‖ ―How do you currently identify?‖ and ―What category were you assigned to at birth?‖ are examples of open-ended questions? [Q4] Movement away from the focus on gender as a(n) support practice based in activism and gender equity.

construct will allow research to

1. valid 2. dichotomous [correct] 3. internal 4. identity [Feedback for Answer Choice 1] If researcher viewed gender as an invalid construct, it would not be suitable for studying. [Feedback for Correct Answer 2] Movement away from the focus on gender as a dichotomous construct will allow research to support practice based in activism and gender equity. [Feedback for Answer Choice 3] Gender is multidimensional and its expression is influenced by the interaction between internal (e.g., biological, cognitive) and external (e.g., social interactions, culture) forces. Research must acknowledge each of these forces if it aims to support practice based in activism to support gender equity. [Feedback for Answer Choice 4] Gender, by its nature, is an identity construct. As such, it is a necessary component for any research which aims to support practice based in activism to support gender equity.

Chapter 5 Application Exercises Application Exercise 5.1: Understanding Gender Socialization and Sexism Learning Outcome 5.1: Define gender and sexism and the relationship to intersecting oppressions. [Q1] Explain the impact that gender socialization has on the expectations and emotional expressions of people who are cisgender and people who are transgender or non-binary (T NB). [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Gender socialization complicates and disempowers the experiences of people who are TNB as well as people who are cisgender.



The gender binary limits experiences through conveying how they should be, look, and act because of their sex and gender identity assignment which then socializes a person’s gender expression.



The interactions that people have with one another in society shape their own gender expectations.



How people make meaning of their own gender significantly affects their views of themselves which, in turn, have numerous mental health implications.



People are often socialized so as not to express certain emotions, and such socialization is based on whether they are assigned ―male‖ (e.g., do not express sadness) or assigned ―female‖ (e.g., do not express anger).

[Q2] Discuss why counselors should seek to understand sexism within a sociocultural context. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Sexism is complicated because it intersects with many other interlocking oppressions, such as cisgenderism, racism, heterosexism, ableism, adultism, ageism, classism, xenophobia, and other systems of oppression.



Consequently, counselors should understand sexism within the specific sociocultural context in which it operates.



Examples of sexism include women being sexualized in popular media solely for entertainment, as well as women earning, on average, less money than their men counterparts with the same experience and position.



Furthermore, women often are expected to take on double (sometimes triple) duties by managing a home, family, and career.



It is also important to note that gender socialization norms vary widely in terms of cultural background, age, and other identities.

[Q3] Briefly explain the importance and clinical benefit of exploring client experiences with sexism. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Counselors should carefully consider how sexism is experienced, minimized, or discussed.



Counselors and clients may minimize the influences of sexism on mental health in the United States.



U.S. women experience a range of sexist influences on their mental health, from (e.g., internalized sexism, dislike of their bodies, low self-esteem, experiencing high rates of sexual violence).



The sexism that women who are cisgender and women who are T NB experience around the world may share significant similarities (e.g., devaluation, being forced into sex work for survival), but also may have some distinct differences (e.g., degree of access for social and/or medical transition for U.S. women who are T NB).

Application Exercise 5.2: Multicultural Counseling Approaches Learning Outcome 5.2: Articulate counseling considerations for cisgender and trans men and women and non-binary people. [URL TITLE] Client and Counselor Session [Q1] Use Pearson eText Video Example 5.2 to answer the following question. Pay particular attention to the exchange between the client and the counselor. What power dynamics are at may be play in this multicultural counseling relationship? [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

The counselor has inherent power due to his position as the professional with the client coming to him for help and support.



The client appears to be a member of the White majority, which would increase her power. However, she is female, which could decrease her power in the relationship and in her daily interactions.



The counselor appears to be Black, which would indicate that he often encounters institutionalized racism and oppression in the United States. However, he is a male, which is not a historically oppressed population.



The client appears to be younger than the counselor. Often, individuals of an older age (who are not yet elderly) are given more respect in the workplace.

[Q2] Use Pearson eText Video Example 5.2 to answer the following question. Pay particular attention to the exchange between the client and the counselor. In what ways can this counselor consider issues of diversity, social context, and power when working with this young, female client? [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

The counselor can work to increase his awareness regarding the effects of social norms regarding sex and gender, commonly held stereotypes about women, and the effects of unique life experiences.



The counselor can work to obtain and apply information about oppression and privilege as they apply to individuals who identify as female.



The counselor can work to understand how experiences of discrimination might affect the physical and mental health of the client.

[Q3] Use Pearson eText Video Example 5.2 to answer the following question. Pay particular attention to the exchange between the client and the counselor. What are some ways in which the counselor can use gender-sensitive interventions with this client? [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

The counselor can use interventions and resources that have been found to be effective with women.



The counselor can work to promote a strong therapeutic relationship in which the client feels as though she is respected and empowered.



The counselor can conduct unbiased assessment and diagnosis with the client.



The counselor can keep sociopolitical issues in the forefront of case conceptualization with the client.



The counselor can advocate for institutional and systemic change that reduces sexism in the world.

Application Exercise 5.2: The Consequences of Sexism Learning Outcome 5.4: Identify the mental, physical, and social consequences of sexism. [Q1] Discuss several mental health consequences associated with sexism. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Rates of depression are twice as high for women who are cisgender as for men who are cisgender.



Incidence of depression for girls begins to spike during adolescence and the gender differences in depression first become apparent.



For T NB women and girls, depression may increase when there is a lack of access to T NB-affirming family, health care, school, employment, and community environments.



One of the greatest mental health consequences of sexism is disordered eating and a negative body image.



Internalized oppression can prevent women from fully expressing themselves and living their full potential because they may believe that they need to conform to prescribed gender norms and expressions.



Trans girls and women may feel that they have to ―prove‖ their femininity because of the anti-T NB bias that exists in schools and workplaces.

[Q2] Briefly describe the common physical consequences associated with the undervaluation of cisgender and trans women and girls and non-binary children and adults. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Cisgender and trans women and non-binary people are at increased risk for experiencing interpersonal violence.



They face higher rates of sexual trauma, increased exposure to occupational and environmental hazards, and disordered eating related to a negative body image and poor self-esteem.



Child sexual abuse and sexual assault are serious concerns for cisgender and trans women and non-binary people.



Women who were repeatedly exposed to violent events have an increased probability of developing depression, suicidal ideation, and post-traumatic stress disorder (PT SD).

[Q3] Explain how workplace sexism contributes to feelings of imposter syndrome among professional women. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Sexism manifests itself in women in the workplace through internalized doubt in their own abilities.



High-achieving women may not trust in their intelligence and work talents, fearing that others will eventually ―find out‖ that they are not as capable as they actually are.



Gender discrimination and the lack of career upward mobility opportunities can contribute to internalized doubt.



Gender stereotyping or internalized stereotypes may also increase feelings of imposter syndrome.

Chapter 5 Test Items Multiple Choice 1.

The term transgender and gender nonconforming (TGNC) may include people who identify and describe themselves as a. people who are transsexual. b. people are who genderqueer. c. people who cross-dress. d. All of the above.

Women are more likely than men to be diagnosed with a. schizotypal personality disorder. b. depression. c. sexual addiction. d. autism.

Enforcement of male-dominated norms is an example of a. heterosexism. b. homophobia. c. sexism. d. transphobia.

Traditional women’s roles were challenged during which major event? a. World War I b. World War II c. The Stonewall Rebellion d. The Civil War

occurs when women or men begin to believe systemically received negative messages about their own sex. a. Sexism b. Male privilege c. Internalized sexism d. Female privilege

Sexism manifests as women internalize doubt in their own abilities through a. the imposter phenomenon. b. social consequences. c. attribution bias. d. social stressors.

Male counselors tend to speak a. more assertively with women but more tentatively with other men. b. more assertively overall (with men and women). c. less assertively with women. d. less assertively with other men.

Female counselors tend to speak a. more assertively with other women but more tentatively with men. b. more assertively overall (with men and women). c. less assertively with women. d. more assertively with men.

In terms of race and gender, same-race and same-gender dyads a. allow for the client and counselor to more quickly establish rapport. b. guarantee better treatment outcomes. c. Both of the above. d. None of the above.

10. According to government statistics, women are a. less likely than men to be depressed. b. twice as likely as men to be depressed. c. five times more likely than men to be depressed. d. as likely as men to be depressed. 11. According to government statistics, girls are a. less likely than boys to be depressed. b. as likely as boys to be depressed. c. seven times more likely than boys to be depressed. d. twice as likely as boys to be depressed. 12. By age , most children can identify ―what boys do‖ versus ―what girls do‖ as a demonstration of their understanding of personality characteristics and mannerisms socially assigned to each gender. a. 2 b. 3 c. 4 d. 6

13. Male gender role conflict (GRC) a. relates to how men treat women. b. constitutes the majority of referrals for counseling. c. describes how gender role socialization can result in negative consequences for men who remain rigid in changing circumstances. d. None of the above. 14. Patterns of male gender role conflict include a. success, power, and competition. b. conflicts between work and family relationships. c. restricted emotionality. d. All of the above. 15. The term machismo refers to a cultural norm regarding gender in

culture.

a. Arab b. Latino c. African d. None of the above. 16. How is gender determined? a. Biologically b. Socially c. Both of the above. d. None of the above. 17. It is considered more respectful to use identify as genderqueer. a. she/her b. he/him c. they/them d. All of the above are respectful pronouns. 18. Internalized sexism is a. being a sexist only on the inside. b. punishment for men who are sexist. c. a manifestation of male privilege. d. people who are born sexist.

pronouns when referring to people who

19. Incorporating a gender-sensitive perspective is important for the counselor working with a. men only. b. women only. c. children only. d. all populations. 20. Problems that we think of as typically male (e.g., difficulty with intimacy, workaholism, alcoholism, abusive behavior, rage) are often attempts to escape a. depression. b. anger. c. sex. d. anxiety. 21. When counseling men, gender-sensitive counselors should engage in specific behaviors that a. create empathy. b. express feelings. c. set specific goals early. d. are sympathetic. 22. Transgenerational focus refers to a. the concept that greater understanding of individual men can be gained by revisiting their relationships with their fathers, grandfathers, and other men in their family. b. the tendency for men to act like their fathers and grandfathers and other men in their family. c. the inability of men to focus on other perspectives outside of their fathers, grandfathers, and other men in their family. d. the concept that men are the focus of their fathers, grandfathers, and the other men within their own family. 23.

describes people who feel that the sex they were assigned at birth is in alignment with their identified gender. a. Transgender b. Gender conforming c. Gender nonconforming d. Cisgender

24. TGNC stands for and describes people whose gender identities and expressions do not fit into societal norms of sex assignment and the gender binary. a. transgender and gender nonconforming b. gender neutral conforming c. transgender and cisgender

d. All of the above. 25.

is a system of oppression based on sex, gender identity, and gender expression. a. Sexism b. Male privilege c. Genderism d. Classism

26. In addition to developing the awareness, knowledge, skills, and actions to address gender and sexism in the counseling process, which of the following factors may lead to more effective outcomes? a. Client-counselor matching b. Exploration of racial and cultural differences c. Communication styles d. All of the above. 27. According to government statistics, women are anxiety disorder.

as men to experience an

a. three times as likely b. twice as likely c. five times as likely d. as likely 28. A common stressor in women’s lives is a. negative media messages. b. economic inequity. c. multiple role overload. d. All of the above. 29. According to Earkas and Leaper (2015), girls become women through a. oppositional behaviors. b. learning to be independent. c. relational activities. d. All of the above. 30. According to Earkas and Leaper (2015), boys become men through a. learning to be tough and independent. b. relational activities. c. emotional expression. d. All of the above.

31. To emotionally relate to others, many men will use a. shame-based responses. b. denial. c. minimization or silence. d. All of the above. 32.

is a term used to describe a theory of understanding how traditional gender role socialization can result in negative consequences for men who remain rigid in changing circumstances. a. Male privilege b. Sexism c. Male gender role conflict d. Classism

33. The male gender role conflict pattern of describes the degree to which men are socialized to focus on high achievement personally and professionally. a. success, power, and competition b. conflict between work and family relationships c. restricted emotionality d. restricted affectionate behavior between men 34. People who are are those who have variations of reproductive or sexual anatomy that do not fit into the socially constructed definitions of male (XX) and female (X Y). a. cisgender b. genderqueer c. intersex d. All of the above. 35. People who are TGNC experience a. employment discrimination. b. lack of health-care access. c. high rates of homelessness and poverty. d. All of the above. 36. The first wave of feminism as a social justice movement in the United States focused on a. equality of the sexes. b. suffrage and suffrage-related issues. c. sexual harassment, domestic abuse, and the wage gap. d. issues important to women of color and queer people. 37. The second wave of feminism in the United States

a. expanded the focus on equal rights to reproductive rights for women. b. focused on suffrage and suffrage-related issues. c. focused on sexual harassment, domestic abuse, and the wage gap. d. focused on issues important to women of color and queer people. 38.

families may endorse more matriarchal norms, with women’s roles described as those of strength and resourcefulness. a. Asian American b. Hispanic/Latino American c. African American d. European American

39.

is a term that describes the gender role expression of Latinas and refers to extreme femininity and subordination to males. a. Machismo b. Marianismo c. Familismo d. All of the above.

40. Judith Herman’s (1992) Trauma and Recovery outlines three stages vital for women’s recovery from sexual abuse. The first stage involves a. making meaning of the trauma. b. ensuring that survivors are safe from their abusers. c. helping survivors reconnect with their sense of self. d. All of the above. 41. The imposter phenomenon was found to occur more frequently in multiple roles and the expectation to fulfill each role perfectly.

, due to

a. women than men b. men than women c. collectivist cultures than individualistic cultures d. individualistic cultures than collectivist cultures 42. A recommended strategy for counselors to address sexism in counseling is a. to identify strengths and resources of women clients who are cisgender and T GNC. b. to help clients who are cisgender and T GNC identify external barriers that affect their development. c. to teach self-empowerment skills to clients who are cisgender and T GNC. d. All of the above are recommended strategies. 43. An example of male privilege is a. men having multiple sex partners without being labeled as promiscuous.

b. men being afraid to walk alone at night in a public place. c. Both of the above. d. None of the above.

Extended Response 1.

Provide examples of how the counseling profession has responded to sexism?

What are some of your own assumptions, values, and biases regarding gender and where did they come from?

As a result of reading the chapter on gender and sexism, how has your awareness of various client worldviews regarding gender and sexism changed or been enhanced? What are some areas you still may need to work on?

Write down a list of all the various ―types‖ of clients you may work with, in terms of gender and its intersections with race/ethnicity, spirituality, and social class. What are some culturally appropriate intervention strategies you might use when working with each type of client?

Consider Erikson’s (1968) fifth stage, identity versus confusion. What was your experience like during this stage, specifically related to your gender?

How do you currently express your social sex role identity and does this differ from your childhood? What specific positive and negative memories do you have of messages you got from others about this (e.g., tomboy, princess)?

Check out the APA Guidelines for Psychological Practice with Girls and Women. What are five ways you might practice advocacy with clients based on these guidelines?

How does gender role conflict limit men’s ability to cope with transition and life’s stressors?

What factors influence treatment outcomes in counseling with reference to race and gender?

10. What are some examples of internalized sexism in the world today? What might that look like in a client? 11. Gender is biologically and socially determined. How do we construct gender in our society today? How would you address gender construction in a counseling session? 12. How has the historical representation of gender influenced the construction of gender and gender norms in society today? 13. Discuss covert or ―modern‖ forms of sexism found in schools, families, workplaces, and careers. 14. Identify and describe the four patterns of male gender role conflict. 15. Discuss at least three of the mental health consequences of sexism addressed in the chapter.

Chapter 5 Test Answer Key ANSWER KEY: Chapter 5 Test (Multiple Choice) 1. d 2. b 3. c 4. b 5. c 6. a 7. b 8. a 9. a 10. b 11. b 12. d 13. c 14. d 15. b 16. c 17. c 18. c 19. d 20. a 21. c 22. a 23. d 24. a 25. a 26. d 27. b 28. d 29. c 30. a 31. d 32. c

33. a 34. c 35. d 36. b 37. a 38. c 39. b 40. b 41. a 42. d 43. a

Chapter 6 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach 4th Edition Danica G. Hays

University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents Chapter 6: Sexual and Affectional Orientation and Heterosexism

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 6: Sexual and Affectional Orientation and Heterosexism Chapter 6 Learning Outcome Quizzes Learning Outcome 6.1: Define and distinguish relevant terms and constructs associated with sexual and affectional orientations. [Q1] This term refers to the gender roles people adopt or adhere to based on cultural norms for feminine, masculine, or androgynous behaviors: 1. gender identity 2. social sex role identity [correct] 3. primary sex characteristics 4. sexual orientation identity [Feedback for Answer Choice 1] Gender identity is the belief a person has about his, her, or their gender (i.e., the psychological sense of being male, female, both, or neither). [Feedback for Correct Answer 2] Social sex role identity refers to the gender roles people adopt or adhere to based on cultural norms for feminine, masculine, or androgynous behaviors. [Feedback for Answer Choice 3] Physical identity, historically framed in the male-female binary, is assigned at birth based on primary sex characteristics. [Feedback for Answer Choice 4] According to the American Institute of Bisexuality (2014), sexual orientation identity comprises a set of seven variables: (a) sexual behaviors; (b) emotions; (c) sexual fantasies; (d) sexual attractions; (e) social preference; (f) living life as a heterosexual, bisexual, or gay or lesbian; and (g) self-identification. [Q2] This term refers to an individual whose sexual and/or affectional attractions are not limited to what is based on gender identity or biological sex: 1. pansexual [correct] 2. heteroflexible 3. questioning 4. affectional orientation

[Feedback for Correct Answer 1] The term pansexual refers to an individual whose sexual and/or affectional attractions are not limited to what is based on gender identity or biological sex. [Feedback for Answer Choice 2] The term heteroflexible refers to someone who identifies as primarily heterosexual but may engage in limited situational same-sex sexual behavior yet does not identify as bisexual. [Feedback for Answer Choice 3] The term questioning refers to an individual who is questioning their sexual orientation and/or gender identity. [Feedback for Answer Choice 4] Affectional orientation is used to describe sexual marginalized identities (i.e., LGBTQ+ individuals) because it broadens the discussion beyond simply sexual attraction. [Q3] In thinking about the systemic oppression of people who are LGBT Q+, it is important that counselors keep in mind that researchers and social justice advocates, such as Berg and colleagues (2016), have recommended using terms such as to acknowledge the devaluation of individuals who are LGBT Q+. 1. homophobia 2. homonegativity [correct] 3. heteropatriarchy 4. heterosexism [Feedback for Answer Choice 1] A related term that many people often confuse with heterosexism is homophobia, which is defined as fear and hatred of people who are LGBT Q+. [Feedback for Correct Answer 2] In thinking about the systemic oppression of people who are LGBT Q+, it is important that counselors keep in mind that researchers and social justice advocates, such as Berg and colleagues (2016), have recommended using terms such as homonegativity to acknowledge the devaluation of individuals who are LGBT Q+. [Feedback for Answer Choice 3] Rooted in feminist theory, the concept of heteropatriarchy refers to a sociopolitical system that elevates cisgender heterosexual men to a position of power and authority over women and individuals of other sexual orientations and identities. [Feedback for Answer Choice 4] Heterosexism is defined as the oppression of LGBT Q+ individuals that involves prejudice and discriminatory behavior.

[Q4] A 2017 Gallup poll reported that

of Americans identified as LGBT.

1. 1.3% 2. 2% 3. 4.4% [correct] 4. 5% [Feedback for Answer Choice 1] A 2011–2013 survey conducted by the National Center for Health Statistics that included 9,175 Americans, aged 18 to 44, found that 1.3% of women between the ages of 18 and 44 years identified as lesbian. [Feedback for Answer Choice 2] A 2011–2013 survey conducted by the National Center for Health Statistics that included 9,175 Americans, aged 18 to 44, found that approximately 2% of males between the ages of 18 and 44 years identified as gay and 2% as bisexual. [Feedback for Correct Answer 3] A 2017 Gallup poll reported that 4.4% of Americans identified as LGBT. [Feedback for Answer Choice 4] A 2011–2013 survey conducted by the National Center for Health Statistics that included 9,175 Americans, aged 18 to 44, found that 5.5% of women between the ages of 18 and 44 years identified as bisexual. Learning Outcome 6.2: Articulate how sexual and affectional orientations intersect with race, ethnicity, gender, age, education, social class, spirituality, and relationship status. [Q1] Which division of the American Counseling Association advocates specifically for individuals with gender and sexuality concerns? 1. The Association for Multicultural Counseling and Development 2. The Society of Sexual, Affectional, Intersex, and Gender Expansive Identities [correct] 3. The Transgender, Gay, and Allied Association 4. The Association for All Individuals [Feedback for Answer Choice 1] The Association for Multicultural Counseling and Development includes all types of diversity, not just sexual diversity. [Feedback for Correct Answer 2] The Society of Sexual, Affectional, Intersex, and Gender Expansive Identities is a branch of the American Counseling Association specifically for individuals with gender and sexuality concerns.

[Feedback for Answer Choice 3] The Transgender, Gay, and Allied Association is not a division of the American Counseling Association. [Feedback for Answer Choice 4] The Association for All Individuals is not a division of the American Counseling Association. [Q2] According to the identity model developed by Morales (1989), individuals move from denying identity conflicts to a state of: 1. labeling oneself as bisexual rather than lesbian/gay. [correct] 2. integrating multiple identities. 3. being conflicted in allegiance between lesbian/gay and ethnic communities. 4. establishing priorities in allegiance. [Feedback for Correct Answer 1] According to the identity model developed by Morales (1989), individuals move from denying identity conflicts to a state of labeling oneself as bisexual rather than lesbian/gay. [Feedback for Answer Choice 2] According to the identity model developed by Morales (1989), individuals move from denying identity conflicts and through three more states before achieving the state of integrating multiple identities. [Feedback for Answer Choice 3] According to the identity model developed by Morales (1989), individuals move from denying identity conflicts and through one more state before achieving the state of being conflicted in allegiance between lesbian/gay and ethnic communities. [Feedback for Answer Choice 4] According to the identity model developed by Morales (1989), individuals move from denying identity conflicts and through two more states before achieving the state of establishing priorities in allegiance. [Q3] Counselors can create a place in which multiculturally diverse clients, especially members of the LGBTQ+ community, can find refuge. This place is commonly known as which of the following? 1. Play Zone 2. Safe Zone [correct] 3. Safe Space 4. Play Space [Feedback for Answer Choice 1] Play Zone is not a counseling-specific term.

[Feedback for Correct Answer 2] Safe Zone is a nationally known training program in which individuals learn how to support members of the LGBTQ+ community. After the training, participants are able to create Safe Zones for LGBT Q+ individuals in their offices or other workspaces. [Feedback for Answer Choice 3] A Safe Space is important in counseling, but it is not specific to the LGBT Q+ community. [Feedback for Answer Choice 4] A Play Space can occur in counseling (especially with play therapy), but it is not specific to counseling with the LGBT Q+ community. [Q4] Adams-Santos (2020) and Johnson & Henderson (2020) have asserted that is a ―weapon‖ of sexism since it functions to systemically and narrowly define gender roles and enforce compulsory heterosexuality. 1. homophobia 2. homonegativity 3. heteropatriarchy 4. heterosexism [correct] [Feedback for Answer Choice 1] A related term that many people often confuse with heterosexism is homophobia, which is defined as fear and hatred of people who are LGBT Q+. [Feedback for Answer Choice 2] Berg and colleagues (2016) have recommended using terms such as homonegativity to acknowledge the devaluation of individuals who are LGBT Q+. [Feedback for Answer Choice 3] Rooted in feminist theory, the concept of heteropatriarchy refers to a sociopolitical system that elevates cisgender heterosexual men to a position of power and authority over women and individuals of other sexual orientations and identities. [Feedback for Correct Answer 4] Adams-Santos (2020) and Johnson & Henderson (2020) have asserted that heterosexism is a ―weapon‖ of sexism since it functions to systemically and narrowly define gender roles and enforce compulsory heterosexuality. Learning Outcome 6.3: Critically evaluate the mental, physical, and social impact of heterosexism on LGBT Q+ individuals and communities. [Q1] According to Haas and colleagues (2011), LGBT Q+ individuals are up to seven times more likely than heterosexuals to: 1. feel worthless.

2. abuse substances. 3. experience depression. 4. attempt suicide. [correct] [Feedback for Answer Choice 1] Many LGBT Q+ individuals attempt to escape and self-medicate their feelings of worthlessness; however, Haas and colleagues (2011) did not report data on the prevalence of this issue. [Feedback for Answer Choice 2] Many LGBT Q+ individuals attempt to escape and self-medicate their feelings of worthlessness, depression, and anxiety by abusing substances; however, Haas and colleagues (2011) did not report data on the prevalence of this issue. [Feedback for Answer Choice 3] Many LGBT Q+ individuals attempt to escape and self-medicate their feelings of depression; however, Haas and colleagues (2011) did not report data on the prevalence of this issue. [Feedback for Correct Answer 4] According to Haas and colleagues (2011), LGBT Q+ individuals are up to seven times more likely than heterosexuals to attempt suicide. [Q2] Data from the 2017 National Youth Risk Behavior Survey revealed sexual minority youth used illicit substances at a rate of: 1. 12.3% 2. 17% 3. 23.1% [correct] 4. 25.4% [Feedback for Answer Choice 1] Data from the 2017 National Youth Risk Behavior Survey revealed use of illicit substances by heterosexual individuals at a rate of12.3%). [Feedback for Answer Choice 2] A study conducted by Rivers (2004) indicated that 17% of students who were LGBT Q+ and who reported being bullied at school because of their actual or perceived sexual orientation experienced post-traumatic stress in adulthood. [Feedback for Correct Answer 3] Data from the 2017 National Youth Risk Behavior Survey revealed sexual minority youth used illicit substances at nearly twice the rate of heterosexual peers (23.1% vs. 12.3%). [Feedback for Answer Choice 4] Data from the 2017 National Youth Risk Behavior Survey revealed that fewer than 25.4% of sexual minority youth used illicit substances.

[Q3] Nicotine, via cigarette smoking, is extremely prevalent in the LGBT Q+ community. According to Ward and colleagues (2014), approximately of gay men smoke. 1. 15.0% 2. 20.3% 3. 25.7% 4. 25.8% [correct] [Feedback for Answer Choice 1] According to Ward and colleagues (2014), the smoking rate for heterosexual women is approximately 15.0%. [Feedback for Answer Choice 2] According to Ward and colleagues (2014), the smoking rate for men in general is approximately 20.3%. [Feedback for Answer Choice 3] According to Ward and colleagues (2014), the smoking rate for lesbians is approximately 25.7%. [Feedback for Correct Answer 4] According to Ward and colleagues (2014), approximately 25.8% of gay men smoke. [Q4] Youths who are LGBTQ+ experience up to peers.

higher rates of cancer than their heterosexual

1. 27% 2. 30% 3. 87% [correct] 4. 90% [Feedback for Answer Choice 1] On the low end, youths who are LGBT Q+ experience at least 30% higher rates of cancer than their heterosexual peers. [Feedback for Answer Choice 2] On the low end, youths who are LGBT Q+ experience at least 30% higher rates of cancer than their heterosexual peers. [Feedback for Correct Answer 3] Youths who are LGBTQ+ experience 30% to 87% higher rates of cancer than their heterosexual peers.

[Feedback for Answer Choice 4] On the high end, youths who are LGBT Q+ experience up to 87% higher rates of cancer than their heterosexual peers. Learning Outcome 6.4: Articulate advances in LGBT Q+ research that can be applied to counseling practice. [Q1] Research related to sexual and affectional orientations has come a long way since early researchers such as began to study LGBT Q+ identities in the 1930s, 1940s, and 1950s. 1. Chaney 2. Kinsey [correct] 3. Scholl 4. Speciale [Feedback for Answer Choice 1] Chaney (2019) cautioned researchers against approaching their studies from heteronormative and cisnormative perspectives that assumes their sample is only heterosexual or that LGBT Q+ participants are one homogenous group. [Feedback for Correct Answer 2] Research related to sexual and affectional orientations has come a long way since early researchers such as Alfred Kinsey, Havelock Ellis, and Evelyn Hooker began to study LGBT Q+ identities in the 1930s, 1940s, and 1950s. [Feedback for Answer Choice 3] Speciale and Scholl (2019) investigated the career-related concerns of LGBT Q+ clients. [Feedback for Answer Choice 4] Speciale and Scholl (2019) investigated the career-related concerns of LGBT Q+ clients. [Q2] Early research tended to focus on whether queer identity was associated with: 1. pathology. [correct] 2. oppression. 3. discrimination. 4. substance abuse. [Feedback for Correct Answer 1] Early research tended to focus on whether queer identity was associated with pathology. [Feedback for Answer Choice 2] Today, a great deal of research related to sexual and affectional identities has focused on oppression, such as the consequences of heterosexism in the lives of LGBT Q+ people.

[Feedback for Answer Choice 3] Current research related to sexual and affectional identities has focused on oppression, such as employment discrimination and involuntary job loss (Fredriksen-Goldsen et al., 2017). [Feedback for Answer Choice 4] Current research related to sexual and affectional identities has focused on the consequences of heterosexism in the lives of LGBTQ+ people. For example, research conducted by DornMedeiros and colleagues (2018) found experiences of heterosexism to be correlated with substance use. [Q3] Which of the following authors published research that provides guidelines for conducting LGBT Q+ affirmative counseling when working with older LGBT Q+ adults? 1. Dworkin and colleagues (2018) 2. Pepping and colleagues (2018) 3. Chaney and Whitman (2020) [correct] 4. Fredriksen-Goldsen and colleagues (2017) [Feedback for Answer Choice 1] Research conducted by Dworkin and colleagues (2018) found experiences of heterosexism to be correlated with PT SD symptoms. [Feedback for Answer Choice 2] The research of Pepping and colleagues (2018) indicates that participation in training on how to utilize affirmative counseling practices with LGBT Q+ clients can increase counselor competence. [Feedback for Correct Answer 3] Chaney and Whitman (2020) published research that provides guidelines for conducting LGBT Q+ affirmative counseling when working with older LGBT Q+ adults. [Feedback for Answer Choice 4] Research conducted by Fredriksen-Goldsen and colleagues (2017) found experiences of heterosexism to be correlated with employment discrimination and involuntary job loss. [Q4] Research conducted by found experiences of heterosexism to be correlated with employment discrimination and involuntary job loss. 1. Dworkin and colleagues (2018) 2. Pepping and colleagues (2018) 3. Chaney and Whitman (2020) 4. Fredriksen-Goldsen and colleagues (2017) [correct]

[Feedback for Answer Choice 1] Research conducted by Dworkin and colleagues (2018) found experiences of heterosexism to be correlated with PT SD symptoms. [Feedback for Answer Choice 2] The research of Pepping and colleagues (2018) indicates that participation in training on how to utilize affirmative counseling practices with LGBT Q+ clients can increase counselor competence. [Feedback for Answer Choice 3] Chaney and Whitman (2020) published research that provides guidelines for conducting LGBT Q+ affirmative counseling when working with older LGBT Q+ adults. [Feedback for Correct Answer 4] Research conducted by Fredriksen-Goldsen and colleagues (2017) found experiences of heterosexism to be correlated with employment discrimination and involuntary job loss. Learning Outcome 6.5: Apply professional counseling competencies that promote a socially just, nonheterosexist society to counseling practice. [Q1] In , both the American Counseling Association (ACA) and the American Psychological Association (APA) passed resolutions opposing prior conceptions that people who are LGBTQ +, by their very nature, have mental disorders. 1. 1973 2. 1998 [correct] 3. 2002 4. 2009 [Feedback for Answer Choice 1] Homosexuality was removed from the DSM in 1973. [Feedback for Correct Answer 2] In 1998, both the American Counseling Association (ACA) and the American Psychological Association (APA) passed resolutions opposing prior conceptions that people who are LGBTQ +, by their very nature, have mental disorders. [Feedback for Answer Choice 3] In their guidelines for the ethical treatment of lesbians and gay males, Chernin and Johnson (2002) cited the APA resolution ―Appropriate Therapeutic Responses to Sexual Orientation,‖ formulated by the Committee on Lesbian and Gay Concerns. This resolution recognizes that homosexuality has been long removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM; e.g., American Psychiatric Association [APA], 2013) and is not a mental disorder; thus, counseling professionals should not pathologize the sexual orientation of clients who are lesbian or gay.

[Feedback for Answer Choice 4] In 2009, a revised and updated resolution reiterating that same-sex feelings, attractions, and behaviors are ―normal‖ and that an LGBTQ+ identity is not a mental illness was created by the American Psychological Association. [Q2] The professional literature recommends which of the following approaches for confronting heterosexism in counselor training programs? 1. Addressing the consequences of an unsafe school environment. 2. Encouraging faculty and staff training on inclusive practices. 3. Integrating multimedia resources that promote the continuum of sexuality. [correct] 4. Advocating for equitable opportunities both in and out of the classroom. [Feedback for Answer Choice 1] LGBTQ+ affirmative counseling strategies for professional school counselors (American School Counselor Association [ASCA], 2014) includes: Addressing the consequences of an unsafe school environment. [Feedback for Answer Choice 2] LGBTQ+ affirmative counseling strategies for professional school counselors (American School Counselor Association [ASCA], 2014) includes: Encouraging faculty and staff training on inclusive practices. [Feedback for Correct Answer 3] The professional literature recommends integrating multimedia resources that promote the continuum of sexuality as one approach to confronting heterosexism in counselor training programs. [Feedback for Answer Choice 4] LGBTQ+ affirmative counseling strategies for professional school counselors (American School Counselor Association [ASCA], 2014) includes: Advocating for equitable opportunities both in and out of the classroom. [Q3] Which of the following is an important consideration related assessing gender identity in counseling? 1. Counselors must remember that gender identity holds equal salience for all clients. 2. It is the counselor’s responsibility to help clients understand their own worldviews. [correct] 3. It is minimally important for clients to share their sexual beliefs, values, and ideologies. 4. The ACA Code of Ethics requires counselors to explore sexual beliefs and values with clients. [Feedback for Answer Choice 1] Some individuals have strong thoughts and feelings about their own gender or others’ genders, and some individuals do not feel as passionately about the subject.

[Feedback for Correct Answer 2] Counselors are not responsible for telling their clients how to think or feel. Rather, counselors are responsible for helping clients identify their own inherent thoughts, feelings, beliefs, and desires. [Feedback for Answer Choice 3] When relevant, it is very important for sexuality to be included in holistic counseling interventions. [Feedback for Answer Choice 4] The ACA Code of Ethics does not require counselors to explore sexual beliefs and values with clients. Instead, the ethical code instructs counselors to broach salient client issues in culturally sensitive and competent manner. [Q4] Reparative therapy is an example of: 1. sexual orientation change efforts. [correct] 2. LGBT Q+ affirmative counseling. 3. systems level advocacy. 4. confronting heterosexism. [Feedback for Correct Answer 1] Efforts to alter same-sex or affectional orientations began in the mid-1800s with studies examining the origins of same-sex attractions. Formerly called reparative therapy, the current umbrella term used to describe any methodological attempts to change sexual orientation is sexual orientation change efforts (SOCE). [Feedback for Answer Choice 2] LGBTQ+ affirmative counseling involves countering the negative societal messages often internalized by LGBT Q+ clients, affirming LGBT Q+ identities, and not pathologizing same-sex behavior and affection or trans or nonbinary gender identities. [Feedback for Answer Choice 3] Counselors and students might use systems level advocacy to help create a more socially just, nonheterosexist society. These efforts might include: Lobbying and Supporting Policy Change, Giving Back to the Community, Giving Back to Schools, and Collaboration with Other Fields. [Feedback for Answer Choice 4] Strategies for confronting heterosexism include: Raising awareness of heterosexual privilege, promote the continuum of sexuality, and provide alternative definitions of socially constructed terms related to heterosexist dichotomies (e.g., heterosexual, gay, among others).

Chapter 6 Application Exercises Application Exercise 6.1: Austin with His Counselor Learning Outcome 6.2: Articulate how sexual and affectional orientations intersect with race, ethnicity, gender, age, education, social class, spirituality, and relationship status. [URL TITLE] Austin with His Counselor

[Q1] Use Pearson eText Video Example 6.3 to answer the following question. Pay particular attention to the information that Austin shares with his counselor. In what ways might this client have experienced oppression and discrimination in his life? [Q1 MODEL RESPONSE] Your answer might include any of the following: 

As a young individual, he might not be respected as a person with wisdom or knowledge.



As a White man, it might be assumed that he does not have any mental health concerns.



As a gay man, he might be ridiculed or shunned by others who do not approve of his sexuality.



He indicated that he recently got a new job and is dressing nicer, and individuals might have treated him with less respect when he did not dress as nicely.

[Q2] Use Pearson eText Video Example 6.3 to answer the following question. Pay particular attention to the information that Austin shares with his counselor. In what ways might the historical oppression and discrimination faced by gay individuals affect Austin’s mental health? [Q2 MODEL RESPONSE] Your answer might include any of the following: 

Austin might feel isolated from others who are heterosexual.



Austin might question his sense of identity because a big portion of himself (i.e., his sexuality) was hidden for so long.



Austin might fear that the people he loves the most will not accept him if they know he identifies as gay.



Austin might resent others who are not gay because they do not have to combat heteronormative stereotypes on a daily basis.



Austin might resent himself or a higher power for making him different than others.



Austin might find an increased sense of self-worth as he continues to solidify his identity as a gay man.

[Q3] Use Pearson eText Video Example 6.3 to answer the following question. Pay particular attention to the information that Austin shares with his counselor. What can the counselor do to address issues of oppression and discrimination with the client? [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

The counselor should maintain an awareness of ways in which she has experience oppression in her own life.



The counselor should work to uncover any hidden biases she might hold in relation to the client.



The counselor should bring any professional concerns or needs to her supervisor or consulting colleagues.



The counselor should validate the client’s experiences of oppression in his daily life.



The counselor should advocate on the client’s behalf or support him through his own advocacy process as needed.

Application Exercise 6.2: The Various Consequences Associated with Heterosexism Learning Outcome 6.3: Critically evaluate the mental, physical, and social impact of heterosexism on LGBT Q+ individuals and communities. [Q1] Explain how heterosexism and homophobia can negatively impact an LGBT Q+ individual’s level of stress and self-esteem. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Stress can be caused by chronic or acute outward events or conditions such as anti-LG BT Q+ slurs, anti–same-sex marriage laws, and bullying.



The expectation of discriminatory events and the anticipatory energy this expectation requires is another source of stress.



Moreover, internalizing society’s negative attitudes and feelings toward individuals who are LGBT Q+ (i.e., internalized homophobia) can create a large amount of stress.



Heterosexist acts also negatively impact an LGBT Q+ individual’s perception of him/herself and his/her environment and, thus, have a detrimental impact on selfesteem.

[Q2] Briefly discuss some of the physical consequences associated with heterosexism and homophobia. [Q2 MODEL RESPONSE] Your answer should include some of the following points:



Heterosexism can lead to internalized homophobia, shame, and poor self-perception.



Some members of the LGBT Q+ community resort to substance abuse to mask negative feelings.



High rates of alcohol abuse are prevalent among those in this group.



Marijuana, cocaine, psychedelics, Ecstasy, nitrate inhalants, and methamphetamine are commonly abused within the LGBTQ+ community.



People who are LGBT Q+ smoke cigarettes at higher rates than other groups and are thus at risk for various types of cancer and other health problems.



Smoking partially explains why the life expectancy of gay men is 8 to 20 years lower than that of other men. Interestingly, youths who are LGBT Q+ have 30% to 87% higher rates of cancer than their heterosexual peers.



Heterosexism is believed to be partly responsible for the high HIV infection rates among individuals who are LGBT Q+.



Youths who are LGBTQ+ come out to their families may experience homophobic reactions, such as violence and rejection.



Some youths who are attracted to the same sex leave home and others are kicked out of their homes.



To survive on the streets, many youths who are LGBT Q+ engage in sex for money to meet basic needs.

[Q3] Explain how heterosexism and homophobia can contribute to diminished interpersonal relationships for LGBT Q+ individuals. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Fear of being identified as LGBTQ+ may prevent individuals who are LGBT Q+ from reaching out to, and participating in, the queer community.



Some heterosexuals may be reluctant to befriend LGBTQ+ individuals due to fear of being perceived as LGBT Q+ by heterosexual peers.



Some individuals who are LGBTQ+ may isolate themselves from family, particularly if the family is not aware of the LGBTQ+ identity.



To overcome these challenges, LGBT Q+ individuals often create their family of choice, which may consist of biological kin and friends considered family, to widen their support.

Application Exercise 6.3: Sex versus Gender Learning Outcome 6.5: Apply professional counseling competencies that promote a socially just, nonheterosexist society to counseling practice. [Q1] Brenda is a new counselor working in an all-male prison. The population is approximately onethird White, one-third Black, and one-third American Indian. One Black prisoner’s legal name is George, and the individual was assigned male gender at birth, but this prisoner identifies as female and prefers to be called Gia. Gia has breast implants and receives daily hormone therapy. Gia is extremely unhappy in the male prison and gets bullied every day. She speaks to her counselor regularly about her difficulties and reports that she fears for her life. Gia states that she has strong faith and has support from her church and loved ones at home. She is proud to be a Black, transgender woman and would not consider returning to a male identity. What cultural considerations must be considered when conceptualizing Gia’s mental health needs? [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

The counselor should take time to identify her own biases openly and honestly and actively overcome such biases when working with Gia.



The counselor should remember that because of her multiple minority statuses, Gia might be at an increased risk for depression, chronic stress, anxiety, and substance abuse.



As a Black prisoner, Gia likely experiences greater levels of discrimination than her White counterparts.



As a transgender prisoner, Gia’s sexuality and gender identity are visibly noticeable to other prisoners and likely different from those of most of the other male prisoners.



Gia might experience discrimination from others in her church depending on their views regarding homosexuality and transgender identities.



Gia might experience discrimination from others who share her same racial/ethnic identity depending on their views regarding homosexuality and transgender identities.



Members of the LGBT community have historically experienced oppression in American society.

[Q2] Brenda is a new counselor working in an all-male prison. The population is approximately onethird White, one-third Black, and one-third American Indian. One Black prisoner’s legal name is George, and the individual was assigned male gender at birth, but this prisoner identifies as female and prefers to be called Gia. Gia has breast implants and receives daily hormone therapy. Gia is extremely unhappy in the male prison and gets bullied every day. She speaks to her counselor regularly about her difficulties and reports that she fears for her life. Gia states that she has strong faith and has support from her church and loved ones at home. She is proud to be a Black, transgender woman and would not consider returning to a male identity. How would you describe Gia’s current racial identity and sexual identity?

[Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Gia seems to be in the Internalization or Integrative Awareness stage of Helm’s People of Color Identity Model.



Gia seems to use internal criteria to find her own sense of personal self-worth, and she has started to advocate for herself to her counselor.



Gia seems to be in the Identity Pride stage of Cass’s Model of Sexual Identity Development.



Gia reports that she is proud of her sexual identity and is not willing to conform to oppressive societal standards.



Gia might be able to move to the Identity Synthesis stage of identity development as she forms healthy, supportive relationships in prison.

[Q3] Brenda is a new counselor working in an all-male prison. The population is approximately onethird White, one-third Black, and one-third American Indian. One Black prisoner’s legal name is George, and the individual was assigned male gender at birth, but this prisoner identifies as female and prefers to be called Gia. Gia has breast implants and receives daily hormone therapy. Gia is extremely unhappy in the male prison and gets bullied every day. She speaks to her counselor regularly about her difficulties and reports that she fears for her life. Gia states that she has strong faith and has support from her church and loved ones at home. She is proud to be a Black, transgender woman and would not consider returning to a male identity. How can counselors advocate for clients like Gia? [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Counselors can educate other prison workers about the mental health difficulties Gia is facing and ask them to offer assistance and support to her.



Counselors can investigate state laws and rules to determine if Gia could be moved to a more supportive prison.



Counselors can join professional organizations like the American Counseling Association to fund lobbyists who advocate for increased access of counselors to oppressed populations.



Counselors can harness resources for this client, such as contacting a local law school to request legal representation for the client.



Counselors can provide supportive mental health services to clients like Gia.

Chapter 6 Test Items Multiple Choice 1.

The number of lesbian, gay, and bisexual Americans is estimated to total a. 3.5 million. b. 9 million. c. 1 million. d. 25 million.

Home ownership is generally lower for same-sex couples because a. most LGBTQ+ individuals are single. b. most LGBTQ+ couples choose to rent. c. most states have laws that prohibit unmarried couples from owning homes together. d. same-sex couples cannot afford to own a home.

Gay men tend to be diagnosed with

more than heterosexual men.

a. sexual dysfunction b. panic disorder c. obsessive compulsive disorder d. schizophrenia 4.

Individuals who are LGBT are than persons who are heterosexual to experience depression, suicide, anxiety, and substance abuse disorders. a. less likely b. as likely c. more likely d. None of the above.

The Defense of Marriage Act is an example of a. a social justice law. b. institutional heterosexism. c. internalized homophobia. d. a law promoting same-sex marriage.

Approximately a. 15% b. 25% c. 45% d. 75%

of LGBTQ+ students have been verbally harassed in schools.

African American gay and bisexual men are more likely to abuse a. marijuana and nicotine. b. alcohol and cocaine. c. GHB and Ecstasy. d. steroids and alcohol.

is(are) NOT associated with bullying of LGBT Q+ youth in schools? a. Depression b. Nightmares c. More casual sex partners in adulthood d. Personality disorders

A competent counselor should refer to a female client who is attracted to other women a. as a lesbian. b. as a bisexual. c. as gay. d. according to how the client prefers to be called.

10. When working with LGBT Q+ clients of color, counselors should focus on a. ethnic identity. b. gender identity. c. sexual orientation. d. All of the above. 11. A common stereotype about LGBT Q+ individuals is that they a. have a high income. b. do not have kids. c. are promiscuous. d. All of the above. 12. While working with LGBT Q+ clients, counselors need to expand the term a. straight. b. gay. c. family. d. sexism. 13. Conversion therapy was used to a. convert negative cognitions into positive cognitions. b. convert the sexual orientation of LGBTQ+ individuals. c. ease tension and anxiety among LGBTQ+ individuals. d. convert non-spiritual clients into spiritual clients.

14. Anti-gay marriage laws are examples of a. homophobia. b. ableism. c. imposter phenomenon. d. institutional heterosexism. 15. Sexual identity includes a. physical identity. b. gender identity. c. social sex role identity. d. All of the above. 16. The preferred term to refer to an individual or group of people who have same-sex feelings and behaviors and who identify with the gay community is a. gay or lesbian. b. homosexual. c. heterosexual. d. bisexual. 17.

is NOT one of the variables described as comprising sexual orientation. a. Sexual behaviors b. Emotions c. Communication style d. Social preference

18. The gay identity development process a. is a fairly simple process. b. begins at a specific age. c. is over by midlife. d. None of the above. 19. Gay affirmative counseling includes a. viewing being gay as a disorder to be cured. b. avoiding discussion of major issues that may arise for gay men and lesbians during counseling. c. counselors being aware of their own strengths and weaknesses in working with gay clients. d. None of the above. 20. Major goals of gay affirmative counseling include a. promoting positive identity development. b. promoting psychological adjustment.

c. focusing on issues specific to people who are gay, lesbian, and bisexual. d. All of the above. 21.

model of gay and lesbian identity development set the groundwork for future identity development models and is one of the most comprehensive models. a. Cass’s b. Coleman’s c. Erikson’s d. Freud’s

22. Which of the following is a difference between the identity development of gay men and lesbians, according to Cass? a. Men are less likely to have a sexually stimulating experience trigger the identity process. b. Lesbians are less likely to have an emotional experience trigger the identity process. c. Lesbians are more likely to reject societal female sex roles. d. Gay men are more likely to reject male sex roles. 23. Based on research, major national medical and psychological organizations have concluded that children of gay and lesbian parents are no different than other children in terms of a. gender role behavior. b. sexual orientation. c. psychological and cognitive development. d. All of the above. 24. A major issue for gay and lesbian ―double and triple minorities‖ is a. moving through several developmental processes in order to develop positive identities. b. fearing that they are risking the acceptance of one group by identifying with another group. c. Both of the above. d. None of the above. 25. A general theme among identity development models is that a. environmental influences do not affect the developmental process. b. minorities within the gay community do not have additional identity issues with which to deal. c. identity development models are a means to better understand human development. d. there are no differences in development among various individuals. 26. According to the ALGBTIC competencies, competent counselors understand that gay/lesbian/bisexuality and gender nonconformity are a. not forms of psychopathology.

b. not evidence of developmental arrest. c. core characteristics that influence clients’ perceptions of themselves and their worlds. d. All of the above. 27. Lesbians, gay men, and bisexuals a. are protected from employment discrimination in the United States. b. are not protected from employment discrimination in most states and communities. c. are covered under federal Title VII of the Civil Rights Act of 1964. d. None of the above. 28. Multicultural counseling focuses on a. the experience of ethnic minority clients. b. gender identity and sexual orientation identities. c. the intersection of multiple cultural identities. d. All of the above. 29. Stress associated with being part of a stigmatized group is called a. stress symptom. b. stigmatized stress. c. minority stress. d. Black stress disorder. 30.

functions to systematically and narrowly define gender roles. a. Sexism b. Homophobia c. Privilege d. Heterosexism

31. The enforcement of heterosexual norms that may be consciously or unconsciously endorsed by individuals and institutions is called a. heterosexism. b. homophobia. c. homoprejudice. d. None of the above. 32. The fear or hatred of L GBT Q+ is called a. heterosexism. b. homophobia. c. internalized heterosexism. d. sexism.

33. The negative attitudes that some LGBT Q+ people hold about their own sexual orientation is called a. heterosexism. b. homophobia. c. internalized homophobia. d. sexism. 34. A system of heterosexism that confers unearned advantages onto heterosexual people is called a. homophobia. b. internalized homophobia. c. heterosexual privilege. d. gay privilege. 35.

marked the beginning of the modern LGBT Q+ rights movement. a. The Stonewall uprising b. Sputnik c. World War I d. World War II

36. LGBT Q+ individuals are a. less likely to live in poverty as compared to heterosexuals. b. more likely to live in poverty as compared to heterosexuals. c. as likely to live in poverty as compared to heterosexuals. d. unlikely to live in poverty at all. 37. A same-sex intimate encounter always means that a person is a. gay/lesbian. b. bisexual. c. questioning. d. None of the above. 38. LGBT Q+ people a. are likely not to be in a committed relationship. b. cannot adopt children. c. have less education than the general population. d. None of the above. 39. A major issue for LGBQ+ people of color is a. religiosity is not typically a factor in coming out.

b. establishing healthy racial and sexual identities simultaneously. c. the numerous sources of social support available. d. None of the above. 40. Which of the following is related to psychological distress in lesbians? a. ableism b. ageism c. sexism d. All of the above. 41. Bisexual individuals are more likely to experience discrimination and intolerance from a. the gay community b. the heterosexual community c. Both of the above. d. None of the above 42. An environmental or internal event that fuels a stress response is called a(n) a. stressor. b. attribution bias. c. hate crime. d. cultural trauma. 43. Most new HIV infections occur among a. heterosexual African American men. b. Latina women. c. heterosexual IV drug users. d. men who have sex with men. 44.

could minimize heterosexual bias in counselor training. a. Reviewing LGBTQ+ resources in courses b. Self-exploration c. Paying attention to power dynamics in language d. All of the above.

45. Laws in some states restricting same-sex parent adoption is an example of a. a social justice law. b. institutional heterosexism. c. internalized homophobia. d. a law promoting same-sex marriage.

Extended Response 1.

What does the term ―heterosexual ally‖ mean? What are steps counselors can take to become heterosexual allies?

Give specific examples of how the American Counseling Association’s Advocacy Competencies could be applied to women and LGBT QI individuals.

Discuss how heterosexism is related to HIV/AIDS infection rates.

Discuss specific ways counselors can help create a more socially just non-heterosexist society.

Discuss the similarities and differences between sexism and heterosexism.

Why is it important to assess the multiple identities of women and LGBTQ+ clients?

Explain the similarities and differences of the mental health consequences associated with sexism and heterosexism.

Check out the ALGBT IC Competencies. What are five ways you might practice advocacy with clients based on these competencies?

Think about the seven variables to describe sexual orientation and how each one relates to your own experience.

10. What are your thoughts on the term ―affectional orientation?‖ Do you think it makes sense as a way to describe the complexity of human emotions and behaviors? Would you want to be described in only sexually based terminology? 11. Why is homosexual no longer the preferred term to refer to someone who has same-sex feelings and behaviors? 12. Describe the process of gay male identity development using one of the models described in this chapter. 13. Describe the process of lesbian identity development using one of the models described in this chapter. 14. How is bisexual identity development similar to and different from lesbian and gay male identity development? 15. Describe the various heterosexual privileges of which counselors should be aware. 16. Describe the challenges faced by LGBT Q+ youth of which counselors should be aware. 17. Explain the meaning of the term ―two-spirit.‖ 18. How do mental health stereotypes of LGBT Q+ people contribute to discrimination and prejudice? 19. Explain what contributes to the disproportionately high rates of substance use among LGB TQ+ persons. 20. What are some of the components of LGBT Q+ affirmative counseling?

Chapter 6 Test Answer Key ANSWER KEY: Chapter 6 Test (Multiple Choice) 1. b 2. c 3. b 4. c 5. b 6. d 7. b 8. d 9. d 10. d 11. d 12. c 13. b 14. d 15. d 16. a 17. c 18. d 19. c 20. d 21. a 22. c 23. d 24. c 25. c 26. d 27. b 28. d 29. c 30. d 31. a 32. b

33. c 34. c 35. a 36. c 37. d 38. d 39. b 40. c 41. c 42. a 43. d 44. d 45. b

Chapter 7 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach th 4 Edition

Danica G. Hays University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents Chapter 7: Social Class and Classism

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 7: Social Class and Classism Chapter 7 Learning Outcome Quizzes Learning Outcome 7.1: Define and differentiate social class, socioeconomic status, and classism. [Q1] Which of the following terms refers to how an individual interacts with finances, how it impacts their daily living, their values, and their worldviews? 1. Net worth 2. Social class [correct] 3. Socioeconomic status 4. Poverty attribution [Feedback for Answer Choice 1] An individual’s economic net worth is based on the sum of the person’s assets (e.g., cash, investments, real estate) minus the sum of her or his liabilities (e.g., debt, mortgage, loans). [Feedback for Correct Answer 2] Social class refers to how an individual interacts with finances, how it impacts their daily living, their values, and their worldviews. [Feedback for Answer Choice 3] Socioeconomic status generally refers to a comparative measure of class standing, or status, based on a combination of educational attainment, income level, and occupational prestige. [Feedback for Answer Choice 4] Poverty attribution refers to how individuals explain poverty, such as through individual causation or structural causation. [Q2] Which of the following terms refers to a comparative measure of class standing, or status, based on a combination of educational attainment, income level, and occupational prestige? 1. Net worth 2. Social class 3. Socioeconomic status [correct] 4. Poverty attribution [Feedback for Answer Choice 1] An individual’s economic net worth is based on the sum of the person’s assets (e.g., cash, investments, real estate) minus the sum of her or his liabilities (e.g., debt, mortgage, loans).

[Feedback for Answer Choice 2] Social class refers to how an individual interacts with finances, how it impacts their daily living, their values, and their worldviews. [Feedback for Correct Answer 3] Socioeconomic status generally refers to a comparative measure of class standing, or status, based on a combination of educational attainment, income level, and occupational prestige. [Feedback for Answer Choice 4] Poverty attribution refers to how individuals explain poverty, such as through individual causation or structural causation. [Q3] Which of the following terms refers to unexamined class biases that shape our beliefs about ourselves and our relative merit in our families, peer groups, and community? 1. Classism 2. Lateral classism [correct] 3. Downward classism 4. Structural classism [Feedback for Answer Choice 1] Classism refers to having negative biases about, and discriminatory behaviors toward, individuals or groups based on their perceived or actual social class. [Feedback for Correct Answer 2] Lateral classism, also called internalized classism, refers to unexamined class biases that shape our beliefs about ourselves and our relative merit in our families, peer groups, and community. [Feedback for Answer Choice 3] Downward classism refers to attitudes, stereotypes, or biases individuals from higher social class groups (e.g., middle class) may have about persons who are from lower social class groups. [Feedback for Answer Choice 4] Structural classism refers to social and institutional practices that discriminate based on SES; these practices may be overt (e.g., ―legacy‖ admissions in higher education) or covert (e.g., lack of public transportation effectively limiting employment options). [Q4] Which of the following terms refers to attitudes, stereotypes, or biases individuals from higher social class groups (e.g., middle class) may have about persons who are from lower social class groups (e.g., poverty)? 1. Downward classism [correct] 2. Internalized classism 3. Structural classism

4. Psychological distancing [Feedback for Correct Answer 1] Downward classism refers to attitudes, stereotypes, or biases individual from higher social class groups (e.g., middle class) may have about persons who are from lower social class groups. [Feedback for Answer Choice 2] Internalized classism, also called lateral classism, refers to unexamined class biases that shape our beliefs about ourselves and our relative merit in our families, peer groups, and community. [Feedback for Answer Choice 3] Structural classism refers to social and institutional practices that discriminate based on SES; these practices may be overt (e.g., ―legacy‖ admissions in higher education) or covert (e.g., lack of public transportation effectively limiting employment options). [Feedback for Answer Choice 4] Psychological distancing refers to ways of thinking and behaving that are used by privileged groups to justify and distance themselves from their role in class injustice. Learning Outcome 7.2: Identify U.S. social class categories and factors that impact social mobility. [Q1] The term skilled labor is typically used to reference which of the following social classes? 1. Working class [correct] 2. Working poor 3. Lower class 4. Underclass [Feedback for Correct Answer 1] The term skilled labor is typically used to reference the working class, also known as the middle class. [Feedback for Answer Choice 2] The term manual labor is typically used to reference the working poor, also called the lower class. [Feedback for Answer Choice 3] The term manual labor is typically used to reference the lower class, also called the working poor. [Feedback for Answer Choice 4] The term underclass refers to underemployed individuals who hold low paying unskilled jobs. [Q2] In the United States, the wealthiest 1. 0.5%, half

hold more than

of total U.S. net worth.

2. 0.5%, one-third 3. 1%, half 4. 1%, one-third [correct] [Feedback for Answer Choice 1] In the United States, the wealthiest 0.5% do not hold more than half of total U.S. net worth. [Feedback for Answer Choice 2] In the United States, the wealthiest 0.5% do not hold more than one-third of total U.S. net worth. [Feedback for Answer Choice 3] In the United States, the wealthiest 1% do not hold more than half of total U.S. net worth. [Feedback for Correct Answer 4] In the United States, the wealthiest 1% hold more than one-third of total U.S. net worth. [Q3] In the United States, nearly

of the U.S. net worth is held by the top

1. two-thirds, 10% 2. two-thirds, 5% [correct] 3. half, 10% 4. half, 5% [Feedback for Answer Choice 1] In the United States, more than two-thirds of the U.S. net worth is held by the top 10%. [Feedback for Correct Answer 2] In the United States, nearly two-thirds of the U.S. net worth is held by the top 5%. [Feedback for Answer Choice 3] In the United States, more than half of the U.S. net worth is held by the top 10%. [Feedback for Answer Choice 4] In the United States, more than half of the U.S. net worth is held by the top 5%. [Q4] The Federal Poverty Level (FPL) is updated yearly and is a fixed dollar amount which qualifies individuals and families for social safety net programs that help cover the cost of: 1. healthcare. [correct] 2. school tuition. 3. relocation expenses. 4. public transportation.

[Feedback for Correct Answer 1] The Federal Poverty Level (FPL) is updated yearly and is a fixed dollar amount which qualifies individuals and families for social safety net programs that help cover the cost of healthcare through Medicaid. [Feedback for Answer Choice 2] School tuition is not one of the social safety net programs associated with the FPL. However, the FPL is used to determine eligibility for community-based educational programs such as Head Start. [Feedback for Answer Choice 3] Providing relocation expenses is not one of the social safety net programs associated with the F PL. [Feedback for Answer Choice 4] Public transportation is not one of the social safety net programs associated with the FPL. Learning Outcome 7.3: Describe individual and structural classism, and how structural classism impacts various systems. [Q1] U.S. Census data from 2019 showed that poverty levels.

female-headed households were below federal

1. 9.4% 2. 10.5% 3. 11.5% 4. 22.2% [correct] [Feedback for Answer Choice 1] U.S. Census data from 2019 showed that 9.4% of men were below federal poverty levels. [Feedback for Answer Choice 2] In 2019 the overall poverty rate (measured by the FPL) in the United States was 10.5%. [Feedback for Answer Choice 3] U.S. Census data from 2019 showed that 11.5% of women, as well as 11.5% of male-headed households, were below federal poverty levels. [Feedback for Correct Answer 4] U.S. Census data from 2019 showed that 22.2% of female-headed households were below federal poverty levels. [Q2]* Social stigma toward people with mental health disorders was found to be highest in areas and among people with education levels.

1. rural, lowest 2. rural, highest 3. urban, highest [correct] 4. urban, lowest [Feedback for Answer Choice 1] Social stigma toward people with mental health disorders was not found to be highest in rural areas and among people with lowest education levels. [Feedback for Answer Choice 2] Social stigma toward people with mental health disorders was not found to be highest in rural areas and among people with highest education levels. [Feedback for Correct Answer 3] Social stigma toward people with mental health disorders was found to be highest in urban areas and among people with highest education levels. [Feedback for Answer Choice 4] Social stigma toward people with mental health disorders was not found to be highest in urban areas and among people with lowest education levels. [Q3] In 2019 the overall poverty rate (measured by the FPL) in the United States was

1. 9.4% 2. 10.5% [correct] 3. 11.5% 4. 22.2% [Feedback for Answer Choice 1] U.S. Census data from 2019 showed that 9.4% of men were below federal poverty levels. [Feedback for Correct Answer 2] In 2019 the overall poverty rate (measured by the FPL) in the United States was 10.5%. [Feedback for Answer Choice 3] U.S. Census data from 2019 showed that 11.5% of women, as well as 11.5% of male-headed households, were below federal poverty levels. [Feedback for Answer Choice 4] U.S. Census data from 2019 showed that 22.2% of female-headed households were below federal poverty levels. [Q4] The 2020 federal poverty threshold (FPL) for a single adult under age 65 years was designated as: 1. $12,000

2. $12,760 [correct] 3. $13,000 4. $15,080 [Feedback for Answer Choice 1] In 2019, rent for a one-bedroom apartment averaged over $1000. Thus, $12,000 is approximately the annual amount that a person would pay to rent a one-bedroom apartment. [Feedback for Correct Answer 2] The 2020 federal poverty threshold (FPL) for a single adult under age 65 years was designated as $12,760. [Feedback for Answer Choice 3] At the current federal minimum wage, an adult working a 40-hour week, every week of the year, will earn $13,000 annually after taxes. [Feedback for Answer Choice 4] At the current federal minimum wage, an adult working a 40-hour week, every week of the year, will earn $15,080 annually before taxes. Learning Outcome 7.4: Articulate areas for future research on social class and classism within counseling. [Q1] A recent study conducted by Cook (2017) found that professional counselors hold considerable social class . 1. awareness. 2. bias. [correct] 3. confusion. 4. sensitivity. [Feedback for Answer Choice 1] Cook (2017) found that professional counselors use social class microaggressions that inadvertently express social class bias. [Feedback for Correct Answer 2] Cook (2017) found that professional counselors hold considerable social class bias. [Feedback for Answer Choice 3] A study conducted by Cook and Lawson (2016) found that counselors experienced confusion, as they struggled to clearly to understand and operationalize social class and related terms. [Feedback for Answer Choice 4] Cook (2017) found that professional counselors inadvertently express social class bias by using social class microaggressions.

[Q2] Most articles written on issues related to social class groups and poverty are nature.

1. conceptual [correct] 2. empirical 3. qualitative 4. quantitative [Feedback for Correct Answer 1] A limited body of literature addresses the specific issues associated with social class groups and experiences, such as poverty. However, there are numerous conceptual articles addressing poverty counseling and interventions. [Feedback for Answer Choice 2] Empirical research on issues related to social class groups and poverty continues to be limited. [Feedback for Answer Choice 3] Qualitative inquiry is a form of empirical research and, as such, continues to be limited. [Feedback for Answer Choice 4] Quantitative inquiry is a form of empirical research and, as such, continues to be limited. [Q3] Clark and colleagues (2020) interviewed professional counselors who provide services to individuals experiencing poverty, yielding five domains of best practices to include counselors’ training, knowledge, awareness, skills, and advocacy. Which research method was utilized to conduct this study? 1. Conceptual 2. Case study 3. Qualitative [correct] 4. Quantitative [Feedback for Answer Choice 1] Conceptual articles are based on existing research and their production does not involve identifying research subjects or conducting interviews. [Feedback for Answer Choice 2] Case studies present hypothetical clinical cases and their production does not involve identifying research subjects or conducting interviews. [Feedback for Correct Answer 3] Conducting interviews is a qualitative research method. [Feedback for Answer Choice 4] Conducting interviews is not a quantitative research method.

[Q4] A critical need in counseling research is the experiences of clients and evidenced-based practices for working with clients from various social class groups. Which research method would be appropriate for advancing this research agenda? 1. Action [correct] 2. Case study 3. Conceptual 4. Qualitative [Feedback for Correct Answer 1] Action-based, also called evidence-based, is a research method that is suitable for investigating the experiences of clients and evidenced-based practices for working with clients from various social class groups. [Feedback for Answer Choice 2] Case studies present hypothetical clinical cases and their production does not involve identifying research subjects or conducting interviews. [Feedback for Answer Choice 3] Conceptual articles are based on existing research and their production does not involve collecting new data to inform novel evidence-based practices. [Feedback for Answer Choice 4] Qualitative research is suitable for investigating the experiences of counselors and clients from various social class groups. However, qualitative data is not generalizable and, as such, cannot generate new evidence-based practices. Learning Outcome 7.5: Identify ways in which one can integrate advocacy into their classconscious counseling practices. [Q1] Which of the following activities provides an opportunity for increasing one’s awareness of social class and classism? 1. Investigating local resources 2. Conducting a self-assessment 3. Completing a class privilege inventory [correct] 4. Reviewing community status reports [Feedback for Answer Choice 1] Investigating local resources falls under the counseling knowledge domain. This activity provides an opportunity to expand one’s professional knowledge and to develop effective tools for counseling persons experiencing poverty.

[Feedback for Answer Choice 2] Conducting a self-assessment falls under the counseling skills domain. This activity provides an opportunity for assessing one’s clinical strengths and limitations in addressing the client’s concerns.

[Feedback for Correct Answer 3] Completing a class privilege inventory provides an opportunity for increasing one’s awareness of social class and classism. [Feedback for Answer Choice 4] Reviewing community status reports falls under the counseling knowledge domain. This activity provides an opportunity to expand one’s professional knowledge and to develop effective tools for counseling persons experiencing poverty. [Q2] Which of the following activities reflects advocacy at the professional level? 1. Practicing self-care [correct] 2. Identifying local resources 3. Investigating local resources 4. Interacting with other social classes [Feedback for Correct Answer 1] Engaging in advocacy work can be inspiring as well as exhausting. It is important for counselors and counselor trainees to build up supportive networks, resources, and self-care practices if they wish to engage in effective and sustained advocacy efforts. [Feedback for Answer Choice 2] Identifying local resources provides counselors an opportunity to expand their professional knowledge and to develop effective tools for addressing client concerns. This activity falls under the counseling knowledge domain, rather than advocacy. [Feedback for Answer Choice 3] Investigating local resources provides counselors an opportunity to expand their professional knowledge and to develop effective tools for addressing client concerns. This activity falls under the counseling knowledge domain, rather than advocacy. [Feedback for Answer Choice 4] Interacting with other social classes provides an opportunity for increasing one’s awareness of social class and classism and is not considered a form of professional advocacy. [Q3] Which of the following websites contains information on medical debt, insurance and hospital billing, and language services? 1. www.familiesusa.org/

2. www.childrensdefense.org/ 3. www.communitycatalyst.org/ 4. www.theaccessproject.com/ [correct]

[Feedback for Answer Choice 1] Families USA functions as a government watchdog and public information clearinghouse. Information about the organization’s trainings and community collaborations is available on their website (www.familiesusa.org/). [Feedback for Answer Choice 2] The Children’s Defense Fund website www.childrensdefense.org/) contains statistics, research, public policy information, and advocacy opportunities for helping poor and minority children and those with disabilities. [Feedback for Answer Choice 3] The goal of Community Catalyst is quality, affordable health care for all through community action, legal means, and policy advocacy. Information about the organization’s partnership with consumer and community groups nationwide is available on their website (www.communitycatalyst.org/). [Feedback for Correct Answer 4] The Access Project provides a policy voice for underserved communities and works to improve health for those who are most vulnerable. The organization’s website (www.theaccessproject.com/) contains information on medical debt, insurance and hospital billing, and language services. [Q4] Which of the following organizations is affiliated with Columbia University and strives to promote policies and practices to improve economic solutions for low-income families and children? 1. Children’s Defense Fund 2. National Center for Children in Poverty [correct] 3. National Law Center on Homelessness and Poverty 4. United for a Fair Economy [Feedback for Answer Choice 1] Founded in 1973 with roots in the Civil Rights Movement, the Children’s Defense Fund advocates for poor and minority children and those with disabilities. [Feedback for Correct Answer 2] Housed in the Mailman School of Public Health at Columbia University, the National Center for Children in Poverty is a public policy group promoting policies and practices to improve economic solutions for low-income families and children.

[Feedback for Answer Choice 3] The National Law Center on Homelessness and Poverty is an organization of lawyers working to prevent and end homelessness through legislative advocacy and public education. [Feedback for Answer Choice 4] United for a Fair Economy provides information and resources for addressing economic injustice, especially as it pertains to tax fairness.

Chapter 7 Application Exercises Application Exercise 7.1: Understanding Social Class, Socioeconomic Status, and Classism Learning Outcome 7.1: Define and differentiate social class, socioeconomic status, and classism. [Q1] Explain the key distinctions between the concepts of social class and socioeconomic status. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Social class is based on quantifiable socioeconomic factors (e.g., educational attainment, type of employment, income level, savings, investments, housing, and property ownership).



Popular labels in U.S. society to describe social class include lower class, working class, middle class, upper middle class, or upper class.



On the other hand, socioeconomic status generally refers to a comparative measure of class standing, or status, based on a combination of educational attainment, income level, and occupational prestige.

[Q2] Highlight some of the terms frequently used to reference the various levels of social class. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Lower-Class Status: low income, working poor, urban poor, rural poor, welfare recipient, high school dropout, manual laborer



Middle-Class Status: middle income, working class, professional, homeowner, high school graduate, skilled laborer



Upper-Class Status: upper income, wealthy, new money, old money, college graduate, executive, elite

[Q3] Why it is important for counselors to consider and explore how a client has been impacted by classism? [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Unexamined class biases may shape a client’s beliefs about themselves, their relative merit in their families, peer groups, and community.



Depending on a client’s perceived social class position, they may view themself to be diminished, accomplished, or superior compared with others.



Identifying and processing the impact of classism on a particular client can promote culturally responsive counseling approaches.



It is also important to understand how internalized and structural classism may be implicated in mental health issues and barriers to counseling.



For example, classist policies related to public transportation (e.g., no bus stops in middle-class and upper-middle-class suburban areas) structurally limit how individuals who do not have personal transportation can commute to and from school, work, and even their counseling appointments.



If a counselor’s office or agency is in an area inaccessible by public transportation, they are limiting which clients can access their services to those who have access to personal transportation.

Application Exercise 7.2: The Impact of Poverty on Mental Health Learning Outcome 7.3: Describe individual and structural classism, and how structural classism impacts various systems. [Q1] Briefly discuss the prevalence and effects of food insecurity in the United States. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

10.5% of all U.S. households experienced some level of food insecurity.



13% of households with children experienced food insecurity (5.3 million children).



Households headed by a single woman, and households of those of African/African American and Latin/Latin American descent experience the highest levels of poverty and food insecurity.



Food insecurity is more prevalent in rural areas.



States in the South (Alabama, Arkansas, Kentucky, Louisiana, New Mexico, North Carolina, Oklahoma, Texas, and West Virginia) and Midwest (Ohio) had higher rates of food insecurity than the national average.



Numerous studies have linked food insecurity with developmental and social delays in children, lowered immune system functioning, obesity, emotional and behavioral problems, and mental health issues (e.g., depression, anxiety, aggression).

[Q2] Explain the impact that underemployment and employment instability have on workers and their families. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Employment is, in general, becoming increasingly unstable.



Wages have stagnated and jobs are being outsourced to other countries.



One illness in a family or one job loss can cause someone to fall from employed, to underemployed, to unemployed, to social welfare.



Women and children are especially vulnerable because women are continually subject to gender inequity in wages.



There are limited employment options suitable for mothers who are primary caregivers.



It is also difficult to find safe and affordable childcare.



Unemployment and underemployment can lead to housing insecurity and homelessness.



Children who experience housing and food insecurity are more likely to develop mental health disorders in adolescence.



In adults, housing insecurity contributes to poorer physical and mental health outcomes, which can be reversed with housing security.

[Q3] Explain how the stigma of poverty may impact a client of low socioeconomic status. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Social class and SES are factors in a client’s overall wellness.



Individual perceptions of social class and SES also play an important role in health outcomes.



Classism and the stigma attached to lower SES status may contribute to feeling deprived of power, place, and voice.



The psychological consequences of feeling devalued and displaced may include humiliation, lowered efficacy, low self-esteem, and higher rates of suicide.

Application Exercise 7.3: Addressing Issues Related to Classism Learning Outcome 7.5: Identify ways in which one can integrate advocacy into their classconscious counseling practices. [Q1] Discuss several practical strategies that counselors and counselor trainees can implement to increase their awareness of how class status, perceptions, beliefs, and biases may influence the counseling relationship. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Recognize that acquiring awareness is a process that is often accompanied by periods of discomfort.



Both differences and similarities in class status can evoke a variety of feelings, including discomfort, resentment, guilt, shame, anger, mistrust, pity, avoidance, pride, and jealousy.



Review and reflect on the Multicultural and Social Justice Counseling Competencies.



Explore your own life story in the context of class and SES.



Identifying how social class has been experienced in your family and how those values have been shared across generations.



Find out about volunteer opportunities at local organizations that work with poor and lowincome community members.



Allow the staff, clients, and community to educate you.



Interact with other social classes.



Attend a training session or workshop that explores social class issues.



Interview professionals in your field.



Complete a class privilege inventory.



Complete a thorough self-inventory of your socialization experiences regarding social class.

[Q2] List the five key knowledge domains related to counseling persons experiencing poverty. [Q2 MODEL RESPONSE] Your answer should include each of the following points: 

Understanding barriers associated with poverty



Recognizing facets of privilege, oppression, and intersectionality



Systems theory



The assessment, diagnosis, and treatment of severe and persistent mental illness



Identification and treatment of crisis and trauma

[Q3] Explain the role that assessment plays in gaining deeper insights into a low SE S client’s presenting concerns and a counselor’s values and biases. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Take the time conduct a comprehensive initial assessment to explore the client’s values and beliefs about social class.



A competent and socially conscious counselor will routinely assess each client’s stressors and resiliency and will include any concerns or goals, with the client’s approval, in the treatment plan.



Pay attention to psychological symptoms that may be caused or triggered by aspects of social inequity.



Assess the client’s awareness of classism, racism, and gender oppression; internalizing any form of oppression has been found to contribute to mental health issues—in particular, depression, low self-esteem, and substance abuse.



It is also critical to conduct a self-assessment to evaluate your own strengths and limitations in addressing the client’s concerns.



Additionally, you may use individual, group, and peer supervision to reflect on your internal process, the quality of the relationship, and your case conceptualization and intervention choices.

Chapter 7 Test Items Multiple Choice 1.

Which of the following statements is TRUE about social class? a. Social class may be rigid or formal, depending on the country. b. Social class may rank people according to their access and ability to manipulate socioeconomic resources. c. There are many ways to conceptualize social class. d. All the above are true statements.

It is possible to move between wealth and poverty, but consistent.

remains more

a. affect b. socioeconomic status c. mood d. availability of resources 3.

When beliefs, values, decisions, and relationships are based on perceptions of a lower social class status it is known as a. socioeconomic statusism. b. structural classism. c. internalized classism. d. class privilege.

A factor that contributes to the relative silence about classism is a. psychological distancing. b. poverty attribution. c. Both of the above. d. None of the above.

In the United States, there is a relatively low degree of a. class mobility. b. poverty attribution. c. classism. d. psychological distancing.

Poverty has NOT been associated with a. a greater incidence of exposure to violence. b. a greater likelihood of accessing mental health resources. c. a higher incidence of mental disorders. d. more severe symptoms of mental disorders.

are overrepresented among the poor in the United States. a. Women and children b. Youth and adolescents c. Single-parent families d. Men

Food insufficiency has been linked with the incidence of recipients.

in female welfare

a. malnourishment b. anorexia nervosa c. depression d. anxiety 9.

Inequities in property taxes may lead to inequities in a. quantifiable resources. b. school facilities. c. opportunities. d. experiences of classism.

10. The

prohibits discrimination in housing rentals, sales, and mortgage lending.

a. Equal Opportunities Act b. Fair Housing Act c. Equal Lenders Act d. Temporary Aid to Needy Families (T ANF) 11. With regard to health insurance, the United States is one of the few developed nations a. without universal health care. b. with universal health care. c. with government-funded health care. d. without government-funded health care. 12. Overall life expectancy varies in direct relationship to a. health. b. mental health access. c. income. d. All of the above. 13. Which of the following does NOT influence health outcomes? a. Level of satisfaction with SES b. Perceptions of our SES

c. Comparative factors of SES d. All of the above influence health outcomes. 14. Class bias may influence therapeutic interventions by a. assuming that people with pressing resource concerns must solve these problems before receiving any counseling. b. ignoring resources stressors. c. infusing counseling with middle-class assumptions and values. d. All of the above. 15. When facing information that contradicts our worldview, we may experience a. cognitive dissonance. b. contradicting dissonance. c. contradicting worldviews. d. poverty attribution. 16. Which of the following is a way to learn more about theory that integrates class and classism? a. Master’s level theories courses b. Journal articles c. Electronic sources d. All of the above. 17.

theory was criticized for emphasizing the empowerment of middle-class, White women. a. Feminist b. Womanist c. Relational-Cultural d. Modern Classism

18.

is NOT one of the domains of the Social Class Worldview Model (SCW M). a. Individual perceptions and attitudes b. Comparison of self to others c. Learned cognitions d. Use of material objects as a reflection of self, lifestyle, and learned social behaviors

19. A professional counselor may investigate local issues of classism by a. arranging informational interviews with other professionals. b. checking local papers and legislator websites. c. Both of the above. d. None of the above.

20. The

provides a very helpful resource for finding local services.

a. American School Counselor Association (ASCA) b. American Psychiatric Association (ACA) c. United Way d. United Classism Association (UCA) 21. A counselor cannot make presenting concern based on SES.

about the origin, nature, or severity of a client’s

a. assumptions b. decisions c. assessment decisions d. assessments 22. During the comprehensive initial assessment, a socially conscious counselor would assess a. gender identity development. b. resource stressors and strengths. c. the client’s cognitive, behavioral, and affective states. d. All of the above. 23. Assessing will provide an opportunity for professional counselors and clients to openly discuss obvious differences in your respective SES. a. class-related concerns b. resource-related concerns c. Both of the above. d. None of the above. 24.

is a way to advocate at the professional level. a. Counselor training b. Research c. Integrated service d. All of the above.

25. Ensuring access to sufficient food is an example of a. attending to basic needs. b. empowerment. c. integrated services. d. food pantry services. 26. Which of the following statements most accurately describes social class in the United States? a. The United States is a classless society.

b. Class status is determined by merit (i.e., it is earned). c. The relevance of class status has declined in the last century. d. Class status affects one’s ability to access resources and power. 27. According to the authors, ―classism‖ can best be described as a. discriminatory behavior toward people who are poor. b. social barriers that keep people from improving their class status. c. a belief that one is better than another because one has more resources. d. discriminatory behavior based on the perceived or actual class status of others. 28.

refers to using a position of class privilege to separate oneself from socioeconomic injustice. a. Structural classism b. Poverty attribution c. Cognitive dissonance d. Psychological distancing

29. The ability to move between social class levels is referred to as a. class mobility. b. class migration. c. structural classism. d. socioeconomic status. 30.

represents a transitional state we may experience as we learn information that conflicts with our personal worldview. a. Class mobility b. Poverty attribution c. Cognitive dissonance d. Psychological distancing

31. Believing that people are poor because they are lazy is a form of a. classism. b. poverty attribution. c. psychological distancing. d. All of the above. 32.

are most at risk for living in poverty. a. White rural families b. Racial minority women and children c. Adults who did not complete high school d. Unemployed young adults with college degrees

33. Based on your reading of the chapter, which of the following statements is most likely? a. Resource deficits are implicated in the development of mental illness. b. Mental illness leads to unemployment and poverty. c. Income level and mental health are unrelated. d. None of the above. 34. The main reason given for funding disparities in public education is a. unfair income tax rates. b. difficulty with community fundraising. c. schools losing funding due to the No Child Left Behind Act of 2001. d. the lack of federal funding standards and overreliance on local property taxes. 35. The United States is one of the wealthiest nations in the world. Which of the following statements is also TRUE when comparing the United States to other developed nations? a. The United States has one of the lowest adult literacy rates. b. The United States has one of the highest infant mortality rates. c. The United States is one of the few developed nations without universal health care. d. All of the above are true. 36. Which of the following is LEAST likely to link directly with economic privilege? a. Increased life expectancy b. Access to higher education c. Dissatisfaction with class status d. Access to safe and affordable housing 37. A living wage is best described as a. the current minimum wage. b. mandatory health insurance for all minimum wage earners. c. a minimum wage that is sufficient to support all basic needs. d. a federal mandate to redistribute income taxes to low-wage earners. 38. Which of the following counselor-client pairs is least likely to be influenced by classism? a. Low-SES counselor: high-SES client b. High-SES counselor: low-SES client c. Middle-SES counselor: middle-SES client d. All of the above will be influenced by classism. 39. The counseling profession as a whole tends to replicate the values, beliefs, and behaviors of the socioeconomic status group. a. Lower-class (poor)

b. Working-class c. Middle-class d. Upper-class 40. Which of the following statements accurately reflects the author’s discussion of classism and theory? a. There are no counseling theories that address classism. b. Some counseling theories are more inclusive of classism than others. c. It is not necessary to have a counseling theory specifically addressing classism. d. The only psychological theory that addresses classism is the Modern Classism Theory. 41. According to the author, who is responsible for initiating a discussion of class in a counseling relationship? a. The client—if it is relevant the client will bring it up. b. The client—it would be disempowering for the counselor to assume it’s an issue. c. The counselor—stigma and power differences may prevent the client from raising the topic. d. The counselor—low-income clients may not understand the significance of classism. 42. The most effective way to make resource referrals with clients is to a. investigate local resources before referring the client. b. work with client to fully assess the client’s needs, ability, and willingness to access resources. c. Both of the above. d. None of the above. 43. The author recommended several levels of intervention for addressing class-based oppression. was NOT included as a level of advocacy. a. Professional level b. Sociopolitical level c. Individual/client level d. All of the above were included. 44. Which of the following would the author recommend as an important first step for a client whose depression is directly related to chronic unmet resource needs (food, housing, employment)? a. Refer the client to a social worker or case manager. b. Refer the client to local resources that can address respective needs. c. Address depressive symptoms so that the client can function better in meeting needs. d. A comprehensive assessment of client’s class-related stressors, strengths, and goals. 45. Counselors can improve their ability to address classism by a. increasing personal awareness of class-based beliefs, biases, and behaviors.

b. assessing and exploring class-related issues and concerns with all clients. c. addressing class-based oppression through social advocacy. d. All of the above. 46.

refers to unexamined class biases which shape our beliefs about our self and our relative merit in our families, peer groups, and community. a. Classism b. Internalized classism c. Structural classism d. Psychological distancing

47.

is having negative biases about, and discriminatory behaviors toward, individuals or groups based on their perceived or actual SES. a. Classism b. Internalized classism c. Structural classism d. Psychological distancing

48. Social and institutional practices that discriminate based on SES, which may be overt or covert, is a concept known as a. Classism b. Internalized classism c. Structural classism d. Psychological distancing

Extended Response 1.

Describe social class and the different ways of conceptualizing social class.

Explain how mental health is related to poverty and the implications poverty has for counseling.

Describe how counselors should address classism in counseling.

Explain a counselor’s role in acquiring self-awareness.

List and describe the activities one can do to increase self-awareness.

Choose and describe two theories that incorporate class and classism.

Describe methods for investigating local issues.

Describe the different aspects professional counselors should assess when working with diverse SES clients.

Explain the two significant areas related to social class that should be focused on during client assessment.

10. Describe one advocacy intervention for each of the levels of intervening. 11. Describe yourself objectively (descriptors that are observable to others) in terms of class

indicators. Class indicators may include, but are not limited to, your style of dress (professional and casual), hairstyle, speaking habits, type of employment and hobbies, recreational activities, housing and neighborhood, mode of transportation, food preferences and eating habits, peer group, and entertainment preferences. How might these class indicators affect your ability to develop relationships with the clients and community members you intend to serve? 12. Describe the community you live in (or where you grew up) in terms of socioeconomic status, class structure, and structural classism. Are you able to describe some parts of the community better than others? What relationship do you see between your own class status and your knowledge of your community? 13. Why might a counselor or counselor-trainee be reluctant to increase his or her awareness of classism? Refer to cognitive dissonance and psychological distancing in your response. 14. Review the poverty risk factors (e.g., food, education, employment, housing, health). Select one risk factor and assess your awareness, knowledge, and skill in addressing this factor with clients. What steps could you take to become more effective in this area? 15. What are some personal and professional barriers you might face when attempting to advocate on class-related issues? What resources might be helpful in addressing these barriers? 16. The author recommends use of a ―comprehensive initial assessment‖ when entering a relationship with any new client. Based on your reading of the chapter, what are three questions or areas you believe are most important to explore with new clients? Explain your choices and the influence you think this additional exploration would have on the counseling process. 17. Schools, colleges, and counseling agencies are rapidly transitioning to electronic recordkeeping, communication, and information distribution (e.g., outreach, community education). What are the implications for clients who do not have access to computers or the Internet? What are the implications for counseling professionals in low-income communities who do not have the economic resources to keep up with advancing technology?

Chapter 7 Test Answer Key ANSWER KEY: Chapter 7 Test (Multiple Choice) 1. d 2. b 3. c 4. c 5. a 6. b 7. a 8. c 9. b 10. b 11. a 12. c 13. d 14. d 15. a 16. d 17. a 18. c 19. c 20. c 21. a 22. b 23. c 24. d 25. a 26. d 27. d 28. d 29. a 30. c 31. d 32. b

33. a 34. d 35. d 36. c 37. c 38. d 39. c 40. b 41. c 42. c 43. d 44. d 45. d 46. b 47. a 48. c

Chapter 8 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach

4th Edition Danica G. Hays University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents

Chapter 8: Disability, Ableism, and Ageism

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 8: Disability, Ableism, and Ageism Chapter 8 Learning Outcome Quizzes Learning Outcome 8.1: Identify the types of disability, including mental illness and/or psychiatric disability, their prevalence, and the civil rights law that serves to ensure inclusivity of individuals with a disability. [Q1] Which of the following is a national benefits program, under the Social Security Administration, provides insurance for eligible people (children and adults) with a disability? 1. SSI 2. ADA 3. SSDI [correct] 4. IDEA [Feedback for Answer Choice 1] Supplemental Security Income (SSI) is a national benefits program; however, it does not insurance for individuals with a disability. [Feedback for Answer Choice 2] The Americans with Disabilities Act (ADA) is a federal nondiscrimination law, not an insurance program. [Feedback for Correct Answer 3] Social Security Disability Insurance (SSDI) is a national benefits program, under the Social Security Administration, that provides insurance for eligible people (children and adults) with a disability. [Feedback for Answer Choice 4] The Individuals with Disabilities Education Improvement Act (IDEA) is a federal law, not an insurance program. IDEA enables specialized educational services to be provided by the public school system. [Q2] According to the Centers for Disease Control and Prevention [CDC] (2020), adults living in the United States with a disability account for of the total U.S. population. 1. 10.8 2. 13.7 3. 17.6 4. 26% [correct]

[Feedback for Answer Choice 1] Of those adults with a disability, 10.8% have a cognition disability with serious difficulty concentrating, remembering or making decisions (CDC, 2020). [Feedback for Answer Choice 2] Of those adults with a disability, 13.7% have a mobility disability with serious difficulty walking or climbing stairs (CDC, 2020). [Feedback for Answer Choice 3] According to the U.S. Census Bureau, in 2018 about 17.6% of U.S. adults (55.2 million people) had a severe disability. [Feedback for Correct Answer 4] According to the Centers for Disease Control and Prevention [CDC] (2020), there are more than 61 million adults (26% of the total U.S. population) living in the United States with a disability. [Q3] According to the U.S. Census Bureau, in 2018 about disability.

of U.S. adults had a severe

1. 10.8% 2. 13.7% 3. 17.6% [correct] 4. 26% [Feedback for Answer Choice 1] Of those adults with a disability, 10.8% have a cognition disability with serious difficulty concentrating, remembering or making decisions (CDC, 2020). [Feedback for Answer Choice 2] Of those adults with a disability, 13.7% have a mobility disability with serious difficulty walking or climbing stairs (CDC, 2020). [Feedback for Correct Answer 3] According to the U.S. Census Bureau, in 2018 about 17.6% of U.S. adults (55.2 million people) had a severe disability. [Feedback for Answer Choice 4] According to the Centers for Disease Control and Prevention [CDC] (2020), there are more than 61 million adults (26% of the total U.S. population) living in the United States with a disability. [Q4] According to a 2021 report produced by the National Alliance on Mental Illness [NAMI], individuals living with mental illness and/or psychiatric disability comprise approximately of the U.S. adult population. 1. 5.9% 2. 6.8%

3. 13.7% 4. 20% [correct] [Feedback for Answer Choice 1] Of those adults with a disability, 5.9% are deaf or have serious difficulty hearing (CDC, 2020). [Feedback for Answer Choice 2] Of those adults with a disability, 6.8% have an independent living disability with difficulty doing errands alone (CDC, 2020). [Feedback for Answer Choice 3] Of those adults with a disability, 13.7% have a mobility disability with serious difficulty walking or climbing stairs (CDC, 2020). [Feedback for Correct Answer 4] According to a 2021 report produced by the National Alliance on Mental Illness [NAMI], individuals living with mental illness and/or psychiatric disability comprise approximately 20% of the U.S. adult population. Learning Outcome 8.2: Compare the models of disability, recognizing which model or models is inclusive of individuals with a disability. [Q1] The past several years have seen a gradual paradigm shift in the conceptualization of health and disability, with a focus away from a purely model. 1. social 2. medical [correct] 3. functional 4. biopsychosocial [Feedback for Answer Choice 1] Movement toward utilizing the social model has contributed to the gradual paradigm shift in the conceptualization of health and disability. [Feedback for Correct Answer 2] The past several years have seen a gradual paradigm shift in the conceptualization of health and disability, with a focus away from a purely medical model. [Feedback for Answer Choice 3] Movement toward utilizing the functional model has contributed to the gradual paradigm shift in the conceptualization of health and disability. [Feedback for Answer Choice 4] Movement toward utilizing the biopsychosocial model has contributed to the gradual paradigm shift in the conceptualization of health and disability.

[Q2] Which of the following models delivers interventions that are aimed at adapting the environment and the individual’s related functional demands to the needs of people with disabilities? 1. Social model 2. Medical model 3. Functional model [correct] 4. Biopsychosocial model [Feedback for Answer Choice 1] The focus of the social model is on societal barriers and biases against people with disabilities, not on the person, the disability, or the medical condition itself. [Feedback for Answer Choice 2] The medical model uses an individual’s medical diagnosis as the basis for counseling and for determining the needs and functional abilities of the individual with a disability. [Feedback for Correct Answer 3] The functional model delivers interventions that are aimed at adapting the environment and the individual’s related functional demands to the needs of people with disabilities. [Feedback for Answer Choice 4] The biopsychosocial model views disability as a combination of the medical model and the social model from the lens of biology, psychology, and sociology. [Q3] Which of the following terms refers to the individual’s diagnosis, disease, injury, condition, or illness? 1. Pathology [correct] 2. Impairments 3. Disability 4. Functional limitations [Feedback for Correct Answer 1] Pathology refers to refers to the individual’s diagnosis, disease, injury, condition, or illness. [Feedback for Answer Choice 2] Impairments refers to the individual’s dysfunction or structural abnormalities in a specific body system (e.g., neurologic, cardiovascular, or respiratory). [Feedback for Answer Choice 3] Disability refers to the individual’s difficulty in doing basic activities, such as work, household management, hobbies, leisure/recreation, and social interactions.

[Feedback for Answer Choice 4] Functional limitations refer to the individual’s ability to perform daily or life activities, such as walking, reading, or speaking. [Q4] Which of the following terms refers to the individual’s ability to perform daily or life activities, such as walking, reading, or speaking? 1. Pathology 2. Impairments 3. Disability 4. Functional limitations [correct] [Feedback for Answer Choice 1] Pathology refers to refers to the individual’s diagnosis, disease, injury, condition, or illness. [Feedback for Answer Choice 2] Impairments refers to the individual’s dysfunction or structural abnormalities in a specific body system (e.g., neurologic, cardiovascular, or respiratory). [Feedback for Answer Choice 3] Disability refers to the individual’s difficulty in doing basic activities, such as work, household management, hobbies, leisure/recreation, and social interactions. [Feedback for Correct Answer 4] Functional limitation refers to the individual’s ability to perform daily or life activities, such as walking, reading, or speaking. Learning Outcome 8.3: Identify the ways in which disability is viewed at the individual, family and community level. [Q1] Which of the following cultures would view a person with blindness in a favorable way and believe that a blind person possesses a specific and valued insight? 1. Australian 2. Eastern European 3. Latin American 4. Southeast Asian [correct] [Feedback for Answer Choice 1] According to Maki and Tarvydas (2011), Western societies such as Australia tend to view a person with blindness in a less than favorable way, as simply someone who has a vision disability and cannot see.

[Feedback for Answer Choice 2] According to Maki and Tarvydas (2011), Western societies such as Eastern Europe tend to view a person with blindness in a less than favorable way, as simply someone who has a vision disability and cannot see. [Feedback for Answer Choice 3] According to Maki and Tarvydas (2011), Western societies such as Latin America tend to view a person with blindness in a less than favorable way, as simply someone who has a vision disability and cannot see. [Feedback for Correct Answer 4] According to Maki and Tarvydas (2011), Southeast Asian cultures view a person with blindness in a favorable way and believe that a blind person possesses a specific and valued insight, while some Western societies view that same individual as someone who has a vision disability and cannot see. [Q2] The term is used to describe two or more permanent injuries to the body that result in physical, cognitive, psychological, or psychosocial impairment and functional disability. 1. PTSD 2. polytrauma [correct] 3. multi-traumatic injury 4. multiple impairments [Feedback for Answer Choice 1] PTSD refers to a mental health condition that is triggered by witnessing or experiencing a traumatic event. [Feedback for Correct Answer 2] Polytrauma is defined as two or more permanent injuries to the body that result in physical, cognitive, psychological, or psychosocial impairment and functional disability (e.g., traumatic brain injury, hearing loss and/or visual impairment, major loss of limb, bone fractures, and burns). [Feedback for Answer Choice 3] Multi-traumatic injury is not a medical- or counseling-specific term. Instead, the term multiple trauma is used to describe several injuries sustained from a single event. [Feedback for Answer Choice 4] Multiple impairments is not a medical- or counseling-specific term. Instead, the term multiple disabilities is used.

[Q3] Which of the following attributes is considered a positive description of an individual with a disability? 1. Burdened 2. Challenged 3. Differently abled [correct] 4. Unfortunate [Feedback for Answer Choice 1] The word burdened is considered a negative description of an individual with a disability. [Feedback for Answer Choice 2] The word challenged is considered a negative description of an individual with a disability. [Feedback for Correct Answer 3] Using the phrase differently abled is considered a positive description of an individual with a disability. [Feedback for Answer Choice 4] The word unfortunate is considered a negative description of an individual with a disability. [Q4] Which of the following reflects the most culturally sensitive description of disability? 1. Person with a disability [correct] 2. Differently abled individual 3. Disabled person 4. Neurodiverse [Feedback for Correct Answer 1] It is important to remember that people with disabilities are people first—who happen to have a disability. Generally, they prefer to be described using person-first language (e.g., person with a disability). [Feedback for Answer Choice 2] Using the description differently abled individual emphasizes the differences associated with their disability rather than their personhood. While this term is considered a positive description of disability, it is not the most culturally sensitive description of those listed. [Feedback for Answer Choice 3] Using the description disabled person emphasizes an individual’s disability instead of their personhood. Thus, this term is not the most culturally sensitive description of those listed. [Feedback for Answer Choice 4] The term neurodiverse refers to variation in the human brain regarding sociability, learning, attention, mood, and other mental functions; however, this term does not encompass all forms

of disability. As such, it would be inappropriate to use it as an umbrella term to refer to a person with a disability who is not neurodiverse. Learning Outcome 8.4: Detail counseling implications for working with individuals with disability and addressing ableism. [Q1] Which of the following acts was passed in 1990 and is regarded as the culmination of a quartercentury trend toward the establishment of legal protections for people with disabilities? 1. Americans with Disabilities Act [correct] 2. Civilian Rehabilitation Act 3. Soldier Rehabilitation Act 4. Individuals with Disabilities Education Improvement Act [Feedback for Correct Answer 1] The Americans with Disabilities Act (ADA) was passed in 1990 and is regarded by some as the culmination of a quarter-century trend toward the establishment of legal protections for people with disabilities and a major victory in the disability rights movement. The ADA protects the rights of people with disabilities and prohibits discrimination in employment, public accommodations, government services, some communication services, and public and private transportation systems. [Feedback for Answer Choice 2] Passed in 1920, the Civilian Rehabilitation Act granted funds to states to implement programs that addressed the needs of ordinary citizens with disabilities. [Feedback for Answer Choice 3] Passed in 1918, the Soldier Rehabilitation Act established a formal program of training and counseling (i.e., vocational rehabilitation) for U.S. veterans. [Feedback for Answer Choice 4] The Individuals with Disabilities Education Improvement Act was signed into law in December 2004, amending the 1990 Individuals with Disabilities Education Act (IDEA), which had introduced a number of new provisions related to the education of children with disabilities. [Q2] Which of the following websites should you visit, if you wanted to learn about the independent federal agency charged with advising the President, Congress, and other federal agencies regarding policies, programs, practices, and procedures that affect people with disabilities? 1. www.ada.gov/pubs/ada.htm 2. www.disability.gov/ 3. www.ncd.gov/ [correct] 4. http://idea.ed.gov/

[Feedback for Answer Choice 1] This website provides a direct link to the Americans with Disabilities Act legislation. [Feedback for Answer Choice 2] This is the website of Online Resource for Americans with Disabilities, which connects people with disabilities, their families, and caregivers to helpful resources on topics such as how to apply for disability benefits, find a job, get health care, or pay for accessible housing. [Feedback for Correct Answer 3] This is the website of the National Council on Disability, an independent federal agency charged with advising the President, Congress, and other federal agencies regarding policies, programs, practices, and procedures that affect people with disabilities. [Feedback for Answer Choice 4] This website provides a direct link to Individuals with Disabilities Education Improvement Act (ID EA) of 2004 legislation. [Q3] The stated mission of which of the following organizations is to ―enhance the development of people with disabilities throughout their life span and to promote excellence in the rehabilitation counseling profession‖? 1. National Council on Rehabilitation Education (NCRE) 2. American Rehabilitation Counseling Association (ARCA) [correct] 3. National Rehabilitation Counseling Association (NRCA) 4. International Association of Rehabilitation Professionals (IARP) [Feedback for Answer Choice 1] The NCRE is a professional organization dedicated to providing quality services for people with disabilities through education and research. [Feedback for Correct Answer 2] The mission of ARCA is to enhance the development of people with disabilities throughout their life span and to promote excellence in the rehabilitation counseling profession. [Feedback for Answer Choice 3] The NRCA is a professional association that is a division of the National Rehabilitation Association and represents professionals in the field of rehabilitation counseling in a wide variety of work settings. [Feedback for Answer Choice 4] The IARP is a professional association that serves a diverse membership practicing in the fields of long-term disability management consulting, case management and managed care, forensics and expert testimony, life care planning, and Americans with Disabilities Act (ADA) consulting.

[Q4] Who served as Commissioner of Vocational Rehabilitation and helped shape the Vocational Rehabilitation Act of 1954? 1. Billy Barner 2. Judy Huemann 3. Douglas Martin 4. Mary Switzer [correct] [Feedback for Answer Choice 1] Billy Barner was the first African American student at the University of California at Berkeley’s Cowell Residence Program for Physically Disabled Students (1969–1973). [Feedback for Answer Choice 2] Judy Huemann cofounded Disabled in Action. Also, cofounded (with Joan Leon and Ed Roberts) and served as co-director of the World Institute on Disability. [Feedback for Answer Choice 3] Douglas Martin was a national leader in Social Security health benefits reform and helped pass the Americans with Disabilities Act (ADA). [Feedback for Correct Answer 4] Mary Switzer served as Commissioner of Vocational Rehabilitation and helped shape the Vocational Rehabilitation Act of 1954. Learning Outcome 8.5: Articulate issues unique to older adults and the counseling process, including ageism. [Q1] According to a 2016 report published by the USDHHS Administration on Aging, have the highest rate of disability among U.S. adults. 1. African Americans [correct] 2. American Indians 3. Latin Americans 4. Whites [Feedback for Correct Answer 1] According to a 2016 report published by the USDHHS Administration on Aging, African Americans have the highest rate of disability among U.S. adults. [Feedback for Answer Choice 2] According to a 2016 report published by the USDHHS Administration on Aging, American Indians have the second highest rate of disability among U.S. adults.

[Feedback for Answer Choice 3] According to a 2016 report published by the USDHHS Administration on Aging, Latin Americans have the fourth highest rate of disability among U.S. adults. [Feedback for Answer Choice 4] According to a 2016 report published by the USDHHS Administration on Aging, Whites have the third highest rate of disability among U.S. adults. [Q2] Which of the following terms refers to the form of discrimination creates a sense of oppression and disempowerment among young people that can be carried on and perpetuated once they become adults? 1. Ageism 2. Adultism [correct] 3. Juvenile-ism 4. Age discrimination [Feedback for Answer Choice 1] Ageism is defined as the assumption that chronological age is the main determinant of human characteristics, and that one age is better than another. [Feedback for Correct Answer 2] Adultism refers to discrimination against young people (youths) and children. This form of discrimination creates a sense of oppression and disempowerment among young people that can be carried on and perpetuated once they become adults. [Feedback for Answer Choice 3] Juvenile-ism is not a counseling-specific term. [Feedback for Answer Choice 4] Age discrimination involves denying a job or promotion to an individual solely based on age and is illegal in the United States. [Q3] Which of the following terms is defined as the assumption that chronological age is the main determinant of human characteristics, and that one age is better than another? 1. Ageism [correct] 2. Adultism 3. Juvenile-ism 4. Age discrimination [Feedback for Correct Answer 1] Ageism is defined as the assumption that chronological age is the main determinant of human characteristics, and that one age is better than another.

[Feedback for Answer Choice 2] Adultism refers to discrimination against young people (youths) and children. This form of discrimination creates a sense of oppression and disempowerment among young people that can be carried on and perpetuated once they become adults. [Feedback for Answer Choice 3] Juvenile-ism is not a counseling-specific term. [Feedback for Answer Choice 4] Age discrimination involves denying a job or promotion to an individual solely on the basis of age and is illegal in the United States. [Q4] Which of the following acts protects the rights of older people and entitles them to adequate retirement income in retirement in accordance with the American standard of living? 1. Civilian Rehabilitation Act of 1920 2. U.S. Age Discrimination in Employment Act of 1986 3. Americans with Disabilities Act of 1990 4. Older Americans Act Amendments of 2006 [correct] [Feedback for Answer Choice 1] The Civilian Rehabilitation Act of 1920 granted funds to states to implement programs that addressed the needs of ordinary citizens with disabilities. [Feedback for Answer Choice 2] The U.S. Age Discrimination in Employment Act of 1986 protects workers over age 40 years of age, has done seemingly little to reduce age discrimination at work. [Feedback for Answer Choice 3] The Americans with Disabilities Act of 1990 protects the rights of people with disabilities and prohibits discrimination in employment, public accommodations, government services, some communication services, and public and private transportation systems. [Feedback for Correct Answer 4] The Older Americans Act Amendments of 2006 protects the rights of older people and entitles them to adequate retirement income in retirement in accordance with the American standard of living, among other rights, benefits, and services. Learning Outcome 8.6: Detail counseling implications for working with older adults. [Q1] authored the classic work, Successful Aging, defined successful aging as the avoidance of disease and disability, the maintenance of cognitive and physical function, and sustained engagement with life. 1. Havighurst (1961) 2. Myers (1992)

3. Myers and Schweibert (1996) 4. Rowe and Kahn (1998) [correct] [Feedback for Answer Choice 1] Havighurst (1961) defined successful aging as the process of adding life to one’s years (rather than years to one’s life) and getting satisfaction out of life. [Feedback for Answer Choice 2] Myers (1992) wrote about efforts taken by the ACA to propose and approve standards for training in gerontological counseling. [Feedback for Answer Choice 3] Myers and Schweibert (1996) developed the ACA gerontological competencies, which include competence statements that were prepared to assist counselor educators in developing curricula and other training experiences to ensure adequate preparation of counselors in gerontological issues. [Feedback for Correct Answer 4] Rowe and Kahn (1998) authored the classic work, Successful Aging, defined successful aging as the avoidance of disease and disability, the maintenance of cognitive and physical function, and sustained engagement with life. [Q2] Which of the following organizations is the principal agency of the U.S Department of Health and Human Services designated to carry out the provisions of the Older Americans Act of 1965? 1. American Geriatrics Society 2. The Administration on Aging [correct] 3. National Institute on Aging 4. Association for Adult Development and Aging [Feedback for Answer Choice 1] This American Geriatrics Society is a professional nongovernmental organization devoted to improving the health, independence, and quality of life of all older people. The Society provides leadership to health-care professionals, policy makers, and the public. [Feedback for Correct Answer 2] The Administration on Aging is the principal agency of the U.S Department of Health and Human Services designated to carry out the provisions of the Older Americans Act of 1965. [Feedback for Answer Choice 3] National Institute on Aging (NIA) is 1 of the 27 Institutes and Centers of the National Institutes of Health that engages in research activities dedicated to understanding the nature of aging, supporting the health and well-being of older adults, and extending healthy, active years of life for more people.

[Feedback for Answer Choice 4] The Association for Adult Development and Aging is a professional nongovernmental organization. The mission of the AADA is to support the professional development of counselors, advocate on issues related to adult development and aging, and address counseling concerns across the life span. [Q3] Which of the following is a nonprofit membership organization of people aged 50 years and older that is dedicated to addressing their needs and interests? 1. AARP [correct] 2. ASFAR 3. N4A 4. NYRA [Feedback for Correct Answer 1] AARP (formerly the American Association for Retired Persons) is a nonprofit membership organization of people aged 50 years and older that is dedicated to addressing their needs and interests. [Feedback for Answer Choice 2] ASFAR (Americans for a Society Free from Age Restrictions) is dedicated to protecting and advancing the legal civil rights of youths. [Feedback for Answer Choice 3] The mission of N4A (National Association of Area Agencies on Aging) members is to help older adults and people with disabilities live with dignity and choices in their homes and communities for as long as possible. [Feedback for Answer Choice 4] NYRA (National Youth Rights Association) is a national youth-led organization that defends the civil and human rights of young people in the United States through educating people about youth rights, working with public officials, and empowering young people to work on their own behalf. [Q4] According to the , a gerontological counselor should: ―Exhibit positive, wellness-enhancing attitudes toward older people, including respect for the intellectual, emotional, social, vocational, physical, and spiritual needs of older individuals and the older population as a whole.‖ 1. ACA Code of Ethics (2014) 2. AACD Ethical Standards (1990) [correct] 3. ACA gerontological competencies (1996) 4. CACREP Standards (2016)

[Feedback for Answer Choice 1] ACA Code of Ethics (2014) does not provide guidelines for specific areas of practice. Rather, the code requires counselors to practice within their scope of competence and seek out additional education, training, and supervision before pursuing new specialty areas of practice. [Feedback for Correct Answer 2] According to the AACD Ethical Standards (1990), a counselor should: “Exhibit positive, wellness-enhancing attitudes toward older people, including respect for the intellectual, emotional, social, vocational, physical, and spiritual needs of older individuals and the older population as a whole.‖ [Feedback for Answer Choice 3] The ACA gerontological competencies (1996) provide additional and expanded guidelines— beyond those stated in the AACD Ethical Standards (1990)— for the practice of gerontological counseling. [Feedback for Answer Choice 4] The CACREP Standards (2016) provide guidelines for training and supervising graduate counseling students. Learning Outcome 8.7: Recommend future counseling research directions regarding disability, ableism, and ageism. [Q1] It is becoming clear that the effectiveness of the therapeutic working alliance between client and counselor depends, in large part, on the counselors’ ability to recognize and understand their clients’ identities. 1. unique 2. cultural 3. oppressed 4. intersectional [correct] [Feedback for Answer Choice 1] It is important for counselors to recognize and understand their clients’ unique identities. Additionally, counselors must have an awareness of the interconnection between a client’s various salient identities. [Feedback for Answer Choice 2] It is important for counselors to recognize and understand their clients’ cultural identities. Additionally, counselors must have an awareness of the interconnection between a client’s various salient identities. [Feedback for Answer Choice 3] It is important for counselors to recognize and understand their clients’ oppressed identities. Additionally, counselors must have an awareness of the interconnection between a client’s various salient identities.

[Feedback for Correct Answer 4] It is becoming clear that the effectiveness of the therapeutic working alliance between client and counselor depends, in large part, on the counselors’ ability to recognize and understand their clients’ intersectional identities. [Q2] According to Frey (2018), significant changes in U.S. population demographics are expected. These changes will include an increase in the size of the population. 1. Millennial 2. Generation Z 3. Elderly [correct] 4. White [Feedback for Answer Choice 1] According to Frey (2018), changes in U.S. population demographics will include rising racial and ethnic diversity among millennials. [Feedback for Answer Choice 2] According to Frey (2018), changes in U.S. population demographics will include rising racial and ethnic diversity among Generation Z. [Feedback for Correct Answer 3] According to Frey (2018), significant changes in U.S. population demographics are expected. These changes will include an increase in the size of the elderly population. [Feedback for Answer Choice 4] According to Frey (2018), changes in U.S. population demographics will include a first-time decline in the size of the White population. [Q3] What professional group advocates for quality and equitable services to individuals with disabilities from culturally diverse populations and supports ongoing research in these areas? 1. BIPOC 2. NAMRC [correct] 3. NCOA 4. POW ADA [Feedback for Answer Choice 1] BIPOC is a racial-ethic group, not a professional group. The acronym stands for Black, Indigenous, People of Color. [Feedback for Correct Answer 2] The National Association of Multicultural Rehabilitation Concerns (NAMRC) advocates for quality and equitable services to individuals with disabilities from culturally diverse populations and supports ongoing research in these areas.

[Feedback for Answer Choice 3] The National Council on Aging (NCOA) is dedicated to improving the health and economic security of older adults. [Feedback for Answer Choice 4] As recent as March 2021, Protecting Older Workers Against Discrimination Act (POW ADA) legislation was re-introduced to Congress as a way to protect against age discrimination in the workplace. [Q4] As recent as March 2021, the legislation was re-introduced to Congress to protect against age discrimination in the workplace. 1. POW ADA [correct] 2. DD Act 3. IDEA 4. USDHHS [Feedback for Correct Answer 1] As recent as March 2021, Protecting Older Workers Against Discrimination Act (POW ADA) legislation was re-introduced to Congress as a way to protect against age discrimination in the workplace. [Feedback for Answer Choice 2] The DD Act was passed in 2000 to protect the rights of individuals with disabilities; provide access to resources and fund support programs; and to promote the inclusion, independence, and productivity of disabled individuals within society. [Feedback for Answer Choice 3] Individuals with Disabilities Education Improvement Act (IDEA) of 2004 defined disability as a physical or mental impairment that adversely affects a child’s educational performance. Specific disability categories are defined in the legislation and specialized educational services can be provided by the public school system. [Feedback for Answer Choice 4] The U.S. Department of Health and Human Services (USDHHS) is a federal agency which includes an Administration on Aging.

Chapter 8 Application Exercises Application Exercise 8.1: Exploring Models of Disability Learning Outcome 8.2: Compare the models of disability, recognizing which model or models is inclusive of individuals with a disability. [Q1] Highlight some of the approaches to managing a disability that align with the biomedical model of disability. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Investing in resources in health care and related services that focus on the medical aspects of the disability or illness such as: medical procedures, surgeries, diagnostic tests, and therapies (physical and/or psychotherapeutic).



Use of assistive or adaptive devices that can be used to help ―normalize‖ the individual with a disability.

[Q2] Discuss how the social model of disability differs from the biomedical model. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Some disability rights groups and advocates have criticized the medical model for focusing on what is wrong with the person with a disability and the resultant need to ―fix‖ the person.



The social model grew out of a response to this criticism.



The focus of the social model is on societal barriers and biases against people with disabilities, not on the person, the disability, or the medical condition itself.



The social model recognizes that, although some people may have a condition that is considered different from what is ―normal‖ in a society, the disability is created from society’s failure or perceived inability to embrace, accommodate, and incorporate people into society to the fullest extent.

[Q3] Briefly explain the purpose of utilizing both extraindividual and intraindividual interventions when working with a client with disability. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

First, the counselor seeks to gain deeper insight into a client’s specific pathology or diagnosis and considers the risk factors that may influence the onset of the pathology that led to the disability.



Based on these insights and considerations, extraindividual intervention strategies may be utilized to secure effective medical and rehabilitative care, caregiver support, adaptive/assistive devices, social service programs, and structural or architectural modifications.



Intraindividual intervention strategies aim to address lifestyle and behavior changes, psychological attributes, coping strategies, and activity accommodations that help the person maintain independence for as long as possible.

Application Exercise 8.2: Understanding Disability at the Individual, Family, and Community Level Learning Outcome 8.3: Identify the ways in which disability is viewed at the individual, family, and community level. [Q1] Highlight some of the key considerations related to viewing disability on an individual level. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

The role that a person with a disability is expected to have in the community helps shape the willingness of the community to integrate the person with a disability into the culture, including the willingness to spend financial or other resources on the person.



For an adult with a disability, the person’s contribution to the family income, full integration into society, and ability to contribute to society are all important considerations.



Tension may exist between the views of the person with a disability and the views of the greater society.



Conflict can occur between a person’s needs and expectations and the concerns of their family and community.



This tension also impacts a person’s plans and aspirations for life, both now and in the future.

[Q2] Discuss how a community’s role in assisting a person with a disability to secure employment can differ across cultures. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

In the United States, the right and ability of a person with a disability to obtain and maintain employment is a primary goal of rehabilitation counseling and is a key outcome in the delivery of rehabilitation services.



In many other cultures, which typically have a more communal society and recognize the influence and importance of extended families, involvement by family, friends, and neighbors can have a significant impact on an individual with a disability.



More specifically, in many cultures, having an individual with a disability engage in the workforce can be considered a sign of neglect and abuse by the family and a ―shirking‖ of the family’s role and responsibility toward caring for the individual.

[Q3] Explain the important role that language plays in positively framing how individuals living with disabilities are characterized. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Positive language is empowering and indicates strength.



Negative or limiting language can be detrimental to how an individual with a disability views him/herself and/or his/her role(s) within society.



People with disabilities are people first—who happen to have a disability. They typically prefer to be called just that: a person with a disability. Recognize that certain groups such as the Deaf and autistic rights communities prefer identity-first language, in which the disability is mentioned first (―Deaf person‖ instead of ―person who is hard of hearing‖ or ―autistic person‖ instead of ―a person with autism‖). Do research in each case to confirm you are representing each community the way they would self-identify and understand that the language used to refer to certain groups of people can and does change over time.



Strengths-based descriptions might include: brave and courageous rather than weak or unfortunate, inspirational rather than pitied, surviving against all odds rather than infirmed or suffering, differently abled rather than challenged.

Application Exercise 8.3: Counseling Individuals with Disability Learning Outcome 8.4: Detail counseling implications for working with individuals with disability and addressing ableism. [Q1] How can increasing awareness of ableism help a counselor become a more effective clinician and advocate? [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Culturally competent counselors should have a general awareness of the range of human beliefs about ableism, disability, and functional impairment—a range that crosses cultures, societies, and even individual beliefs.



Counselors who become more aware of ableism and its effects on individuals with disabilities can improve the personalized nature of their services.



Increased awareness also inspires counselors to overcome their professional objectivity and strive to become more directly involved in helping clients overcome barriers to full inclusion in society.



Adopting an advocacy role enables a counselor to take a more proactive and less passive role when working with clients who are confronted by oppression and injustice.

[Q2] Briefly describe the role that social advocacy should play within the counseling relationship. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

When counseling individuals with a disability, the counselor must serve as an advocate for the client and the client’s needs.



Social advocacy involves the counselor initiating or participating in activities that are aimed at redistributing power and resources away from those individuals or groups that are considered the most ―able‖ and toward those individuals or groups who demonstrate a need for such power and resources.



Another component of social advocacy for a counselor is the ability to inform, empower, encourage, and support clients so that they are better able to make informed decisions that will meet their own needs.

[Q3] Explain some of the basic tenets and goals of disability-affirmative counseling (D-AT). [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

D-AT views individuals with disabilities as having value and worth, rather than as being deviant or pathological.



Disability intersects with a client’s diverse characteristics to create advantageous and disadvantageous circumstances and privileges in much the same way that gender and race intersect.



Disabilities provide learning opportunities for coping and compensatory mechanisms for people with disabilities, but also for those who work and socialize with individuals with disabilities.



These opportunities are integrated into selfhood and can lead to a greater appreciation of all people within the work, family, and community environments and the greater society.



The goals of counseling for clients with disabilities usually are not limited simply to a reduction of symptoms.



D-AT helps clients take responsibility for their disability, manage, and prevent the internalization of negative reactions, and feel important connections with peers and family members.

Chapter 8 Test Items Multiple Choice 1.

Individuals with disabilities may especially value a. time with their families. b. economic security. c. relationships. d. secure health care coverage.

The definition of delivery systems).

is dependent on the source (e.g., legislatures, organizations,

a. ageism b. economic security c. disability d. ableism 3.

The system.‖

program requires the client to have previously worked and ―paid into the

a. SSI (Supplemental Security Income) b. SSDI (Social Security Disability Insurance) c. Both of the above. d. None of the above. 4.

Children with significant disabilities might be eligible for the a. SSI (Supplemental Security Income) program. b. SSDI (Social Security Disability Insurance) program. c. Both of the above. d. None of the above.

Which of the following is a critical element included in the Americans with Disabilities Act (A DA)? a. Physical or mental impairment b. Substantial limits to major life activities c. Difficulty walking, speaking, hearing d. All of the above.

Which of the following is a component of the Americans with Disabilities Act’s (ADA) definition of a disability? a. Mental disorder b. Anatomical loss c. Cosmetic disfigurement

d. All of the above. 7.

What percentage of the American people live with some type of disability? a. 33% b. 11.5% c. 18.7% d. 3.9%

The individual.

model has been criticized for focusing on what is wrong with the

a. social b. medical c. Both of the above. d. None of the above. 9.

The origins of the social model of disability in the United States can be traced back to a. the Civil Rights Movement. b. World War I . c. the Great Depression. d. the Feminist Movement.

10. According to Verbrugge and Jette’s (1994) classic model of disability, the term impairment refers to a. diagnosis, disease, and injury. b. structural abnormalities. c. difficulty doing basic activities. d. walking, reading, or speaking. 11. Culturally competent counselors must be aware of counseling services.

to deliver effective

a. cross-cultural considerations b. functional impairments c. ableism d. All of the above. 12. State workers’ compensation programs a. provide for health-care costs related to the employee’s work injury. b. provide a percentage of the employee’s average weekly wages for the time the employee is out of work due to the injury. c. Both of the above. d. None of the above. 13. Understanding challenges associated with different cultures will help a professional

counselor to eliminate the concept of a. disability. b. ableism. c. cognitive incapacity. d. prejudice. 14. The biggest change in the population by the turn of the 22nd century is expected to be in the number of a. adolescents. b. children. c. older men. d. older women. 15. In comparison to the past, people are living a. longer lives. b. shorter lives. c. the same length of lives. d. There is no conclusive evidence to have any definitive answer. 16. Adultism can lead to discrimination against a. the elderly. b. children. c. middle-aged adults. d. adults in their twenties. 17. Psychological concerns among older adults may be caused by a. health changes. b. reduction of independence. c. reduction of their ability to perform daily routines. d. All of the above. 18. Which of the following statements is TRUE about the grieving process? a. It is a complex process. b. It is specific to the individual. c. Both of the above. d. None of the above. 19. Older adults may undergo issues related to a. physical condition. b. psychological functioning. c. socioeconomic status.

d. All of the above. 20. Older adults may experience ageism concerning a. employment. b. driving. c. Social Security. d. legislation. 21. The A CA approved standards for training gerontological counselors later adopted by a. the code of ethics. b. the Council for Accreditation of Counseling and Related Educational Programs (CACR EP). c. the American School Counseling Association. d. state legislations. 22. A CA’s Gerontological Competencies are used as a list of

competencies.

a. essential b. minimum c. Both of the above. d. None of the above. 23. Which of the following is one of ACA’s Gerontological Competencies? a. Demonstrates knowledge of special considerations and techniques for group work with older persons. b. Demonstrate knowledge of sources of literature reporting research about older persons and ethical issues in research with older subjects. c. Exhibits sensitivity to sensory and physical limitations of older persons through appropriate environmental modifications. d. All of the above. 24. As a counselor, it is important to remember that it is more helpful to facilitate clients’ ability to a. build upon the positive aspects of aging. b. ignore the negative aspects of aging. c. work through both positive and negative events of their past. d. All of the above. 25. Disability is a. always b. not c. sometimes d. almost always

considered a universal concept among cultures and languages.

26. Approximately

U.S. children, ages 6 to 14 years, have a disability.

a. half a million b. 2 million c. 4 million d. 10 million 27. There has been a gradual paradigm shift in the conceptualization of health and disability away from the model toward the model. a. social; medical b. medical; social c. inclusive; exclusive d. None of the above 28. Combat veterans have

rates of polytrauma.

a. lower b. insignificant c. higher d. inconclusive 29. The social model of disability a. focuses on medical procedures and diagnostic tests. b. does not align well with the counseling process. c. espouses that disability and illness occur as the result of a physical or mental condition. d. focuses on societal barriers and biases against people with disabilities. 30. Disability is low resources.

with low education, poverty, community setting, environment, and

a. minimally correlated b. moderately correlated c. highly correlated d. not correlated 31. The classic model of the disability process consists of four main parts that emphasize the relationship between a. pathology, impairments, functional limitations, and disability. b. diagnosis, condition, daily life activities, and disability. c. disease, dysfunction, limitations, and daily life activities. d. None of the above. 32. Rehabilitative care is an example of a. extraindividual intervention. b. intraindividual intervention.

c. Both of the above. d. None of the above. 33.

refers to two or more permanent injuries to the body that result in physical, cognitive, psychological, or psychosocial impairment and functional disability. a. Double trauma b. Posttraumatic stress disorder c. Polytrauma d. Aversive stress

34. Social attitudes, rehabilitation and counseling practices, and policies that favor individuals who have or are perceived as having full physical and mental health abilities is known as a. classism. b. sexism. c. disability. d. ableism. 35. All of the following are considered key historical disability policies and legislation EXCEPT a. the Civilian Rehabilitation Act. b. the Education for All Handicapped Children Act of 1975. c. the Elementary and Secondary Education Act of 1965. d. the Defense of Marriage Act. 36. Disability-affirmative counseling (D-AT) a. views individuals with disabilities with value and worth. b. takes a pathological perspective to client treatment. c. focuses on solely the personal impact on the client with a disability. d. All of the above. 37. Which of the following factors will put more emphasis on social policies that directly benefit older adults? a. The advancing age of baby boomers. b. The increased life expectancy of older adults. c. Increased racial and ethnic diversity of older adults. d. All of the above. 38. Over the next 40 to 50 years, the number of people over the age of 65 is expected to , and the number of people over the age of 85 is expected to . a. quadruple; double. b. triple; quadruple. c. double; triple. d. triple; double.

39.

is the assumption that chronological age is the main determinant of human characteristics and that one age is better than another. a. Adultism b. Ageism c. Ableism d. Classism

40. The belief that youth and children are ignorant, untrustworthy, unpredictable, and have nothing to contribute to their own well-being or society is known as . a. Adultism b. Ageism c. Ableism d. Classism 41. Age discrimination, or denying a job or promotion to an individual solely on the basis of age, is in the United States. a. not addressed b. legal c. illegal d. legal, but considered unethical 42. Under the Older Americans Act Amendments of 2006, older people are entitled to a. adequate retirement income. b. suitable housing. c. restorative services. d. All of the above. 43. The of disability implies that disability is more than the individual’s difference and includes attributes that are outside the individual (i.e., socially or culturally based). a. medial model b. biomedical model c. social model d. economic model 44. Considering language as a powerful tool, which of the following words would be least appropriate to describe individuals with disabilities? a. Differently abled b. Brave c. Survivor d. Challenged 45. An example of a type of disability is

a. blindness or vision impairment. b. epilepsy. c. traumatic brain injury. d. All of the above are examples of disabilities.

Extended Response 1.

Describe the Social Security Administration and eligibility requirements.

Provide at least three examples of types of disabilities.

Explain the paradigm shift of the models of disability.

Compare and contrast the medical and social models of disability.

Describe Verbrugge and Jette’s (1994) classic social model of disability.

Explain some of the factors to consider when counseling individuals with disabilities.

Discuss combat soldiers and veterans as a subgroup of clients with a disability. Identify issues that counselors should be aware of when working with this population.

Describe at least three of the disability laws that have been passed since 1965.

List and describe the skills list compiled by Smart and Smart (2006) to be an effective counselor with individuals with disabilities.

10. Explain how age demographics have changed since the early 1900s. 11. Describe the socioeconomic issues relevant to older individuals. 12. Explain the Older Americans Act Amendments of 2006. 13. Describe the skills that are needed for professional counselors to work with older adults. 14. List five of the ACA’s Gerontological Competencies. 15. Discuss language as an important component of ableism.

Chapter 8 Test Answer Key ANSWER KEY: Chapter 8 Test (Multiple Choice) 1. b 2. c 3. b 4. a 5. d 6. d 7. c 8. b 9. a 10. b 11. d 12. c 13. b 14. c 15. a 16. b 17. d 18. c 19. d 20. a 21. b 22. c 23. d 24. a 25. b 26. c 27. b 28. c 29. d 30. c 31. a 32. a

33. c 34. d 35. d 36. a 37. d 38. c 39. b 40. a 41. c 42. d 43. c 44. d 45. d

Chapter 9 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach th 4 Edition

Danica G. Hays University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents Chapter 9: Individuals and Families of African and African American Descent

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 9: Individuals and Families of African and African American Descent Chapter 9 Learning Outcome Quizzes Learning Outcome 9.1: Identify key demographics of Black individuals and families. [Q1] Enslavers used the now-outdated term mulatto to refers to individuals who were: 1. half Black and half White. [correct] 2. one-fourth Black. 3. one-eighth Black. 4. Black according to the one-drop rule. [Feedback for Correct Answer 1] Enslavers used the outdated term mulatto to refer to individuals who were half Black and half White. [Feedback for Answer Choice 2] Enslavers used the outdated term quadroon to refer to individuals who were one-fourth Black. [Feedback for Answer Choice 3] Enslavers used the outdated term octoroon to refer to individuals who were one-eighth Black. [Feedback for Answer Choice 4] The outdated one-drop rule stated that having one drop of Black blood makes one Black; however, only individuals who were half Black and half White were referred to as mulatto. [Q2] Historically, Black people began labeling themselves publicly as a group most noticeably in the , with the expression ―Black is beautiful.‖ 1. 1950s 2. 1960s [correct] 3. 1970s 4. 1980s [Feedback for Answer Choice 1] Historically, Black people began labeling themselves publicly as a group most noticeably after the 1950s. [Feedback for Correct Answer 2] Historically, Black people began labeling themselves publicly as a group most noticeably in the 1960s, with the expression ―Black is beautiful.‖

[Feedback for Answer Choice 3] Historically, Black people began labeling themselves publicly as a group most noticeably prior to the 1970s. [Feedback for Answer Choice 4] Historically, Black people began labeling themselves publicly as a group most noticeably prior to the 1980s. [Q3] The term African American came about in the and emphasized Black Americans’ ties to Africa as well as to the country of their citizenship, the United States. 1. 1950s 2. 1960s 3. 1970s 4. 1980s [correct] [Feedback for Answer Choice 1] The term African American came about several decades after the 1950s. [Feedback for Answer Choice 2] The term African American came about a couple decades after the 1960s. However, Black people began labeling themselves publicly as a group most noticeably in the 1960s, with the expression ―Black is beautiful.‖ [Feedback for Answer Choice 3] The term African American came about a decade after the 1970s. [Feedback for Correct Answer 4] The term African American came about in the 1980s. Coined by Reverend Jesse Jackson, it emphasized Black Americans’ ties to Africa as well as to the country of their citizenship, the United States. [Q4] According to 2019 U.S. Census data, individuals of African and African American descent make up approximately of the U.S. population. 1. 9% 2. 11.8% 3. 13.4% [correct] 4. 17.9% [Feedback for Answer Choice 1] According to 2019 U.S. Census data, the Black population has grown by 9% since 2010. [Feedback for Answer Choice 2] According to 2019 U.S. Census data, 11.8% of the Black population is over 65 years old.

[Feedback for Correct Answer 3] According to 2019 U.S. Census data, individuals of African and African American descent make up approximately 13.4% (44 million) of the U.S. population. [Feedback for Answer Choice 4] The U.S. Census Bureau projects that, by the year 2060, the Black population will increase to 74.5 million, accounting for 17.9% of the total U.S. population. Learning Outcome 9.2: Describe historical and contemporary experiences of discrimination for Black individuals and families. [Q1] was considered a mental illness of enslaved Africans who tried to escape from their owners. 1. Individualism 2. Drapetomania [correct] 3. Quadroon 4. Octoroon [Feedback for Answer Choice 1] The term individualism was not used to refer to the presumed mental illness of enslaved Africans who tried to escape from their owners. [Feedback for Correct Answer 2] Drapetomania was considered a mental illness of enslaved Africans who tried to escape from their owners. [Feedback for Answer Choice 3] The outdated term quadroon was used by slave owners to refer to individuals who were onefourth Black. [Feedback for Answer Choice 4] The outdated term octoroon was used by slave owners to refer to individuals who were oneeighth Black. [Q2] According to the research of , despite President Obama’s presence in the White House, the status of Black people in relation to health and education continues to lag Whites. 1. Alexander (2012) 2. Hinton and colleagues (2018) 3. Rosino and Hughey (2016) 4. Rocque and Sellings (2018) [correct]

[Feedback for Answer Choice 1] According to the research of Alexander (2012), the War on Drugs has had a debilitating impact on Black communities throughout the United States and continues to this day. [Feedback for Answer Choice 2] According to the research of Hinton and colleagues (2018), the War on Drugs has had a debilitating impact on Black communities throughout the United States and continues to this day. [Feedback for Answer Choice 3] According to the research of Rosino and Hughey (2016), the War on Drugs has had a debilitating impact on Black communities throughout the United States and continues to this day. [Feedback for Correct Answer 4] According to the research of Rocque and Sellings (2018), despite President Obama’s presence in the White House, the status of Black people in relation to health and education continues to lag Whites. [Q3] According to some, the ascent of President Obama purportedly signified the triumphant arrival of a society in which race no longer dictated one’s station in life, as it once did in the United States. 1. anti-racist 2. color-blind 3. covertly racist 4. postracial [correct] [Feedback for Answer Choice 1] Anti-racist is a fairly recent term that refers to a manner of thinking and acting and is not typically used to characterize historical events. [Feedback for Answer Choice 2] According to Vittrup (2018), a color-blind racial ideology is a ―set of beliefs that serves to minimize, ignore, or distort the existence of race and racism‖ (p. 95). [Feedback for Answer Choice 3] Covert racism can take the form of subtle microaggressions and/or microinvalidations. This term has not been used to describe the significance of President Obama’s election. [Feedback for Correct Answer 4] According to some, the ascent of President Obama purportedly signified the triumphant arrival of a postracial society in which race no longer dictated one’s station in life, as it once did in the United States. [Q4]

The incentivized states and localities to build more jails and prisons and to pass sentencing laws and other punitive measures. This bill increased the number and length of prison sentences while reducing the possibility of early release for those incarcerated, disproportionately impacting people of color. 1. Jim Crow laws 2. War on Drugs 3. 1994 Crime Bill [correct] 4. Stop and frisk [Feedback for Answer Choice 1] Jim Crow laws maintained and supported segregationist policies that governed the lives of Black people in America. [Feedback for Answer Choice 2] The War on Drugs was initiated under the auspices of the Nixon and Reagan administrations which, subsequently, has had a debilitating impact on Black communities throughout this country that continues to this day. [Feedback for Correct Answer 3] The Violent Crime Control Act and Law Enforcement Act of 1994, better known as the 1994 Crime Bill, incentivized states and localities to build more jails and prisons and to pass sentencing laws and other punitive measures. This bill also increased the number and length of prison sentences while reducing the possibility of early release for those incarcerated, disproportionately impacting people of color. [Feedback for Answer Choice 4] Stop and frisk is a policing practice used by law enforcement in Black neighborhoods which virtually guarantees police contact with Black residents. Learning Outcome 9.3: Articulate how the constructs of racial identity and acculturation influence Black individuals and families. [Q1] Which author(s) developed a multidimensional model of racial identity that provides a framework for understanding both the significance of race in the self-concept of African Americans and the qualitative meaning that is attributed to being a member of that racial category? 1. Parham (1989) 2. Banks and colleagues (2014) 3. Boyd-Franklin (2013) 4. Sellers and colleagues (1998) [correct] [Feedback for Answer Choice 1] The research of Parham (1989) applied The Cross (1971) model of Black racial identity development to investigate counseling settings with cross-racial dyads of clients and counselors.

[Feedback for Answer Choice 2] The research of Banks and colleagues (2014) found that a client’s Black identity— especially if seen as excessively negative— can have negative implications for mental health issues and self-esteem. [Feedback for Answer Choice 3] The research of Boyd-Franklin (2013) applied The Cross (1971) model of Black racial identity development to investigate client racial preferences for counselors. [Feedback for Correct Answer 4] Sellers and colleagues (1998) developed a multidimensional model of racial identity that provides a framework for understanding both the significance of race in the self-concept of African Americans and the qualitative meaning that is attributed to being a member of that racial category. [Q2] found that Black adolescents who received affirming cultural socialization messages within schools were less likely to experience adverse consequences (e.g., a lower grade point average and diminished educational aspirations). 1. Barnes and colleagues (2014) 2. Mushonga and Henneberger (2020) 3. Wang and Huguley (2012) [correct] 4. Willis and Neblett (2020) [Feedback for Answer Choice 1] Barnes and colleagues (2014) found that some Black individuals do not embrace a positive Black identity and do not consider their Black heritage to be an important aspect of their identities, whereas others see being Black as a central part of their identities. [Feedback for Answer Choice 2] Research conducted by Mushonga and Henneberger (2020) found that a positive racial identity serves a protective function for individuals of African and African American descent. [Feedback for Correct Answer 3] Wang and Huguley (2012) found that Black adolescents who received affirming cultural socialization messages within schools were less likely to experience adverse consequences (e.g., a lower grade point average and diminished educational aspirations). [Feedback for Answer Choice 4] Research conducted by Willis and Neblett (2020) found that a positive racial identity serves a protective function for individuals of African and African American descent. [Q3] Ascribing to a White beauty ideal, the rejection of a Black identity, and the disparagement of other Blacks are examples of: 1. drapetomania.

2. institutional racism. 3. internal oppression. 4. internalized racism. [correct] [Feedback for Answer Choice 1] Drapetomania was considered a mental illness of enslaved Africans who tried to escape from their owners. [Feedback for Answer Choice 2] Ascribing to a White beauty ideal, the rejection of a Black identity, and the disparagement of other Blacks may be a byproduct, but are not examples, of institutional racism. [Feedback for Answer Choice 3] Internal oppression is not a counseling-specific term. [Feedback for Correct Answer 4] Ascribing to a White beauty ideal, the rejection of a Black identity, and the disparagement of other Blacks are examples of internalized racism. [Q4] According to Johnson and Carter (2020), this counseling approach involves assessing and utilizing a family’s skills, abilities, and knowledge to empower clients: 1. Narrative Family Therapy 2. Strengths-based Counseling [correct] 3. Structural family Therapy 4. Bowenian Family Therapy [Feedback for Answer Choice 1] Johnson and Carter (2020) offer a broad description of how counseling approaches can empower clients, rather than advocating for a specific theory. [Feedback for Correct Answer 2] According to Johnson and Carter (2020), strengths-based counseling approaches involve assessing and utilizing a family’s skills, abilities, and knowledge to empower clients. [Feedback for Answer Choice 3] Johnson and Carter (2020) offer a broad description of how counseling approaches can empower clients, rather than advocating for a specific theory. [Feedback for Answer Choice 4] Johnson and Carter (2020) offer a broad description of how counseling approaches can empower clients, rather than advocating for a specific theory.

Learning Outcome 9.4: Understand the general cultural values as well as unique relationship and cultural factors that characterize Black individuals and families. [Q1] According to Boyd-Franklin (2013), middle-class Black people who are isolated from the Black community may experience symptoms of depression and: 1. anxiety 2. survivor guilt [correct] 3. somatization 4. lowered self-esteem [Feedback for Answer Choice 1] According to Greer and Spalding (2017), racial discrimination is a strong predictor of anxiety. [Feedback for Correct Answer 2] According to Boyd-Franklin (2013), middle-class Black people who are isolated from the Black community may experience symptoms of depression and guilt for ―making it‖ (i.e., survivor guilt) when others in the Black community have not. [Feedback for Answer Choice 3] According to Greer and Spalding (2017), racial discrimination is a strong predictor of somatization. [Feedback for Answer Choice 4] Paradies and colleagues (2015) found a relationship between internalized racism, on the one hand, and lower self-esteem, on the other. [Q2] A meta-analysis conducted by Paradies and colleagues (2015) found a relationship between , on the one hand, and alcohol consumption, psychological distress, depression, and lower self-esteem, on the other. 1. survivor guilt 2. socioeconomic status 3. institutional racism 4. internalized racism [correct] [Feedback for Answer Choice 1] According to Boyd-Franklin (2013), middle-class Black people who are isolated from the Black community may experience symptoms of depression and guilt for ―making it‖ (i.e., “survivor guilt‖) when others in the Black community have not. [Feedback for Answer Choice 2] According to Lewis-McCoy (2014), middle-class Black people often face issues different from those encountered by working-class Black people.

[Feedback for Answer Choice 3] Across all socioeconomic levels, institutional racism increases psychological distress for Black people (Cenat, 2020; Paniagua, 2014; Williams, 2018). [Feedback for Correct Answer 4] A meta-analysis conducted by Paradies and colleagues (2015) found a relationship between internalized racism, on the one hand, and alcohol consumption, psychological distress, depression, and lower self-esteem, on the other. [Q3] Which of the following represents a general value associated with Black individuals? 1. Individualism 2. Person-centered [correct] 3. Rigid time orientation 4. Hierarchical romantic relationships [Feedback for Answer Choice 1] Generally, Black individuals value collectivism and group identity, over individualism. [Feedback for Correct Answer 2] Communalism— being person-centered as opposed to object-centered— is a general value associated with Black individuals. [Feedback for Answer Choice 3] Generally, Black individuals value a flexible time orientation, rather than a rigid time orientation. [Feedback for Answer Choice 4] Generally, Black individuals value gender-egalitarian romantic relationships over hierarchical romantic relationships. [Q4] According to Wicker and Brodie (2004), the number of unmarried Black women has increased due in part to: 1. persistent relational conflicts. 2. feelings of marital unhappiness. 3. the view that marriage is outdated. 4. the number of Black men who marry non–Black women. [correct] [Feedback for Answer Choice 1] Persistent relational conflicts are considered one of the predictors of marital dissatisfaction among Black couples; however, Wicker and Brodie (2004), do not attribute these conflicts to the rise in unmarried Black women.

[Feedback for Answer Choice 2] Feelings of marital unhappiness are considered one of the predictors of marital dissatisfaction among Black couples; however, Wicker and Brodie (2004), do not attribute these feelings to the rise in unmarried Black women. [Feedback for Answer Choice 3] Wicker and Brodie (2004) do not attribute the view that marriage is outdated to the rise in unmarried Black women. [Feedback for Correct Answer 4] According to Wicker and Brodie (2004), the number of unmarried Black women has increased due in part to the number of Black men who marry non–Black women, growing disparities in educational attainment between Black men and women, as well as a high mortality rate of Black men due to homicide. Learning Outcome 9.5: Outline the general mental issues of Black individuals and apply theoretical approaches when counseling this population. [Q1] According to a 2017 report from the CDC, one of the leading causes of death for Black people under the age of 65 years is: 1. Diabetes 2. Cancer [correct] 3. Suicide 4. Stroke [Feedback for Answer Choice 1] According to a 2017 report from the CDC, diabetes is one of the common chronic diseases reported by Black people under the age of 65 years, but not a leading cause of death. [Feedback for Correct Answer 2] According to a 2017 report from the CDC, one of the leading causes of death for Black people under the age of 65 years is cancer. [Feedback for Answer Choice 3] The 2017 report from the CDC does not contain data related to suicide rates of Black people under the age of 65 years. [Feedback for Answer Choice 4] According to a 2017 report from the CDC, stroke is one of the common chronic diseases reported by Black people under the age of 65 years, but not a leading cause of death. [Q2] This approach’s ultimate goal of self-acceptance is consistent with the African worldview: 1. Adlerian 2. Psychodynamic

3. Solution-focused 4. Client-centered [correct] [Feedback for Answer Choice 1] Collective unity and social interest consist of working toward fitting in within the community, contributing to the community, and supporting the cultural value system of many Black people, which is consistent with an Adlerian approach. [Feedback for Answer Choice 2] Psychoanalysis, which is based in psychodynamic theory, believes that impulses, which are described as sexual, cause nervous and mental disorders (Freud, 1924). These general principles are inconsistent with an Afrocentric framework. [Feedback for Answer Choice 3] Self-acceptance is not the ultimate goal of solution-focused therapy. [Feedback for Correct Answer 4] Client-centered therapy’s ultimate goal of client self-acceptance is consistent with the African worldview. [Q3] The formation of Afrocentrism, as a coherent set of concepts and ideas, is often attributed to the pioneering work of in the early 1980s. 1. Molefi Assante [correct] 2. Marcus Garvey 3. Amy Jacques-Garvey 4. John Henrick Clarke [Feedback for Correct Answer 1] The formation of Afrocentrism, as a coherent set of concepts and ideas, is often attributed to the pioneering work of Molefi Assante in the early 1980s. [Feedback for Answer Choice 2] Many of the fundamental tenets and ideas regarding Afrocentrism in this country were inspired by the monumental contributions found in the writing of Black revolutionary thinkers such as Marcus Garvey. [Feedback for Answer Choice 3] Many of the fundamental tenets and ideas regarding Afrocentrism in this country were inspired by the monumental contributions found in the writing of Black revolutionary thinkers such as Amy Jacques-Garvey. [Feedback for Answer Choice 4] Many of the fundamental tenets and ideas regarding Afrocentrism in this country were inspired by the monumental contributions found in the writing of Black revolutionary thinkers such as John Henrick Clarke.

[Q4] The tendency to pathologize cultural differences is a shortcoming of using which of the following theoretical approaches with Black clients? 1. Adlerian 2. Psychodynamic [correct] 3. Solution-focused 4. Client-centered [Feedback for Answer Choice 1] The Adlerian approach is thought to be respectful of both the individual and her or his cultural heritage; however, the treatment outcome research with Black clients has been equivocal. [Feedback for Correct Answer 2] The tendency to pathologize cultural differences is a shortcoming of utilizing a psychodynamic approach with Black clients. [Feedback for Answer Choice 3] One limitation of the solution-focused approach is its idea that the counselor’s intent to promote growth in the client seems to suggest a hierarchical relationship that is more consistent with a European rather than an African worldview. [Feedback for Answer Choice 4] One limitation of the client-centered approach is its idea that the counselor’s intent to promote growth in the client seems to suggest a hierarchical relationship that is more consistent with a European rather than an African worldview. Learning Outcome 9.6: Identify areas for future scholarship regarding Black individuals and families. [Q1] What is the title of the American period film that depicts the life of Nat Turner, an enslaved man who led a slave rebellion in Southampton County, VA in 1831? 1. Roots 2. The Color Purple 3. A Time to Kill 4. The Birth of a Nation [correct] [Feedback for Answer Choice 1] Roots (1977) is a television miniseries based on author Alex Haley’s family line progressing from ancestor Kunta Kinte’s enslavement to his descendants’ liberation. [Feedback for Answer Choice 2] The Color Purple (1985) is a dramatic film about a Black southern woman who is faced with racism, poverty, and sexism during the early 1900s.

[Feedback for Answer Choice 3] A Time to Kill (1996) is a film depicting the struggles of a young lawyer who is defending a Black male accused of murdering the two men who raped his 10-year-old daughter. The jury’s verdict sparks the rebirth of the Ku Klux Klan. [Feedback for Correct Answer 4] The Birth of a Nation (2016) is an American period film that depicts the life of Nat Turner, an enslaved man who led a slave rebellion in Southampton County, VA in 1831. [Q2] This organization focuses on the political, educational, social, and economic equality of rights for all people and on eliminating race-based discrimination: 1. NAACP [correct] 2. NAMI 3. JBHE 4. COSEBC [Feedback for Correct Answer 1] The National Association for the Advancement of Colored People (NAACP) focuses on the political, educational, social, and economic equality of rights for all people and on eliminating race-based discrimination. [Feedback for Answer Choice 2] The National Alliance on Mental Illness (NAMI) is an organization dedicated to raising awareness and providing support for a range of mental health issues. [Feedback for Answer Choice 3] The Journal of Blacks in Higher Education (JBHE) publishes articles on the status and prospects for Black people in higher education. [Feedback for Answer Choice 4] The Coalition of Schools Educating Boys of Color (COSEBC) is the only national educational organization of practitioners focused solely on promoting the educational success of boys and young men of color. [Q3] provided a systematic review of the literature on colorism and health outcomes, specifically, and found that there is, indeed, strong evidence to substantiate the notion that darker-skin Black people experience more prejudice than those with lighter skin. 1. Harris (2018) 2. Jones and Ferguson (2020) 3. Keyes and colleagues (2020) [correct] 4. Watson and Hunter (2015)

[Feedback for Answer Choice 1] Harris (2018) delved into contextual factors that influence this process among biracial individuals, including those of African and African American descent and shared examples of the unique, yet related factors individuals of different races may weigh in making their final decisions. [Feedback for Answer Choice 2] Jones and Ferguson (2020) offer a solid introductory discussion of writings detailing the experiences of Black gay men pre- and post-slavery, for instance. [Feedback for Correct Answer 3] Keyes and colleagues (2020) provided a systematic review of the literature on colorism and health outcomes, specifically, and found that there is, indeed, strong evidence to substantiate the notion that darker-skin Black people experience more prejudice than those with lighter skin. [Feedback for Answer Choice 4] Watson and Hunter (2015) examined the relationship between the strong Black woman role and attitudes toward psychological help-seeking. [Q4] examined the relationship between the strong Black woman role and attitudes toward psychological help-seeking. 1. Harris (2018) 2. Jones and Ferguson (2020) 3. Keyes and colleagues (2020) 4. Watson and Hunter (2015) [correct] [Feedback for Answer Choice 1] Harris (2018) delved into contextual factors that influence this process among biracial individuals, including those of African and African American descent and shared examples of the unique, yet related factors individuals of different races may weigh in making their final decisions. [Feedback for Answer Choice 2] Jones and Ferguson (2020) offer a solid introductory discussion of writings detailing the experiences of Black gay men pre- and post-slavery, for instance. [Feedback for Answer Choice 3] Keyes and colleagues (2020) provided a systematic review of the literature on colorism and health outcomes, specifically, and found that there is, indeed, strong evidence to substantiate the notion that darker-skin Black people experience more prejudice than those with lighter skin. [Feedback for Correct Answer 4] Watson and Hunter (2015) examined the relationship between the strong Black woman role and attitudes toward psychological help-seeking.

Chapter 9 Application Exercises Application Exercise 9.1: The Case of Burritu Learning Outcome 9.2: Describe historical and contemporary experiences of discrimination for Black individuals and families. [Q1] Burritu is an Ethiopian refugee with permanent citizenship in the United States. She was separated from her family when she was 13 years old; her father was murdered, and her mother fled the area. Burritu was placed in a Kenyan refugee camp for 7 years; she arrived by herself in the United States at the age of 20 with the help of a social justice organization. Burritu learned how to speak some English in Kenya, but she could write very little in English. Burritu successfully obtained a job involving packing clothing orders in a factory, and she enrolled in a community college to study nursing. She is a hardworking and efficient employee, but she has had continued struggles with her academic work. After 3 years in the United States, she has frequently noted that White Americans are able to obtain more resources and seem to be favored by school tutors, government agencies, and other people in positions of authority. Burritu has also noted that Black Americans have values that she feels are different from those of individuals who are from Africa (i.e., Black immigrants) and now live in the United States. Write a paragraph explaining your opinion regarding Burritu’s claim that White Americans seem to be favored over non-White individuals in the United States. [Q1 MODEL RESPONSE] Your response should include some of the following points: 

Racism and oppression are key considerations for counselors working in the United States.

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White privilege in the United States is a valid concept that can be quite challenging and scary for White counselors to accept and address in their personal and professional lives.

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Many people in the United States engage in race-based stereotyping and racism directed toward non-White citizens. Black American individuals and Black immigrants are both likely to experience some discrimination in the United States.

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Individuals who are not White often have to work harder to get the same privileges as White people.

[Q2] Burritu is an Ethiopian refugee with permanent citizenship in the United States. She was separated from her family when she was 13 years old; her father was murdered, and her mother fled the area. Burritu was placed in a Kenyan refugee camp for 7 years; she arrived by herself in the United States at the age of 20 with the help of a social justice organization. Burritu learned how to speak some English in Kenya, but she could write very little in English. Burritu successfully obtained a job involving packing clothing orders in a factory, and she enrolled in a community college to study nursing. She is a hardworking and efficient employee, but she has had continued struggles with her academic work. After 3 years in the United States, she has frequently noted that White Americans are able to obtain more resources and seem to be favored by school tutors, government agencies, and other people in positions of authority.

Burritu has also noted that Black Americans have values that she feels are different from those of individuals who are from Africa (i.e., Black immigrants) and now live in the United States. Write a paragraph describing similarities and differences in the general cultural values of Black American individuals and Black immigrants in the United States. [Q2 MODEL RESPONSE] Based on the research presented in the text, your response should include some of the following points: 

Black American individuals and Black immigrants might hold some similar cultural values, such as a preference for collectivism over individualism and high levels of respect for adults/elderly.

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Black American individuals have a long history of oppression in the United States, which has created a historical trauma response.

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Black American individuals lost much of their heritage through slavery and have created a new culture that is separate and different from that ascribed to by White Americans.

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Black immigrants might also have experienced traumatic events that created the need for leaving their home country.

[Q3] On a personal level, how does the concept of White privilege apply to your life experiences? Why do you think it is important to understand its impact? [Q3 MODEL RESPONSE] Your response should include some of the following points: 

All individuals, regardless of race, have experienced the benefits/challenges associated with White privilege.

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For those of you who have experienced the benefits of White privilege, your answer should explain how your life has been easier because others perceive you as White.

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For those of you who are not White, your answer should explain whether you have experienced any difficulties because of racism—for example, feeling pressure to straighten your hair to be accepted.

Application Exercise 9.2: Diverse Relationships Learning Outcome 9.4: Understand the general cultural values as well as unique relationship and cultural factors that characterize Black individuals and families. [URL TITLE] Marie and Her Counselor

[Q1] Use Pearson eText Video Example 9.2 to answer the following question. Pay particular attention to the information Marie conveys to her counselor. Using what you have learned from the video and the research in the text, what cultural messages and historical experiences contribute to the client’s statement that ―Black folks don’t go to counseling‖? [Q1 MODEL RESPONSE] Based on the research presented in the text, your answer should include some of the following points: 

African cultures value a collectivist society but typically try to solve family problems within the family unit.

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The Black church is an important source of support and guidance for some in the Black American community. Individuals might turn to spiritual leaders instead of mental health professions for support with mental health concerns.

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The counseling profession is predominantly White, and the White community has historically oppressed Black American individuals. As such, counseling might not feel like a safe space for Black American clients.

[Q2] Use Pearson eText Video Example 9.2 to answer the following question. Pay particular attention to the information Marie conveys to her counselor. Using what you have learned from the video and the research in the text, how would you respond to the statement that ―Black folks don’t go to counseling,‖ if you were a White, female counselor working with a Black female client? [Q2 MODEL RESPONSE] Based on the research presented in the text, your answer should include some of the following points: 

Validate the client’s perspective—for example, ―You rightfully wonder if this will work for you,‖ or ―There are a lot of ways that race informs your life, and I will have to really try to understand your point of view.‖

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Discuss the concept of racism and allow the client to share ways that her life has been different from yours.

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Consider helping the client speak about words such as racism and oppression.

[Q3] Use Pearson eText Video Example 9.2 to answer the following question. Pay particular attention to the information Marie conveys to her counselor. Using what you have learned from the video and the research in the text—and keeping in mind that every individual has unique life experiences—what cultural considerations should the counselor make when working with this client? [Q3 MODEL RESPONSE] Based on the research presented in the text, your answer should include some of the following points:

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The counselor must be able to admit and understand that because of White privilege, the counselor has not likely faced racial discrimination in daily life to the extent that the client has.

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The client’s story should be understood through the lens of an individual who has experienced oppression in daily life and has not experienced the inherent privilege that comes with membership in White culture.

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Understand the client’s non-verbals. Black clients might use more muted/negative nonverbal behaviors than White counselors.

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Black clients might not use a lot of eye contact when listening to others speak.

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The counselor should view all clients as inherently motivated, resilient individuals.

Application Exercise 9.3: Cultural and Theoretical Considerations Related to Counseling Black Clients Learning Outcome 9.5: Outline the general mental issues of Black individuals and apply theoretical approaches when counseling this population. [Q1] Based on the research presented in the text—and keeping in mind that every individual has unique life experiences— provide several cultural and contextual considerations that may contribute to Black people underutilizing mental health services [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Black people have been found to be disproportionately represented in the lower-SES group.

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Higher rates of mental illness often go hand in hand with poverty, higher rates of violence, and little attention to mental health treatment.

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Additionally, there remains a negative social stigma within the Black community around mental illness and treatment for mental illnesses.

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Ward et al. (2013) found that 63% of the study’s Black participants believed mental illnesses was a sign of personal weakness and expressed concerns about the stigma associated with mental illness, thus limiting their openness and willingness to seek out mental health treatment.

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Black people may underutilize mental health services due to this stigma, may only seek treatment in times of crisis, and may have more severe symptoms once obtaining treatment.

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The Black community also faces some uniquely negative environmental influences that affect their mental health, such as: higher unemployment rates, educational and occupational deficits, more grief and bereavement issues, higher rates of incarceration for Black men, higher rates of violence in urban communities, single-parent status and its concomitant economic hardships, poverty, and lower educational attainment.

[Q2] Based on the research presented in the text—and keeping in mind that every individual has unique life experiences—highlight some of the support systems that may be used by Black individuals. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Participation in religious activities which allows for opportunities for self-expression, leadership, and community involvement

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Black organizations, such as fraternities and sororities, and the National Association for the Advancement of Colored People (NAACP)

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Extended family

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Sister Circles, which are social groups for Black women whose sole purpose is to provide one another with emotional and spiritual support

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Brotherhood opportunities, which are social experiences for Black men that provide a connection with, and support for, Black men

[Q3] Based on the research presented in the text—and keeping in mind that every individual has unique life experiences—briefly discuss some of the benefits and limitations of utilizing clientcentered counseling approaches with Black clients. [Q3 MODEL RESPONSE] Based on the research in the text—and keeping in mind that every individual has unique life experiences—your answer should include some of the following points: 

Conditions sought in a client-centered therapeutic relationship include genuineness, congruence, positive regard, acceptance of the client, and empathic understanding.

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This approach’s ultimate goal of client self-acceptance is consistent with the African worldview (i.e., unity and integration).

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When working with a Black client, client-centered counseling has utility especially when helping to set or create conditions in which the client may feel comfortable and supported within the counseling relationship.

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A limitation of this approach is its idea that the counselor’s intent to promote growth in the client seems to suggest a hierarchical relationship that is more consistent with a European rather than an African worldview.



This approach also appears to suggest that the client lacks, in some basic way, an understanding of self or the concept of harmony and unity that is inherent in the African worldview, which constitutes another limitation.



The focus remains solely on the individual, primarily without any focus on the connection to others as a part of the concept of self, which is rooted in a connection or existence within a community.



In an African worldview, the concept of the individual exists within the context of community (unity), as well as harmony or balance within the larger universe structure.

Chapter 9 Test Items Multiple Choice 1.

The first Africans came to the United States in a. 1609. b. 1619. c. 1776. d. 1809.

Jim Crow was a. the individual who founded the Ku Klux Klan. b. a set of segregationist laws primarily in the South. c. the Governor of Georgia who refused to let Georgian schools be integrated in the 1950s. d. a civil rights leader.

Colorism in the Black American community is a preference for individuals a. with darker skin tones. b. with lighter skin tones. c. who are not Black. d. who are Black.

Most African Americans may prefer to be called a. Black. b. individuals of African Descent. c. African American. d. Each person should be asked what they prefer to be called.

According to research presented in the text, Black values may include a. collectivism, spirituality, and extended family relationships. b. individualism, linear time orientation, mastery over nature. c. machismo, marianismo, and filial piety. d. indirect communication, nonverbal communication, and suppression of conflict.

Racial differences should a. only be brought up if the client brings them up. b. be brought up after a firm relationship has been established. c. be brought up early in the counseling relationship. d. never be discussed because it is offensive to clients.

Racial identity is a. essential to understanding and working with clients of African descent. b. an empirically based construct. c. an important variable in assessing a client of African descent’s mental health. d. All of the above.

Assessing a client of African descent’s level of acculturation includes a. an assessment of values, cultural practices, and beliefs. b. conceptualizing Black clients on the Traditional, Bicultural, Highly Acculturated, and Marginal continuum. c. exploring how connected a client of African descent is to the Black community. d. All of the above.

Common self-selected Black support systems include a. The Black Church. b. The Association of Black Psychologists. c. Social Workers. d. Government Agencies.

10. The five principles of NTU Psychotherapy are a. harmony, awareness, alignment, actualization, and synthesis. b. harmony, mindfulness, self-focus, humanism, and reactivation. c. collectivism, spirituality, educational attainment, assertion, and interrelatedness. d. gender egalitarianism, racial socialization, reinforcement of kinship bonds, spirituality, and communalism. 11. Traditional counseling approaches should a. never be used with clients of African descent. b. always be used with clients of African descent. c. always be modified for clients of color. d. be assessed for effectiveness with individual clients instead of blindly applied. 12. The goal of an NT U counselor is to help the client reestablish client a. harmony. b. kinship bonds. c. goals. d. homeostasis. 13. Black families often include a. extended family members. b. friends of the family.

c. members of the church. d. All of the above. 14. Black Americans of the middle class may deal with a. survivor guilt. b. glass ceilings. c. isolation from the Black community. d. All of the above. 15. A Black working class client may deal with a. inferior educational systems. b. poorer health care. c. poverty. d. All of the above. 16. Research demonstrates that Black couples of have a levels of marital satisfaction than White couples.

divorce rate and report

a. higher; lower b. lower; higher c. lower; lower d. higher; higher 17.

represented an unethical practice initiated during the middle of the 18th century through the beginning of the 20th century where pseudoscientists played an integral role in promulgating myths that indigenous non-Whites were racially inferior. a. Institutional racism b. Microaggressions c. Scientific racism d. Structural racism

18. Historically, in the U.S. educational system children of African descent were often placed in a. programs for the educable mentally retarded. b. honors courses. c. average courses. d. special education programs. 19. Gays and lesbians of African descent often face a. dual discrimination from the Black community. b. dual discrimination from the White gay community. c. support from the Black community for being both Black and gay. d. support from the White gay community for being both Black and gay.

20. According to research, individuals of African descent often describe themselves as a. not religious. b. somewhat religious. c. very spiritual. d. very religious. 21. When treating African Americans, it is recommended that multiculturally sensitive counselors use a. a color-blind racial ideology. b. NT U counseling alone. c. a strengths-based approach. d. psychoanalysis. 22. A traditional psychotherapy that includes attention to culture as part of its core is counseling. a. client-centered b. psychoanalytic c. Adlerian d. NT U 23. Multiculturally sensitive counselors working with clients of African descent use a a. broad-based and flexible approach. b. narrow focus and rigid approach. c. medium focus and Afrocentric approach. d. wide focus and traditional approach. 24. In working with clients of African descent, cultural mistrust should be viewed as a. normal. b. abnormal. c. excessive resistance. d. a crisis of identity. 25. Research demonstrates that Black clients usually prefer a. Black counselors. b. White counselors. c. female counselors. d. male counselors. 26. The is the chronic disparity in academic performance between White students and some ethnic minority students, including African American students. a. acculturation level b. achievement gap

c. deficit perspective d. ecological perspective 27.

is applied to counseling settings with cross-racial dyads of clients and counselors, client racial preferences for counselors, and supervisor-supervisee cross-racial pairings; and used to explore how racial identity can change over the life span. a. Multidimensional Model of Racial Identity b. Cross Model of Black Racial Identity c. Hoffman’s Stages of Racial Identity Development d. Helms’s Model of White Racial Identity Development

28. Which of the following is the most accurate description of the ―one-drop rule?‖ a. Having one drop of Black blood makes one Black. b. Having one drop of White blood makes one White. c. Having one drop of White or Black blood makes one biracial. d. All of the above. 29. An individual who rejects the beliefs and practices of his or her culture of origin in favor of those of the dominant society or never learned his or her own cultural traditions would be considered a. traditional. b. bicultural. c. highly acculturated. d. marginal. 30.

focuses upon social interest as an organizing principle. It explores an individual’s social nature during interactions and the influences of the social environment on development. a. Adlerian psychotherapy b. NT U counseling c. Person-centered counseling d. Psychodynamic counseling

31. Early models of mental health pathologized Africans. For example, noted mental illness of slaves who tried to escape from their owners. a. hypomania b. histrionic personality disorder c. brief psychotic disorder d. drapetomania

was a

32.

refers to the extent to which ethnic and cultural minorities participate in the cultural values, beliefs, and practices of their own culture versus those of the dominant White society. a. Racial identity b. Ethnic identity c. Acculturation d. Microaggression

33.

are considered the most common support systems for many clients of African descent to help combat societal oppression and increase economic support. a. Group memberships b. School/Community counselors c. Spirituality and religion d. Friends

34. An individual who is immersed in many of the beliefs, practices, and values of their own culture would be considered on the acculturation continuum. a. traditional b. bicultural c. highly acculturated d. marginal 35. Psychodynamic theory’s general principle of Afrocentric counseling framework.

is inconsistent with an

a. individualism b. unconscious mental processes c. impulses d. All of the above. 36. About

of Black families are headed by couples.

a. 15% b. 32% c. 41% d. 55% 37.

counseling is a spiritually based Afrocentric approach to psychotherapy that aims to assist people and systems to become authentic and balanced within a shared energy and essence that is in alignment with natural order. a. Spirituality b. NT U c. Multicultural d. Client-centered

38. An individual who either rejects or never acquires beliefs and practices of his or her own culture or of the dominant culture would be considered on the acculturation continuum. a. traditional b. bicultural c. highly acculturated d. marginal 39. In the Black community today, African Americans with lighter skin are often perceived as having an easier time than African Americans with darker skin, a concept known as a. prejudice. b. colorism. c. Black privilege. d. racism. 40. The provides a framework for understanding both the significance of race in the self-concept of African Americans and the qualitative meaning that is attributed to being a member of that racial category. a. Multidimensional model of racial identity b. Cross model of Black racial identity c. Hoffman’s stages of racial identity development d. Helms’s model of White racial identity development 41. There is now mounting documentation of the link between racial identity attitudes and mental health, generally suggesting that greater internalization of a positive racial identity is related to among African Americans. a. an increased psychological well-being b. better employment opportunities c. a stronger community support system d. an increase in SES 42. An individual who is in the middle of the continuum of acculturation, and who has retained beliefs and practices of his or her own culture, but also has assimilated some beliefs and practices of the dominant White society, and participates in two very different cultural traditions simultaneously would be considered a. traditional. b. bicultural. c. highly acculturated. d. marginal.

43.

counseling is thought to be more congruent with many of the traditional beliefs of African descent people and offers flexibility within the range of interventions offered. a. Cognitive behavioral b. Client-centered c. Psychodynamic d. Adlerian

44. Across all socioeconomic levels, Americans.

increases psychological distress for African

a. institutional racism b. scientific racism c. colorism d. racial segregation 45. The primary characteristic of counseling is its focus on the relationship between the counselor and the client and how client change is facilitated through the development of the therapeutic relationship. a. psychodynamic b. Adlerian c. client-centered d. cognitive behavioral 46. In the U.S. school system of the mid-to-late 20th century, intelligence tests, which had not at the time been normed on Black children or children of lower socioeconomic status (SE S), were used as the sole measure for a. referring children to mental health counseling. b. placing children in special education programs. c. removing children from the home. d. placing children within the welfare system. 47. Cognitive behavioral counseling is effective for Black and White clients in the treatment of a. personality disorders. b. clinical disorders. c. mood disorders. d. anxiety disorders.

Extended Response 1.

Explain how the concept of race as a biological construct no longer applies today. Give specific examples supporting the idea that race is more of an economic and social construct than a biological construct.

As a multiculturally sensitive counselor, what things do you need to incorporate in your

practice with individuals of African descent? Support your answer with evidence from the chapter. 3.

As a multiculturally sensitive counselor, what do you need to incorporate in your practice with families of African descent? Support your answer with evidence.

Review the differences between racial identity and acculturation. Explain the differences between these two constructs. How might you verbally assess these in your initial session with a client of African descent? Why it is important to assess these constructs for individuals and families of African descent?

Review NT U along with two traditional counseling approaches (e.g., client-centered, psychodynamic). How might you combine the strengths of these approaches to work with a client of African descent?

Past negative history has contributed to the general cultural mistrust that some African Americans have of government, medical, and mental health professionals and institutions. How can you assess and address cultural mistrust early in the therapeutic relationship?

Identify and describe two racial identity models.

When working with Black clients, how can you assess how central clients’ racial awareness and identity is to who they say they are as individuals. What influence would this have throughout the counseling process?

What is acculturation? Identify and describe the four groupings of acculturation. How can you assess the client’s level of acculturation during the counseling sessions?

10. How would you describe the differences and/or similarities between the general perception of American cultural orientations or worldviews with African-centered values or beliefs? 11. Marriage trends demonstrate that African American women are less likely to marry than their counterparts of other ethnic groups. Describe factors that may influence trends of Black couples? What are some predictors of marital dissatisfaction compared to other ethnic groups? 12. Describe various challenges Black children may encounter in developing a racial identity. How are these challenges different and like those from middle- or working-class backgrounds and the environment in which they reside? 13. Identify several challenges faced by middle-class Black clients within the work environment. What impact do you think social class can have on presenting treatment issues of Black clients? 14. Describe some of the psychological and physical effects of racial discrimination. How can the impact of discrimination on Black clients be assessed during the counseling process? 15. What are some of the limitations related to treatment efficacy of using European worldview counseling systems and techniques with Black clients? 16. Provide examples of culture-centered practices that could be used within the counseling sessions with Black clients.

Chapter 9 Test Answer Key ANSWER KEY: Chapter 9 Test (Multiple Choice) 1. b 2. b 3. b 4. d 5. a 6. c 7. d 8. d 9. a 10. a 11. d 12. a 13. d 14. d 15. d 16. a 17. c 18. d 19. b 20. d 21. c 22. c 23. a 24. a 25. a 26. b 27. b 28. a 29. c 30. a 31. d 32. c

33. c 34. a 35. d 36. c 37. b 38. d 39. b 40. a 41. a 42. b 43. d 44. a 45. c 46. b 47. d

Chapter 10 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach

4th Edition Danica G. Hays University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents

Chapter 10: Individuals and Families of Arab and Arab American Descent

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 10: Individuals and Families of Arab and Arab American Descent Chapter 10 Learning Outcome Quizzes Learning Outcome 10.1: Identify countries of origin of individuals and families of Arab and Arab American descent, as well as identify some of the larger communities within the United States. [Q1] The Arab American demographic majority is made up of the United States over a longer period than their

Arabs who immigrated to Arab counterparts.

1. Christian, Muslim [correct] 2. Muslim, Christian 3. Muslim, Jewish 4. Jewish, Muslim [Feedback for Correct Answer 1] The Arab American demographic majority is made up of Christian Arabs who immigrated to the United States over a longer period than their Muslim Arab counterparts. [Feedback for Answer Choice 2] The Arab American demographic majority is made up of Christian Arabs, not Muslim Arabs. [Feedback for Answer Choice 3] The Arab American demographic majority is made up of Christian Arabs, not Muslim Arabs. [Feedback for Answer Choice 4] The Arab American demographic majority is made up of Christian Arabs, not Jewish Arabs. [Q2] Which member of the League of Arab States is also grouped into the Gulf States? 1. Iraq 2. Kuwait [correct] 3. Lebanon 4. Libya [Feedback for Answer Choice 1] Iraq is a member of the League of Arab States that is also grouped into Greater Syria. [Feedback for Correct Answer 2] Kuwait, along with Saudi Arabia and Oman, is a member of the League of Arab States that is also grouped into the Gulf States.

[Feedback for Answer Choice 3] Lebanon is a member of the League of Arab States that is also grouped into Greater Syria. [Feedback for Answer Choice 4] Libya is a member of the League of Arab States that is also grouped into the area of North Africa referred to as the Maghreb. [Q3] The second wave of Arab immigrants arrived in the United States after World War II. Which ethnic group comprised the largest portion of the second- wave immigrants? 1. Syrians 2. Jordanians 3. Egyptians 4. Palestinians [correct] [Feedback for Answer Choice 1] A significant number of Syrians immigrated to the United States after World War II . However, this group did not comprise the largest portion of the second- wave Arab immigrants. [Feedback for Answer Choice 2] A significant number of Jordanians immigrated to the United States after World War II . However, this group did not comprise the largest portion of the second- wave Arab immigrants. [Feedback for Answer Choice 3] A significant number of Egyptians immigrated to the United States after World War II . However, this group did not comprise the largest portion of the second- wave Arab immigrants. [Feedback for Correct Answer 4] The second wave of Arab immigrants arrived after World War II . Palestinians who were escaping civil war in 1948, as the British mandate in the area expired and territories were seized by Israel, comprised the largest portion of the second -wave immigrants. [Q4] Arabs have arrived in the United States in four distinct waves of immigration. Which wave marks a period when restrictions on immigration had been eased and a group predominately composed of formally educated Muslims moved to the United States in search of the American Dream? 1. First wave 2. Second wave 3. Third wave [correct] 4. Fourth wave [Feedback for Answer Choice 1] Most of the immigrants during the first wave were Christians who wanted to escape the Islamic Ottoman Empire.

[Feedback for Answer Choice 2] The second wave of Arab immigrants arrived after World War II . Palestinians who were escaping civil war in 1948, as the British mandate in the area expired and territories were seized by Israel, comprised the largest portion of the second- wave immigrants. Those who left were formally educated Muslims with the means to escape their undesirable situations during this period of tight restrictions on immigration. [Feedback for Correct Answer 3] The third wave of immigrants was composed predominantly of formally educated Muslims. This group’s motivation to move to the United States was a search for better lives as part of the American Dream. Restrictions on immigration had been eased in the 1960s, making it easier to take advantage of the opportunity. [Feedback for Answer Choice 4] The fourth wave largely comprised refugees who fled their homeland due to the situation created by the Gulf War. This group included Iraqis who worked with the United States in its war efforts in the region and who faced harsh consequences for that choice. Learning Outcome 10.2: Understand some current U.S. and global policies that affect individuals and communities of Arab and Arab American descent. [Q1] According to the Muslim Public Affairs Council (2021), one reason for the under-reporting of anti-Arab hate crimes is: 1. distrust toward government. [correct] 2. psychological distress. 3. persistent discrimination. 4. violation of cultural values. [Feedback for Correct Answer 1] According to the Muslim Public Affairs Council (2021), reasons for the under-reporting of antiArab hate crimes can include reasons common to other marginalized ethnic groups such as: cultural and language barriers, immigration status, and lack of knowledge about the criminal justice system, as well as distrust toward government due to post-9/11 policies and fear of retribution. [Feedback for Answer Choice 2] Victims of anti-Arab hate crimes will likely experience some level of psychological distress; however, the Muslim Public Affairs Council (2021) does not cite this issue as a reason for the under-reporting of anti-Arab hate crimes. [Feedback for Answer Choice 3] Victims of anti-Arab hate crimes may have encountered persistent discrimination throughout their time in the United States; however, the Muslim Public Affairs Council (2021) does not cite this issue as a reason for the under-reporting of anti-Arab hate crimes.

[Feedback for Answer Choice 4] The Muslim Public Affairs Council (2021) does not cite the violation of cultural values as a reason for the under-reporting of anti-Arab hate crimes. [Q2] Television shows such as All-American Muslim and Ramy are fraught with political controversy and have been accused of portraying images of Arab Americans. 1. falsified 2. normalized 3. stereotyped [correct] 4. caricatured [Feedback for Answer Choice 1] The television shows All-American Muslim and Ramy have made a sincere attempt to present authentic at presenting accurate images to normalize the experiences Arab Americans. As such, these shows have not been accused of portraying falsified images. [Feedback for Answer Choice 2] The television shows All-American Muslim and Ramy have tried to normalize the experiences Arab Americans. These shows have not been critiqued for their effort to normalize Arab American images but, rather for how these efforts have had the unintended effect of portraying stereotyped images of Arab Americans. [Feedback for Correct Answer 3] There are very few normalized images to counter those exaggerated and falsified ones that permeate U.S. culture and consciousness, and contemporary attempts at creating normalized images, such as the television shows All-American Muslim and Ramy that are fraught with political controversy and have been accused of portraying stereotyped images of Arab Americans. [Feedback for Answer Choice 4] The television shows All-American Muslim and Ramy have tried to counter the exaggerated and caricatured images of Arab Americans that are typically portrayed in popular culture. [Q3] The writing of noted that against a backdrop of stereotypes and misunderstanding, the personal and political choice of Arab Americans to identify strongly with their ethnicity can be a difficult one. 1. Ashraf and Nassar (2018) 2. Ikizler and Szymanski (2018) 3. D’Orazio and Salehyan (2018) 4. Nassar-McMillan and colleagues (2011) [correct]

[Feedback for Answer Choice 1] Ashraf and Nassar (2018) examined vicarious trauma associated with the discrimination experiences of American Muslims. [Feedback for Answer Choice 2] Ikizler and Szymanski (2018) have responded to the post-9/11 environment by realizing the need for solidarity among members of the Arab American community. [Feedback for Answer Choice 3] D’Orazio and Salehyan (2018) wrote about media bias and its role in perpetuating fear of the stereotypical ―Muslim terrorist.‖ [Feedback for Correct Answer 4] The writing of Nassar-McMillan and colleagues (2011) noted that against a backdrop of stereotypes and misunderstanding, the personal and political choice of Arab Americans to identify strongly with their ethnicity can be a difficult one. [Q4] In addition to documenting hate crimes, the American Arab Anti-Discrimination Committee (2020) recorded countless cases of workplace discrimination, which included: 1. unlawful termination. 2. religious harassment. [correct] 3. unequal compensation. 4. unfavorable performance evaluations. [Feedback for Answer Choice 1] The American Arab Anti-Discrimination Committee (2020) documented hate crimes and recorded countless cases of workplace discrimination against Arab Americans. This report indicated that victims of discrimination quit their jobs as a result of workplace harassment but did not present data related to job loss due to unlawful termination. [Feedback for Correct Answer 2] In addition to documenting hate crimes, the American Arab Anti-Discrimination Committee (2020) recorded countless cases of workplace discrimination, which included religious and personal harassment. [Feedback for Answer Choice 3] The American Arab Anti-Discrimination Committee (2020) documented hate crimes and recorded countless cases of workplace discrimination against Arab Americans, but this report did not contain data related to unequal compensation. [Feedback for Answer Choice 4] The American Arab Anti-Discrimination Committee (2020) documented hate crimes and recorded countless cases of workplace discrimination against Arab Americans, but this report did not contain data related to unfavorable performance evaluations. Learning Outcome 10.3: Identify cultural beliefs and values commonly associated with individuals and families of Arab and Arab American descent.

[Q1] According to a 2018 report published by the Arab American Institute, the predominant religion among Arab Americans is: 1. Islam. 2. Protestant. 3. Catholic. [correct] 4. Christian Orthodox. [Feedback for Answer Choice 1] Although a common stereotype in America is that Arab American individuals are often Muslim, the majority of Arab Americans do not practice Islam. [Feedback for Answer Choice 2] The majority of Arab Americans do not belong to Protestant religions. [Feedback for Correct Answer 3] The majority of Arab Americans are Christian, with the largest religious group being Catholic. [Feedback for Answer Choice 4] The majority of Arab Americans are Christian. However, the number who practice the Christian Orthodox faith is considerably smaller than the number of Arab American Catholics. [Q2] This high level of importance placed on the family unit invariably incorporates the idea of marriage and divorce. Arab and Arab American communities view the act of divorce as something that is: 1. rarely acceptable. 2. highly frowned upon. [correct] 3. generally permissible. 4. typically justified. [Feedback for Answer Choice 1] Arab and Arab American communities do not view the act of divorce as something that is rarely acceptable. [Feedback for Correct Answer 2] Arab and Arab American communities view the act of divorce as something that is highly frowned upon. [Feedback for Answer Choice 3] Arab and Arab American communities do not view the act of divorce as something that is generally permissible.

[Feedback for Answer Choice 4] Arab and Arab American communities do not view the act of divorce as something that is typically justified. [Q3] Arab Americans culture includes the concept of kinship. This term illustrates which of the following cultural values? 1. Religion and faith 2. Collectivism [correct] 3. Socioeconomic status 4. Communication styles [Feedback for Answer Choice 1] The Arab Americans concept of kinship may provide opportunities for individuals to share their faith with others, but it does not illustrate the cultural value of religion and faith. [Feedback for Correct Answer 2] Arab Americans culture includes the concept of kinship, which comprises ―extended family that provide connection, security, and identity for Arab men and women‖ (Beitin & Aprahamian, 2014, p. 69). As such, this term illustrates the Arab American cultural value of collectivism. [Feedback for Answer Choice 3] The Arab Americans concept of kinship does not illustrate the cultural value of socioeconomic status. [Feedback for Answer Choice 4] The Arab Americans concept of kinship may provide opportunities for individuals to communicate with others through a preferred cultural style, but it does not illustrate the cultural value of communication styles. [Q4] One of the Pillars of Islam, this term refers to the formal practice of worshiping by bowing toward Mecca five times daily and praying: 1. Salat. [correct] 2. Sawm. 3. Zakah. 4. insha’Allah. [Feedback for Correct Answer 1] The Five important spiritual practices, known as the Pillars of Islam, include Salat, which is the formal practice of worshiping by bowing toward Mecca five times daily and praying.

[Feedback for Answer Choice 2] The Pillars of Islam, includes Sawm, the month long fast observed during Ramadan—a practice that serves to build patience and obedience to God, as well as to teach compassion for those who go hungry. [Feedback for Answer Choice 3] The Pillars of Islam include Zakah, or the donation of 2.5% of one’s income to the mosques as a form of giving alms. [Feedback for Answer Choice 4] The role of Islam in everyday life can also be seen in the everyday words and phrases used by Muslim Arab Americans. For example, insha’Allah is a commonly used phrase that means ―God willing.‖ Learning Outcome 10.4: Articulate the influence of acculturation, ethnicity, and gender identity on individuals of Arab and Arab American descent. [Q1] Which of the following groups, according to Kira and colleagues (2014), are less capable of attending to the process of establishing themselves in their new communities? 1. Refugees [correct] 2. First-generation immigrants 3. Undocumented individuals 4. Individuals with a temporary work visa [Feedback for Correct Answer 1] Involuntary immigration, or situations in which newcomers seek refuge because conditions in their original country are intolerable, carries unique difficulties and stressors. According to Kira et al. (2014), refugees from war, violence, occupation, and instability may experience posttraumatic stress disorder (PT SD) and are less capable of attending to the process of establishing themselves in their new communities. [Feedback for Answer Choice 2] Kira and colleagues (2014) do not indicate that first-generation immigrants are less capable of attending to the process of establishing themselves in their new communities. [Feedback for Answer Choice 3] Kira and colleagues (2014) do not indicate that undocumented individuals are less capable of attending to the process of establishing themselves in their new communities. [Feedback for Answer Choice 4] Kira and colleagues (2014) do not indicate that individuals with temporary work visas are less capable of attending to the process of establishing themselves in their new communities. [Q2] The practice of veiling within the Muslim Arab American community is an expression of: 1. ethnicity.

2. oppression. 3. acculturation. 4. gender identity. [correct] [Feedback for Answer Choice 1] Veiling is practiced my Muslim women and girls as a sign of religious devotion not ethnicity. [Feedback for Answer Choice 2] The use of the veil may be viewed by non-Muslims as oppressive, whereas Muslim women and girls who agree to wear veils may feel that it is a sign of their religious devotion and cultural pride. [Feedback for Answer Choice 3] The practice of veiling within the Muslim community is not an expression of acculturation. [Feedback for Correct Answer 4] The practice of veiling is an example of Muslim Arab American gender identity. Muslim women and girls who agree to wear veils may feel that it is a sign of their religious devotion and cultural pride. Moreover, some women who veil their faces or dress in modest attire also indicate that they are free to develop their minds and opinions when attention is taken away from their physical selves. [Q3] If the Arab American parents have chosen the culturally preferred parenting style, then the children may come to understand and expect that someone in the family hierarchy is looking out for their interests and will help them with important decisions. 1. authoritarian 2. authoritative [correct] 3. permissive 4. overinvolved [Feedback for Answer Choice 1] The authoritative parenting style is not the culturally preferred parenting style among Arab Americans. [Feedback for Correct Answer 2] If the Arab American parents have chosen the culturally preferred authoritative parenting style, then the children may come to understand and expect that someone in the family hierarchy is looking out for their interests and will help them with important decisions. [Feedback for Answer Choice 3] The permissive parenting style is not the culturally preferred parenting style among Arab Americans. [Feedback for Answer Choice 4] Overinvolved is not one of the four styles of parenting.

[Q4] Arab American is an example of a(n)

term.

1. clinical 2. outdated 3. monolithic 4. panethnic [correct] [Feedback for Answer Choice 1] While the term Arab American is suitable for use in a clinical setting, it is not clinical in nature. [Feedback for Answer Choice 2] The term Arab American is not an outdated term. [Feedback for Answer Choice 3] Arab American is not an example of a monolithic term, as it refers to a broad region and encapsulates a diverse range of ethnicities and cultures. [Feedback for Correct Answer 4] Arab American is an example of a panethnic term, as it refers to a broad region and encapsulates a diverse range of ethnicities and cultures. Learning Outcome 10.5: Articulate various challenges to the mental health of individuals and families of Arab and Arab American descent. [Q1] highlight(s) the importance of taking into account premigration displacement and postmigration adjustment and adaptation. 1. Atiyeh and colleagues (2020) 2. Bauer (2016) 3. Chung (2017) [correct] 4. Dari and colleagues (2019) [Feedback for Answer Choice 1] Atiyeh and colleagues (2020) found that group interventions may be especially appropriate in addressing acculturation among various groups. [Feedback for Answer Choice 2] Bauer (2016) discovered that intergenerational stress, among both recent and later generations of immigrants, may pose additional family stressors. [Feedback for Correct Answer 3] Chung (2017) highlights the importance of taking into account premigration displacement and postmigration adjustment and adaptation. [Feedback for Answer Choice 4]

Dari and colleagues (2019) found that group interventions may be especially appropriate in addressing acculturation among various groups. [Q2] According to Nassar-McMillan and colleagues (2015), psychosocial issues for Arab Americans often present as issues. 1. relational 2. religious 3. cultural 4. physical [correct] [Feedback for Answer Choice 1] According to Nassar-McMillan and colleagues (2015), psychosocial issues for Arab Americans do not often present as relational issues. [Feedback for Answer Choice 2] According to Nassar-McMillan and colleagues (2015), psychosocial issues for Arab Americans do not often present as religious issues. [Feedback for Answer Choice 3] According to Nassar-McMillan and colleagues (2015), psychosocial issues for Arab Americans do not often present as cultural issues. [Feedback for Correct Answer 4] According to Nassar-McMillan and colleagues (2015), psychosocial issues for Arab Americans often present as physical issues. Depression or anxiety, for example, may become manifest in digestive, sleep, or any number of other physical disorders. [Q3] contributed to the evolution of ethnic identity models for individuals of Arab and Arab American descent. 1. Awad and colleagues (2019) [correct] 2. Goold and colleagues (2018) 3. Lipson and colleagues (2018) 4. Samari and colleagues (2019) [Feedback for Correct Answer 1] Awad and colleagues (2019) contributed to the evolution of ethnic identity models for individuals of Arab and Arab American descent. [Feedback for Answer Choice 2] Goold and colleagues (2018) illuminated the numerous health care disparities within Arab American communities and demonstrated the need for further investigating this issue. [Feedback for Answer Choice 3]

Lipson and colleagues (2018) also illuminated the numerous health care disparities within Arab American communities and demonstrated the need for further investigating this issue. [Feedback for Answer Choice 4] Samari and colleagues (2019) further illuminated the numerous health care disparities within Arab American communities and demonstrated the need for further investigating this issue. [Q4] According to Hakim-Larson and Nassar (2020), counselors working with refugees should first: 1. assess for PT SD 2. address basic needs [correct] 3. be cognizant of stigma associated with mental illness 4. encourage, when appropriate, prayer and reliance on religious beliefs [Feedback for Answer Choice 1] According to Hakim-Larson and Nassar (2020), assessing for PT SD is part of the third phase of working with refugees. [Feedback for Correct Answer 2] According to Hakim-Larson and Nassar (2020), counselors working with refugees should first address the basic needs of the client. [Feedback for Answer Choice 3] According to Hakim-Larson and Nassar (2020), being cognizant of the stigma associated with mental illness is part of the second phase of working with refugees. [Feedback for Answer Choice 4] According to Hakim-Larson and Nassar (2020), encouraging, when appropriate, prayer and reliance on spiritual and religious beliefs as helpful tools for those struggling with trauma should take place in the later stages of work with refugees. Learning Outcome 10.6: Evaluate the benefits and challenges of Western approaches for counseling individuals and families of Arab and Arab American descent. [Q1] For Arab American clients who are more approaches may be beneficial. 1. collectivist 2. acculturated [correct] 3. religious 4. verbal

[Feedback for Answer Choice 1]

, insight-based counseling

Since Arab Americans tend to be collectivist people, family and community units are tight knit and each person has a role that is critical within those structures. Thus, any goals aimed at building additional client insights run the risk of concurrently creating more internal conflicts. [Feedback for Correct Answer 2] Many Western approaches to counseling apply insight-based strategies. For Arab American clients who are more acculturated, this approach may be beneficial. [Feedback for Answer Choice 3] The religiosity of an Arab American client does not increase the suitability or benefit of using insight-based counseling approaches with them. [Feedback for Answer Choice 4] The suitability and benefit of using insight-based counseling approaches with Arab American clients is based on cultural factors and not on their level of verbal expression. [Q2] As a group, Arab Americans generally tend to prefer: 1. narrative approaches. 2. emotionally focused approaches. 3. pragmatic interventions. [correct] 4. constructivist approaches. [Feedback for Answer Choice 1] Narrative approaches may be useful, particularly in a situation in which the counselor is not Arab American, in that they allow clients to tell their own story and be heard, understood, and validated. However, Arab Americans as a group tend to prefer pragmatic and practical interventions over constructivist approaches. [Feedback for Answer Choice 2] Emotionally focused approaches may be useful, particularly in a situation in which the counselor is not Arab American, in that they allow clients to tell their own story and be heard, understood, and validated; however, Arab Americans as a group tend to prefer pragmatic and practical interventions. [Feedback for Correct Answer 3] As a group, Arab Americans generally tend to prefer solution-focused, cognitive–behavioral, or other pragmatic and practical interventions. [Feedback for Answer Choice 4] Constructivist approaches may be useful, particularly in a situation in which the counselor is not Arab American, in that they allow clients to tell their own story and be heard, understood, and validated; however, Arab Americans as a group tend to prefer pragmatic and practical interventions.

[Q3]

Arab Americans tend to be collectivistic people. Accordingly, whenever attendance at a local community event can be incorporated into the treatment plan, it could be important to do so. For example, inviting a person who is self-conscious about their personal appearance or social skills to a community event, together with homework involving the counselor or others, may be beneficial. This approach is an example of: 1. a clinical misstep. 2. a boundary violation. 3. a breach of confidentiality. 4. community involvement. [correct] [Feedback for Answer Choice 1] If this approach is carefully considered by the counselor and presented to the client with a clear clinical rationale, and characterized as a voluntary opportunity for therapeutic growth, then this approach would not be considered a clinical misstep. [Feedback for Answer Choice 2] This approach may appear to run counter to the traditional Western view, but, for the Arab and Arab American populations, it may be very effective. From a traditional perspective, this approach may constitute boundary crossing (which is sometimes necessary and beneficial) but given its cultural suitability it is not considered a boundary violation (which is unethical and typically harmful). [Feedback for Answer Choice 3] On the one hand, it may be viewed as positive, in the sense that the counselor may have a better understanding and appreciation of cultural issues. On the other hand, issues of confidentiality may be less clear and may need to be reiterated more as a part of the counseling process. By revisiting the nature and limits of confidentiality, the client is reminded of the potential for the public to gain awareness of their participation in counseling and, thus, can offer their consent to participate or opt out of the proposed activity. After the client’s consent is obtained, participation in the activity would not constitute a breach in confidentiality. [Feedback for Correct Answer 4] In general, Arab Americans tend to be collectivistic people. Therefore, to promote resilience, individual counseling not only should be focused on the collective unit rather than the individual, but also should utilize community involvement. Along those lines, whenever attendance at a local community event can be incorporated into the treatment plan, it could be important to do so. [Q4] This is the oldest Washington-based institution dedicated solely to the study of the Middle East, to increasing knowledge of the Middle East among the citizens of the United States, and to promoting a better understanding between the people of these two areas: 1. Middle East Institute [correct] 2. Middle East Policy Council 3. National Network for Arab American Communities 4. America–Mideast Educational and Training Services, Inc.

[Feedback for Correct Answer 1] The Middle East Institute is the oldest Washington-based institution dedicated solely to the study of the Middle East, to increasing knowledge of the Middle East among the citizens of the United States, and to promoting a better understanding between the people of these two areas. [Feedback for Answer Choice 2] The Middle East Policy Council is a nonprofit organization whose mission is to contribute to American understanding of the political, economic, and cultural issues that affect U.S. interests in the Middle East. [Feedback for Answer Choice 3] The mission of the National Network for Arab American Communities is the development of Arab American community–based nonprofit organizations that understand, meet the needs, and represent the concerns of Arab Americans at a local level while also collectively addressing those issues at a national level. [Feedback for Answer Choice 4] America–Mideast Educational and Training Services, Inc. [AMIDEAST] is an American nonprofit organization engaged in international education, training, and development activities in the Middle East and North Africa.

Chapter 10 Application Exercises Application Exercise 10.1: Religious Beliefs and Cultural Values of Arab and Arab American Clients Learning Outcome 10.3: Identify cultural beliefs and values commonly associated with individuals and families of Arab and Arab American descent. [Q1] Based on the research presented in the text, highlight several aspects of Arab culture that reflect the value of collectivism. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Contrary to the U.S. system, in which individuals are expected to become more independent as they mature, Arab Americans may continue seeing themselves as part of an extended family and community structure.



Decisions may be made within a collectivist context.



Help may be sought from other members of the collective group.



Appropriate behavior may be defined by the shared beliefs of the community.



Interdependence may be valued as a sign of dedication and loyalty to the group.



Arab Americans may be highly aware of both major and minor circumstances that could bring either honor or shame to their family and the larger community.



The idea of honor and shame may play a large role in the decisions, goals, and behaviors made by many Arab Americans.



An Arab or Arab American client may be expected to sacrifice individual goals or needs for the sake of the extended family.



Collective societies value trust, so outsiders must work to gain favor through sustained demonstrations of knowledge, awareness, and skillful assistance.

[Q2] Based on the research presented in the text, briefly discuss some of the important religious concepts and practices counselors should consider when working with Muslim clients. Please keep in mind that that every individual has unique life experiences. [Q2 MODEL RESPONSE] Based on the research presented in the text, your answer should include some of the following points: 

The religious diversity of the Arab American community is commonly overlooked.



The majority of Arabs in the Middle East are Muslim. However, counselors should not assume a client of Arab descent is Muslim, since the majority of Arab Americans are Christian, with the largest religious group being Catholic.



Because less may be known about Islam than some of the other, more dominant U.S. faiths, it is important to familiarize yourself with the history of this religion and the basic teachings of the Qur’an.



Many Muslims view Islam as not merely their religion, but their guide for everyday life.



Islamic law is written to help believers lead ethical lives that respect others and promote peace.



Men and women are considered by Islam to be equals before God.



Muslim women are able to obtain an education, own property, make their own decisions about marriage and divorce, and vote.



Muslim women also pray in the same way that the men do, but as with many other activities in traditional Arab Muslim households, the genders are separated.



For counselors who may not typically include religion as a topic of assessment, the presence of Islamic ethics in all parts of daily life means that an important influence could otherwise be missed.

[Q3] Based on the research presented in the text, why it is important for counselors to understand and respect the cultural communication styles of Arab and Arab American clients? [Q3 MODEL RESPONSE] Based on the research presented in the text, your answer should include some of the following points: 

Some of the cultural characteristics of Arab and Arab American clients are different from the average U.S. conversational style.



These differences may include: the use of non-verbal gestures to express emotion and respect, comfort with touching and standing in close proximity while communicating with those they are familiar with, and the use of a loud voice or repetition to emphasize a critical point.



Expressiveness may not extend to the sharing of emotional feelings or issues.



Arab Americans may be reluctant to share feelings with those outside their culture.



Arab clients may somaticize their emotions, a phenomenon in which deep emotions are inadvertently expressed through physical symptoms.



They may be reluctant to say anything negative about a family member or person from their community.



Hierarchy is respected and an emphasis is placed on children speaking respectfully to their elders and women being respectful to men while in public settings.



When communicating in public and around strangers, women may be less direct and less intense than men.



If the counselor is seen as an authority figure, the client (in any setting) may expect the counselor to provide concrete solutions to problems, rather than to ask questions designed to promote insight into a situation.



Arab American clients may initially be reserved with members of other ethnic groups, until an initial sense of trust is established.



Learning a few key Arabic greetings and other phrases from one’s clients can enhance rapport.

Application Exercise 10.2: The Case of Naseeb Learning Outcome 10.5: Articulate various challenges to the mental health of individuals and families of Arab and Arab American descent. [Q1] Naseeb is an Arab American male who was born in the United States and raised by parents who came to America from Iraq approximately 30 years ago. He is a 23-year-old male in college, and he recently experienced a hate crime. Three White males cornered him in an alley and beat him up while yelling ―Get out of our home. Go back to your own country.‖ Naseeb has come to counseling for support working through this experience. What do you think the men who beat up Naseeb meant when they said, ―Go back to your own country?‖ [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Naseeb likely has physical features that indicate his ancestors are from the Saudi Arabian Peninsula (e.g., dark brown hair, dark brown eyes, darker skin than White people).



Because Naseeb doesn’t necessarily look American, his attackers assumed he was from a different country.



The attackers likely have animosity for Arab individuals based on stereotypes they have learned in the media (e.g., Arab individuals as desert nomads and religious extremists).



The 9/11 tragedy has enhanced animosity toward individuals of Arabic descent in the United States, and Naseeb was likely targeted because of prejudices held by the attackers.

[Q2] Naseeb is an Arab American male who was born in the United States and raised by parents who came to America from Iraq approximately 30 years ago. He is a 23-year-old male in college, and he recently experienced a hate crime. Three White males cornered him in an alley and beat him up while yelling ―Get out of our home. Go back to your own country.‖ Naseeb has come to counseling for support working through this experience. What are some other individual, family, and community factors that might contribute to Naseeb’s worldview and overall mental health needs? [Q2 MODEL RESPONSE] Your answer might include any of the following: 

Gender



Sexual orientation



Socioeconomic status



Refugee status



Level of acculturation



Spirituality



Disability



Cognitive abilities



Biology



Genetics



Psychological needs



Family communication habits



Family values



Family roles and behaviors



Family race and ethnicity



School factors—classroom management, school climate, peer networks, teacher attitude, administrative policies



Community diversity



Public health services



Community resources and organizations



Economic opportunities



Legal resources

[Q3] Naseeb is an Arab American male who was born in the United States and raised by parents who came to America from Iraq approximately 30 years ago. He is a 23-year-old male in college, and he recently experienced a hate crime. Three White males cornered him in an alley and beat him up while yelling ―Get out of our home. Go back to your own country.‖ Naseeb has come to counseling for support working through this experience. What considerations should a counselor make when working with Naseeb? [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Psychosocial issues for Arab individuals are often manifested in physical ways. Counselors should assess clients’ digestive or sleep difficulties.



Counselors should assess the degree to which Naseeb identifies with his Arab heritage.



Counselors should remember that family is important in Arab cultures.



Solution-focused or cognitive-behavioral interventions might be most effective with Arab American clients as opposed to insight-based approaches.



Arab clients should be given the opportunity to tell their stories, especially if counselors are from a different ethnic background.



Arab individuals might be reluctant to express negative emotions, but once comfortable with a counselor, they might be highly expressive.

Application Exercise 10.3: Cultural and Clinical Considerations for Working with Clients of Arab Descent Learning Outcome 10.6: Evaluate the benefits and challenges of Western approaches for counseling individuals and families of Arab and Arab American descent. [Q1] Based on the research discussed in the text, highlight several best practices that counselors should strive to implement when working with clients of Arab and Arab American descent. [Q1 MODEL RESPONSE] Based on the research discussed in the text, your answer should include some of the following points: 

Avoid the tendency to impose Western biases and approaches.



Engage community and family members in the counseling process as much as possible.



Understand and identify the nature of stigmas and help-seeking behaviors.



Be mindful of standards for cultural competence and strive for cultural humility.



Embrace the complexity of diversity within the Arab American population—each person is the expert on their own experiences.



Seek to understand how social class, immigration status, location in the United States, and other critical factors influence the client’s culture and experiences with discrimination.



Critically reflect on the impact of their personal biases (whether implicit or explicit) and assumptions about a client’s culture/background.

[Q2] Based on the research discussed in the text, briefly explain how Western counseling approaches can be utilized to meet the cultural expectations and goals of Arab American clients. [Q2 MODEL RESPONSE] Based on the research discussed in the text, your answer should include some of the following points: 

Arab Americans as a group tend to may solution-focused, cognitive–behavioral, or other pragmatic or practical interventions.



In a situation in which a counselor is not Arab American, constructivist approaches may be useful for helping clients to tell their own story and be heard, understood, and validated.



Building a positive working alliance with an Arab American client will involve both intellectual skills (e.g., understanding preferred approaches, learning about the individual

and the group) and personal skills (e.g., monitoring internal prejudices, becoming empathetic, finding ways to relate).

[Q3] Based on the research discussed in the text, discuss some of the professional adjustments that counselors may need to implement to effectively address the stigma associated with seeking counseling services within the Arab American community. [Q3 MODEL RESPONSE] Based on the research discussed in the text, your answer should include some of the following points: 

Counselors should be aware of the cultural tendency toward somatization.



Work to develop an authoritative stance, perhaps more consistent with that of a medical professional, that may be most effective with the cultural beliefs and expectations of Arabs and Arab Americans.



Counseling is viewed as a Western concept and is more likely to be sought out by later generations of Arab Americans.



More recent immigrants are more inclined to seek out help from medical professionals or members of the clergy.



Accordingly, it is important to collaborate with helping professionals across a variety of arenas to develop client education interventions about counseling services and referral networks with the Arab American community.



For counselors of Arab and Arab American descent, ethnicity may allow prospective clients to feel more culturally understood.



This shared background may also create issues of confidentiality if the client and counselor live in the same community.

Chapter 10 Test Items Multiple Choice 1.

is NOT a member of the League of Arab States. a. Jordan b. Afghanistan c. Morocco d. Djibouti

The earliest Arab immigrants to the United States were a. well-educated and Christian. b. well-educated and Muslim. c. poorly educated and Christian. d. poorly educated and Muslim.

Which of the following is NOT among the Five Pillars of Islam? a. Donation of income to the mosque. b. Fasting during the month of Ramadan. c. Bowing and praying five times a day. d. Males as protectors of the household, females in domestic roles.

Some important cultural characteristics of Arabs include each of the following EXCEPT a. strong tendency toward religiosity. b. dedication to family. c. advocates for education. d. nonverbal communication often used to emphasize verbal messages.

Arab Americans can be identified by a. a habit of wearing veils or turbans. b. dark hair/eyes and olive-colored skin. c. Arabic names. d. None of the above.

Most Arab Americans are a. maintaining Arab cultural traditions and avoiding American traditions. b. fully Americanized in their traditions. c. marginalized by living in the United States and therefore adhering to neither set of cultural traditions. d. at various positions along the range of acculturation characteristics.

Children in collectivistic families (as Arab American families may be) are: a. less likely to express family conflict in the teen years b. more likely to be protected against influences perceived as corrupting c. less likely to choose a profession or academic major without consulting with their family d. All of the above.

Counselors working with Arab American clients should explore all of the following EXCEPT a. their degree of acculturation to U.S. or Arab American customs. b. how their families are related to the presenting problem or solution. c. their childhood influences in detail, looking for insights into current issues. d. any expectations or concerns they may have about the counseling process.

A recent refugee experiencing posttraumatic stress disorder might demonstrate a. anxiety in everyday settings. b. medical complaints such as headaches, stomach problems, difficulty sleeping. c. depression or anger about his/her current situation. d. All of the above.

10. Providing culturally competent counseling to an Arab American client would NOT always include a. focusing on Islam and how it functions in the client’s life. b. inquiring about community ties and involving influential others in the therapy. c. increasing one’s own knowledge, awareness, and skills with respect to the ethnic group and some common cultural characteristics. d. reading about political and social conflicts in the Middle East. 11. Major religious groups coexisting in the Arab Middle East include each of the following EXCEPT a. Jews. b. Christians. c. Buddhists. d. Muslims. 12. Among Arab Americans, religious faiths include each of the following EXCEPT a. Christian. b. Muslim. c. Jewish. d. Orthodox. 13. The Arab Middle East is geographically located in a. sub-Saharan Africa and Asia. b. Asia.

c. Asia and Eastern Europe. d. Asia and Northern Africa. 14. Typical reasons for immigration among the various waves of Arab American immigrants include each of the following EXCEPT a. economic opportunity. b. religious persecution. c. political tensions in the homeland. d. United States cultural values. 15. Largest groups of Arab Americans include each of the following EXCEPT a. Lebanese. b. Sudanese. c. Egyptians. d. Syrians. 16. Current issues for Arab Americans include each of the following EXCEPT a. civil liberties. b. hate crimes. c. refugee issues. d. poverty. 17.

is NOT a tenet of Islam. a. Salat b. Sawm c. Shalom d. Zakah

18. According to Islam, Muslim women are currently prohibited from a. obtaining education. b. owning property. c. making decisions about marriage or divorce. d. None of the above. 19. When counseling Arab Americans, it is important to consider clients’ extended kinship network, which may include each of the following EXCEPT a. imams. b. extended family. c. community leaders. d. school teachers.

20. Arab Americans tend to be well represented in all sectors of professional life EXCEPT a. teaching. b. entrepreneurship. c. business. d. government. 21.

is/are NOT among the key mental health issues for Arab Americans. a. Immigration and acculturation b. Ethnic identity development c. Oppression d. Suicide

22.

is NOT among typical acculturative stressors for Arab Americans. a. Language acquisition b. Professional and educational transferability c. Networking within Arab American communities d. Learning new cultural customs

23. Arab Americans may typically present with all of the following issues in counseling EXCEPT a. depression or anxiety. b. digestive issues. c. sleep issues. d. various physical disorders. 24. Important considerations in counseling Arab American clients are likely to include each of the following EXCEPT a. refraining from imposing Western cultural values. b. engaging family and community members if possible. c. engaging clients in developing client’s self-awareness and insight. d. understanding and identifying the nature of cultural stigmas. 25. In counseling Arab American clients, the ideal counseling dyad includes a. an Arab American counselor. b. a non–Arab American counselor. c. a counselor who periodically reviews confidentiality and other aspects of the counseling relationship. d. a counselor who serves as the authority figure and resolves the clients issues. 26. The second wave of Arab immigrants arrived in the United States after WWII due to political tension. This wave was called the because those who left were formally educated Muslims with the means to escape.

a. American Dream b. Brain Drain c. Refugees d. None of the above 27. Which of the following is true regarding Arab Americans’ collective worldview? a. Arab Americans see themselves as part of an extended family and community structure. b. Help is sought from other members of the group. c. Interdependence is valued as a sign of dedication. d. All of the above are true. 28. The Arab social structure is a. patrilineal. b. matriarchal. c. democratic. d. authoritative. 29. The majority of Arabs in the Middle East are within Arab Americans is .

, but the largest religious group

a. Christian; Muslim. b. Muslim; Catholic. c. Muslim; Protestant. d. Muslim; Jewish. 30. The religious text of Islam is the a. Bible. b. Torah. c. Qur’an. d. All of the above. 31.

is the Pillar of Islam regarding the pilgrimage to Mecca. a. Shahadah b. Zakah c. Salat d. Hajj

32. The Pillar of Islam that involves the formal practice of worshiping by bowing toward Mecca five times daily and praying is known as . a. Shahadah. b. Sawm. c. Salat.

d. Zakah. 33.

is the Pillar of Islam regarding the month-long fast observed during Ramadan. a. Hajj b. Shahadah c. Sawm d. Zakah

34. For prayer and other activities in traditional Arab Muslim households, a. men and women worship together. b. only the women pray five times daily. c. the genders are separated. d. only the men pray five times daily. 35. For Muslims, the religious leader is known as the

a. Rabbi. b. Imam. c. Reverend. d. None of the above. 36.

of Arab Americans have a high school diploma and over degree.

have a bachelor

a. 50%; 25% b. 95%; 80% c. 20%; 30% d. 85%; 40% 37. A career-related issue that an Arab American client may present in counseling is a. workplace discrimination. b. the impact of immigration on work. c. the impact of cultural adjustment on work. d. All of the above are possible career-related issues. 38. The overall rate of employment and mean household income among Arab Americans is a. very low. b. low. c. moderate. d. high. 39. Regarding communication styles, Arab Americans clients may a. use nonverbal gestures to express emotion and respect. b. display discomfort with touching.

c. maintain far proximity even with people they are familiar with. d. use a low volume and tone of voice when speaking. 40. If the counselor is seen as an authority figure, the client may expect the counselor to a. help the client find insight. b. provide concrete solutions to problems. c. use open-ended questions to fully explore issues. d. All of the above. 41. A factor that might influence the ease or difficulty of an Arab American’s adjustment process is a. their country of origin. b. their reason for coming to the United States. c. their proximity to an Arab American enclave. d. All of the above. 42. Which of the following is true regarding the practice of veiling? a. Muslim women who agree to wear veils may consider it a sign of their religious devotion and cultural pride. b. Some Muslim women have an ambivalent view, in which they accept the practice at certain times and reject it at others. c. Some women indicate that they can develop their minds and opinions when attention is taken away from their physical selves. d. All of the above are true regarding the practice of veiling. 43. All of the following are examples of acculturative stress for Arab Americans EXCEPT a. learning a new language and cultural customs. b. living in close proximity to an Arab American enclave. c. transferring former levels of education and employment credentials. d. navigating a new social structure. 44. Western counseling approaches (i.e., insight-based strategies) may be beneficial for Arab Americans who are a. less acculturated. b. more acculturated. c. Both of the above. d. None of the above. 45.

counseling approaches may be useful for Arab American clients because these approaches allow clients to tell their story and be heard, understood, and validated. a. Psychodynamic b. Gestalt

c. Constructivist d. Cognitive-behavioral

Extended Response 1.

How do the stereotypes of Arabs that exist in U.S. culture prevent us from discovering the reality of Arab Americans and their lives?

What are some of the current dynamics that might make it challenging to build a healthy Arab American ethnic identity?

Explain the religious demographics of the Arab American community in the United States in terms of the waves of immigration history (e.g., why are the majority of Arab Americans non-Muslim if the majority of the Arab Middle East is Muslim)?

Explain the five Pillars of Islam.

Compare Islam to Christianity and Judaism. What similarities and differences did you find?

Describe some of the cultural values of Arab American individuals and communities and how they manifest (e.g., through lifestyle, community involvement, among others) in contemporary U.S. society.

List and describe some of the issues around the practice of veiling or wearing hijab, among Arab American women.

What are some of the possible mental health issues that Arab American clients might present in counseling? How might level of acculturation play a role in either the presenting issues, the appropriate interventions, or both?

What are some ways in which to engage family or community members in providing counseling services or treatment for an Arab American individual?

10. What approaches to counseling Arab American clients might you consider within your own setting (e.g., school, college, community)? 11. Brainstorm a list of stereotypes about Arab Americans and discuss their origins. 12. Discuss some acculturative stressors that Arab Americans may face. 13. Why might biculturalism be challenging for Arab Americans to develop? 14. In terms of communication styles, what characteristics are important for counselors to be aware of when working with Arab American clients? 15. Describe a few main aspects of the collectivist Arab American culture (e.g., social structure, values).

Chapter 10 Test Answer Key ANSWER KEY: Chapter 10 Test (Multiple Choice) 1. b 2. c 3. d 4. a 5. d 6. d 7. d 8. c 9. d 10. a 11. c 12. c 13. d 14. d 15. b 16. d 17. c 18. d 19. d 20. d 21. d 22. c 23. a 24. c 25. c 26. b 27. d 28. a 29. b 30. c 31. d 32. c 33. c 34. c 35. b 36. d 37. d 38. d 39. a 40. b 41. d 42. d 43. b 44. b 45. c

Chapter 11 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach th 4 Edition Danica G. Hays University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents Chapter 11: Individuals and Families of Asian and Asian American Descent

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 11: Individuals and Families of Asian and Asian American Descent Chapter 11 Learning Outcome Quizzes Learning Outcome 11.1: Describe historical forms of discrimination faced by individuals and communities of Asian and Asian American descent. [Q1] Since the large-scale arrival of laborers on the sugar plantations of Hawaii and the gold mines of California in the mid-1800s, immigration has been a common thread shared by numerous Asian ethnic groups. 1. Chinese [correct] 2. Filipino 3. Taiwanese 4. Punjabi [Feedback for Correct Answer 1] Since the large-scale arrival of Chinese laborers on the sugar plantations of Hawaii and the gold mines of California in the mid-1800s, immigration has been a common thread shared by numerous Asian ethnic groups. [Feedback for Answer Choice 2] There was not a large-scale arrival of Filipino laborers on the sugar plantations of Hawaii and the gold mines of California in the mid-1800s. [Feedback for Answer Choice 3] There was not a large-scale arrival of Taiwanese laborers on the sugar plantations of Hawaii and the gold mines of California in the mid-1800s. [Feedback for Answer Choice 4] Lured by the prospects of earning economic fortunes and the potential to provide for one’s family, Punjabi laborers favored the hills and fields of California in the 1850s over the sugar plantations of Hawaii. [Q2] The effectively restricted Filipino immigration, even though Filipinos were considered U.S. nationals at the time. 1. Gentleman’s Agreement of 1907 2. Immigration Act of 1917 3. Tydings–McDuffie Act of 1934 [correct] 4. Immigration and Nationality Act of 1965

[Feedback for Answer Choice 1] The Gentleman’s Agreement of 1907 restricted Japanese immigration. [Feedback for Answer Choice 2] The Immigration Act of 1917 restricted Asian Indian immigration. [Feedback for Correct Answer 3] The Tydings–McDuffie Act of 1934 effectively restricted Filipino immigration despite the fact that Filipinos were considered U.S. nationals at the time. [Feedback for Answer Choice 4] Contemporary Asian America emerged with the passage of the Immigration and Nationality Act of 1965. Prior to 1965, existing immigration laws severely restricted Asian immigration while also favoring European immigration. [Q3] The Gentleman’s Agreement of 1907 restricted immigration from which of the following countries? 1. China 2. Japan [correct] 3. India 4. Philippines [Feedback for Answer Choice 1] The Chinese Exclusion Act of 1882, the first ethnicity-specific ban of its kind, prohibited immigration from China. [Feedback for Correct Answer 2] The Gentleman’s Agreement of 1907 restricted Japanese immigration. [Feedback for Answer Choice 3] The Immigration Act of 1917 restricted Asian Indian immigration. [Feedback for Answer Choice 4] The Tydings–McDuffie Act of 1934 effectively restricted Filipino immigration despite the fact that Filipinos were considered U.S. nationals at the time. [Q4] Not until the 1960s did student activists begin to informally use the term Asian American in recognition of their commonalities and shared history of oppression. 1. Asian Indian 2. Korean 3. Taiwanese 4. Japanese [correct]

[Feedback for Answer Choice 1] Asian Indian student activists did not begin to informally use the term Asian American in the 1960s. [Feedback for Answer Choice 2] Korean student activists did not begin to informally use the term Asian American in the 1960s. [Feedback for Answer Choice 3] Taiwanese student activists did not begin to informally use the term Asian American in the 1960s. [Feedback for Correct Answer 4] Not until the 1960s did Japanese, Chinese, and Filipino student activists begin to informally use the term Asian American in recognition of their commonalities and shared history of oppression. Learning Outcome 11.2: Identify contemporary forms of discrimination faced by individuals and communities of Asian and Asian American descent, including the model minority myth. [Q1] Modern-day examples of ―English-only‖ language initiatives.

racism against Asian Americans include

1. overt 2. covert 3. symbolic 4. institutional [correct] [Feedback for Answer Choice 1] Gee and colleagues (2009) discussed the idea that discrimination can be overt (e.g., hate crimes, poor treatment). [Feedback for Answer Choice 2] Gee and colleagues (2009) discussed the idea that discrimination can be covert/symbolic (e.g., an implicit attitude). [Feedback for Answer Choice 3] Gee and colleagues (2009) discussed the idea that discrimination can be covert/symbolic (e.g., an implicit attitude). [Feedback for Correct Answer 4] Modern-day examples of institutional racism against Asian Americans include ―English-only‖ language initiatives. [Q2] Gover and colleagues (2020) posited that despite comprising a tapestry of diverse ethnicities, Asian Americans have been historically viewed as a(n) group. 1. enigmatic

2. monolithic [correct] 3. mythical 4. ambitious [Feedback for Answer Choice 1] Gover and colleagues (2020) do not posit that Asian Americans have been historically viewed as an enigmatic group. [Feedback for Correct Answer 2] Gover and colleagues (2020) posited that despite comprising a tapestry of diverse ethnicities, Asian Americans have been historically viewed as a monolithic group. [Feedback for Answer Choice 3] Gover and colleagues (2020) highlight the model minority myth attributed to Asian Americans but do not posit that they have been historically viewed as a mythical group. [Feedback for Answer Choice 4] Gover and colleagues (2020) highlight the model minority myth attributed to Asian Americans but do not posit that they have been historically viewed as an ambitious group. [Q3] Dating back to the publication of a 1966 New York Times magazine article titled ―Success Story: Japanese-American Style,‖ the stereotype has been used to describe and elevate the status of Asian Americans. 1. visionary 2. model-minority [correct] 3. forward-thinker 4. social climber [Feedback for Answer Choice 1] The 1966 New York Times magazine article titled ―Success Story: Japanese-American Style‖ did not perpetuate did not stereotype Asian Americans as visionaries. [Feedback for Correct Answer 2] Since the 1966 New York Times magazine article titled ―Success Story: Japanese-American Style,‖ the model-minority stereotype has been used to describe and elevate the status of Asian Americans. According to this stereotype, Asian Americans as a group have become a model community that has ―overcome‖ its minority status, despite the barriers presented by racism. [Feedback for Answer Choice 3] The 1966 New York Times magazine article titled ―Success Story: Japanese-American Style‖ did not perpetuate did not stereotype Asian Americans as forward-thinkers.

[Feedback for Answer Choice 4]

The 1966 New York Times magazine article titled ―Success Story: Japanese-American Style‖ did not perpetuate did not stereotype Asian Americans as social climbers.

[Q4] A study conducted by Siy and Cheryan (2013) found that hearing stereotypes about their group was associated with part of Asian American participants.

emotions on the

1. positive, negative [correct] 2. positive, positive 3. negative, negative 4. negative, minimal [Feedback for Correct Answer 1] A study conducted by Siy and Cheryan (2013) found that hearing positive stereotypes about their group, such as the stereotype that Asians are good at math, was associated with negative emotions on the part of Asian American participants. [Feedback for Answer Choice 2] The study conducted by Siy and Cheryan (2013) did not find that hearing positive stereotypes was associated with positive emotions. [Feedback for Answer Choice 3] The study conducted by Siy and Cheryan (2013) did not investigate the impact of hearing negative stereotypes. [Feedback for Answer Choice 4] The study conducted by Siy and Cheryan (2013) did not investigate the impact of hearing negative stereotypes. Learning Outcome 11.3: Describe the heterogeneity of Asian and Asian American descent individuals. [Q1] According to a 2017 report published by the Pew Research Center, were born abroad. 1. 27% 2. 30% 3. 59% [correct] 4. 73%

[Feedback for Answer Choice 1]

of Asian Americans

According to a 2017 report published by the Pew Research Center, 27% of Japanese Americans are foreign born. [Feedback for Answer Choice 2] According to a 2017 report published by the Pew Research Center, the percentage of Asian Americans born abroad is significantly larger than 30%. [Feedback for Correct Answer 3] According to a 2017 report published by the Pew Research Center, more than half (59%) of Asian Americans were born abroad. [Feedback for Answer Choice 4] According to a 2017 report published by the Pew Research Center, almost 73% of Asian American adults were born abroad. [Q2] According to the U.S. Census Bureau, which of the following ethnicities is one of the five fastest growing Asian ethnic groups in the United States? 1. Filipino 2. Korean 3. Pakistani [correct] 4. Vietnamese [Feedback for Answer Choice 1] According to the U.S. Census Bureau, Filipinos are one of the 10 largest Asian ethnic groups, but are not one of the five fastest growing Asian ethnicities, in the United States. [Feedback for Answer Choice 2] According to the U.S. Census Bureau, Koreans are one of the 10 largest Asian ethnic groups, but are not one of the five fastest growing Asian ethnicities, in the United States. [Feedback for Correct Answer 3] According to the U.S. Census Bureau, Pakistanis are one of the five fastest growing Asian ethnic groups in the United States. [Feedback for Answer Choice 4] According to the U.S. Census Bureau, Vietnamese are one of the 10 largest Asian ethnic groups, but are not one of the five fastest growing Asian ethnicities, in the United States. [Q3] According to Uy (2004), statistics showed that, in California, Chinese men made income that White men made. 1. 40% 2. 62% 3. 68% [correct] 4. 82%

of the

[Feedback for Answer Choice 1] According to Uy (2004), statistics showed that, in California, Asian American women made 40% less than White women. [Feedback for Answer Choice 2] According to Uy (2004), statistics showed that, in California, Filipino men made 62% of the income that White men made. [Feedback for Correct Answer 3] According to Uy (2004), statistics showed that, in California, Chinese men made 68% of the income that White men made. [Feedback for Answer Choice 4] According to Uy (2004), statistics showed that, in California, Korean men made 82% of the income that White men made. [Q4] According to a 2018 report published by the Pew Research Center, speak English proficiently.

of Indian Americans

1. 70% 2. 80% [correct] 3. 82% 4. 84% [Feedback for Answer Choice 1] As a group, 70% of Asian Americans ages 5 years and above speak English proficiently (Pew Research Center, 2018). [Feedback for Correct Answer 2] According to a 2018 report published by the Pew Research Center, 80% of Indian Americans speak English proficiently. [Feedback for Answer Choice 3] According to a 2018 report published by the Pew Research Center, 82% of Filipino Americans speak English proficiently. [Feedback for Answer Choice 4] According to a 2018 report published by the Pew Research Center, 84% of Japanese Americans speak English proficiently. Learning Outcome 11.4: Identify and describe core aspects of culture and values of individuals of Asian and Asian American descent.

[Q1]

is an abstract concept that prescribes the way children need to show respect and obedience toward their parents, elders, and ancestors. 1. Kinship 2. Filial piety [correct] 3. Authoritarian parenting 4. Generational expectations [Feedback for Answer Choice 1] The concept of kinship is typically associated with Arab American families and refers to the ―extended family that provide connection, security, and identity for Arab men and women‖ (Beitin & Aprahamian, 2014, p. 69). [Feedback for Correct Answer 2] This emphasis on a family identity and interdependence makes filial piety a strongly espoused value in the Asian American family. Filial piety is an abstract concept that prescribes the way children need to show respect and obedience toward their parents, elders, and ancestors. [Feedback for Answer Choice 3] Parenting that tends to be authoritarian has a direct influence on filial piety. Actions that benefit the family are praised, whereas guilt-inducing techniques, such as withdrawing familial support, are often used as a means of enforcing discipline and maintaining family cohesion. [Feedback for Answer Choice 4] The term generational expectations is a broad term that refers to hopes and desires that parents and grandparents may have for their children and grandchildren. [Q2] The belief that important life decisions should be made for the betterment of others is called: 1. individualism. 2. group culture. 3. collectivism. [correct] 4. cultural encapsulation. [Feedback for Answer Choice 1] Individualism promotes the belief that important life choices should be made for the betterment of the self. [Feedback for Answer Choice 2] Group culture refers to the culture within a specific group, but it does not specify the specific values held within that group. [Feedback for Correct Answer 3] Collectivist cultures promote the idea that important decisions should be made according to what is best for the group rather than any single individual. [Feedback for Answer Choice 4]

Cultural encapsulation refers to a lack of awareness of others’ cultures, which could occur in an individualistic or collectivistic culture. [Q3] According to Enrile and Agbayani (2008),

tend to be more egalitarian.

1. Chinese Americans 2. Filipino Americans [correct] 3. Koreans 4. Southeast Asians [Feedback for Answer Choice 1] Unlike more egalitarian cultures, Chinese Americans tend to be more patriarchal and traditional in orientation (Enrile & Agbayani, 2008). [Feedback for Correct Answer 2] According to Enrile and Agbayani (2008), Filipino Americans tend to be more egalitarian. [Feedback for Answer Choice 3] Unlike more egalitarian cultures, Koreans tend to be more patriarchal and traditional in orientation (Enrile & Agbayani, 2008). [Feedback for Answer Choice 4] Unlike more egalitarian cultures, Southeast Asians tend to be more patriarchal and traditional in orientation (Enrile & Agbayani, 2008). [Q4] According to Qin (2008), Asians tend not to be too emotionally demonstrative in their relationships, and displaying strong emotions is often seen as a sign of . 1. respect. 2. weakness. 3. vulnerability. 4. immaturity. [correct] [Feedback for Answer Choice 1] Qin (2008) does not indicate that Asians view displaying strong emotions as a sign of respect. [Feedback for Answer Choice 2] Qin (2008) does not indicate that Asians view displaying strong emotions as a sign weakness. [Feedback for Answer Choice 3] Qin (2008) does not indicate that Asians view displaying strong emotions as a sign vulnerability. [Feedback for Correct Answer 4]

According to Qin (2008), Asians tend not to be too emotionally demonstrative in their relationships, and displaying strong emotions is often seen as a sign of immaturity. Learning Outcome 11.5: Identify how cultural factors (i.e., immigration, enculturation, acculturation, ethnicity, race, gender roles, sexuality, and sexual identity) shape individual experiences of those of Asian and Asian American descent. [Q1] Which of the following might make Asian individuals more likely to access mental health services in America? 1. Supportive and caring family members 2. Counseling center integration within a medical clinic [correct] 3. Limited exposure to Western mental health treatment 4. Availability of alternative healing practices [Feedback for Answer Choice 1] To Asians and many Asian Americans, personal problems and weaknesses are to be shared only with family members. Moreover, the family is seen as the only party responsible for taking care of such problem. Thus, supportive and caring family members diminish the likelihood of an Asian individual accessing mental health services in America. [Feedback for Correct Answer 2] Various cultural beliefs and expectations may provide barriers to seeking out counseling. However, Asian individuals might have more trust in visiting a counseling center within a medical clinic. [Feedback for Answer Choice 3] It is helpful for most individuals to learn what to expect before accessing counseling services. Thus, a lack of knowledge or lack of exposure to Western mental health treatment and misconceptions about professional counseling may be barriers to seeking professional help. [Feedback for Answer Choice 4] The availability of alternative healing practices have been noted to contribute to underutilization of mental health services among Asian Americans, especially for those residing in immigrant communities. [Q2] According to Yoo and colleagues (2010), the difficulty in recognizing that Asian Americans experience discrimination is a function of: 1. the model-minority myth. 2. related racial politics of success and economics. 3. the absence of racial socialization among new immigrants. 4. the tendency to dichotomize racism as a Black–White issue. [correct] [Feedback for Answer Choice 1]

According to Abrams (2019), the difficulty in recognizing that Asian Americans experience discrimination is a function of the model-minority myth. [Feedback for Answer Choice 2] The difficulty in recognizing that Asian Americans experience discrimination is also a function of related racial politics of success and economics. However, this influence is not noted by Yoo and colleagues (2010). [Feedback for Answer Choice 3] According to Kim and Chao (2009), the absence of racial socialization and a language speak to these issues among new immigrants. [Feedback for Correct Answer 4] According to Yoo and colleagues (2010), the difficulty in recognizing that Asian Americans experience discrimination is a function of the tendency to dichotomize racism as a Black–White issue. [Q3] An Asian American receiving a compliment for speaking good English or speaking without an accent is an example of: 1. a microassault. 2. a microinsult. 3. a microinvalidation. [correct] 4. cultural frame switching. [Feedback for Answer Choice 1] Microassaults are a type of microaggression that can take the form of racial slurs. [Feedback for Answer Choice 2] The assumption that Asian Americans may not be good managers is an example of a microinsult. [Feedback for Correct Answer 3] An Asian American receiving a compliment for speaking good English or speaking without an accent is an example of a microinvalidation. [Feedback for Answer Choice 4] Cultural frame switching refers to the notion that different aspects of identity may be activated based on different contexts. However, this term does not refer to comments one may receive about their behavior and/or identity. [Q4] Millan and Alvarez (2014) investigated the link between racial discrimination faced by Asian Americans and: 1. anxiety

2. depression. 3. internalization. [correct] 4. overall decrease in health and well-being. [Feedback for Answer Choice 1] Kim and colleagues (2017) investigated the link between racial discrimination faced by Asian Americans and anxiety. [Feedback for Answer Choice 2] Nadal and colleagues (2015) investigated the link between racial discrimination faced by Asian Americans and depression. [Feedback for Correct Answer 3] Millan and Alvarez (2014) investigated the link between racial discrimination faced by Asian Americans and internalization, which involves going through multiple stages wherein individuals may wish to own or disown their ethnic heritage. [Feedback for Answer Choice 4] Nicholson and Mei (2020) investigated the link between racial discrimination faced by Asian Americans and an overall decrease in health and well-being. Learning Outcome 11.6: Describe mental health challenges faced by individuals of Asian and Asian American descent. [Q1] According to Sue and colleagues (2012), reviewing the body of research on counseling Asian Americans is likely to provide answers. 1. definitive 2. tentative 3. conflicting [correct] 4. misleading [Feedback for Answer Choice 1] Sue and colleagues (2012) indicate that, as a relatively new field, the research on counseling Asian Americans is far from definitive. [Feedback for Answer Choice 2] Sue and colleagues (2012) do not indicate that body of research on counseling Asian Americans is likely to provide tentative answers. [Feedback for Correct Answer 3] According to Sue and colleagues (2012), reviewing the body of research on counseling Asian Americans is likely to provide conflicting answers. [Feedback for Answer Choice 4]

Sue and colleagues (2012) do not indicate that body of research on counseling Asian Americans is likely to provide misleading answers. [Q2] The National Latino and Asian American Study (NLAAS) conducted by Takeuchi and colleagues (2007) provides data on the causes and prevalence of psychological disorders among Asian Americans. The NLAAS is an example of a(n): 1. epidemiological study [correct] 2. national survey 3. mixed-methods experiment 4. qualitative research project [Feedback for Correct Answer 1] Since the National Latino and Asian American Study (NLAAS) provides data on the causes and prevalence of psychological disorders, it is an example of an epidemiological study. [Feedback for Answer Choice 2] The NLAAS is not an example of a national survey. [Feedback for Answer Choice 3] The NLAAS is not an example of a mixed-methods experiment. [Feedback for Answer Choice 4] The NLAAS is not an example of a qualitative research project. [Q3] Zhang and colleagues (2013) found that lifetime prevalence rates of suicidal ideation among U.S.-born Chinese Americans was: 1. 15.2%. 2. 18.4%. [correct] 3. 23.2%. 4. 24.6%. [Feedback for Answer Choice 1] Takeuchi and colleagues (2007) found that lifetime rates of mental health disorders for foreignborn Asian Americans was 15.2%. [Feedback for Correct Answer 2] Zhang and colleagues (2013) found that lifetime prevalence rates of suicidal ideation among U.S.-born Chinese Americans was 18.4%. [Feedback for Answer Choice 3] Zhang and colleagues (2013) found that lifetime prevalence rates of depressive disorders among U.S.-born Chinese Americans was 23.2%. [Feedback for Answer Choice 4]

Takeuchi and colleagues (2007) found that lifetime rates of mental health disorders for U.S.born participants was 24.6%. [Q4] For Asian immigrants whose cultural values and beliefs greatly influence their daily lives and attitudes toward health and well-being, the use of alternative forms of healing is an example of: 1. relative functionalism. 2. filial piety. 3. cultural frame switching 4. sites of resiliency. [correct] [Feedback for Answer Choice 1] Asian Americans place a higher value on education as the most viable means of upward mobility, a concept Sue and Okazaki (2009) refer to as relative functionalism. [Feedback for Answer Choice 2] Filial piety is an abstract concept that prescribes the way children need to show respect and obedience toward their parents, elders, and ancestors. [Feedback for Answer Choice 3] Cultural frame switching refers to the notion that different aspects of identity may be activated based on different contexts. Related to these varying aspects of identity is the role of race and racial identity in Asian American lives. [Feedback for Correct Answer 4] Sites of resiliency represent those psychological or physical spaces that help Asian Americans cope. For instance, the use of alternative forms of healing has been noted as an important source of resiliency, particularly for Asian immigrants whose cultural values and beliefs greatly influence their daily lives and attitudes toward health and well-being. Learning Outcome 11.7: Describe and critique current research on individuals of Asian and Asian American descent. [Q1] The vast majority of Asian American mental health scholarship is: 1. conceptual 2. qualitative 3. quantitative [correct] 4. mixed methods [Feedback for Answer Choice 1] Scholars such as Kiang and colleagues (2016) and Wei and colleagues (2014) have consistently pointed out the need for more qualitative studies but there have been few changes in this trend. [Feedback for Answer Choice 2]

Conceptual articles do not comprise most Asian American mental health scholarship. [Feedback for Correct Answer 3] The vast majority (approximately 70%) of Asian American mental health scholarship is quantitative based with a correlational design. [Feedback for Answer Choice 4] Scholars such as Kiang and colleagues (2016) and Wei and colleagues (2014) have consistently pointed out the need for more mixed methods studies but there have been few changes in this trend. [Q2] The scholarship on Asian American mental health has given the least attention to which age range? 1. childhood and adolescence (6–17 years) [correct] 2. emerging adults (18–25 years), 3. early adulthood (26–39 years) 4. middle age (40–64 years) [Feedback for Correct Answer 1] According to Kim and colleagues (2015), there continues to be a lack of attention on Asian American children and youth particularly at the younger ages. [Feedback for Answer Choice 2] According to Kim and colleagues (2015), the scholarship on Asian American mental health has focused on the age range between 18 and 64, with almost an equal focus on emerging adults, early adulthood, and middle age. [Feedback for Answer Choice 3] According to Kim and colleagues (2015), the scholarship on Asian American mental health has focused on the age range between 18 and 64, with almost an equal focus on emerging adults, early adulthood, and middle age. [Feedback for Answer Choice 4] According to Kim and colleagues (2015), the scholarship on Asian American mental health has focused on the age range between 18 and 64, with almost an equal focus on emerging adults, early adulthood, and middle age. [Q3] The scholarship on Asian American mental health has given the least attention to which ethnic group? 1. Asian Indians 2. Chinese Americans 3. Korean Americans

4. Taiwanese [correct]

[Feedback for Answer Choice 1] Relative to their representation in the general population, Asian Indians tend to be the most disproportionately underrepresented in the literature on Asian American mental health. [Feedback for Answer Choice 2] The scholarship on Asian American mental health has given the most attention to East Asian groups—predominantly Chinese Americans and Korean Americans. [Feedback for Answer Choice 3] The scholarship on Asian American mental health has given the most attention to East Asian groups—predominantly Korean Americans and Chinese Americans. [Feedback for Correct Answer 4] Taiwanese mental health— along with a wide range of other Asian ethnic groups such as Cambodian, Pakistani, Thai, and Laotian— have received little to no scholarly attention. [Q4] Sue and Morishima are two of the most senior scholars in the field of Asian American Mental health. One of their notable contributions to the profession was the publication of: 1. Handbook of Asian American Psychology 2. Mental Health of Asian Americans [correct] 3. Asian American Journal of Psychology 4. Americans: Personality Patterns, Identity, and Mental Health [Feedback for Answer Choice 1] Lee and Zane (1998) authored the foundational text Handbook of Asian American Psychology. [Feedback for Correct Answer 2] Sue and Morishima (1992) authored the foundational text Mental Health of Asian Americans. [Feedback for Answer Choice 3] The Asian American Journal of Psychology was created in 2010 under the sponsorship of the Asian American Psychological Association. [Feedback for Answer Choice 4] Uba (1994) authored the foundational text Americans: Personality Patterns, Identity, and Mental Health. Learning Outcome 11.8: Apply knowledge about unique history, culture, and issues faced by these communities in conceptualizing clinical and advocacy work with individuals of Asian and Asian American descent.

[Q1] Alvarez and Chen (2012) argued that this self-reflection is , regardless of whether the client and the counselor are similar or different in terms of race, ethnicity, gender, or any other cultural dimension. 1. aspirational 2. beneficial 3. mandatory [correct] 4. optional [Feedback for Answer Choice 1] Alvarez and Chen (2012) did not argue that this self-reflection is aspirational. [Feedback for Answer Choice 2] While self-reflection is beneficial to the multicultural counseling process, regardless of counselor-client similarities and differences, this topic is not the central focus of Alvarez and Chen’s (2012) argument. [Feedback for Correct Answer 3] Alvarez and Chen (2012) argued that this self-reflection is mandatory, regardless of whether the client and the counselor are similar or different in terms of race, ethnicity, gender, or any other cultural dimension. [Feedback for Answer Choice 4] Alvarez and Chen (2012) did not argue that this self-reflection is optional. [Q2] Asian Americans tend to be deferential to people in authority, such as counselors. According to Wong and colleagues (2007), when working with Asian American clients with low levels of acculturation, promoting may not be the most effective way of creating a therapeutic alliance. 1. kinship 2. equality [correct] 3. credibility 4. familiarity [Feedback for Answer Choice 1] Wong and colleagues (2007) do not write about kinship. However, kinship can be developed with Asian American clients during the therapeutic process— through the appropriate use of counselor self-disclosure— and may be needed to build a therapeutic alliance. [Feedback for Correct Answer 2] Depending on their acculturation level, Asian Americans tend to be deferential to people in authority, such as counselors. Thus, equality is not the most effective way of creating a therapeutic alliance.

[Feedback for Answer Choice 3] Wong and colleagues (2007) do not write about credibility. However, credibility is an important consideration for Asian American clients, regardless of acculturation level. [Feedback for Answer Choice 4] Wong and colleagues (2007) do not write about familiarity. However, familiarity can be developed with Asian American clients during the therapeutic process— through the appropriate use of counselor self-disclosure— and may be needed to build a therapeutic alliance. [Q3] ―Word-of-mouth‖ referrals play a significant role for Asian Americans who seek counseling. This attitude is strongly related to the issue of . 1. safety 2. kinship 3. equality 4. credibility [correct] [Feedback for Answer Choice 1] For Asian American clients, safety is developed during the process of therapy and is positively impacted by a counselor’s willingness to disclose personal information. [Feedback for Answer Choice 2] For Asian American clients, kinship is developed during the process of therapy and is positively impacted by a counselor’s willingness to disclose personal information. [Feedback for Answer Choice 3] Depending on their acculturation level, Asian Americans tend to be deferential to people in authority, such as counselors. Thus, equality is not a significant motivation for those who seek counseling, nor is it the most effective way of creating a therapeutic alliance. [Feedback for Correct Answer 4] ―Word-of-mouth‖ referrals play a significant role for Asian Americans who seek counseling. This attitude is strongly related to the issue of credibility. Accordingly, counselor credibility is an important factor in mental health utilization among Asian Americans. [Q4] According to Inman and colleagues (2007), getting to know their counselor on a level allows Asian American clients to develop a sense of safety and kinship that may be needed in building the therapeutic relationship. 1. clinical 2. personal [correct] 3. professional 4. therapeutic

[Feedback for Answer Choice 1] Getting to know their counselor on a clinical level allows Asian American clients to determine credibility and trustworthiness; however, Inman and colleagues (2007) do not indicate whether perceived trustworthiness promotes a sense of safety and kinship. [Feedback for Correct Answer 2] According to Inman and colleagues (2007), intrinsic to developing trust is the extent to which a counselor self-discloses personal information. Thus, getting to know their counselor at a personal level allows Asian American clients to develop a sense of safety and kinship that may be needed in building the therapeutic relationship. [Feedback for Answer Choice 3] Getting to know their counselor on a professional level allows Asian American clients to determine credibility and trustworthiness; however, Inman and colleagues (2007) do not indicate whether perceived trustworthiness promotes a sense of safety and kinship. [Feedback for Answer Choice 4] Getting to know their counselor on a therapeutic level allows Asian American clients to determine credibility and trustworthiness; however, Inman and colleagues (2007) do not indicate whether perceived trustworthiness promotes a sense of safety and kinship.

Chapter 11 Application Exercises Application Exercise 11.1: The Case of Min Yang Learning Outcome 11.5: Identify how cultural factors (i.e., immigration, enculturation, acculturation, ethnicity, race, gender roles, sexuality, and sexual identity) shape individual experiences of those of Asian and Asian American descent. [URL TITLE] Min-Yang and Her Counselor

[Q1] Use Pearson eText Video Example 11.2 to answer the following question. Pay particular attention to the information Min-Yang shares with her counselor. Where is Min-Yang’s family from, and how might she identify her ethnicity? [Q1 MODEL RESPONSE] Your answer should include the following: 

Min-Yang’s parents are from Vietnam.



Her ethnicity is likely Asian American.

[Q2] Use Pearson eText Video Video Example 11.2 to answer the following question. Pay particular attention to the information Min-Yang shares with her counselor Using what you have learned from the video and the research in the text, how might Min-Yang feel about going to counseling? [Q2 MODEL RESPONSE] Based on the video and the research in the text, your answer should include some of the following points: 

Min-Yang may feel conflicted.



Her parents may not believe in counseling due to cultural values and a lack of awareness about such services.



Min-Yang was raised in the United States and seems to think counseling will help her.



Min-Yang probably wants to please her parents while remaining true to herself.



She probably would not want her parents to know that she is in counseling.

[Q3] Use Pearson eText Video Video Example 11.2 to answer the following question. Pay particular attention to the information Min-Yang shares with her counselor. Using what you have learned from the video and the research in the text, why might Min-Yang’s parents value a career in medicine over a career in the social sciences?

[Q3 MODEL RESPONSE] Based on the video and the research presented in the text, your answer should include some of the following points: 

Asian Americans may be more comfortable with somatic difficulties than mental health difficulties. Her parents might view a career in medicine as more helpful than a career in psychology.

Min-Yang’s parents likely want her to be happy and successful, and they might not fully understand the benefits of mental health services. Application Exercise 11.2: Conceptualizing Clinical Work with Asian and Asian American Clients Learning Outcome 11.5: Apply knowledge about unique history, culture, and issues faced by these communities in conceptualizing clinical and advocacy work with individuals of Asian and Asian American descent. [Q1] Explain how conducting a self-assessment can enhance a counselor’s ability to deliver culturally sensitive services to Asian and Asian American clients. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Multicultural competence requires a frank assessment of oneself before entering a session.



Counselors would do well to reflect on their socialization experiences with Asian Americans, as well as their assumptions and biases about that community.



Self-reflection is mandatory, regardless of whether the client and the counselor are similar or different in terms of race, ethnicity, gender, or any other cultural dimension.



Counselors must be aware of how their assumptions and biases may inhibit their effectiveness and strive to bracket these perspectives as needed.



Given the significance of issues such as race, gender, and experiences of oppression, counselors may further benefit from an awareness of the extent to which they are comfortable and able to raise those issues in counseling.



Assessing one’s biases, gaps in cultural knowledge, and comfortability broaching issues of culture and race will provide opportunities for counselors to increase the cultural sensitivity and appropriateness of their clinical approaches.

[Q2] Based on the research presented in the text, discuss several cultural and contextual factors counselors should consider when conceptualizing the process of counseling an Asian American client. [Q2 MODEL RESPONSE] Based on the research presented in the text, your answer should include some of the following points:



Level of acculturation and view of authority.



Asian Americans may be deferential to people in authority (e.g., the counselor); thus, equality may not be the most effective way of creating a therapeutic alliance.



Level of comfort with questions asked during the intake and the anticipated length of treatment.



Potential conflict in Western treatment approaches and the values and goals of Asian American clients may create frustration.



Accordingly, the expectation that clients talk about their issues goes against some Asian cultural values, such as the stigma attached to sharing personal information with strangers.



Conducting therapy by first developing a relationship with your Asian American client is important in creating a trusting environment that will allow conversations to occur.



Disclosing tangible ideas used in personal challenges that might share some similarity with those of the client has been noted to increase trust levels in client–counselor relationships.

[Q3] Based on the research presented in the text——and keeping in mind that every individual has unique life experiences—highlight several general counseling principles that a multiculturally competent counselor might utilize with an Asian Americans client. [Q3 MODEL RESPONSE] Based on the research presented in the text—and keeping in mind that every individual has unique life experiences—your answer should include some of the following points: 

Research suggests that, because of the emphasis on privacy within Asian American families, Asian Americans might not openly express strong emotions.



Asian Americans may prefer an authoritarian, directive, and structured approach to treatment.



Some researchers have observed that Asian Americans do better when there is both ethnic and gender matching in the therapeutic relationship.



Finally, because of the significant role that families play, family therapy might be an appropriate therapeutic intervention.



Avoid stereotyping and overgeneralizations.



Key factors to consider in working with Asian American clients include: adherence to Asian cultural values, acculturation level, immigration experience, communication style, family dynamics and interdependence, proneness to shame, and use of traditional healing methods.



Interventions should be responsive to the specifics of your client, rather than following without question what has been found in the literature.



Developing a range of treatment modalities is important in working with the diverse Asian community.



Assessing whether the problem is individual, systemic (e.g., relational), environmental, or a combination of these is important as well.

Chapter 11 Test Items Multiple Choice 1.

Among Asian Americans, kinship refers to a. an extended network of relationships that encompass several households. b. the immediate nuclear family. c. parents and siblings. d. a network of relationships.

In the Asian American household a. family needs supersede individual needs. b. individual needs are more important. c. one’s actions do not influence the integrity of the family. d. All of the above.

Saving face among Asian Americans a. refers to protecting the honor of the family. b. involves having a strong duty toward the family. c. is subsumed under the value of filial piety. d. All of the above.

South Asians have been noted to be a. traditional at home and contemporary in relation to their education and achievement. b. contemporary at home and traditional in relation to their education and achievement. c. traditional in relation to their home and educational achievements. d. contemporary in relation to their home and educational achievements.

Asian Americans tend to value a. self-restraint and harmony in relationships. b. modesty in intimate relations. c. filial piety. d. All of the above.

Acculturation is mediated by a. nature and reason for immigration. b. the age at immigration. c. immigration status. d. All of the above.

Asian American lives are significantly impacted by their ethnic and racial identity because a. the salience of ethnic and racial identity is influenced by social cues. b. a connection with a racialized identity increases the ability to navigate interactions within the dominant society. c. ethnic and racial identities provide a social location within society. d. All of the above.

Enculturation and acculturation are often referred to in the immigration literature. Which of the following statements is true? a. Enculturation refers to socialization within the host culture whereas acculturation refers to socialization to one’s cultural of origin. b. Enculturation refers to socialization within one’s culture of origin whereas acculturation refers to socialization to the host culture. c. Enculturation and acculturation are two sides of the same coin. d. All of the above.

According to Chung and Katayama, a. Asian Americans undergo a parallel process of development in relation to their ethnic and sexual identities. b. Asian Americans undergo a dual but parallel development in relation to their ethnic and sexual identities. c. Asian Americans undergo a dual development in relation to their ethnic and sexual identities. d. All of the above.

10. Asian American overutilization rates of mental health services has been attributed to a. more severe symptoms. b. inconsistencies with cultural values. c. lack of culturally sensitive services. d. All of the above. 11. Barriers to seeking mental health services among Asian American immigrants have been attributed to a. lack of knowledge and exposure to Western mental health treatment. b. limited language proficiency. c. availability of alternative healing practices. d. All of the above. 12. Western approaches to mental health endorse values related to a. self-reliance. b. emotion management. c. individual goals.

d. collective goals. 13. Asian Americans a. emphasize equality in relationships. b. are comfortable with intrusive questions. c. share personal information freely. d. appreciate self-disclosure on the part of their counselor. 14. Cultural conceptualizations of problems need to incorporate a. individual, systemic, and environmental influences. b. pre-immigration and post-immigration adjustment. c. outreach and advocacy. d. All of the above. 15. Being a culturally competent counselor involves a. an awareness of how meanings of identities shift across social locations. b. an awareness of one’s own assumptions and biases about a group. c. challenging discriminatory practices at the individual and systemic levels. d. All of the above. 16. Large-scale Asian American immigration began with a. the arrival of Punjabi laborers in the 1900s. b. passage of the Immigration and Naturalization Act of 1965. c. the Gentlemen’s Agreement of 1907. d. Chinese immigration to California and Hawaii. 17. The Model Minority myth a. emerged from images of Filipino American patriotism during World War II . b. developed during the Civil Rights unrest of the 1960s. c. emerged with the murder of Vincent Chin. d. None of the above. 18. Which of the following is NOT used to challenge the model minority myth? a. Utilization rates of mental health services b. Larger number of wage earners per household c. Concentration in high-cost urban areas d. Income-to-education disparities 19. According to the U.S. Census, which of the following is accurate about Asian Americans as a group? a. Over 50% had entered the country in the last 50 years and are foreign born. b. They are primarily foreign born and have high-median family incomes.

c. They are generally older and are primarily foreign born. d. They have a lower percentage who are married and were generally born in the United States. 20.

is a stereotype of Asian Americans. a. Yellow peril b. Heathen c. Dog-eaters d. All of the above.

21.

was NOT cited in the chapter as an example of institutional racism. a. English-only initiatives b. Glass ceiling effects c. Individualism as a value d. Chinese Exclusion Law of 1882

22.

racism is experienced by Asian Americans. a. Biographical b. Cultural c. Historical d. All of the above.

23. Cultural racism is manifested in a. underlying assumptions, values, and beliefs of the dominant culture. b. regulations, laws, policies, and procedures. c. acting upon the belief in one’s cultural superiority over another group. d. racial socialization of stereotypic attitudes. 24. The term ―Asian American‖ was inspired by the a. Anti-Vietnam war movement. b. nationalism of the Gray Panthers. c. victory over the Japanese in World War II . d. None of the above. 25. The rates of psychopathology among Asian Americans a. have generally not been examined. b. are difficult to determine because of relatively few epidemiological studies. c. have been difficult to determine because of a reliance on representative and randomized samples. d. All of the above.

26. The National Latino and Asian American Study found that Asian Americans a. experience racism at rates comparable to other communities of color. b. report higher rates of anxiety disorders but lower rates of depression. c. report lower rates of depression but higher rates of psychotic disorders. d. report a lower incidence of psychological disorders among immigrants. 27. Being an ethical, socially responsible counselor involves a. respect, responsibility, and action. b. respect, accountability, and follow through. c. challenging the institutional and structural barriers. d. advocacy, integrity, and action. 28. The model minority status accorded to Asian Americans a. perpetuates the perception that Asian Americans have overcome their minority status. b. presumes rightly that Asian Americans have achieved equity as American citizens. c. maximizes the racial and socioeconomic inequities among Asian Americans. d. All of the above. 29. Sites of resiliency a. represent hope for Asian Americans. b. represent psychological or physical spaces that help Asian American cope. c. help increase social networks for Asian Americans. d. All of the above. 30. Asian Americans experienced discrimination in the form of a. anti-miscegenation laws. b. educational opportunities. c. land ownership. d. All of the above. 31. Microaggression for Asian Americans occur in the form of microassaults, microinsults, and a. microwaves. b. microcosms. c. microinvalidations. d. micromanagement. 32. The Gentleman’s Agreement of 1907 a. was the first ethnic-specific ban of its kind. b. restricted Japanese immigration. c. restricted Asian Indian immigration. d. All of the above.

33. The Tydings-McDuffie Act of 1934 a. authorized the incarceration of Japanese Americans in internment camps. b. restricted Asian Indian immigration. c. restricted Filipino immigration. d. was the first ethnic-specific ban of its kind. 34. The , which based immigration on family reunification rather than national origins quotas, resulted in an 800% increase in the number of Asian immigrants since 1970. a. Immigration and Nationality Act of 1965 b. Immigration Act of 1917 c. Gentleman’s Agreement of 1907 d. Tydings-McDuffie Act of 1934 35. An example of individual racism that Asian Americans continue to experience is a. differential treatment. b. verbal insults and racial slurs. c. physical harassment. d. All of the above. 36.

is an abstract concept which prescribes the way children need to show respect and obedience toward their parents, elders, and ancestors. a. Family b. Kinship c. Filial piety d. Saving face

37. It is after marriage.

for Asian American adult children to reside with their parents until and

a. uncommon b. common c. disrespectful d. shameful 38. Asian American parenting tends to be a. authoritative. b. authoritarian. c. permissive. d. neglectful. 39. All of the following are considered virtues in Asian American culture EXCEPT a. being nondirective.

b. being nonconfrontational. c. being emotionally expressive. d. silence. 40. Which of the following is highly valued and indicative of a good family upbringing among Asian Americans? a. Academic achievement b. A successful career c. Both of the above d. None of the above 41.

refers to the notion that different aspects of identity may be activated based on different contexts. a. Cultural frame switching b. Biculturalism c. Acculturation d. Enculturation

42. Perceived services.

was strongly related to Asian Americans’ utilization of counseling

a. therapeutic alliance b. trustworthiness c. counselor credibility d. client-counselor match 43. All of the following are sites of resiliency that have been identified for the Asian American community EXCEPT a. alternative forms of healing. b. introduction to individualistic values. c. holistic emphasis on health and a spiritually guided life. d. family and social community. 44. Asian Americans typically prefer a(n) a. authoritarian b. directive c. structured d. All of the above. 45. Asian American family structure is typically a. patriarchal. b. matriarchal. c. egalitarian.

approach to counseling treatment.

d. child-centered.

Extended Response 1.

What are some of the challenges of defining acculturation in the traditional manner?

Discuss the role of indigenous/alterative healing in the Asian American community.

Discuss the role and significance of counselor credibility in the Asian American community.

Discuss and provide examples of the intersection of ethnic, racial, and gender identities in Asian American lives.

What are examples of Asian American heterogeneity and why is this important for counselors to know?

Discuss and provide examples of the types of racism experienced by Asian Americans and the relevance to counseling.

What is the current status of the literature on psychopathology among Asian Americans? Discuss the strengths and limitations of this literature.

Discuss the distinct groups that subsume the overarching umbrella of Asian Americans.

Reflecting on the history of Asian Americans in the United States, what were some of their experiences in this country? Identify at least four examples.

10. How and why did the term ―Asian Americans‖ come into existence? 11. What are some contemporary discriminatory practices and stereotypes that Asian Americans face in the United States? 12. Define and discuss the concept of ―microaggressions.‖ Identify microaggressions that may occur in relation to different social identities (e.g., gender, sexual orientation)? 13. How do you think the myth of the model minority influences Asian American experiences? Discuss the challenges associated with this label for Asian Americans. Explore how this label has influenced relationships with other ethnic minorities in the United States. 14. The authors highlight a substantial gap between occupational and educational achievement for Asian Americans. What are your reactions to this information? Were you surprised by this information? If so, why do you think this issue is not recognized or addressed in our society? If not surprised, why not? 15. Identify the important cultural values discussed in this chapter for Asian Americans. What are some important cultural values for your own cultural group? Discuss any similarities and differences you notice between the different cultural groups that you represent. 16. Reflect on your own family/cultural group immigration histories. Discuss how previous generations of immigrants from your families/cultural groups have acculturated to the United States. Discuss which groups may have had an easier time in integrating themselves (i.e., considered as American) into the dominant culture and why. Conversely, why have some groups had a harder time being accepted as ―American?‖ 17. Review the differences between immigrants and refugees. Compare and contrast their transition experiences in terms of legal standing, psychological adjustment, as well as social, economic, and educational resources. 18. Discuss the concepts of racial and ethnic identity. Explore how you have internalized or developed these identities.

19. Discuss the concept of ―intersectionality of identities.‖ What does this mean and how does it apply to your experience? How do you think this influences the way you interact with others? How do you think this influences how you perceive situations? Identify one or two examples. 20. The authors speak to a dual and parallel process of identity development for Asian Americans when dealing with their sexual identity. Discuss what the implications are of this dual process of identity development. How might you explore this with your clients? 21. Identify the individual, cultural, and systemic barriers that Asian Americans may face in seeking counseling services. 22. In reading about the utilization rates and the barriers that exist for Asian Americans seeking mental health services, what can you do in your own work to create a change in the situation? 23. Given the cultural values embedded within the Asian community (e.g., collectivism, hesitance to share personal information with outsiders, the focus on saving face), how might you introduce the idea of talk therapy to individuals in the Asian American community who may question the validity of this approach? 24. What are some traditional and nontraditional approaches of interventions that you would use with Asian American clients? 25. The chapter highlights the need for counselors to engage in self-assessment. How might you explore your own cultural identities? How might your identities shape your work with your client? How might you address any cultural differences between you and your client? 26. Identify social actions that can be taken at the local, national, professional, and political levels for Asian Americans.

Chapter 11 Test Answer Key ANSWER KEY: Chapter 11 Test (Multiple Choice) 1. a 2. a 3. a 4. a 5. d 6. d 7. d 8. b 9. b 10. a 11. d 12. c 13. d 14. d 15. d 16. d 17. b 18. a 19. b 20. d 21. c 22. b 23. a 24. d 25. b 26. d 27. a 28. a 29. b 30. d 31. c 32. b 33. c 34. a 35. d 36. c 37. b 38. b

39. c 40. c 41. a 42. c 43. b 44. d 45. a

Chapter 12 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach 4th Edition Danica G. Hays University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents

Chapter 12: Individuals and Families of Latin and Latin American Descent

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 12: Individuals and Families of Latin and Latin American Descent Chapter 12 Learning Outcome Quizzes Learning Outcome 12.1: Identify the salient historical aspects that shape the worldviews of individuals and families of Latin and Latin American descent. [Q1] Individuals from Brazil, Guyana, Surinam, and French Guiana are considered to be but not . 1. Latino, Hispanic [correct] 2. Hispanic, Latino 3. Latin, Hispano 4. Hispano, Hispanic [Feedback for Correct Answer 1] Individuals from Brazil, Guyana, Surinam, and French Guiana are considered to be Latino—but not Hispanic—because these parts of Latin America were colonized by French and Portuguese conquistadors. [Feedback for Answer Choice 2] Individuals from Brazil, Guyana, Surinam, and French Guiana are not considered to be Hispanic because these parts of Latin America were colonized by French and Portuguese conquistadors. [Feedback for Answer Choice 3] The term Latin is typically used to describe geographic regions, while the term Latino is used to describe individuals from Brazil, Guyana, Surinam, and French Guiana. [Feedback for Answer Choice 4] The Spanish word Hispano is related to the term Hispanic. Because Brazil, Guyana, Surinam, and French Guiana were colonized by French and Portuguese conquistadors, individuals from these places are not considered Hispanic. [Q2] The term Latina/o was reintroduced into books written in English during the 1. 1940s 2. 1950s 3. 1960s 4. 1970s [correct]

[Feedback for Answer Choice 1] The term Latina/o was sparsely used during the 1940s and had yet to be reintroduced in books written in English. [Feedback for Answer Choice 2] The term Latina/o was sparsely used during the 1950s and had yet to be reintroduced in books written in English. [Feedback for Answer Choice 3] The term Latina/o was sparsely used during the 1960s and had yet to be reintroduced in books written in English. [Feedback for Correct Answer 4] The term Latina/o was sparsely used prior to the 1960s but was reintroduced in books written in English during the 1970’s. [Q3] Members of which of the following groups are most likely to use the term Latinx? 1. Academics [correct] 2. Latino/a youth 3. Spanish youth 4. Cubans [Feedback for Correct Answer 1] Despite the increase in popularity of the term Latinx in academia and activist organizations (Salinas, 2020), there has been limited research on how individuals from Latin and Latin American descent make meaning of this term to self-identify. [Feedback for Answer Choice 2] According to a 2020 study conducted by the Pew Research Center, approximately 25% of individuals from Latin and Latin American descent are aware of the term Latinx and only 3% use it to self-identify. [Feedback for Answer Choice 3] Spanish youth are considered Hispanic, not Latino. Accordingly, the term Latinx is not intended to include individuals who identify as Spanish/Hispanic. [Feedback for Answer Choice 4] According to a 2013 study conducted by the Pew Research Center, a preference has been noted by individuals to identify by their family origin (e.g., Cuban). [Q4] The term Latinx is not linguistically inclusive of all individuals from Latin and Latin American descent. Accordingly, it fails to include individuals from Latin American countries that speak Quechua, since this language does not contain the letter X. The Quechua language is primarily spoken in which of the following countries? 1. Brazil

2. Ecuador [correct] 3. Argentina 4. Puerto Rico [Feedback for Answer Choice 1] Portuguese is the native language spoken in Brazil. [Feedback for Correct Answer 2] The Quechua language is primarily spoken in Ecuador, as well as in Peru, Bolivia, Chile, and Columbia. [Feedback for Answer Choice 3] Spanish is the native language spoken in Argentina. [Feedback for Answer Choice 4] Spanish is the native language spoken in Puerto Rico. Learning Outcome 12.2: Compare and contrast the similarities and differences among large groups of Latinos/as/x living in the United States. [Q1] In 2019, the U.S. Latina/o/x population accounted for over

% of the U.S. population.

1. 7.5 2. 9 3. 12 4. 18 [correct] [Feedback for Answer Choice 1] According to a 2016 study conducted by the Pew Hispanic Center, Latinos/as/x held 7.5% of U.S. jobs in management and business. [Feedback for Answer Choice 2] According to a 2016 study conducted by the Pew Hispanic Center, Latinos/as/x held 9% of U.S. jobs in construction trades. [Feedback for Answer Choice 3] According to a 2016 study conducted by the Pew Hispanic Center, Latinos/as/x held 12% of U.S. jobs in office and administrative support positions. [Feedback for Correct Answer 4] In 2019, the U.S. Latina/o/x population accounted for over 18% of the U.S. population, or roughly 60.6 million residents. [Q2] The Pew Research Center reported in 2020 that Latinos/as/x with heritage comprise the largest group of U.S. Latinos/as/x.

1. Cuban 2. Mexican [correct] 3. Puerto Rican 4. Salvadoran [Feedback for Answer Choice 1] According to a 2019 study conducted by Pew Research Center, individuals of Cuban heritage tied with individuals of Salvadoran heritage for the third largest group of Latinos/as/x in the United States (2.3 million). [Feedback for Correct Answer 2] The Pew Research Center reported in 2020 that Latinos/as/x with Mexican heritage comprise the largest group of U.S. Latinos/as/x. According to the same study, Mexicans accounted for 36.6 million of all U.S. Latinos/as/x in 2017. [Feedback for Answer Choice 3] According to a 2019 study conducted by Pew Research Center, individuals of Puerto Rican heritage comprise the second largest group of Latinos/as/x in the United States (5.6 million). [Feedback for Answer Choice 4] According to a 2019 study conducted by Pew Research Center, individuals of Salvadoran heritage tied with individuals of Cuban heritage for the third largest group of Latinos/as/x in the United States (2.3 million). [Q3] The Pew Research Center reported in 2019 that Latinos/as/x with heritage comprise the second largest group of U.S. Latinos/as/x. 1. Cuban 2. Mexican 3. Puerto Rican [correct] 4. Salvadoran [Feedback for Answer Choice 1] According to a 2019 study conducted by Pew Research Center, individuals of Cuban heritage tied with individuals of Salvadoran heritage for the third largest group of Latinos/as/x in the United States (2.3 million). [Feedback for Answer Choice 2] The Pew Research Center reported in 2020 that Latinos/as/x with Mexican heritage comprise the largest group in the United States (36.6 million). [Feedback for Correct Answer 3] According to a 2019 study conducted by Pew Research Center, individuals of Puerto Rican heritage comprise the second largest group of Latinos/as/x in the United States (5.6 million).

[Feedback for Answer Choice 4] According to a 2019 study conducted by Pew Research Center, individuals of Salvadoran heritage tied with individuals of Cuban heritage for the third largest group of Latinos/as/x in the United States (2.3 million). [Q4] The Pew Research Center reported in 2019 that Latinos/as/x with heritage have the highest college graduation rates among all U.S. Latinos/as/x. 1. Cuban [correct] 2. Mexican 3. Puerto Rican 4. Salvadoran [Feedback for Correct Answer 1] The Pew Research Center reported in 2019 that Latinos/as/x with Cuban heritage have the highest college graduation rates among all U.S. Latinos/as/x. Notably, 27% of Cubans aged 25 years and older having obtained at least a bachelor’s degree (compared to 16% of all U.S. Latinos/as/x). [Feedback for Answer Choice 2] The Pew Research Center reported in 2016 that only 9% of Mexicans and Mexican Americans living in the United States have a 4-year college degree. [Feedback for Answer Choice 3] While the Pew Research Center does not have data on the college graduation rates of U.S. Latinos/as/x of Puerto Rican heritage, the 16% of all U.S. Latinos/as/x that hold a 4-year college degree falls below the rate that Latinos/as/x with Cuban heritage have completed college (27% of Cubans aged 25 years and older). [Feedback for Answer Choice 4] While the Pew Research Center does not have data on the college graduation rates of U.S. Latinos/as/x of Salvadoran heritage, the 16% of all U.S. Latinos/as/x that hold a 4-year college degree falls below the rate that Latinos/as/x with Cuban heritage have completed college (27% of Cubans aged 25 years and older). Learning Outcome 12.3: Evaluate how immigration impacts the daily lives of individuals and families of Latin and Latin American descent. [Q1] According to the Immigration and Nationality Act of 2008, undocumented Latinos/as/x who are 18 years old and older, living without proper documentation to be in the United States are violating federal law. Unlawful presence in the United States is considered a: 1. felony 2. misdemeanor 3. criminal offense

4. civil infraction [correct] [Feedback for Answer Choice 1] Unlawful presence in the United States is not considered a criminal offense. Consequently, living without proper documentation to be in the United States cannot be classified as a felony. [Feedback for Answer Choice 2] Unlawful presence in the United States is not considered a criminal offense. Consequently, living without proper documentation to be in the United States cannot be classified as a misdemeanor. [Feedback for Answer Choice 3] Unlawful presence in the United States is not considered a criminal offense. [Feedback for Correct Answer 4] Unlawful presence in the United States is considered a civil infraction, rather than a criminal offense. [Q2] Which of the following resulted in a federal ruling that gave undocumented Latina/o/x youth the right to a K-12 education if they were residing in the United States? 1. Title IV 2. Plyler versus Doe [correct] 3. Immigration and Nationality Act of 2008 4. Deferred Action of Childhood Arrivals (DACA) [Feedback for Answer Choice 1] Title IV, also called the Higher Education Act of 1965, prevents undocumented youth from obtaining college federal aid such as federal student loans, grants, and work study programs [Feedback for Correct Answer 2] The U.S. Supreme Court case Plyler versus Doe resulted in a federal ruling that gave undocumented Latina/o/x youth the right to a K-12 education if they were residing in the United States. [Feedback for Answer Choice 3] According to the Immigration and Nationality Act of 2008, undocumented Latinos/as/x who are 18 years old and older, living without proper documentation to be in the United States are violating federal law. [Feedback for Answer Choice 4] In June 2012, President Obama issued an executive order for the Deferred Action of Childhood Arrivals (DACA) which provided temporary relief from deportation and work authorization for undocumented youth who came to the United States as children.

[Q3] According to a 2020 study conducted by the Pew Research Center, Latinos/as/x live in poverty.

% of all U.S.

1. 13 2. 18 3. 19 [correct] 4. 20 [Feedback for Answer Choice 1] According to a 2020 study conducted by the Pew Research Center, 13% of all Americans live in poverty. [Feedback for Answer Choice 2] According to a 2020 study conducted by the Pew Research Center, 18% of all foreign-born U.S. Latinos/as/x live in poverty. [Feedback for Correct Answer 3] According to a 2020 study conducted by the Pew Research Center, 19% of all U.S. Latinos/as/x live in poverty. [Feedback for Answer Choice 4] According to a 2020 study conducted by the Pew Research Center, 20% of all Latinos/as/x born in the United States live in poverty. [Q4] The fact that U.S. Latinos/as/x have grown up in a hybrid culture composed of U.S. and Latina/o/x customs may cause tensions with U.S. Latinos/as/x. 1. first-generation, second-generation 2. second-generation, first-generation [correct] 3. second-generation, third-generation 4. third-generation, second-generation [Feedback for Answer Choice 1] First-generation U.S. Latinos/as/x did not grow up in a hybrid culture. [Feedback for Correct Answer 2] The fact that second-generation (and beyond) U.S. Latinos/as/x have grown up in a hybrid culture composed of U.S. and Latina/o/x customs may cause tensions with first-generation U.S. Latinos/as/x. [Feedback for Answer Choice 3] Second-generation and third-generation U.S. Latinos/as/x have both grown up in a hybrid culture and have likely experienced similar challenges with navigating U.S. and Latina/o/x customs.

[Feedback for Answer Choice 4] Third-generation and second-generation U.S. Latinos/as/x have both grown up in a hybrid culture and have likely experienced similar challenges with navigating U.S. and Latina/o/x customs. Learning Outcome 12.4: Reflect and evaluate how to improve their culturally competent practice with individuals and families of Latin and Latin American descent. [Q1] Latina/o/x children who were born in the United States are than Latina/o/x children who were born in their native country and immigrated to the United States (first-generation U.S. Latinos/as/x) at a young age. 1. less likely to have academic difficulty. [correct] 2. less likely to attain cognitive fluency in Spanish. 3. more likely to experience academic difficulty. 4. at greater risk for acculturative stress. [Feedback for Correct Answer 1] According to a 2016 study conducted by the Pew Hispanic Center, Latina/o/x children who were born in the United States are less likely to have academic difficulty than Latina/o/x children who were born in their native country and immigrated to the United States (first-generation U.S. Latinos/as/x) at a young age. [Feedback for Answer Choice 2] According to Archuleta and Lakwan (2016), U.S. Latina/o/x children who were born in their native country and immigrated to the United States (first-generation U.S. Latinos/as/x) at a young age are less likely to attain cognitive fluency in Spanish than Latina/o/x children who were born in the United States. [Feedback for Answer Choice 3] According to Archuleta and Lakwan (2016), U.S. Latina/o/x children who were born in their native country and immigrated to the United States (first-generation U.S. Latinos/as/x) at a young age are more likely to experience academic difficulty than Latina/o/x children who were born in the United States. [Feedback for Answer Choice 4] According to Archuleta and Lakwan (2016), U.S. Latina/o/x children who were born in their native country and immigrated to the United States (first-generation U.S. Latinos/as/x) at a young age face greater risk for acculturative stress than Latina/o/x children who were born in the United States. [Q2] What might an individual of Latin American descent believe about seeking mental health services? 1. Getting counseling is better than getting help from a clergy member. 2. My family might judge me for utilizing counseling services. [correct]

3. Counseling is a part of my heritage. 4. Counselors are more effective helpers than family members. [Feedback for Answer Choice 1] It may be common for individuals from Latin American cultures to turn toward religious figures for support in their mental health needs. [Feedback for Correct Answer 2] Because it may be common for individuals from Latin American cultures to turn toward religious figures or family members for support in their mental health needs, some individuals might be judged for moving away from that tradition. [Feedback for Answer Choice 3] It is common for individuals from Latin American cultures to turn toward family members for support in their mental health needs. [Feedback for Answer Choice 4] Because it is common for individuals from Latin cultures to turn toward family members for support in their mental health needs, family members might be viewed as more effective helpers than professional counselors. [Q3] Cuento therapy is most like which of the following? 1. Art therapy 2. Bibliotherapy [correct] 3. Group Therapy 4. Psychoeducation [Feedback for Answer Choice 1] Cuento therapy is creative and expressive in nature; however, it relies on the reading of fairy tales, rather than creating art, to advance therapeutic goals. [Feedback for Correct Answer 2] Cuento translates into ―fairy tale‖ in Spanish. In essence, cuento therapy is like bibliotherapy, but instead of reading a book and leading a group or individual discussion with a child, the counselor shares a native folk story with the child(ren) and then processes the events and characters in the story. [Feedback for Answer Choice 3] Cuento therapy is a suitable option for adjuncting traditional group therapy approaches. [Feedback for Answer Choice 4] Cuento therapy is less directive and formally educational in nature than traditional psychoeducation approaches.

[Q4] Which of the following theoretical approaches has been demonstrated to be effective for working with Latina/o/x adolescents to address behavior issues? 1. Cuento Therapy 2. Motivational Interviewing 3. Cognitive-Behavioral Therapy 4. Brief Strategic Family Therapy [correct] [Feedback for Answer Choice 1] Limited research on Cuento Therapy has produce marginal, but positive potential for improving self-esteem and self-concept for Latina/o/x youth in school settings. [Feedback for Answer Choice 2] Motivational Interviewing has been demonstrated to be effective for working with Latina/o/x adults to address substance use disorders. [Feedback for Answer Choice 3] Cognitive-Behavioral Therapy has been demonstrated to be effective for working with Latina/o/x adults to address mood disorders such as depression and anxiety. [Feedback for Correct Answer 4] Brief Strategic Family Therapy has been demonstrated to be effective for working with Latina/o/x adolescents to address behavior issues.

Chapter 12 Application Exercises Application Exercise 12.1: Latin American and U.S. Latino/a/x Cultural Values Learning Outcome 12.2: Compare and contrast the similarities and differences among large groups of Latinos/as/x living in the United States. [Q1] Based on the research in the text, explain how the Spanish language may serve as strength and resource for U.S. Latinas/os/x and their counselors. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

The use of, and familiarity with, Spanish may help promote a sense of understanding and community between U.S. Latinos/as/x from different countries of origin.



Recently immigrants may find comfort in their ability to consume Spanish-language content on the radio and television.



Additionally, many local libraries and national bookseller chains carry Spanish-language books and translations can be utilized on smartphones to enhance Spanish communication.



These types of resources also provide a benefit to counselors and other helping professionals in that they give them access to some aspects of life for U.S. Latinos/as/x, even if they are not fluent in Spanish.

[Q2] Based on the research in the text—and keeping in mind that every individual has unique life experiences—discuss why it is important for counselors to assess the role that religion and spirituality may play in the lives of their U.S. Latino/a/x clients. [Q2 MODEL RESPONSE] Based on the research in the text, your answer should include some of the following points: 

Latinos/as/x who have immigrated to the United States and their U.S.-born offspring may have continued their religious traditions.



Religious affiliation may be important to U.S. Latinos/as/x that many of their first encounters in the United States occur in churches and places of worship.



U.S. Latinos/as/x are also more likely to turn to a priest, minister, or healers in a time of emotional difficulty than a counselor or other mental health expert.



Religious expression can vary greatly among U.S. Latinos/as/x individuals; thus, it is important for counselors to assess the role that religion and spirituality play in the lives of their U.S. Latino/a/x clients.



Counselors may need to conduct additional research on certain practices with which they may be unfamiliar.



Facilitating conversations on spirituality can strengthen cultural approaches to working with Latino/a/x clients.

[Q3] Explain the cultural concepts of machismo and marianismo as discussed in Chapter 12. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Machismo represents a strong, virile, omnipotent cis-gendered man who takes care of his family by providing food and shelter.



In some contexts, machismo has been characterized as chauvinistic, rude, and hypersexualized.



The term machismo has been criticized as lacking dimensionality and not representing the positive aspects of men.



Marianismo refers to the cis-gendered women’s role in family responsibilities, such as child rearing, housework, being submissive, obedient, and subordinate in the familial structure.



Additional understandings of this term relate to being chaste, not engaging in premarital sex, not asking for help, not putting your needs first, and being able to self-silence to maintain harmony in the family.



Many first-generation U.S Latinos/as/x may accept these traditional roles, however immigration, acculturation, and generational status may influence their degree of acceptance.

Application Exercise 12.2: The Impact of Immigration Status on U.S. Latinos/as/x Learning Outcome 12.3: Evaluate how immigration impacts the daily lives of individuals and families of Latin and Latin American descent. [Q1] Based on the research presented in the text—and keeping in mind that every individual has unique life experiences—discuss how a Latino/a/x client’s immigration status, along with their reasons for immigrating to the United States, may impact their mental health and well-being. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

The immigration status of undocumented Latinos/as/x can have a detrimental effect on their emotional stability as well as their general health.



Undocumented Latinos/as/x may experience anxiety, doubt, and frustration associated with their immigration status, and a fear of being deported.



The concepts of forced migration and voluntary migration may also influence the American experience for U.S. Latinos/as/x.



Those individuals who were forced to leave their native lands because of political persecution, ethnic violence, war, or religious discrimination may experience more grief and loss, greater difficulty adjusting to a new community, and deeper feelings of hopelessness than voluntary immigrants, who came to the United States for economic opportunities or to improve their lives.

[Q2] Based on the research presented in the text—and keeping in mind that every individual has unique life experiences—highlight some of the primary societal factors that infringe on the overall well-being of U.S. Latinos/as/x. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Communication barriers may contribute to or complicate mental health concerns for that group.



Many U.S. Latinos/as/x are bombarded with language-related stressors on a regular basis.



Difficulty communicating with coworkers, school peers, members of the justice system, or children’s teachers, or whether they even understand traffic signs and laws may all contribute to increased stress and frustration.



U.S. Latinos/as/x also are faced with overcoming barriers in workforce and school settings they may adversely affect mental health and compound mental health problems.



Nearly 40% of Latinos/as/x reported experiencing discrimination in 2017.

[Q3] Based on the research presented in the text—and keeping in mind that every individual has unique life experiences—briefly explain the nature and effect of acculturative stress on U.S. Latinos/as/x. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Acculturative stress is the internal psychological reaction to balancing the strains of learning about a new culture while longing for the familiarity of one’s previous surroundings.



It affects first-generation U.S. Latinos/as/x as they learn English or figure out hidden rules and agendas at work and in schools, as well as future generations of U.S. Latinos/as/x.



This stress can be further exacerbated by the challenges of immigration, an undocumented status, and the process of migration into the United States.



Acculturative stress can be a lifelong occurrence and can range from an unpleasant level of pressure to posttraumatic stress disorder (PT SD; particularly for Latino/a/x refugees fleeing war-torn lands or political oppression).

Application Exercise 12.3: Accepting an Offer Learning Outcome 12.4: Reflect and evaluate how to improve their culturally competent practice with individuals and families of Latin and Latin American descent. [URL TITLE] Melissa and Her Supervisor

[Q1] Use Pearson eText Video Example 12.5 to answer the following question. Pay particular attention to the clinical information that is discussed between Melissa and her supervisor. Based on the research discussed in the text, what is the cultural consideration to which the supervisor is referring? [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Personalismo is a common value in Latin American cultures in which individuals show affection for another person by offering him or her smiles, hugs, tokens, or favors.



The client’s grandmother might be displaying personalismo, and it might be considered rude for the counselor to decline.



Declining dinner might hurt the grandmother’s or client’s feelings and ultimately damage the therapeutic relationship.

[Q2] Use Pearson eText Video Example 12.5 to answer the following question. Pay particular attention to the clinical information that is discussed between Melissa and her supervisor. What ethical and legal concerns might the counselor have when being asked to have dinner with the client? [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Counselors are not allowed to have personal relationships with clients for 5 years after termination of the counseling relationship.



The counselor must strive to maintain the therapeutic relationship to uphold the ethical principle of beneficence.



Counselors understand the challenges associated with accepting gifts from clients and evaluate their motivation for accepting such gifts.

[Q3] Use Pearson eText Video Example 12.5 to answer the following question. Pay particular attention to the clinical information that is discussed between Melissa and her supervisor. Using what you have learned from the video and the research in the text, what are some ways in which the counselor can respond to the dinner invitation in the most ethical and competent manner? [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

The counselor could accept the dinner invitation and document that the therapeutic relationship likely would have been damaged if the invitation was declined.



The counselor could ask to take the food to go in order, thereby accepting the invitation while still upholding ethical boundaries.



The counselor might consider identifying other ways to show mutual care for her clients (e.g., kind words and smiles).

Chapter 12 Test Items Multiple Choice 1.

U.S. Latinas/os/x represent roughly

countries.

a. 7 b. 9 c. 15 d. 19 2.

U.S. Latinas/os/x are considered to be a a. family-centered, individualistic culture. b. Individually centered, collectivistic culture. c. family-centered, collectivistic culture. d. Individually centered, individualistic culture.

The preferred term for Latinas/osx and those of Latina/o/x heritage living in the United States is a. Hispanic. b. Latina/o/x. c. Hispanic American. d. It varies from individual to individual.

U.S. Latinas/os/x currently account for about

of the U.S. population.

a. 4.5% b. 12.1% c. 17.4% d. 24.1% 5.

Which of the following statements is FALSE for the general U.S. Latina/o/x population? On average, a. U.S. Latinas/os work in lower-skilled occupations than their non-Latina/o/x peers. b. the unemployment rate is higher for U.S. Latinas/os than their non-Latina/o/x peers. c. the median age is higher for U.S. Latinas/os than their non-Latina/o/x peers. d. U.S. Latinas/os are more likely to live below the poverty line than their non-Latina/o/x peers.

U.S. Latinas/os of Mexican heritage make up about population. a. 33% b. 40% c. 64%

of the U.S. Latina/o/x

d. 85% 7.

Which of the following is FALSE when considering the experiences of U.S. Latinas/osx of Mexican heritage? a. Many report being discriminated against on the job. b. High school dropout rates are higher than for non-Latina/o peers. c. Individuals of Mexican heritage have positively impacted U.S. society. d. Most are in the United States illegally.

Which of the following is TRUE for U.S. Latinas/os/x of Puerto Rican heritage? a. Ninety-nine percent are U.S. citizens. b. They are evenly dispersed throughout major metropolitan centers in the United States. c. As a whole, they have a lower income than U.S. Latinas/os/x of Mexican heritage. d. They lag behind U.S. Latinas/os/x of Cuban heritage with regard to educational attainment.

Which two events account for a majority of immigration activity in relation to U.S. Latinas/os/x of Cuban Heritage? a. Fidel Castro’s rise to power in 1959 and the Cuban Missile Crisis. b. The fall of the USSR and the 1980 Mariel Boatlift. c. The 1980 Mariel Boatlift and the Cuban Missile Crisis. d. Fidel Castro’s rise to power in 1959 and the 1980 Mariel Boatlift.

10.

is NOT represented in the United States by at least 500,000 U.S. Latinas/os/x: a. Argentina b. Colombia c. Dominican Republic d. El Salvador

11. The shared worldview of U.S. Latinas/os/x can be attributed to a. identifying as immigrants. b. Spanish-language usage. c. the role of religion and spirituality. d. All of the above. 12. With relation to Spanish dominance, which of the following groups is LEAST likely to indicate Spanish as their dominant or preferred language? a. First-generation U.S. Latinas/os/x b. Second-generation U.S. Latinas/os/x c. Third-generation U.S. Latinas/os/x d. All of the above equally.

13. The majority of U.S. Latinas/os/x self-identify as a. Protestant Christian. b. Roman Catholic. c. Jewish. d. Muslim. 14. Which of the following is TRUE about the influence of immigration status for U.S. Latinas/os/x? a. Immigration status becomes much less of a concern once the individual has become a U.S. resident or citizen. b. Immigration status is connected to being considered for in-state college tuition rates. c. Being considered for federal student financial aid is guaranteed for all U.S. Latinas/os/x high school graduates and college students regardless of immigration status. d. Becoming a legal U.S. resident or citizen removes the ―immigration status‖ stigma for U.S. Latinas/os/x. 15. Orientation to gender roles in Latino culture is based on a. marianismo and machismo. b. marianismo and the Women’s Liberation Movement. c. machismo and the Women’s Liberation Movement. d. machismo and religion/spirituality. 16. By definition, familismo is represented by which of the following statements? a. It is important to think for oneself and become independent. b. One should consider parents and other family members when making decisions. c. Children are not considered important members of the family. d. Familismo can be traced back to the indigenous cultures of Latin America. 17. Though familismo is seen as a positive trait by first-generation U.S. Latinas/os, secondgeneration U.S. Latinas/os/x may not feel as favorable toward it, because secondgeneration U.S. Latinas/os/x may a. not like their parents meddling in their business. b. feel that familismo disrespects their autonomy. c. resent the notion they must sacrifice their own interests for the family. d. don’t like the connection of familismo to Latin America’s colonial period. is closest to the counseling notion of ―rapport.‖

18.

a. Personalismo b. Confianza c. Amabilidad d. Amistad

19. Though acculturative stress can impact many U.S. Latina/os/x, to experience acculturative stress.

are most likely

a. Mexican Americans b. first-generation U.S. Latinas/os/x c. Cuban Americans d. second-generation U.S. Latinas/os/x 20. One of the more alarming aspects of acculturative stress is that a. it denies those who suffer from it to secure jobs. b. it prevents individuals from becoming resilient. c. U.S. Latinas/os/x can continue to suffer from it as they continue to acculturate. d. it leads most people to forget about their native language and customs. would be considered a ―grief and loss‖ concern for U.S. Latinas/os/x.

21.

a. Missing loved ones back in their country of origin b. Fear of future generations losing their Latina/o/x heritage c. Feelings associated with isolation and loneliness d. All of the above. 22.

approaches to counseling appear most effective for U.S. Latinas/os/x. a. Person-centered b. Psychodynamic c. Cognitive-behavioral d. Existential

23.

are important factors to consider when counseling U.S. Latina/o/x children. a. Age and religious affiliation b. Gender and birth order c. Age and country of birth d. National heritage and cognitive development

24. Counselors are particularly encouraged to account for the influence of the system on adolescent U.S. Latina/o/x clients. a. political b. justice/criminal c. educational d. social class

25. Eco-maps would be formally considered a type of a. genogram. b. confianza-building exercise. c. familismo assessment. d. cognitive-behavioral therapy technique. 26.

compose the largest sub-population of Latinas/os/x living in the United States. a. Mexicans b. Cubans c. El Savadorans d. Puerto Ricans

27.

is used by the U.S. Census Bureau to refer to individuals of Latin descent. a. Latina/o/x b. Hispanic c. Hispanic American d. Spanish-American

28. Regarding personal earnings, on average

have the lowest personal earnings.

a. African Americans b. Asian and Asian Americans c. Latinas/os/x d. Non-Latina/o/x Whites 29. In the past,

have been granted refugee status by the U.S. State Department.

a. Mexicans and Central Americans b. Cubans and Mexicans c. Cubans and Central Americans d. Puerto Ricans and Cubans 30. The fourth largest group of Latinas/os/x living in the United States are a. Colombians. b. El Salvadorans. c. Nicaraguans. d. Venezuelans. 31. Which of the following shared Latin cultural values can be credited with ―helping promote a sense of understanding and community between U.S. Latinas/os/x from different countries of origin?‖ a. Being immigrants b. Language

c. Religion d. Resiliency 32. About

of Latinas/os/x living in the United States are Catholic.

a. 67.6% b. 76.7% c. 89.9% d. 98.9% 33. The concept of marianismo means that women are a. willing to sacrifice their betterment for that of their children. b. being submissive to their husbands. c. disempowered to speak for themselves. d. good role models for their sons regarding how women should act. 34.

entails ―a certain level of automatic respect for older generations, including those older adults who remained in their country of origin.‖ a. Machismo b. Gender Roles c. Familismo d. Confiazna

35. Immigrants who are granted temporary legal status upon being classified as ―refugees‖ are eligible for permanent legal status upon a. residing in the United States for 1 year. b. residing in the United States for 1 year without getting into legal trouble. c. residing in the United States for 2 years without getting into legal trouble. d. Refugees are not eligible for permanent legal status. 36. Individuals who were born in the United States to foreign-born parents are considered a. first-generation immigrants. b. second-generation immigrants. c. third-generation immigrants. d. fourth-generation immigrants. 37.

is synonymous with ―the internal psychological reaction to balancing the strains of learning about a new culture while longing for the familiarity of one’s previous surroundings.‖ a. Acculturative stress b. Assimilative stress c. Adjustment stress d. Accommodative stress

38.

involves the use of fairy tales in Spanish for helping children grasp counseling ideas. a. Cuento therapy b. Biblio-Cuento therapy c. Cuento analysis d. Cuento assessment

39. Which of the following issues should counselors be aware of when working with Latina/o/x teens? a. Difficulty with reconciling bicultural status b. Limited exposure to culturally related extracurricular school activities c. Limited exposure to various career opportunities and career role models d. All of the above. 40. Group work may be difficult with Latinas/os/x because a. it is difficult to get too many Latinas/os/x to agree on a meeting time. b. Latinos/as do not trust the counseling process. c. Latinos/as are afraid of gossiping in the group and have issues with confidentiality. d. the heterogeneity of this cultural group may make it difficult to establish universality in some instances. 41. Eco-maps can be used as a. visual depictions of the systems that influence an individual’s world. b. verbal representations of factors that impact one’s wellness. c. oral stories of social and historical contexts influencing one’s decisions. d. historical accounts of familial effects on socioeconomic status. 42. Which of the following contribute to issues of low socioeconomic status in Latinas/os/x? a. Sending remittances to family members in their native countries b. Legal residency status c. Low college enrollment rates d. All of the above. 43. U.S. Latinos/as/x are more likely to turn to a than a counselor or other mental health expert.

in a time of emotional difficulty

a. priest b. minister c. curandero (healing man) d. All of the above 44.

refers to warmth, affection, concern about others, and positive regard for those close to an individual.

a. Confianza b. Personalismo c. Familismo d. Machismo 45. The concept of , or being a gentleman, promotes a more pro-social type of masculinity for adolescent Latinos. a. machismo b. marianismo c. caballerismo d. personalismo

Extended Response 1.

Describe the impact of personalismo and confianza on the counseling relationship, and particularly any personal difficulties you would have with these concepts as they relate to your own theoretical orientation.

Why is it important for counselors to be ―self-aware‖ when it comes to counseling U.S. Latinas/os? Pay close attention to personal issues of countertransference, perhaps as it relates to your personal feelings regarding illegal immigration and the acculturation of U.S. immigrants.

Discuss counseling considerations for working with U.S. Latina/o children and describe at least one counseling activity for this population.

Discuss counseling considerations for working with U.S. Latina/o adolescents and describe at least one counseling activity for this population.

Discuss counseling considerations for working with U.S. Latina/o adults and describe at least one counseling activity for this population.

Describe how similarities and differences between U.S. Latina/o culture and your own culture may impact your current and future work with Latina/o clients.

How might the immigration patterns and experiences of different U.S. Latina/o groups influence their reasons for seeking the assistance of a mental health specialist? And how might the immigration pattern and experiences of your current and future U.S. Latina/o client affect the type of counseling theories and techniques you use with them?

Describe the type of generational issues that may arise between younger U.S. Latina/o clients and their parents, grandparents, and older family members.

What influence, impact, and lasting effects do you think Latin American history has on the current traditions, interests, and experiences of U.S. Latinas/os/x?

10. Describe some of the more prevalent mental health issues of U.S. Latinas/os/x, and share how you might help a client deal with these issues. 11. What is the purpose of understanding Latin American history about counseling Hispanic/Latino clients in the United States? 12. Explain how acculturative stress can affect the personal lives of Hispanic/Latino clients, and what ―clues‖ does acculturative stress provide for possible concerns of Hispanic/Latino

clients? 13. Discuss marianismo and machismo and how these concepts might influence or affect the counseling relationship and/or counseling process. 14. How do economic barriers manifest in the counseling concerns of Hispanic/Latino clients, and how might you, as a counselor, help the client deal with related issues? 15. What might be some initial differences between the presenting problems of secondgeneration Hispanic/Latino immigrant clients versus fourth-generation Hispanic/Latino immigrant clients? 16. The Spanish language can serve as a bond between Hispanic/Latino clients of different nationalities. But might language serve as a barrier between a Hispanic/Latino client and a counselor, assuming the counselor does not speak Spanish? And how does the counselor address this lack of language fluency? 17. How does a Hispanic/Latino client’s immigration status influence the counseling process? 18. How might you use Cuento Therapy with school-aged Hispanic/Latino clients, and how is this intervention different from bibliotherapy or narrative therapy approach? 19. According to the literature, what are some common counseling concerns to look for when working with Hispanic/Latino adolescents?

Chapter 12 Test Answer Key ANSWER KEY: Chapter 12 Test (Multiple Choice) 1. d 2. c 3. d 4. c 5. c 6. c 7. d 8. a 9. d 10. a 11. d 12. c 13. b 14. b 15. a 16. b 17. c 18. b 19. b 20. c 21. d 22. c 23. c 24. c 25. a 26. a 27. b 28. c 29. c 30. b 31. b 32. a 33. a 34. c 35. b 36. b 37. a 38. a

39. d 40. d 41. a 42. d 43. d 44. b 45. c

Chapter 13 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach 4th Edition Danica G. Hays University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents

Chapter 13: Counseling Individuals and Families of Native American Descent

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 13: Counseling Individuals and Families of Native American Descent Chapter 13 Learning Outcome Quizzes Learning Outcome 13.1: Identify key aspects of Native American history and events that led to historical oppression. [Q1] Researchers have highlighted the fact that Native American people are at greater risk than other ethnic groups for which of the following? 1. Anxiety 2. Depression 3. Discrimination 4. Accidental death [correct] [Feedback for Answer Choice 1] Researchers have identified links between racial discrimination and the anxiety, depression, anger, avoidance, and despair that are at times experienced by Native American peoples. However, this research does not indicate Native American people are at greater risk than other ethnic groups for these mental health problems. [Feedback for Answer Choice 2] Researchers have identified links between racial discrimination and oppression, and the anxiety that is experienced at times by Native American peoples. However, this research does not indicate Native American people are at greater risk than other ethnic groups for anxiety. [Feedback for Answer Choice 3] Researchers have identified links between racial discrimination and oppression, and the depression that is experienced at times by Native American peoples. However, this research does not indicate Native American people are at greater risk than other ethnic groups for depression. [Feedback for Correct Answer 4] Researchers have highlighted the fact that Native American people are at greater risk than other ethnic groups for accidental death, as well as substance misuse, suicide, violence, incarceration, infant mortality, and mental health problems. [Q2] It is important for counselors to understand their Native American clients’ degree of: 1. enculturation. [correct] 2. blood quantum. 3. tribal membership. 4. Native American identity.

[Feedback for Correct Answer 1] It is important for counselors to understand their Native American clients’ degree of enculturation (i.e., the extent to which they have learned and practice the culture, values, and behaviors of their own tribe or community). [Feedback for Answer Choice 2] In order for tribal members to obtain treaty benefits, tribes must establish legally defensible membership criteria. This is done on a tribe-by-tribe basis via proof of direct lineage from a tribal member, and in many tribes, via proof of one’s blood quantum (percentage of Native American ancestry). However, it would be culturally insensitive and offensive for counselors to inquire about a client’s blood quantum. [Feedback for Answer Choice 3] Tribal membership is one element of cultural identity and influences a client’s degree of enculturation. By striving to understand Native American clients’ degree of enculturation, counselors will certainly learn if a client holds membership in a particular tribe. [Feedback for Answer Choice 4] It is important for counselors to understand their Native American clients’ degree of enculturation. This process facilitates understanding of the values and experiences that a client derives from their Native American identity. [Q3] Between the years 1600 and 1650, European-borne smallpox, measles, and flu viruses killed of the Indigenous peoples of the Americas. 1. 75% 2. 80% 3. 85% 4. 90% [correct] [Feedback for Answer Choice 1] Between the years 1600 and 1650, European-borne smallpox, measles, and flu viruses killed more than 75% of the Indigenous peoples of the Americas. [Feedback for Answer Choice 2] Between the years 1600 and 1650, European-borne smallpox, measles, and flu viruses killed more than 80% of the Indigenous peoples of the Americas. [Feedback for Answer Choice 3] Between the years 1600 and 1650, European-borne smallpox, measles, and flu viruses killed more than 85% of the Indigenous peoples of the Americas. [Feedback for Correct Answer 4] Between the years 1600 and 1650, European-borne smallpox, measles, and flu viruses killed 90% of the Indigenous peoples of the Americas.

[Q4] Garrett (1996) suggested that governmental policies regarding the disposition of Native Americans can be conceptualized by five distinct time periods. Which period was marked by the passing of the Appropriations Bill for Indian Affairs, which enabled Congress to begin confining western tribes onto reservations? 1. The Second Period [correct] 2. The Third Period 3. The Fourth Period 4. The Fifth Period [Feedback for Correct Answer 1] The Second Period (1860s to 1920s) was marked by the passing of the Appropriations Bill for Indian Affairs in 1851, which enabled Congress to begin confining western tribes onto reservations. [Feedback for Answer Choice 2] The Third Period was the reorganization period (1930s to 1950s). During this time, the United States reversed its major goal of assimilation in order to support the re-establishment of tribal sovereignty and self-sufficiency. [Feedback for Answer Choice 3] The Fourth Period was the termination period (1950s to 1960s). This time was marked by a movement to reverse the gains of the third period. The House Concurrent Resolution 108 of 1953 and Public Law 280 sought to end official relationships of the United States with federally recognized tribes. [Feedback for Answer Choice 4] The Fifth Period is the self-determination period (1975 to the present). During this time, the position of the federal government reversed again with the passage of the Indian Selfdetermination and Education Assistance Act of 1975 and the Tribal Self-Governance Act of 1994. Learning Outcome 13.2: Understand current social, economic, and political issues in the United States that impact Native Americans. [Q1] Contemporary Native American scholars, such as Brave Heart (2020), have coined the term as a way of identifying the cumulative emotional and psychological suffering experienced by Native Americans because of massive group trauma experiences. 1. historical trauma [correct] 2. grief constellation 3. cultural dissonance 4. summative suffering

[Feedback for Correct Answer 1] Contemporary Native American scholars, such as Brave Heart (2020), have coined the term ―historical trauma‖ as a way of identifying the cumulative emotional and psychological suffering experienced by Native Americans because of massive group trauma experiences. [Feedback for Answer Choice 2] Brave Heart and colleagues (2020) identified a constellation of features associated with experiencing historical trauma (e.g., unresolved grief, substance misuse, self-destructive behaviors, suicidal thoughts and behaviors, depression, anxiety, low self-esteem). However, grief constellation is not a term used by Brave Heart. [Feedback for Answer Choice 3] Native American young people find themselves in cross-cultural situations where their values and ideals must yield to institutional norms. Kirmayer and colleagues (2011) have investigated the cultural dissonance experienced by Native American youth in the U.S. educational system. [Feedback for Answer Choice 4] Summative suffering is not a counseling-specific term. [Q2] General trends indicate that although there is a general proclivity toward a nuclear family structure with two working adults, approximately of Native American adults are not married. 1. 27% 2. 35% 3. 40% [correct] 4. 47% [Feedback for Answer Choice 1] Approximately 27% of White adults in America are not married. [Feedback for Answer Choice 2] The percentage of unmarried Native American adults is greater than 35%. [Feedback for Correct Answer 3] General trends indicate that although there is a general proclivity toward a nuclear family structure with two working adults, approximately 40% of Native American adults are not married. [Feedback for Answer Choice 4] Approximately 47% of Black adults in America are not married. [Q3] According to recent data collected by the U.S. Census Bureau, one in three Native Americans live in poverty, with a median household income of approximately: 1. $12,760

2. $27,000 3. $45,000 [correct] 4. $66,000 [Feedback for Answer Choice 1] The 2020 federal poverty threshold (FPL) for a single adult under age 65 years was designated as $12,760. [Feedback for Answer Choice 2] According to the U.S. Census Bureau, the median household income on some reservations is as low as $27,000. [Feedback for Correct Answer 3] According to recent data collected by the U.S. Census Bureau, one in three Native Americans live in poverty, with a median household income of approximately $45,000. [Feedback for Answer Choice 4] According to the U.S. Census Bureau, the overall U.S. population median income is $66,000. [Q4] The rate of alcoholism is double that of the general U.S. population, with Native Americans times more likely to die from alcohol-induced causes than the rest of the population. 1. 1.5 2. 2.5 3. 3 4. 6.5 [correct] [Feedback for Answer Choice 1] The rate of suicide among Native American adolescents and adults combined is 1.5 times the national rate. [Feedback for Answer Choice 2] Compared to non-Hispanic Whites, Native Americans are 2.5 times more likely to die from diabetes. [Feedback for Answer Choice 3] Compared to non-Hispanic Whites, Native Americans are 3 times more likely to be diagnosed with Type II diabetes. [Feedback for Correct Answer 4] The rate of alcoholism is double that of the general U.S. population, with Native Americans 6.5 times more likely to die from alcohol-induced causes than the rest of the population. Learning Outcome 13.3: Identify common Native American traditions, values, and strengths with the understanding that each Native American client is a unique individual with their own story.

[Q1] Which of the following is a core value of Native American culture? 1. Doing 2. Competition 3. Humor [correct] 4. Progress [Feedback for Answer Choice 1] Native American traditions emphasize being over doing. [Feedback for Answer Choice 2] Native American traditions emphasize cooperation over competition. [Feedback for Correct Answer 3] Humor is an important part of the Native American culture, and it is often used to communicate principles, information, opinions, and idea. [Feedback for Answer Choice 4] Progress is a value of the dominant U.S. culture. In contrast, Native Americans value following the old ways. [Q2] Many religious and spiritual beliefs appear to cut across Native American tribes’ religious preferences. Which of the following refers to the Native American belief that: ―One must seek for God, especially as a young person, to get guidance for their life‖? 1. Oneness 2. Four Directions 3. Vision Quest [correct] 4. All of Life Has Spirit [Feedback for Answer Choice 1] Oneness refers to the Native American belief that: ―We are made up of spirit, mind, and body that are all interconnected.‖ [Feedback for Answer Choice 2] Four Directions refers to the Native American belief that: ―Religion is not a discrete aspect of life. Spirituality permeates the social, political, and cultural aspects of life.‖ [Feedback for Correct Answer 3] Vision Quest refers to the Native American belief that: ―One must seek for God, especially as a young person, to get guidance for their life.‖ [Feedback for Answer Choice 4] All of Life Has Spirit refers to the Native American belief that: ―Life in all of its forms is important, and we can learn from all forms of life.‖

[Q3] Which of the following is used by Native Americans for ceremonial healings and purification, and also serves as a symbol of wisdom, power, freedom, and trust? 1. Eagle feather [correct] 2. The Ghost Dance 3. Great Spirit 4. Vision Quest [Feedback for Correct Answer 1] Eagle feathers are used by Native Americans for ceremonial healings and purification, and also serve as a symbol of wisdom, power, freedom, and trust. [Feedback for Answer Choice 2] The Ghost Dance refers to the Native American belief that: ―The Creator God wants us to be good and love each other and not fight, steal, and lie.‖ [Feedback for Answer Choice 3] Great Spirit refers to the Native American belief that: ―There is a Great Spirit who has created the world and all of its creatures and has given us charge to care for them.‖ [Feedback for Answer Choice 4] Vision Quest refers to the Native American belief that: ―One must seek for God, especially as a young person, to get guidance for their life.‖ [Q4] Which of the following refers to the Native American practice of seeking to understand the purpose, meaning, and direction of their lives? 1. Being 2. Harmony 3. Relation 4. Vision [correct] [Feedback for Answer Choice 1] Being refers to the Native American belief that it is important to develop oneself and to develop one’s relationships with others, as this supersedes personal accomplishment. [Feedback for Answer Choice 2] The cultural value of harmony guides the behaviors and interactions of Native Americans. Cooperation and sharing, as a reflection of harmony, are essential to keeping good relationships. [Feedback for Answer Choice 3] Relation refers to the Native American value of practicing respect for the interconnection that living things share and for observing certain natural or social laws.

[Feedback for Correct Answer 4] Vision refers to the Native American practice of seeking to understand the purpose, meaning, and direction of their lives. Learning Outcome 13.4: Understand counseling implications for working with and advocating for Native American clients. [Q1] Counseling-related literature on issues affecting Native American has tended to focus more on than on other issues. 1. suicide 2. poverty 3. depression 4. substance use/misuse [correct] [Feedback for Answer Choice 1] Suicide in a critical issue facing the Native American community; however, it remains understudied. [Feedback for Answer Choice 2] Further research is also needed on the impact of poverty within the Native American community. [Feedback for Answer Choice 3] Depression is another critical issue facing the Native American community that requires further investigation. [Feedback for Correct Answer 4] Counseling-related literature on issues affecting Native American has tended to focus more on substance use/misuse than on other issues. [Q2] Which of the following authored the book, American Indian Historical Trauma: Anticolonial Prescriptions for Healing, Resilience, and Survivance? 1. Lopez (2020) 2. Gonzales et al. (2020) 3. Hartmann et al. (2019) [correct] 4. Weaver (2019) [Feedback for Answer Choice 1] The research of Lopez (2020) found that Native American college students are motivated by the desire to give back to the Native American communities.

[Feedback for Answer Choice 2] The research of Gonzales and colleagues (2020) confirmed that depression is one of the deleterious effects of substance misuse among Native Americans. [Feedback for Correct Answer 3] Hartmann and colleagues (2019) authored the book, American Indian Historical Trauma: Anticolonial Prescriptions for Healing, Resilience, and Survivance. This text clarifies the concept of historical trauma as not only trauma that happened to one’s ancestors, but that continues to carry the pernicious effects of colonization into the lives of contemporary Native Americans. [Feedback for Answer Choice 4] Weaver (2019) authored the book, Trauma and Resilience in the Lives of Contemporary Native Americans, which discusses the need to use the historical trauma framework to understand the range of social and health challenges faced by Native Americans. [Q3] Which of the following authored the book, Trauma and Resilience in the Lives of Contemporary Native Americans? 1. Lopez (2020) 2. Gonzales et al. (2020) 3. Hartmann et al. (2019) 4. Weaver (2019) [correct] [Feedback for Answer Choice 1] The research of Lopez (2020) found that Native American college students are motivated by the desire to give back to the Native American communities. [Feedback for Answer Choice 2] The research of Gonzales and colleagues (2020) confirmed that depression is one of the deleterious effects of substance misuse among Native Americans. [Feedback for Answer Choice 3] Hartmann and colleagues (2019) authored the book, American Indian Historical Trauma: Anticolonial Prescriptions for Healing, Resilience, and Survivance. This text clarifies the concept of historical trauma as not only trauma that happened to one’s ancestors, but that continues to carry the pernicious effects of colonization into the lives of contemporary Native Americans. [Feedback for Correct Answer 4] Weaver (2019) authored the book, Trauma and Resilience in the Lives of Contemporary Native Americans, which discusses the need to use the historical trauma framework to understand the range of social and health challenges faced by Native Americans. [Q4] Current scholarship has advocated for using a historical trauma framework to understand the range of social and health challenges faced by Native Americans in order to better address these issues. Recently recommended counseling protocols have addressed which of the following?

1. Psychoeducation [correct] 2. Dual-diagnoses 3. Co-morbidities 4. Intersectionality [Feedback for Correct Answer 1] Recently recommended counseling protocols have included such practices as: psychoeducation, establishing a working alliance, psychotherapeutic techniques such as dream interpretation, and motivational interviewing. [Feedback for Answer Choice 2] There remains a need to further refine and empirically examine best practices related to dual diagnoses. Thus, counseling protocols for dual diagnoses cannot be recommended at this time. [Feedback for Answer Choice 3] There remains a need to further refine and empirically examine best practices related to comorbidities. Thus, counseling protocols for co-morbidities cannot be recommended at this time. [Feedback for Answer Choice 4] There remains a need to further refine and empirically examine best practices related to intersectionality. Thus, counseling protocols for intersectionality cannot be recommended at this time. Learning Outcome 13.5: Recognize the importance of examining one’s own biases and potential need for training and supervision as it relates to counseling Native American clients. [Q1] According to Robinson-Wood (2016), when working with Native American clients, counselors should assess the extent to which the process of has affected the client’s cultural identity and understand the influence of on their experience and current presenting issues. 1. oppression, acculturation, 2. acculturation, oppression [correct] 3. negative cognitions, privilege 4. negative cognitions, trauma [Feedback for Answer Choice 1] According to Robinson-Wood (2016), when working with Native American clients, counselors should assess the extent to which the process of acculturation has affected the client’s cultural identity and understand the influence of oppression on their experience and current presenting issues. [Feedback for Correct Answer 2] According to Robinson-Wood (2016), when working with Native American clients, counselors should assess the extent to which the process of acculturation has affected the client’s cultural

identity and understand the influence of oppression on their experience and current presenting issues. [Feedback for Answer Choice 3] Robinson-Wood (2016) encourages counselors to understand the influence of oppression on client experiences and their current presenting issues. Oppression is not considered a privilege, so this answer is incorrect. [Feedback for Answer Choice 4] Robinson-Wood (2016) encourages counselors to assess the extent to which the process of acculturation—not negative cognitions— has affected the client’s cultural identity. [Q2] According to Rosen and colleagues (2017), focusing only on the client’s cultural background and failing to acknowledge one’s own beliefs can contribute to: 1. othering [correct] 2. tunnel vision 3. cognitive dissonance 4. psychological distancing [Feedback for Correct Answer 1] According to Rosen and colleagues (2017), focusing only on the client’s cultural background and failing to acknowledge one’s own beliefs can contribute to othering. Consequently, othering (seeing those outside of our own group as ―others‖) may lead a counselor to focus only on differences between the client and counselor and make assumptions about the client’s background. [Feedback for Answer Choice 2] Tunnel vision is not a counseling-specific term. [Feedback for Answer Choice 3] Cognitive dissonance describes the state of psychological disequilibrium experienced when we are facing, but have not yet resolved, information that contradicts our worldview. Rosen and colleagues (2017) do not mention this concept. [Feedback for Answer Choice 4] Psychological distancing refers to ways of thinking and behaving that are used by privileged groups to justify and distance themselves from their role in class injustice. Rosen and colleagues (2017) do not mention this concept. [Q3] A counselor begins working with a Native American client and, early into the counseling process, identifies a lack of competence in meeting this client’s needs. What is the first step the counselor should take to ethically address this concern? 1. consider referring out 2. consult with a trusted colleague [correct]

3. conduct a self-assessment inventory 4. seek out additional professional development [Feedback for Answer Choice 1] A counselor who identifies a lack of competence in meeting a client’s needs should only consider referring out after consulting with a trusted colleague. [Feedback for Correct Answer 2] If a counselor begins working with a Native American client and then identifies a lack of competence in meeting this client’s needs, the counselor should first consult with a trusted colleague. [Feedback for Answer Choice 3] Conducting a self-assessment is helpful for counselors to identify their strengths and weaknesses. In this scenario, the counselor has already identified an area of deficiency, so conducting a formal assessment is not necessary. [Feedback for Answer Choice 4] If a counselor decides to refer out due to lack of competence, this action should signal to the counselor the need for more professional development on working with Native American populations. [Q4] During an intake session with a Native American client, a counselor asks the question: “What (if any) traditions do you and/or your family regularly engage in?‖ The purpose of asking this type of question is to determine the client’s level of: 1. historical trauma. 2. privilege. 3. oppression. 4. acculturation. [correct] [Feedback for Answer Choice 1] A counselor would not ask the question: “What (if any) traditions do you and/or your family regularly engage in?‖ to assess the impact of historical trauma. [Feedback for Answer Choice 2] While a client’s response to the question “What (if any) traditions do you and/or your family regularly engage in?‖ may elicit expressions of client privilege, determining the client’s level of privilege is not purpose of the question. [Feedback for Answer Choice 3] While a client’s response to the question “What (if any) traditions do you and/or your family regularly engage in?‖ may lead to a discussion of oppression, determining the client’s level of oppression is not purpose of the question.

[Feedback for Correct Answer 4] The purpose of asking the question “What (if any) traditions do you and/or your family regularly engage in?‖ is to determine the client’s level of acculturation.

Chapter 13 Application Exercises Application Exercise 13.1: Physical, Social, and Political Challenges Faced by Native Americans Learning Outcome 13.2: Understand current social, economic, and political issues in the United States that impact Native Americans. [Q1] Based research discussed in the text—and keeping in mind that every individual has unique life experiences—briefly describe some of the current sociocultural characteristics that may be present in Native American Families. [Q1 MODEL RESPONSE] Based research discussed in the text, your answer should include some of the following points: 

Native American families are as varied as those of other racial groups.



General trends indicate that although there is a general proclivity toward a nuclear family structure with two working adults, approximately 40% of Native American adults are not married.



Among Native Americans, there are higher rates of partner-violence and violence against girls and women (both within and without the family). This appears to be linked to intergenerational and epigenetic trauma, to racism and patriarchalism that devalues the place of honor and leadership traditionally held by Native American women, and to the internalization of colonialism (i.e., internalized attitudes of racial and cultural inferiority experienced by people because of colonization) (Baskin, 2020; Figley & Burnette, 2017).



Some Native Americans live with their extended families, which can include both fictive and kindred relatives, and members from different tribes or cultural backgrounds.



Many Native American families have a skip-generational structure (with grandparents raising grandchildren) because of the absence of birth parents.

[Q2] Based research discussed in the text—and keeping in mind that every individual has unique life experiences—discuss some of the overarching health challenges experienced by Native Americans. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Scholars have written extensively about the ongoing effects of racism, discrimination, and stereotyping on Indigenous people (e.g., Dickerson et al., 2019). There are significant disparities between Native Americans and White Americans in wealth, health, safety, and education. Whether living in rural areas that lack a viable economic infrastructure, or in lower SES urban areas, many Native Americans grow up in communities characterized by high rates of unemployment, poverty, physical and mental health disparities, and lower levels of educational achievement (Fortuna et al., 2020).



Childhood abuse and neglect, homicide, suicide, chemical dependency, and domestic violence are scourges on Native American people and their communities.



Poor physical health, including high rates of diabetes, obesity, cirrhosis, and infant mortality.



The rate of alcoholism is double that of the general U.S. population, with Native Americans 6.5 times more likely to die from alcohol-induced causes than the rest of the population.



The rate of fetal alcohol syndrome is three times that of the general population.



Depression is also a predominant mental health challenge among Native Americans.



One in six Native American adolescents attempt suicide, a rate four times that of all other American groups.

[Q3] Based on the research presented in the chapter, discuss the various efforts and advances that Native Americans have made toward the goal of cultural preservation. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Programs have been developed both inside and outside of the schools to teach Native American youth about cultural topics such as: traditional arts and crafts, Native American languages, ceremonies and prayers, songs, chants, and dance.



Many of these cultural classes and extracurricular activities are housed in residential youth treatment and sobriety treatment centers, which have become increasingly effective and popular.



There have also been positive advances in cultural preservation since the passage of the Indian Civil Rights Act of 1968, the Indian Education Act of 1972, and the Indian Religious Freedom Act of 1978.



Moreover, local programs in tribal communities often operate under a mandate to promote the wellness of Native American tribal members and work to: restore cultural integrity, eliminate existing disparities in health and development, maintain sensitivity to and respect historical contexts, build community trust, and foster ongoing responsibility to tribal members and to the betterment of the tribal community overall.

Application Exercise 13.2: Native American Values and Traditions Learning Outcome 13.3: Identify common Native American traditions, values, and strengths with the understanding that each Native American client is a unique individual with their own story. [Q1] Based research discussed in the text—and keeping in mind that every individual has unique life experiences—discuss the ways in which the values of humility and sharing find expression within Native American culture. [Q1 MODEL RESPONSE]

Your answer should include some of the following points: 

For many Native Americans, self-promotion by boasting of one’s accomplishments or engaging in behavior that attracts attention to oneself is offensive and highly discouraged.



Among both traditional and non-traditional Native Americans, placing value on oneself by devaluing others may bring disgrace to the individual, as well as to the individual’s immediate and extended family.



Native Americans may work to ensure equitable treatment and may take joy in the accomplishments of others.



Views concerning the sharing of property accentuate the underlying belief that ―whatever belongs to the individual also belongs to the group,‖ and vice versa. Sharing is not considered an event, but a lifestyle.

[Q2] Based research discussed in the text—and keeping in mind that every individual has unique life experiences—explain how humor is valued and expressed within Native American culture. Additionally, provide some important clinical considerations for the appropriate use of humor with Native American clients. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Humor is an important part of the Native American culture.



Native American people may use humor to communicate principles, information, opinions, and ideas to each other.



Humor is also entertaining, and lifts, energizes, and encourages individuals.



Many times, humor is only used to communicate with people who are outside of the Native American culture when trust is established.



When Native American clients share humorous stories or jokes with their counselors, it is appropriate for the counselor to laugh and enjoy the moment.



However, counselors must consider their own therapeutic model if they are considering telling their client a joke or sharing a funny saying. Unless engaging in humor in an overt way will accomplish a therapeutic goal, it is contraindicated to tell jokes to your client.



Counselors should be careful to not interpret Native Americans’ humor as a defense mechanism, as this categorical labeling of a culturally based expression can perpetuate oppression.

[Q3] Based research discussed in the text—and keeping in mind that every individual has unique life experiences—briefly explain the Native American spiritual concept of harmony and how this view is expressed in daily life. [Q3 MODEL RESPONSE] Your answer should include some of the following points:



To cultivate harmony, Native American people in some tribes may practice silence, modesty, and patience.



Direct confrontation may be avoided, as it disrupts the harmony that is essential to keeping good relationships.



Cooperation and sharing, as a reflection of harmony, may be an important part of interacting with others.

Application Exercise 13.3: Culturally Sensitive Approaches to Counseling Native American Clients Learning Outcome 13.5: Recognize the importance of examining one’s own biases and potential need for training and supervision as it relates to counseling Native American clients. [Q1] Based on the research in the text, highlight several practical strategies that a counselor who is not Native American could implement to address their biases and gaps in knowledge related to counseling Native American clients. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Focusing only on the client’s cultural background and failing to acknowledge one’s own beliefs can contribute to ―othering.‖



―Othering‖ may lead a counselor to focus only on differences between the client and counselor and make assumptions about the client’s background.



Counselors must recognize the implicit biases they hold toward Native Americans so that they prevent these biases from negatively impacting the counseling relationship.



Counselors need to discuss topics related to oppression in supervision and consultation with experienced professionals to recognize how their position might be impacting their work with clients.



Counselors must also examine their competence for working with Native populations.



Counselors should address their biases, increase their exposure to Native American culture, and consult with professionals who have experience with Native American populations to avoid doing harm through the counseling relationship.

[Q2] Based on the research in the text, discuss some of the pitfalls that a counselor who is not Native American should avoid when eliciting cultural information from Native American clients. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

A counselor should not ask a client how much Native American the client is, and the counselor should not relate personal stories of Native American heritage in their own family as a way of connecting with that client.



This acceptance of client self-report is a way to understand that client without having to get into the painful (and sometimes irrelevant) politics of categorization.



When working with a Native American client, it is important to recognize that it is not the client’s job to educate the counselor on their tribe’s customs, beliefs, or other general knowledge.



Counselors must take time on their own to explore and learn more about Native American topics.



However, a counselor can certainly address how the client’s Native American identity or heritage has a positive impact on them.



Questions should always be posed in a respectful way that are not laced with assumptions.

[Q3] Based on the research in the text—and keeping in mind that every individual has unique life experiences—how might a counselor draw on the cultural values of a Native American client to enhance the therapeutic relationship? [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Native American clients can be encouraged to talk about their worldview if appropriate and if it helps to further the client’s goals.



This could include questions related to the meaning of family, clan, or tribe to them as a way of exploring worldview, especially in light of intergenerational differences or the effects of oppression or presenting issues.



Counselors should consider how to build on their knowledge of these values, beliefs, experiences, and traditions to show understanding, develop rapport, and identify interventions that align with the client’s worldview.

Chapter 13 Test Items Multiple Choice 1.

The general term, Native Americans refer to a. American Indian b. Alaska Native c. Both of the above. d. None of the above.

Of the total U.S. population, Native Americans represent about

a. 1% b. 25% c. 40% d. 50% 3.

There are about

federally recognized Native American reservations.

a. 200 b. 245 c. 324 d. 556 4.

The majority of Native Americans live in/on a. rural areas. b. urban areas. c. suburban areas. d. reservations.

Although Native American tribes/nations are described as heterogeneous, it is common for tribes/nations to have strong a. traditions. b. worldviews. c. cultural values. d. All of the above.

The U.S. Bureau of Indian Affairs legally recognizes any Native American as a person who fits into any of the following EXCEPT one who a. has a DNA analysis. b. has a blood quantum of one-fourth or more. c. is an enrolled or registered member of a tribe. d. has been genealogically derived from Native American ancestry.

Having to prove cultural identity leaves Native Americans with differing feelings. These feelings include all of the following EXCEPT feelings of a. oppression by the dominant group. b. pride for who they are as a culture. c. acceptance by the dominant group. d. normalcy as this practice is accepted.

Full blood refers to Native Americans who are a. one-fourth Native American b. 100% Native American blood of one tribe/nation. c. 100% Native American blood of mixed tribes/nations. d. All of the above.

Native Americans attained citizenship in the year a. 1889. b. 1919. c. 1924. d. 1978.

10. Religious freedom for Native Americans was taken away in

and restored in

a. 1889; 1978 b. 1924; 1988 c. 1978; 1990 d. 1941; 2000 11. Native Americans are affected by Native people.

at a rate which is 33 times higher than non-

a. diabetes b. fetal alcohol syndrome c. heart disease d. pneumonia 12. For traditional Native Americans, the proper way of greeting is a. a gentle handshake. b. a firm handshake. c. direct eye contact and a head nod. d. a brief hug. 13. Sacred places are used for all of the following EXCEPT a. prayer. b. vision seeking.

c. teaching youth traditions. d. community and political meetings. 14. Developing programs both inside and outside of the schools to teach their youth such things as traditional arts and crafts, the language, ceremonies and prayers, songs and chants, as well as dance, are being done to a. preserve culture. b. inform non-native people. c. bring money into the tribe/nation. d. give Native Americans something to take their mind off poverty. 15. The primary objective of Native American boarding schools was to a. give Native Americans a trade. b. remove culture from Native Americans. c. preserve Native American cultural heritage. d. educate Native Americans and prepare them for college. 16. One’s ―Indianness‖ is determined by a. blood quantum b. ethnic heritage and life/choice experiences c. tribe/nation membership d. All of the above. 17. There is a degree of psychological homogeneity across Native American nations/tribes. This is based on a. communal poverty. b. common core values. c. shared feelings on oppression. d. traditional beliefs and practices. 18. According to Garrett, by accepting responsibility for the gift of life by taking good care of that gift, the gift of life that others have received, and the surrounding beauty of the world in which we live refers to the purpose of a. the caretaker. b. the individual. c. respecting Mother Earth. d. respecting Father Sky. 19. A single higher power exists within the context of Native American traditionalism and spirituality. This higher power a. has a specific gender. b. has one name among many tribes.

c. is the only power Native Americans believe in. d. may be referred to as one gender but does not exist within one specific gender. 20. Native Americans believe that illness affects the body, mind, and spirit, and that natural illness is caused by a. use of witchcraft with destructive intentions. b. violating the sacred social/natural law of Creation. c. contracting various infectious diseases. d. All of the above. 21. The Native American philosophy of child rearing would be closely related to a. ―one for all, and all for one.‖ b. ―our home is where the heart is.‖ c. ―it takes a village to raise a child.‖ d. ―the child is the center of all beings.‖ 22. A sign of respect for elders and honored persons is to a. bow to them. b. avoid eye contact with them. c. shake their hand with mild firmness. d. embrace and kiss their cheek three times. 23. Native Americans use

to symbolize wisdom and humility.

a. family b. schooling c. generosity d. social status 24. For traditional Native American clients, it may be helpful to suggest including the in the counseling process. a. family b. medicine person c. Both of the above. d. None of the above. 25. Native Americans value communication to express feelings, beliefs, and importance of experience through a. storytelling. b. confrontation. c. nonverbal awareness. d. basic verbal expressions.

26. According to recent U.S. Census Bureau (2011) data, the greatest number of Native people live in . a. California b. Arizona c. Oklahoma d. North Carolina 27. All of the following tribes are considered the largest Native American tribes in the United States EXCEPT a. Sioux b. Navajo c. Cherokee d. Kiowa 28. A multidimensional body of lived experiences that informs and sustains people who make their homes in a local area is known as a. tribal membership. b. tribal sovereignty. c. indigenous ways of knowing. d. historical trauma response. 29. The most recent census data shows that the majority of Native Americans live in/on a. reservation areas. b. urban areas. c. rural areas. d. None of the above. 30. The U.S. Bureau of Indian Affairs legally defines Native American as a. enrolled or registered members. b. blood quantum. c. Both of the above. d. None of the above. 31. Which of the following comprised one of the five eras of U.S. government policy leading to the current state of tribal sovereignty experienced by Native tribes? a. The reservation period (1860 to 1920s) characterized by the saying, ‟kill the Indian, but save the man.‖ b. The reorganization period (1930s to 1950s) with schools allowed on reservations. c. The termination period (1950s to 1960s) with Relocation Programs intended to achieve sociocultural integration to end dependence on the federal government (resulted in the sale of huge acres of Native lands and increased poverty). d. All of the above.

32.

is an aspect of the pertinent historical experience that Brave Heart and other scholars identified as being critically important in creating the trauma that Native people survive. a. Colonization b. The boarding school experience c. Forced assimilation d. All of the above.

33. Colonization is an apt description for the entire experience of Native peoples being subjugated through European conquest, including a. the impact of infectious diseases. b. the introduction of alcohol. c. massacres and forced migration. d. All of the above. 34. The cumulative emotional and psychological wounding over the lifespan and across generations emanating from massive group trauma experiences is called a. historical trauma. b. historical trauma response. c. forced assimilation. d. All of the above. 35. The historical trauma response is the constellation of features in reaction to historical trauma that may include a. substance abuse, as a vehicle for attempting to numb the pain associated with trauma, and often includes other types of self-destructive behavior. b. suicidal thoughts and gestures. c. difficulty recognizing and expressing emotions. d. All of the above. 36. The transgenerational effects of the residential boarding schools on Native people include a. impaired emotional response (a reflection of the lack of warmth and intimacy in childhood). b. repetition of physical and sexual abuse. c. loss of knowledge, language, and tradition. d. All of the above. 37. The barriers to economic development that exist for many Native American communities include a. access to capital. b. abundance of human capital (education, skills, technical expertise) and the means to develop it.

c. abundance of entrepreneurial skills and experience as well as programs to foster these skills and experience. d. All of the above. 38.

is/are current social, economic, and political issues which involve Native American nations demanding the immediate return of all skeletal remains, burial goods, and sacred objects, through the passage of critical legislation that now protects Native gravesites from looting and provides Native people with legal means for reclaiming both remains and sacred objects. a. Self-determination and sovereignty b. Federal and state recognition c. Repatriation d. Tribal resources

39. The cultural change that occurs when two or more cultures are in persistent contact is known as a. indigenous ways of knowing. b. acculturation. c. historical trauma response. d. All of the above. 40. Of the five levels of acculturation identified for Native Americans in the chapter, is the one where Native clients may or may not speak English, but generally speak and think in their native language, hold only traditional values and beliefs, and practice only traditional tribal customs and methods of worship. a. traditional b. marginal c. bicultural d. assimilated 41. Of the five levels of acculturation identified for Native Americans in the chapter, is the one where Native clients are generally accepted by the dominant society and tribal society/nation and are simultaneously able to know, accept, and practice both mainstream values/behaviors and the traditional values and beliefs of their cultural heritage. a. traditional b. marginal c. bicultural d. assimilated 42.

is the Native concept which implies that the very essence of our being, or life force, exists in all creatures on Mother Earth. a. Medicine b. Harmony c. Relation

d. Vision 43.

is a traditional Native American value that requires individuals to know and experience their connections and honor their relations with all their heart. a. Humility b. Generosity c. Patience d. Being

44. Which of the following practical, tribally specific interventions discussed in the chapter involves assisting Native clients with exploration of personal and career issues by focusing on the positive, cultural themes of belonging, mastery, independence, and generosity identified as culturally appropriate ways. a. Examine/teach the historical context b. Promote positive cultural identity c. Reduce isolation/enhance social connections d. Work with the noninterference principle 45. Working with Native clients and communities from a social justice and advocacy perspective involves a. implementing direct counseling strategies based on understanding the social, political, economic, and cultural contexts in which clients live, and facilitating self-advocacy on the part of the client. b. directly addressing external barriers that impede the client’s development that the client him or herself is unable to address due to lack of resources, access, or power. c. getting involved in assisting community organizations that are working for change. d. All of the above.

Extended Response 1.

As you read this chapter, what thoughts and feelings were you thinking and experiencing as you learned about the oppression and subordination of Native Americans?

How might generational grief and trauma affect the Native American worldview?

In this chapter, you learned that Native Americans were restricted from practicing their religions. How might the restriction of religious freedom for 89 years have affected tribes emotionally and culturally?

As a professional school counselor at a school with a high population of Native peoples, how might the high prevalence of alcohol mortality and fetal alcohol syndrome affect your job? What would you do to provide effective counseling and education?

Looking at the educational statistics provided within this chapter, as a professional school counselor, how might you work to improve the academic statistics that affect the Native American society as a whole?

Consider that you are working with a Native American teenager who has threatened to take his own life. How would you handle this situation? Do the suicide statistics for Native Americans factor into the situation, even if the teenager does not have a plan?

Since Native Americans have been oppressed for such a long time, how might clientcounselor trust be built?

Make a chart highlighting the suggested Dos and Don’ts of demonstrating culturally responsive ways to work with traditional Native Americans. For the purpose of this activity, examine the Dos and Don’ts of: greeting, hospitality, silence, space, eye contact, intention, and collaboration.

Define indigenous ways of knowing (IWOK) and discuss how an understanding of IW OK would be important in the counseling context working with Native clients.

10. Briefly discuss your understanding of Native American history, then define and discuss historical trauma and its identified outcomes. 11. Select and discuss three of the current social, economic, and political issues affecting Native Americans. Consider the potential implications of these issues when working with Native clients. 12. Define acculturation related to Native Americans and discuss the implications for working with clients at each of the stages of acculturation presented in the chapter. 13. Discuss the four general components of traditional Native spirituality and how each might influence work with a Native client depending on level of acculturation. 14. Discuss how you might incorporate an emphasis on tribe/nation, family, and the powerful role of elders from a traditional Native perspective to help with the therapeutic process for Native clients. 15. Pick at least three cultural values that would be different for you when working with a Native client and discuss how you might deal with those differences in a way that would promote positive outcomes within the counseling process. 16. Discuss at least three practical, tribally specific interventions and how you would implement them effectively with Native clients in a setting in which you intend to work. 17. Discuss what it would mean for you to work with Native clients from a social justice and advocacy counseling perspective incorporating indigenous ways of knowing into the setting in which you intend to work. 18. Discuss the three biggest strengths and three biggest challenges you anticipate when counseling Native clients.

Chapter 13 Test Answer Key ANSWER KEY: Chapter 13 Test (Multiple Choice) 1. c 2. a 3. c 4. b 5. d 6. a 7. c 8. b 9. c 10. a 11. b 12. a 13. d 14. a 15. b 16. b 17. b 18. a 19. d 20. b 21. c 22. b 23. c 24. c 25. a 26. a 27. d 28. c 29. b 30. c 31. d 32. d 33. d 34. a 35. d 36. d 37. a 38. c

39. b 40. a 41. c 42. a 43. d 44. b 45. d

Chapter 14 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach 4th Edition Danica G. Hays University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents

Chapter 14: Individuals and Families of European Descent

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 14: Individuals and Families of European and European American Descent Chapter 14 Learning Outcome Quizzes Learning Outcome 14.1: Understand key terminology and significant events in European American history. [Q1] Prior to the 15th century, the collective we now call Europe was more commonly called: 1. Pangea 2. Germania 3. Greater Caucasus 4. Christianitas [correct] [Feedback for Answer Choice 1] Pangea refers to the existence of a ―supercontinent‖ that eventually separated into seven continents. Europe was never commonly called Pangea. [Feedback for Answer Choice 2] Germania refers to a historical region in North-Central Europe— not the entire collective we now call Europe— that existed during the Roman Era. [Feedback for Answer Choice 3] The Greater Caucasus are a major mountain range that form a boundary between Eastern Europe and Western Asia. [Feedback for Correct Answer 4] Prior to the 15th century the collective we now call Europe was more often articulated as Christianitas, clearly signifying the centrality of Christianity as an inclusive/exclusive distinction. [Q2] Which of the following terms refers to an ethnic group of people traditionally from the isthmus between the Black and Caspian Seas? 1. Anglo 2. Euro American 3. Caucasian [correct] 4. White [Feedback for Answer Choice 1] The term Anglo, along with other terms such as Anglo American, Euro American, and European American, is used to describe the dominant cultural–racial group in the United States. Members

of this group are also identified as being part of the White racial group. For many Americans, these terms are used interchangeably. [Feedback for Answer Choice 2] The term Euro American, along with other terms such as Anglo American, Anglo, and European American, is used to describe the dominant cultural–racial group in the United States. Members of this group are also identified as being part of the White racial group. For many Americans, these terms are used interchangeably. [Feedback for Correct Answer 3] The term Caucasian refers to an ethnic group of people traditionally from the isthmus between the Black and Caspian Seas. [Feedback for Answer Choice 4] The term White, along with other terms such as Anglo, Anglo American, Euro American, and European American, is used to describe the dominant cultural–racial group in the United States. [Q3] When the United States experienced a large influx of immigrants from a particular geographic region, the dominant groups in America marginalized immigrants from various European countries. Which of the following ethnic groups experienced the most severe marginalization? 1. German 2. Scots-Irish 3. French 4. Russian [correct] [Feedback for Answer Choice 1] Over time, the dominant culture expanded from only English heritage to include other Englishspeaking or Western and Northern European ethnicities such as Germans. For an extensive period, European descendants from the Mediterranean and Slavic areas were not as likely to be seen as White. [Feedback for Answer Choice 2] Over time, the dominant culture expanded from only English heritage to include other Englishspeaking or Western and Northern European ethnicities such as Scots-Irish. For an extensive period, European descendants from the Mediterranean and Slavic areas were not as likely to be seen as White. [Feedback for Answer Choice 3] Over time, the dominant culture expanded from only English heritage to include other Englishspeaking or Western and Northern European ethnicities such as the French. For an extensive period, European descendants from the Mediterranean and Slavic areas were not as likely to be seen as White. [Feedback for Correct Answer 4] The dominant groups in America marginalized immigrants from various European countries, including those from much of Eastern Europe (particularly people of Polish, Russian, and

Ukrainian descent). For an extensive period, European descendants from the Mediterranean and Slavic areas were not as likely to be seen as White.

[Q4] In the early 21st century, European immigrants continued to settle in the largest urban centers, particularly in: 1. Austin 2. Chicago [correct] 3. Minneapolis/St. Paul 4. Seattle [Feedback for Answer Choice 1] Austin is a city that has experienced a recent influx of transplants from other U.S. States. However, in the early 21st century, European immigrants continued to settle in the largest urban centers, particularly New York, Chicago, and Los Angeles. [Feedback for Correct Answer 2] In the early 21st century, European immigrants continued to settle in the largest urban centers, such as Chicago. [Feedback for Answer Choice 3] In the early 21st century, European immigrants continued to settle in the largest urban centers, particularly New York, Chicago, and Los Angeles. [Feedback for Answer Choice 4] In the early 21st century, European immigrants continued to settle in the largest urban centers, particularly New York, Chicago, and Los Angeles. Learning Outcome 14.2: Explain the development of a White American ethnic identity, the American Dream, and the American heritage. [Q1] Which term was commonly used to describe the process of blending multiple cultural backgrounds to create a new culture? 1. melting pot [correct] 2. acculturation 3. enculturation 4. awakening stage [Feedback for Correct Answer 1] Although this term is no longer used to describe the United States, a melting pot is a conglomerate of different cultures blended together to make a new one. [Feedback for Answer Choice 2]

Acculturation refers to an existing culture shifting in response to encountering a new and different culture. [Feedback for Answer Choice 3] Enculturation refers to the process of an individual learning about an existing culture. [Feedback for Answer Choice 4] The awakening stage is part of a racial identity model in which individuals realize that there are cultural differences between certain groups. [Q2] The belief that all individuals, regardless of multicultural factors, can succeed if they work hard is called: 1. color-blindness. 2. meritocracy. [correct] 3. psychological disposition. 4. White privilege. [Feedback for Answer Choice 1] Color-blindness refers to an individual’s inability or refusal to acknowledge racial dynamics within a culture. [Feedback for Correct Answer 2] Meritocracy is the belief that all individuals have equal opportunities, regardless of racial status, and can succeed through hard work. [Feedback for Answer Choice 3] Psychological disposition simply refers to an individual’s emotional and cognitive patterns and is not directly related to multiculturalism. [Feedback for Answer Choice 4] White privilege is an inherent benefit experienced by members of the majority racial group in the United States. [Q3] The Calvinist understanding of to lead to a ―pioneer spirit‖ that valued exploration and ―conquering‖ the land as a matter of course. 1. Asceticism 2. Protestant work ethic 3. Predestination [correct] 4. Manifest destiny [Feedback for Answer Choice 1]

Historian Max Weber argues that the Calvinist teachings on Asceticism and Predestination contributed to the spread of capitalism.

[Feedback for Answer Choice 2] The term Protestant work ethic is associated with Calvinism; however, it was coined several centuries after John Calvin’s death. This concept emphasizes hard work, personal achievement and independence, and an optimistic belief in the ability of the individual to conquer problems. [Feedback for Correct Answer 3] The authors of this chapter contend that the Calvinist understanding of the doctrine of predestination led to a ―pioneer spirit‖ that valued exploration and ―conquering‖ the land as a matter of course. Accordingly, the settlers may have believed that it was the divine right on the part of God’s chosen people to convert (and conquer) all those encountered along the way. [Feedback for Answer Choice 4] Manifest destiny was a cultural belief, rather than a religious doctrine. Widely held during the 19th century, this belief asserted that the American settlers were destined by God to dominate and expand across North America. [Q4] Which of the following metaphors highlights a new sense of pluralism and inclusion that has helped many people of color, as well as many recent immigrant families, take pride in their own cultural heritage? 1. Utopia 2. American Dream 3. Melting pot 4. Salad bowl [correct] [Feedback for Answer Choice 1] It has been argued that The American Dream is the manifestation of White American cultural values and reinforces the notion of the United States as a utopia. [Feedback for Answer Choice 2] One of the common beliefs associated with the American Dream is that anyone can grow up to be a star, to own a business, even to be president of the country if they just work hard enough. At its core, the American Dream and meritocracy represent the cultural belief in the agency of the individual. [Feedback for Answer Choice 3] The term melting pot was commonly used as a metaphor to describe the process of combining a variety of cultural backgrounds and beliefs to create a new, virtuous (i.e., White American) culture, with the idea being it’s okay to be different, as long as one accepts mainstream (e.g., White Protestant) values. [Feedback for Correct Answer 4]

The melting pot idea was replaced with a new sense of multiculturalism focusing on inclusion and ethnic pride. Several metaphors have been suggested to replace the melting pot, such as viewing the United States as a salad bowl where several different ethnic flavors coexist and add to the overall culinary gestalt while maintaining their own distinct characteristics. Learning Outcome 14.3: Understand the relationship between privilege, oppression, and White supremacy. [Q1] Which of the following is identified as a ―value‖ of White people? 1. Individualism [correct] 2. Privilege 3. Oppression 4. White supremacy [Feedback for Correct Answer 1] Individualism is commonly identified as a ―value‖ of White people. [Feedback for Answer Choice 2] According to the authors of this chapter, privilege would never be identified as one of the ―values‖ of White people, nor is it exclusive to White Americans, yet it has become a global political reality and certainly among the most widely recognized expressions of White culture worldwide. [Feedback for Answer Choice 3] According to the authors of this chapter, oppression would never be identified as one of the ―values‖ of White people, nor is it exclusive to White Americans, yet it has become a global political reality and certainly among the most widely recognized expressions of White culture worldwide. [Feedback for Answer Choice 4] According to the authors of this chapter, white supremacy would never be identified as one of the ―values‖ of White people, nor is it exclusive to White Americans, yet it has become a global political reality and certainly among the most widely recognized expressions of White culture worldwide. [Q2] White members of American society are given significant social and economic advantages that are based on a(n): 1. Meritocracy 2. American Dream 3. Awareness of privilege 4. Pattern of social practices [correct] [Feedback for Answer Choice 1]

White members of American society are given significant social and economic advantages that have nothing to do with the meritocracy that is supposed to exist in the United States.

[Feedback for Answer Choice 2] White members of American society are not given significant social and economic advantages that are based on a belief in the American Dream. [Feedback for Answer Choice 3] According to the authors of this chapter, the teaching of a national heritage and an American Dream based on a meritocracy go hand in glove with the denial of privilege. [Feedback for Correct Answer 4] White members of American society are given significant social and economic advantages that are based on a pattern of social and political practices in the United States to keep power in the hands of those who already have it. [Q3] According to Gibbins (2018) and Horne (2018), capitalism, colonialism, and land ownership cannot exist without: 1. Meritocracy 2. Virtuous rationalizations 3. White Supremacy [correct] 4. Systemic Oppression [Feedback for Answer Choice 1] Slater and colleagues (2018) touched on broader issues, noting that the combination of the belief in a meritocracy and virtuous rationalizations for civilizing communities deemed godless or uncivil, facilitates the invisibility of systematic oppression to which European Americans and White Americans have subjected other groups of people. [Feedback for Answer Choice 2] Slater and colleagues (2018) touched on broader issues, noting that the combination of the belief in a meritocracy and virtuous rationalizations for civilizing communities deemed godless or uncivil, facilitates the invisibility of systematic oppression to which European Americans and White Americans have subjected other groups of people. [Feedback for Correct Answer 3] According to Gibbins (2018) and Horne (2018), capitalism, colonialism, and land ownership cannot exist without White Supremacy. [Feedback for Answer Choice 4] Slater and colleagues (2018) touched on broader issues, noting that the combination of the belief in a meritocracy and virtuous rationalizations for civilizing communities deemed godless or uncivil, facilitates the invisibility of systematic oppression to which European Americans and White Americans have subjected other groups of people.

[Q4] provides an opportunity for White Americans to explore the full complexity of their cultural identities, choose the values they wish to honor, and be intentional about living with others in accordance with the proclaimed values. 1. Meritocracy 2. Pluralism [correct] 3. The Golden Rule 4. The American Dream [Feedback for Answer Choice 1] The concept of meritocracy emphasizes hard work and personal success but has no connection with exploring and appreciating diverse cultural identities. [Feedback for Correct Answer 2] Pluralism provides an opportunity for White Americans to explore the full complexity of their cultural identities, choose the values they wish to honor, and be intentional about living with others in accordance with the proclaimed values. [Feedback for Answer Choice 3] The Golden Rule refers to treating others the way you want to be treated. It does not explicitly invite White Americans to explore the full complexity of their cultural identities. [Feedback for Answer Choice 4] The concept of The American Dream emphasizes hard work and personal success but has no connection with exploring and appreciating diverse cultural identities. Learning Outcome 14.4: Understand the process individuals go through to acculturate to White America, as well as the heterogeneity among European Americans. [Q1] Over time, and largely in response to new immigrants coming to the United States from areas with more visible differences to the Anglo Americans, the parameters for defining who was White became more inclusive. However, for an extensive period, European descendants from were not as likely to be seen as White. 1. France 2. Ireland 3. Greece [correct] 4. Scotland [Feedback for Answer Choice 1] Slowly, the dominant culture expanded from only English heritage to include Western European ethnicities such as the French. [Feedback for Answer Choice 2]

Slowly, the dominant culture expanded from only English heritage to include Northern European ethnicities such as the Scots-Irish. [Feedback for Correct Answer 3] Slowly, the dominant culture expanded from only English heritage to include other Englishspeaking or Western and Northern European ethnicities, although for an extensive period, European descendants from the Mediterranean and Slavic areas were not as likely to be seen as White.

[Feedback for Answer Choice 4] Slowly, the dominant culture expanded from only English heritage to include Northern European ethnicities such as the Scots-Irish. [Q2] After World War II, Americans of descent, and to a lesser extent Americans of descent, would often go ―underground‖ and hide or deny their ethnic heritage by assimilating into the White American ethnicity. 1. Italian, German 2. German, Italian [correct] 3. German, Polish 4. Italian, Polish [Feedback for Answer Choice 1] After World War II, some Americans of Italian descent went ―underground‖ to hide or deny their ethnic heritage by assimilating into the White American ethnicity. However, not to the extent that Americans of German descent went ―underground.‖ [Feedback for Correct Answer 2] After World War II, Americans of German descent, and to a lesser extent Americans of Italian descent, would often go ―underground‖ and hide or deny their ethnic heritage by assimilating into the White American ethnicity. [Feedback for Answer Choice 3] After World War II, Americans of German descent would often go ―underground‖ and hide or deny their ethnic heritage by assimilating into the White American ethnicity. However, Americans of Eastern European descent, such as the Polish, were unable to go ―underground‖ in the same manner. [Feedback for Answer Choice 4] After World War II, Americans of Italian descent would often go ―underground‖ and hide or deny their ethnic heritage by assimilating into the White American ethnicity. However, Americans of Eastern European descent, such as the Polish, were unable to go ―underground‖ in the same manner. [Q3]

Which of the following is typically associated with the process of ‟becoming White‖? 1. Strengthening one’s cultural identity 2. Synthesizing ethnic values with the dominant culture 3. Striving for financial success [correct] 4. Forsaking interpersonal competition [Feedback for Answer Choice 1] The process of ‟becoming White‖ requires individuals to give up a degree of their original cultural identity to become fully White. This process is problematic in that much of what is most meaningful about the culture of origin is lost. [Feedback for Answer Choice 2] Adopting values of the dominant culture of the United States— rather than synthesizing the values of one’s ethnic heritage with U.S. culture— is a central component of the process of ‟becoming White.‖ [Feedback for Correct Answer 3] Striving for financial success represents one of the dominant cultural values of the United States. As such, this value is associated with the process of ‟becoming White.‖ [Feedback for Answer Choice 4] Forsaking interpersonal competition represents another dominant cultural value of the United States is not associated with the process of ‟becoming White.‖ [Q4] One of the most prominent variables accounting for intragroup differences among European Americans and White Americans is the degree to which individuals identify with: 1. a non-ethnic marginalized group identity. 2. membership in the middle class. 3. a particular religious tradition. 4. their European heritage. [correct] [Feedback for Answer Choice 1] Many White Americans may also be part of marginalized groups that are not based on ethnicity. People of varying levels of ability may experience discrimination, which may provide a different perspective on the role of privilege in our culture. However, it is not one of the most prominent variables accounting for intragroup differences among European Americans and White Americans. [Feedback for Answer Choice 2] Socioeconomic class also plays a key role in the variance among White American. However, it is not one of the most prominent variables accounting for intragroup differences among European Americans and White Americans. [Feedback for Answer Choice 3]

Religious affiliations, and differing views within those affiliations, can also have a profound effect on one’s values. However, it is not one of the most prominent variables accounting for intragroup differences among European Americans and White Americans. [Feedback for Correct Answer 4] One of the most prominent variables accounting for intragroup differences among European Americans and White Americans is the degree to which individuals identify with their European heritage. There is great diversity among European ethnicities along several lines, including focus on achievement, individual or group focus, gender roles, conceptualizations of family, and treatment of elderly people. Even over long periods of time, some European groups have assimilated into the White American ethnicity to a greater degree, whereas others have been more intentional about holding on to their heritage. Learning Outcome 14.5: Discuss the common experiences of stress and oppression and acculturation process for recent European American immigrants. [Q1] Which of the following terms refers to noncitizens who are most commonly individuals who were in United States on temporary status and stayed beyond the established time? 1. Refugee 2. Immigrant 3. Foreign national 4. Undocumented immigrant [correct] [Feedback for Answer Choice 1] The term refugee refers to a person who is living outside their native country and who is granted permission to set up residence in a host country because they are either unable or unwilling to return to their native country for fear of persecution. [Feedback for Answer Choice 2] The term immigrant is often used as a general term for individuals who are living in a country other than their native country, but it is actually a specific term that refers to noncitizens of a host country who are granted legal permission to permanently reside in the new host country. [Feedback for Answer Choice 3] The term foreign national was not defined in the U.S. Immigration and Nationality Act (INA). Instead, the term alien is used in the INA. [Feedback for Correct Answer 4] The term undocumented immigrant refers to noncitizens of a host country who did not go through the procedures established by the host country’s policies. Undocumented immigrants are most commonly individuals who were in their host country on temporary status and stayed beyond the established time, or individuals who entered the host country without going through inspection. [Q2]

According to the U.S. Department of Homeland Security (2020), over 1 million Europeans immigrated to the United States annually since 2017, with the majority coming from . 1. Italy and Greece 2. Russia and the United Kingdom [correct] 3. Germany and France 4. Portugal and Spain [Feedback for Answer Choice 1] Immigrants from Southern Europe (e.g., Italy, Greece, Portugal, Spain) comprise the smallest percentage of Europeans who immigrate to the United States each year. [Feedback for Correct Answer 2] According to the U.S. Department of Homeland Security (2020), over 1 million Europeans immigrated to the United States annually since 2017, with the majority coming from Russia and the United Kingdom. [Feedback for Answer Choice 3] Immigrants from Western Europe (e.g., Germany, France) comprise the second smallest percentage of Europeans who immigrate to the United States each year. [Feedback for Answer Choice 4] Immigrants from Southern Europe (e.g., Italy, Greece, Portugal, Spain) comprise the smallest percentage of Europeans who immigrate to the United States each year. [Q3] Immigrants might experience a process similar to living in a new country.

when adjusting to

1. grieving [correct] 2. anxiety 3. depression 4. traumatic stress [Feedback for Correct Answer 1] Like immigrants from any culture, the path of life for many European immigrants has been filled with a variety of stressors, often paired with a loss of previously used coping resources. Immigrants might experience a process like grieving when adjusting to living in a new country. [Feedback for Answer Choice 2] Anxiety may be a byproduct of moving to a new country but, strictly speaking, it is considered a disorder and not a process. [Feedback for Answer Choice 3] Depression may be a byproduct of moving to a new country but, strictly speaking, it is considered a disorder and not a process.

[Feedback for Answer Choice 4] Traumatic stress is not typically associated with the period of adjusting to living in a new country. However, before the process of relocation, immigrants who are refugees may have witnessed traumatic events in their home countries or experienced severe oppression and persecution that may produce traumatic stress.

[Q4] Recent research conducted by Liu and colleagues (2019) supports the idea that does not follow a linear model; rather, it is a complex and cyclical process that is characterized by repeated experiences of interaction with host culture and the individual’s interpretation of those experiences. 1. adoption 2. acceptance 3. acculturation [correct] 4. assimilation [Feedback for Answer Choice 1] Research conducted by Liu and colleagues (2019) did not investigate the phenomenon of cultural adoption. [Feedback for Answer Choice 2] Research conducted by Liu and colleagues (2019) did not investigate the phenomenon of cultural acceptance. [Feedback for Correct Answer 3] Recent research conducted by Liu and colleagues (2019) supports the idea that acculturation does not follow a linear model; rather, it is a complex and cyclical process that is characterized by repeated experiences of interaction with host culture and the individual’s interpretation of those experiences. [Feedback for Answer Choice 4] Research conducted by Liu and colleagues (2019) did not investigate the phenomenon of cultural assimilation. Learning Outcome 14.6: Describe the counseling implications while counseling White individuals and commonly found mental health issues. [Q1] The existing body of literature related to multicultural counseling considerations for individuals and families of European descent seems to indicate that counseling strategies are seen as White individuals. 1. effective for all

2. effective for most 3. appropriate for all [correct] 4. appropriate for most [Feedback for Answer Choice 1] The existing body of literature related to multicultural counseling considerations for individuals and families of European descent does not indicate that counseling strategies are seen as effective for all White individuals. [Feedback for Answer Choice 2] The existing body of literature related to multicultural counseling considerations for individuals and families of European descent does not indicate that counseling strategies are seen as effective for most White individuals. [Feedback for Correct Answer 3] The existing body of literature related to multicultural counseling considerations for individuals and families of European descent seems to indicate that counseling strategies are seen as appropriate for all White individuals. [Feedback for Answer Choice 4] The existing body of literature related to multicultural counseling considerations for individuals and families of European descent does not indicate that counseling strategies are seen as appropriate for most White individuals. [Q2] Which of the following topics has received the least scholarly attention over the past decade? 1. The impact of White racial trauma 2. The psychology of European Americans 3. Differences within cultural experiences of White individuals [correct] 4. The effectiveness of traditional counseling methods for treating clients of European descent [Feedback for Answer Choice 1] Middleton et al. (2016) discussed important topics such as White racial trauma, hegemonic Whiteness, and the decline of the one-drop racial rule but does not specifically cover the intricacies of individuals of European descent. This issue is more widely covered than other related topics. [Feedback for Answer Choice 2] Downey and D’Andrea (2012) explored the psychology of European Americans and examined poverty, traumatic experiences, and alcohol abuse as major impediments to positive mental health. This issue is more widely covered than other related topics. [Feedback for Correct Answer 3]

The research that has focused on White identity in the last decade has not paid sufficient attention to the differences within cultural experiences and perspectives of White individuals of European descent, which are quite diverse. [Feedback for Answer Choice 4] There is a solid body of research indicating that traditional counseling methods are effective for treating clients of European descent (see Erford, 2018). [Q3] Which of the following social classes experiences feelings of inadequacy as the forward- and upward-moving society puts pressure on them to constantly do better? 1. Upper class 2. Middle class [correct] 3. Lower class 4. Underclass [Feedback for Answer Choice 1] Wealthy individuals may suffer from a fear of inadequacy, believing that they must continue to perform— not necessarily do better— or risk slipping to a lower class. [Feedback for Correct Answer 2] Middle-class White Americans may experience feelings of inadequacy, as the forward- and upward-moving society puts pressure on them to constantly do better. [Feedback for Answer Choice 3] If poor White Americans believe that the United States is a true meritocracy, then they risk carrying the double burden of feeling oppressed by the upper classes as well as guilt and shame for not having been more successful. However, since the lower class is often overlooked or looked down upon, this pressure is internal rather than societal. [Feedback for Answer Choice 4] If poor White Americans believe that the United States is a true meritocracy, then they risk carrying the double burden of feeling oppressed by the upper classes as well as guilt and shame for not having been more successful. However, since the under (lower) class is often overlooked or looked down upon, this pressure is internal rather than societal. [Q4] According to the research presented in the text, which of the following is not considered a White American ethnic value? 1. Independence 2. Individualism 3. Meritocracy 4. Help-seeking [correct] [Feedback for Answer Choice 1]

According to research presented in the text, Independence, rather than interdependence, is a White American ethnic value. [Feedback for Answer Choice 2] According to research presented in the text, Individualism, rather than collectivism, is a White American ethnic value. [Feedback for Answer Choice 3] Most White American ethnics believe the United States is a meritocracy. As such, all individuals have equal opportunities, regardless of racial status, and can succeed through hard work.

[Feedback for Correct Answer 4] According to research presented in the text, White American ethnics may believe that struggles in life should be overcome by individual effort, thus, a failure to overcome an obstacle is due to personal weakness. Consequently, asking for help is often seen as an admission of failure and cannot be considered a White American ethnic value.

Chapter 14 Application Exercises Application Exercise 14.1: Historical Development of White American Ethnic Identity Learning Outcome 14.2: Explain the development of a White American ethnic identity, the American Dream, and the American heritage. [Q1] Contrast the concept of the United States as a melting pot with the salad bowl view of American society presented in Chapter 14 [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

The term melting pot was commonly used as a metaphor to describe the process of combining a variety of cultural backgrounds and beliefs to create a new, virtuous (i.e., White American) culture, with the idea being it is okay to be different, as long as one accepts the mainstream.



The vision of the melting pot was an idealized notion used to demonstrate the United States as a utopia.



However, those who do not or cannot assimilate into the dominant culture are often excluded from adding their contribution or flavor to the cultural pot.



The popular notion of the United States as a melting pot began to dissolve during the civil rights movement of the 1960s and was replaced with a new sense of multiculturalism focusing on inclusion and ethnic pride.



Several metaphors have been suggested to replace the melting pot, such as viewing the United States as a salad bowl where several different ethnic flavors coexist and add to the overall culinary gestalt while maintaining their own distinct characteristics.

[Q2] Explain the connection between the American Dream and the idea of the United States as a meritocracy as discussed in Chapter 14. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

White American ethnicity and cultural values are commonly known as the American Dream.



One of the common beliefs perpetuated in the United States is that anyone can grow up to be a star, to own a business, even to be president of the country if they just work hard enough.



This belief is the prime example of the idea of a meritocracy where individual success is based on personal skills, abilities, and work ethic, rather than on external factors.



At its core, the American Dream and meritocracy represent the cultural belief in the agency of the individual.

[Q3] Discuss some critiques of the notion that America is a meritocracy as discussed in Chapter 14. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Meritocracy, to the degree that it exists, exists for a very narrow range of the American population.



For most of the population, there is not equitable access to resources, the playing field is decidedly not level, and although some are born into privilege, many others are born into oppression.



For White Americans to acknowledge that social factors inhibit the success of some groups is to acknowledge that the meritocracy, which is at the very core of many White Americans’ ethnic identity, is an illusion.

Application Exercise 14.2: The Challenges of Immigration Learning Outcome 14.5: Discuss the common experiences of stress and oppression and acculturation process for recent European American immigrants. [URL TITLE] Couple in Counseling [Q1] Use Pearson eText Video Example 14.3 to answer the following question. Pay particular attention to the information and issues the couple convey to their counselor. Using what you have learned from the video and the research in the text, what cultural concerns might the counselor consider with this couple? [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Individuals from European countries might hold traditional values, such as the man being the primary authority in a romantic relationship. This seems to be the case, as the husband speaks for his wife frequently in this clip. Accordingly, this traditional value might make it more difficult for the wife to take control of her own mental health and wellness.



Family is an important part of European culture, and special attention should be paid to the client’s relationships to people in the United States and in her home country.



As the client’s children become exposed to American customs, they might lose their European values that place family at the heart of life decisions and values.



The client seems to be grieving the loss of cultural norms of her home country and worried about her children’s adjustment to the new customs.



White immigrants might experience the assumption that they are acculturated into American society which can add additional stress and pressure onto European immigrants.



European immigrants might experience conflicting values and morals as they work toward acculturation in the United States.

[Q2] Use Pearson eText Video Example 14.3 to answer the following question. Pay particular attention to the information and issues the couple convey to their counselor. Using what you have learned from the video and the research in the text, how would you conceptualize the couple’s current cultural identity development? [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

The husband and wife may be facing a dilemma between maintaining their cultural heritage and integrating components of their new culture.



The couple may feel pressure to acculturate and accept American values and behaviors.



The wife may be in a stage of cognitive dissonance as she tries to hold on to her past cultural values while integrating aspects of her new culture.



The husband and wife are in a stage of identity deconstruction and reconstruction as they determine ways to maintain their cultural heritage while embracing aspects of American culture.

[Q3] Using what you have learned from Pearson eText Video Example 14.3 and the research in the text, pay particular attention to the information and issues the couple convey to their counselor. Using what you have learned from the video and the research in the text, what models of multicultural counseling might the counselor use? [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

The counselor could implement a variety of evidence-based practices in culturally responsive ways. For example, the client might benefit from cognitive-behavioral therapy (CBT) for depressive symptoms. The counselor could implement CBT interventions while keeping multicultural issues at the forefront of the conceptualization.



Counselors might work to become aware of themselves by asking questions such as: ―Who am I?,‖ ―Who am I with you?,‖ and ―Who are we together?‖



Humanistic approaches that place the therapeutic relationship at the forefront of client change can be used to demonstrate relationships that are typical in American society or to provide support similar to that from the client’s original culture.



Counselors might utilize Adlerian theory to understand the client’s cultural heritage and identify ways to promote social belongingness in the new cultural setting.

Application Exercise 14.3: Cultural Considerations for Counseling White Clients Learning Outcome 14.6: Describe the counseling implications while counseling White individuals and commonly found mental health issues.

[Q1] Based on the research presented in the text, highlight some of the gaps in the current literature related to the experiences and mental health issues of White Americans and individuals of European descent. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

The diversity of experiences of White Americans and individuals of European descent.



Future research is needed to examine how specific counseling interventions promote or hinder the well-being of White individuals of European descent.



Future inquiry should also seek to understand how intersecting identities impact the mental health and well-being of White individuals.

[Q2] Based on the research presented in the text, explain how White American cultural values can influence mental health. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

The cultural belief in a meritocracy can lead to feelings of inferiority and shame (―hidden injuries‖) over perceived failures, particularly among working-class White men and women.



As White Americans may believe that struggles in life should be overcome by individual effort, it follows that a failure to overcome an obstacle is due to personal weakness.



Because asking for help is often seen as an admission of failure, people and families commonly build rigid boundaries and adopt a ―no-help necessary‖ policy.

[Q3] Based on the research presented in the text, provide a brief explanation of how narrative counseling approaches can be utilized to address the issues and concerns of White clients. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

The narrative approach consists of three core phases: deconstructing the dominant culture narrative, externalizing the problem, and reauthoring the story.



Deconstructing the dominant narrative can help clients gain greater awareness of how their life has been influenced by experiences of inferiority or superiority and how these experiences help them in finding mutuality and authenticity in relationships.



Externalizing problems may be particularly helpful for White immigrants from cultures who have a tendency toward self-blame and feelings of guilt and shame.



Counselors can also prompt their White clients to reflect on personal strengths used in the past and how these strengths might be used to work through present challenges. This process can help clients as they deconstruct and reconstruct their ethnic identities.



Narrative approaches can help rebuild a sense of identity and self-efficacy for White immigrants, through sharing stories from their home countries and helping them construct new and hopeful narratives about life in the United States.

Chapter 14 Test Items Multiple Choice 1.

In the Middle Ages, people were identified as ―Europeans‖ based upon a. physical characteristics. b. cultural practices. c. adoption of Christianity. d. All of the above.

Most early European immigrants came to North America a. out of a sense of adventure. b. to pursue religious freedom. c. to avoid taxation without representation. d. for economic reasons.

English became the primary language for the colonies because a. the English were the first to settle in the colonies. b. English immigrants were the dominant social/political group. c. the British throne decreed it. d. the colonies voted for English to be the official language.

Originally, the term ―melting pot‖ was used to describe the United States as a a. leading industrial nation. b. place where everyone could live in peace. c. utopia where various cultures would be combined to create a new culture. d. hot spot for cultural events such as art, music, and theater.

The American Dream is, in many ways, the manifestation of the a. melting pot. b. rebellious nature of European immigrants. c. White American ethnic cultural values. d. philosophy of open immigration.

The term refers to individuals living in the United States who are recent immigrants from or identify closely with the European heritage in terms of values, traditions, and worldview. a. Caucasian b. European American c. White American ethnic d. All of the above

The term describes individuals of European descent who ethnically identify themselves as American, and who have adopted the culture, traditions, and values of the dominant culture in the United States. a. Caucasian b. European American c. White American ethnic d. All of the above

Which of the following metaphors has/have been suggested to replace the term ―melting pot,‖ to align more appropriately with multiculturalism, inclusion, and ethnic pride? a. Salad bowl b. Quilt c. Both of the above d. None of the above

Which of the following is a necessary prerequisite for a true meritocracy to exist? a. A level playing field regarding education and opportunity. b. An egalitarian society. c. Individual success being due to ability and work rather than external and/or systemic help. d. All of the above.

10. The National Heritage of the United States was developed in large part due to a. a national commitment to separate from European cultural norms. b. a grassroots effort to create a collective memory among U.S. residents. c. the U.S. Department of Defense funding war monuments in the early 1900s. d. a call for immigrants to assimilate more completely into U.S. culture. 11. Referring to their own ethnic identity, many White American ethnics a. do not see themselves as having an ethnicity. b. are uncomfortable talking about ethnicity and ethnic differences. c. describe themselves as ―regular Americans.‖ d. All of the above. 12. According to Sue, ethnocentric monoculturalism refers to a. White Americans’ failure to recognize their own ethnocentric beliefs and values. b. the national heritage of post-colonial immigrants. c. the process of acculturation for European immigrants. d. All of the above

13. The idea of which individuals and groups are considered ―White Americans‖ a. has been consistent throughout the history of the United States. b. has evolved over time in response to immigration patterns. c. is based on biological differences between the races. d. was expanded in the 1900s in response to official legislation. 14. A growth in the American middle class following World War II is most clearly related to a. a desire for education in light of the atrocities of the Nazi party. b. women entering the workforce in record numbers. c. more people being considered ―White.‖ d. soldiers going to college under the GI Bill. 15. The process of ―becoming White‖ most closely refers to a. marrying into European-descent families. b. the process of accepting the privileges that are afforded to White Americans. c. formally rejecting one’s previous cultural heritage. d. moving into middle-class America. 16. When conceptualizing a White American, which of the following within-group variables will be important to consider? a. Geographic variables b. European-American identity c. Socioeconomic class d. All of the above within-group variables are important to consider. 17. Which European ethnicity makes up the largest percentage of European Americans today? a. Irish b. Italian c. English d. German 18. Compared to non-European immigrants, the process of immigration to the United States for Europeans a. is fundamentally different because language issues are not as much of a problem. b. has many similar aspects, such as feelings of grief, underemployment, and difficulties adjusting to culture. c. is much easier because they can become White. d. is more difficult because of recent legislation. 19. Overt discrimination against European immigrants is more likely to occur a. against children and adolescents. b. at the hands of other European immigrants.

c. when immigrants have noticeable differences compared to the majority culture. d. All of the above. 20. The belief in a meritocracy can contribute to mental health concerns by a. creating a racist society. b. putting an emphasis on adaptive fatalism. c. creating a lower class. d. leading to feelings of guilt and shame. 21. Many European Americans and White American ethnics grew up in families that discouraged emotional expression in favor of a. the family’s welfare. b. self-control and self-sufficiency. c. a strong work ethic. d. a collectivist society. 22. Many White American ethnics, and in particular males, are less likely to seek counseling for emotional complaints, and more likely to seek counseling with concerns about a. other people’s emotions. b. their ability to function autonomously. c. family relations. d. All of the above. 23. Part of the power of many group counseling approaches with European American and White American ethnics is a. the development of relationships with the group leader based on European American cultural norms. b. the development of relationships with peers within the group that are very different from cultural norms. c. identify behavior patterns that are not culturally appropriate. d. All of the above. 24. Which of the following is important in understanding a White American ethnic client from a multicultural perspective? a. An understanding of the cultural worldview of White American ethnics. b. A culturally based concept of the client’s specific beliefs and values. c. Understanding the role that cultural values may play in the client’s presenting problem. d. All of the above are important. 25. From a multicultural perspective, a White American adolescent who experiences isolation from peers and feels that she does not fit in anywhere may be experiencing a. a conflict between personal values and cultural values. b. a loss of privilege due to rejecting his or her culture.

c. White guilt. d. acculturation issues. 26. Counselors of color working with White American clients may want to a. instruct clients about the damage that privilege causes to society. b. avoid talking about culture as much as possible. c. help build client awareness of White American ethnic cultural values through selfdisclosure and meaningful discussion within a strong working relationship. d. All of the above. 27. European immigrant children and adolescents often first receive counseling a. at the request of their parents. b. through school referrals in response to academic concerns. c. for behavior problems. d. in order to help their families cope with transitions. 28. Counselors working with recent European immigrants can encourage clients to share stories from their home country so that a. the counselor can better understand the client. b. the client can rebuild and/or reconnect with his sense of identity. c. the client can begin to construct a new story in the United States. d. All of the above. 29. Ethnocentric monoculturalism is a. an overt form of racism. b. easily detected by the dominant group. c. more subtle and often invisible to the majority culture. d. All of the above. 30. The major difference between enculturation and acculturation is a. enculturation is generally seen as positive, while acculturation is generally seen as negative. b. enculturation occurs when a person learns the values, beliefs, and rituals of their primary culture, while acculturation results in acquisition of a secondary set of cultural norms. c. enculturation is the choice of the person entering a new culture, where acculturation is forced on an individual by the dominant culture. d. there is no practical difference. 31. Most European refugees entering the United States in recent years come from a. Russia. b. former Soviet Union countries (e.g., Ukraine, Moldova).

c. Both of the above. d. None of the above. 32. Recent research on acculturation suggests that a. acculturation follows very predictable developmental stages. b. immigrants and refugees feel relieved when they are fully acculturated. c. the acculturation process is a complex and cyclical process. d. it should be a goal of counseling. 33. When working with recent European immigrants, counselors should a. attend to both pre- and post-migration stressors. b. be aware of client factors related to identity deconstruction and reconstruction. c. understand that stressors may have begun long before the relocation event. d. All of the above. 34. Meritocracy, or the belief that individual success is based on personal skills, abilities, and work ethic, a. upholds equality. b. justifies inequality. c. exists for all cultures and groups of the American population. d. considers external factors when determining success. 35.

instills in members of a dominant group a belief in the superiority of the values and practices of that group, without making the individuals aware that their beliefs are culturally based. a. Ethnocentric monoculturalism b. Ethnocentric multiculturalism c. Privilege d. Oppression

36. All of the following factors facilitate the invisibility of systemic and systematic oppression EXCEPT a. the belief in a meritocracy. b. rationalizations for civilizing communities deemed godless or uncivil. c. the adoption of the salad bowl metaphor. d. common teachings that racism only occurs through individual acts of meanness. 37. A new, vast a. lower b. middle c. upper d. wealthy

class was created when soldiers attended college under the GI Bill.

38.

are noncitizens of a host country who did not go through the procedures established by the host country’s policies. a. International students b. Undocumented immigrants c. Refugees d. All of the above.

39.

are people living outside their native country who are granted permission to reside in a host country because they are unable to return to their native country. a. International students b. Undocumented immigrants c. Refugees d. All of the above.

40. An example of an immigration stressor is a. isolation. b. disconnection from community, family, and friends. c. communication difficulties. d. All of the above. 41. Ethnic identity reconstruction is a. an interactional model in which individuals participate in a process of building ideas about one’s identity through discourse with others within important social contexts. b. a model of acculturation for recent European American immigrants. c. a model commonly used in group counseling settings and in schools. d. All of the above. 42. Which of the following statements is true regarding mental health issues of White American ethnic clients? a. The value on youth and the characteristics associated with youth contribute to emotional difficulties of older adults. b. Individualism may play a role in marriage problems. c. Due to the value placed on independence, failure to overcome an obstacle is perceived as personal weakness. d. All of the above statements are true. 43. All of the following counseling approaches stress the importance of European and White American values (e.g., individual responsibility, commitment to work hard) in the healing process EXCEPT a. a psychodynamic approach. b. a humanistic approach.

c. Adlerian. d. reality therapy. 44.

describe values and beliefs within the White American cultural framework that are in conflict with one another or conflict with the reality of the situation. a. Intracultural conflicts b. Intercultural conflicts c. Internalized conflicts d. None of the above.

45. Helping clients develop insight or deepen awareness is a concept known as a. dream analysis. b. the unconscious. c. consciousness-raising. d. autonomous thinking. 46. The approach to counseling may be particularly helpful for European immigrants because of its wellness orientation that emphasizes the human potential to continually learn. a. psychodynamic b. behavioral c. narrative d. solution-focused

Extended Response 1.

What physical, geographical, cultural, and religious factors contributed to the creation of the geographic region we now refer to as Europe?

Although the early White American ethnicity was based primarily on British cultural norms, the geographic setting (e.g., open ―unsettled‖ land, variety of landscapes) also influenced the developing culture. In what ways do you believe that geography of the North American continent influenced cultural norms and beliefs of the White American ethnic, and how might they be playing out today?

The image of the United States as a great melting pot has been replaced by other metaphors, such as the salad bowl (Lee, 2013). Discuss the similarities and differences between these two metaphors, as well as social changes that contributed to the change in metaphors.

The belief in a meritocracy can have both positive and negative effects on citizens. Describe how the belief in a meritocracy can help people succeed, and how it may provide additional barriers to success for others. Who do you think may benefit most from a meritocracy?

The melting pot, the American dream, and national heritage were presented in this chapter as important components of the White American ethnicity. Although presented independently, they are clearly related and interrelated. What are some common factors of these concepts? How do you see them being related to each other?

Ethnocentric multiculturalism can lead to a subtle yet pervasive form of oppression by convincing the majority culture that their beliefs are ―universal truths.‖ Identify some common culturally based beliefs and/or values that are often perceived as ―universal truths‖ by the majority culture in the United States.

How is the process of immigrating to the United States for Europeans like the immigration process for non-European immigrants? How is it different?

Shame and guilt were discussed as a by-product of White American ethnic values. Describe how you see European American and White American ethnic cultural values contributing to feelings of guilt and shame, as well as the way feelings of guilt and shame may become manifest as mental health concerns.

Multicultural counseling has not historically been presented as an approach to take when working with European Americans or White American ethnics. What advantages do you believe using a multicultural approach may have when working with clients of European descent?

10. What role do you believe privilege plays in White American ethnics being largely unaware of their cultural values and uncomfortable discussing ethnicity? 11. Discuss how the narrative approach to counseling and creative arts can be helpful for European immigrant clients. 12. Discuss how the confusion over the meaning of ethnicity in the United States may contribute to many White Americans’ resistance to the concept of multiculturalism. 13. Discuss the role that the U.S. Department of Defense played in creating the beginning of a national American heritage. 14. Discuss and explain the following statement: For a true meritocracy to exist, privilege must be denied. 15. Identify the common mental health concerns of recent European immigrants, refugees, and international students.

Chapter 14 Test Answer Key ANSWER KEY: Chapter 14 Test (Multiple Choice) 1. d 2. d 3. b 4. c 5. c 6. b 7. c 8. c 9. d 10. c 11. d 12. a 13. b 14. d 15. b 16. d 17. d 18. b 19. c 20. d 21. b 22. b 23. b 24. d 25. a 26. c 27. b 28. d 29. c 30. b 31. c 32. c

33. d 34. b 35. a 36. c 37. b 38. b 39. c 40. d 41. a 42. d 43. b 44. a 45. c 46. c

Chapter 15 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach

4th Edition Danica G. Hays University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents

Chapter 15: Individuals and Families of Multiracial Descent

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 15: Individuals and Families of Multiracial Descent Chapter 15 Learning Outcome Quizzes Learning Outcome 15.1: Define key terms associated with the multiracial population. [Q1] The terminology used to describe multiracial individuals has expanded. Which of the following terms reflects part of this expanded terminology? 1. Mixed 2. Multi-ethnic [correct] 3. Non-monoracial 4. Dual-national [Feedback for Answer Choice 1] Mixed is not typically a term used to describe multiracial individuals. The term mixed-race is a more appropriate and commonly accepted description. [Feedback for Correct Answer 2] The term multi-ethnic reflects the expanded terminology used to describe multiracial individuals. [Feedback for Answer Choice 3] Non-monoracial is occasionally used in the academic literature when defining the expanded terms used to describe multiracial individuals; however, the word itself does not constitute one of the expanded terms. [Feedback for Answer Choice 4] Dual-national is a legal term denoting dual citizenship. Holding citizenship in two countries may, but not always, reflect an individual’s racial or ethnic heritage. Therefore, it is not an accurate or commonly used term to describe multiracial individuals. [Q2] The term multi-ethnic is meant to convey the: 1. multiple dimensions of identity. 2. quantity of racial identities in a person. 3. cultural experiences that occur from two or more ethnicities. [correct] 4. backgrounds that include identities other than race. [Feedback for Answer Choice 1] The term multiple heritage speaks to the multiple dimensions of identity. [Feedback for Answer Choice 2] The term biracial is used to describe the quantity of racial identities in a person.

[Feedback for Correct Answer 3] The term multi-ethnic is meant to convey the cultural experiences that occur from two or more ethnicities and describe the facets of culture that cannot be encompassed through traditional ideas of race that are often limited to phenotype. [Feedback for Answer Choice 4] The term multiple heritage also speaks to backgrounds that include identities other than race. [Q3] The term interracial is synonymous with the meaning of which of the following terms? 1. Multiracial [correct] 2. Multi-ethnic 3. Dual-national 4. Multiple heritage [Feedback for Correct Answer 1] Like the term mixed-race, the term interracial is essentially synonymous with the meaning of multiracial. It is not intended to convey anything more than multiple races that comprise an individual’s identity. [Feedback for Answer Choice 2] Multi-ethnic is meant to convey the facets of culture that cannot be encompassed through traditional ideas of race that are often limited to phenotype. [Feedback for Answer Choice 3] Dual-national is a legal term denoting dual citizenship. Holding citizenship in two countries may, but not always, reflect an individual’s racial or ethnic heritage. [Feedback for Answer Choice 4] The term multiple heritage speaks to the multiple dimensions of identity, culture, and backgrounds of members of this population that include identities other than race [Q4] When counseling multiracial families, it is important for counselors to: 1. recall prior coursework on multiracial families. 2. avoid inquiring about the family’s racial-ethic background. 3. discretely ascertain the multiple racial identities within the family. 4. use the terminology the family uses to describe their identity. [correct] [Feedback for Answer Choice 1] Prior coursework on multiracial families may provide general information and concepts that may be helpful in working with a particular family. However, it is important to inquire about the unique and salient components of the family’s racial and ethnic identities.

[Feedback for Answer Choice 2] Counselors should be comfortable with broaching issues related to race and identity. This task is critical and should not be avoided. [Feedback for Answer Choice 3] Again, counselors should be comfortable with broaching issues related to race and identity. These approaches should be direct rather than discrete. [Feedback for Correct Answer 4] When counseling multiracial families, it is important for counselors to use the terminology the family uses to describe their identity. Allowing clients to identify themselves removes any preconceived notions that the counselor might have about the client’s racial make-up and demonstrates respect and cultural sensitivity. Learning Outcome 15.2: Understand U.S. demographic trends of the multiracial population. [Q1] U.S. interracial marriages have been on the rise since: 1. 1957 2. 1967 [correct] 3. 1977 4. 1987 [Feedback for Answer Choice 1] In 1957, some states still had laws against interracial marriage. [Feedback for Correct Answer 2] U.S. interracial marriages have been on the rise since the 1967 U.S. Supreme Court’s Loving decision struck down remaining laws against interracial marriage. [Feedback for Answer Choice 3] While interracial marriage continued to rise in the 1970s, this trend dates back to the U.S. Supreme Court’s Loving decision. [Feedback for Answer Choice 4] While interracial marriage continued to rise in the 1980s, this trend dates back to the U.S. Supreme Court’s Loving decision. [Q2] According to Rico et al. (2018), the prevalence of interracial marriage rose to 1. 7.4 2. 10.2 [correct] 3. 11 4. 18

% in 2016.

[Feedback for Answer Choice 1] According to Rico et al. (2018), the prevalence of interracial marriage was 7.4% in 2000. [Feedback for Correct Answer 2] According to Rico et al. (2018), the prevalence of interracial marriage rose to 10.2% in 2016. [Feedback for Answer Choice 3] According to Livingston and Brown (2017), in 2015, 11% of marriages were interracial in rural areas compared to 18% in metropolitan cities. [Feedback for Answer Choice 4] According to Livingston and Brown (2017), in 2015, 18% of marriages were interracial in metropolitan cities compared to 11% in rural areas. [Q3] Data on intermarriage continue to reveal that certain groups are more likely to intermarry than others. Which racial-ethnic group had the highest rate of intermarriage in 2015? 1. Asian or Asian American descent [correct] 2. Latin or Latin American descent 3. African or African American descent 4. European or European American descent [Feedback for Correct Answer 1] In 2015, 29% of those identifying as Asian or Asian American descent married a person of a different racial background. [Feedback for Answer Choice 2] In 2015, 27% of those identifying as Latin or Latin American descent married a person of a different racial background. [Feedback for Answer Choice 3] In 2015, 18% of those identifying as African or African American descent married a person of a different racial background. [Feedback for Answer Choice 4] In 2015, 11% of those identifying as European or European American descent married a person of a different racial background. [Q4] Data on intermarriage continue to reveal that certain groups are more likely to intermarry than others. Which racial-ethnic group had the lowest rate of intermarriage in 2015? 1. Asian or Asian American descent 2. Latin or Latin American descent 3. African or African American descent 4. European or European American descent [correct]

[Feedback for Answer Choice 1] In 2015, 29% of those identifying as Asian or Asian American descent married a person of a different racial background. [Feedback for Answer Choice 2] In 2015, 27% of those identifying as Latin or Latin American descent married a person of a different racial background. [Feedback for Answer Choice 3] In 2015, 18% of those identifying as African or African American descent married a person of a different racial background. [Feedback for Correct Answer 4] In 2015, 11% of those identifying as European or European American descent married a person of a different racial background. Learning Outcome 15.3: Identify contextual factors that influence the counseling process with multiracial clients. [Q1] Working with families and individuals of multiracial descent requires counselors to have knowledge of the various models that explain the identity development processes of these individuals. The Multiracial Identity Development Model proposed by Jacobs (1992) fundamentally differs from which of the follow Models? 1. Poston (1990) 2. Root (1990) 3. Phinney (1993) [correct] 4. Kerwin and Ponterotto (1995) [Feedback for Answer Choice 1] Like the Model proposed by Jacobs (1992), Poston (1990) presents a developmental model that spans from childhood through adulthood. [Feedback for Answer Choice 2] Like the Model proposed by Jacobs (1992), Root (1990) presents a developmental model that spans from childhood through adulthood. [Feedback for Correct Answer 3] Unlike the Model proposed by Jacobs (1992), Phinney (1993) presents a developmental model that only spans the period of adolescence. [Feedback for Answer Choice 4] Like the Model proposed by Jacobs (1992), Root Kerwin and Ponterotto (1995) present a developmental model that spans from childhood through adulthood.

[Q2] Awareness of biracial status is Stage 3 of which of the following Multiracial Identity Development Models? 1. Poston (1990) 2. Jacobs (1992) 3. Phinney (1993) 4. Kerwin and Ponterotto (1995) [correct] [Feedback for Answer Choice 1] Stage 3 of the Model proposed by Poston (1990) relates to enmeshment/denial and the experience of being confused by a single identity choice. [Feedback for Answer Choice 2] Establishing a biracial identity is Stage 3 of the Model proposed by Jacobs (1992). [Feedback for Answer Choice 3] Achieved ethnic identity is Stage 3 of the Model proposed by Phinney (1993). [Feedback for Correct Answer 4] Awareness of biracial status is Stage 3 of the Model proposed by Kerwin and Ponterotto (1995). [Q3] Villegas-Gold and Tran (2018) explored the role of racial socialization in the multiracial population and found that appreciation for diversity and in one’s upbringing positively impacted overall well-being and a multiracial integrated identity. 1. positive role models 2. family characteristics 3. cross-racial engagement [correct] 4. visible identity factors [Feedback for Answer Choice 1] Positive role models certainly hold the potential to impact the well-being and identity development of multiracial individuals. However, this phenomenon was not investigated by Villegas-Gold and Tran (2018). [Feedback for Answer Choice 2] The Root (2002) Ecological Framework for Understanding Multiracial Identity Development provides a perspective of how family characteristics influence and shape Multiracial identity. [Feedback for Correct Answer 3] Villegas-Gold and Tran (2018) explored the role of racial socialization in the multiracial population and found that appreciation for diversity and cross-racial engagement in one’s upbringing positively impacted overall well-being and a multiracial integrated identity.

[Feedback for Answer Choice 4] The Root (2002) Ecological Framework for Understanding Multiracial Identity Development provides a perspective of how visible identity factors influence and shape Multiracial identity. [Q4] According to the Ecological Framework for Understanding Multicultural Identity Development, Misidentification by Strangers is listed is which of the following categories? 1. Phenotype [correct] 2. Traits and Aptitudes 3. Family Socialization 4. Community Attitudes and Racial Socialization [Feedback for Correct Answer 1] According to the Ecological Framework for Understanding Multicultural Identity Development, Misidentification by Strangers is listed in the Phenotype category. [Feedback for Answer Choice 2] The Traits and Aptitudes category of the Ecological Framework for Understanding Multicultural Identity Development lists qualities such as temperament, social skills, giftedness, and health. [Feedback for Answer Choice 3] The Family Socialization category of the Ecological Framework for Understanding Multicultural Identity Development lists qualities such as home language, parent’s identity, nativity, given names, and home values/spirituality. [Feedback for Answer Choice 4] The Community Attitudes and Racial Socialization category of the Ecological Framework for Understanding Multicultural Identity Development lists: school/work, community, friends, and new community. Learning Outcome 15.4: Understand and utilize key concepts and techniques in the counseling process with multiracial clients that underscore the Multicultural and Social Justice Counseling Competency framework and Competencies for Counseling the Multiracial Population. [Q1] Which of the following interventions would be inappropriate to use in an individual counseling session with a multiracial college student? 1. Bibliotherapy 2. Homework assignments 3. Validation-gram [correct] 4. Behavioral goal setting

[Feedback for Answer Choice 1] Bibliotherapy—or the therapeutic use of books—is an appropriate intervention to use in an individual counseling session with a multiracial college student. [Feedback for Answer Choice 2] Assigning homework to complete between counseling sessions is an appropriate intervention to use in an individual counseling session with a multiracial college student. [Feedback for Correct Answer 3] A validation-gram is not an intervention that is delivered during individual counseling sessions. Rather, it is a tool used by couples counselors to help partners in interracial marriages to practice validating themselves and their partner. [Feedback for Answer Choice 4] Behavioral goal setting is also a useful intervention for multiracial college students. [Q2] According to Brown et al. (2019), counselors should help adult clients of multiracial descent: 1. utilize genograms to explore what it means to be multiracial. 2. develop coping skills that are affirming and foster resiliency. [correct] 3. examine the influences of family relationships and dynamics. 4. explore the client’s denial of cultural or racial significance. [Feedback for Answer Choice 1] Logan et al.’s (1987) ecological approach provides a framework for utilizing genograms to explore what it means to be multiracial. [Feedback for Correct Answer 2] According to Brown et al. (2019), counselors should help adult clients of multiracial descent develop coping skills that are affirming and foster resiliency. [Feedback for Answer Choice 3] According to Logan et al.’s (1987) ecological approach, utilizing genograms can help multiracial clients examine the influences of family relationships and dynamics. [Feedback for Answer Choice 4] Logan et al.’s (1987) ecological approach provides a framework for utilizing the cultural continuum tool to explore the client’s denial of cultural or racial significance. [Q3] According to Harris (2009), the most important skill counselors must use when working with children of multiracial descent is: 1. culturally sensitive listening. [correct] 2. culturally sensitive interventions. 3. developmentally appropriate language.

4. family counseling approaches to involve a significant parent/adult. [Feedback for Correct Answer 1] According to Harris (2009), the most important skill counselors must use when working with children of multiracial descent is culturally sensitive listening. [Feedback for Answer Choice 2] Using culturally sensitive interventions is a foundational component of working with children of multiracial descent; however, Harris (2009) does not list it as the most important skill. [Feedback for Answer Choice 3] Using developmentally appropriate language is another vital component of working with children of multiracial descent; however, Harris (2009) does not list it as the most important skill. [Feedback for Answer Choice 4] Using family counseling approaches to involve a significant parent/adult is something that counselors should consider when feasible; however, Harris (2009) does not list it as the most important skill working with children of multiracial descent. [Q4] Using a family sculpture activity to help a family explore the way in which they respond to questions about how they identify, is a technique that is drawn from which of the following theoretical orientations? 1. Solution-Focused Family Therapy 2. Structural Family Therapy 3. Narrative Family Therapy 4. Experiential Family Therapy [correct] [Feedback for Answer Choice 1] Family therapists operating from a solution-focused perspective might use exceptions questions or the Miracle Question to explore issues related to multiracial identity. [Feedback for Answer Choice 2] Family therapists operating from a Structural perspective might use techniques such as roleplaying and reframing. [Feedback for Answer Choice 3] Narrative family therapists might invite clients to externalize conversations about their identity or imagine telling their story of identity in front of a supportive audience. [Feedback for Correct Answer 4] Family sculpting is a hallmark of Experiential Family Therapy.

Chapter 15 Application Exercises Application Exercise 15.1: The Growing Multiracial Population Learning Outcome 15.2: Understand U.S. demographic trends of the multiracial population. [Q1] Based on the research in the text, highlight some of the important historical events that contributed to an increase in interracial marriages over the past 60 years. [Q1 MODEL RESPONSE] Based on the research in the text, your answer should include some of the following points: 

The first and most salient historical event was the landmark Loving v. Virginia (1967) Supreme Court decision, which struck down all U.S. laws against interracial marriage.



Encouraged by the progress being made in other arenas of the Civil Rights Movement, the Lovings sought the assistance of the U.S. Attorney General’s Office and the American Civil Liberties Union. On June 12, 1967, the U.S. Supreme Court voted unanimously in favor of the Lovings.



The U.S. Supreme Court’s 1967 Loving decision made illegal the anti-miscegenation laws that remained on the books of Virginia and 16 other states, including Alabama, Arkansas, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, and West Virginia.



The 1980s and early 1990s saw the emergence of a multiracial civil rights movement. Led by multiracial individuals and families, it was a movement that saw the development of organizations around the country geared toward bringing public consciousness and positive awareness of the issues and concerns of the multiracial population to the forefront.

[Q2] Based on the research in the text, describe the projected growth of the multiracial population in the United States over the next 40 years. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

In 2018, 2.4% of the population identified as multiracial.



By 2060, the total U.S. population is expected to reach more than 404 million, with a substantial decrease in the proportions of White individuals and a significant increase in the percentage of multiracial individuals (6.2%).

[Q3] Based on the research in the text, provide some of the key statistics related to the current prevalence and social acceptability of interracial marriage in the United States.

[Q3 MODEL RESPONSE] Based on the research in the text, your answer should include some of the following points: 

U.S. interracial marriages have been on the rise since the 1967 U.S. Supreme Court’s Loving decision struck down remaining laws against interracial marriage.



One in 10 individuals who married in 2015 had a racially or ethnically different spouse.



In 2015, 29% of those identifying as Asian or Asian American descent, 27% of those identifying as Latin or Latin American descent, 18% of those identifying as African or African American descent, and 11% of those identifying as White or European Descent married a person of a different racial background.



Black men are twice as likely as Black women to marry someone of a different race.



Women of Asian American or Asian descent are more likely (one-third of Asian newlywed women) than men of Asian American or Asian descent to marry someone of a different race. Regional patterns related to interracial marriage consistently reveal that the rates for these marriages tend to be highest in the metropolitan United States.



In 2015, 18% of marriages were interracial in metropolitan cities compared to 11% in rural areas.

Application Exercise 15.2: Counseling Multiracial Individuals, Couples, and Families Learning Outcome 15.3: Identify contextual factors that influence the counseling process with multiracial clients. [Q1] Based on the research in the text, describe some of the factors that influence positive racial identity and well-being for multiracial individuals. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

The achievement of a positive racial and cultural identity and self-concept depends on individuals’ support systems, how concerns are managed at each age and phase of life, and the strengths, assets, and inner resources that come with developmental growth and maturity.



The level of understanding and support provided by family and salient others, and the way the individual negotiates these themes, have implications for positive and healthy identity development, identity integration, and psychological adjustment throughout the life span.

[Q2] Based on the research in the text, discuss some of the protective factors and support systems that promote well-being for interracial couples. [Q2 MODEL RESPONSE] Your answer should include some of the following points:



Knowledge of the history of one’s race and positive views about one’s race on the part of both partners in the relationship is seen as a positive influence of relationship satisfaction.



The issue of gender role fairness regarding household chores, childcare, decisionmaking processes, sexual relationships, and finances has also been discussed as contributing to relationship satisfaction.



The resilience of interracial couples may be a result of the support that they receive from friends, family, and co-workers and may also lie within the many strengths and assets that may be afforded to them as individual partners and as couples.



These strengths and assets include that they are often more socially connected, that they have gained maturity because of overcoming adversity, and that they have distanced ―themselves from negative environments and hostility.‖

[Q3] Based on the research in the text, highlight some of the social and emotional challenges that may persist for interracial families. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Interracial couples must deal with societal perceptions toward their offspring and families who are multiracial.



Prevailing myths and stereotypes also portray multiracial individuals as destined to have social and psychological problems; have low self-esteem; and be troubled, lost, and confused about their identity (Franco et al., 2020).



Parents and children alike frequently deal with curiosities and assumptions regarding the child’s racial identity based on their physical appearance.



The physical appearance of individuals of multiracial descent may make it difficult to discern where they fit in terms of mainstream racial ideologies and perceptions.

Application Exercise 15.3: Culturally Sensitive Approaches to Counseling Multiracial Clients Learning Outcome 15.4: Understand and utilize key concepts and techniques in the counseling process with multiracial clients that underscore the Multicultural and Social Justice Counseling Competency framework and Competencies for Counseling the Multiracial Population. [Q1] Based on the research in the text, discuss some of the mindsets and clinical skills necessary for promoting a strong counseling relationship with multiracial clients. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Counselors should be self-aware, knowledgeable, skilled, and action-oriented in understanding the impact and influence of the counseling relationship on multiracial clients.



Counselors play critical roles in conversations around race, identity, and discrimination with their clients.



Broaching issues related to the client’s salient identities can enhance the counseling relationship and increase understanding the client’s worldview.



Broaching also validates both the multiple identities held by the client and counselor and invites a discussion of the impact of these identities on the counseling relationship.

[Q2] Based on the research in the text, describe several ways that a counselor can advocate for the interracial couples with whom they work. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Partners or couples who present for counseling to address race- and culture-related objections to their relationship will benefit from counselors who have knowledge of the underlying racial and cultural biases associated with these objections and who can empathize with and affirm the partner’s or couple’s feelings.



Counselors should help the partner or couple to explore and use their individual and relational strengths to address and respond to objections and negative reactions.



The counselor may also want to assess sources of support and validation available to the partner or couple for dealing with the objections and possible ramifications.



Implement the strategies recommended by Seshadri and Knudson-Martin (2013).



Utilize the Interracial Couple Questionnaire developed by Watts and Henriksen (1998).



Use narrative techniques to help partners to explore their level of satisfaction with the relationship, the effectiveness of their communication, and to address and deal with their concerns.



Utilize Ishiyama’s (2006) self-validation model and/or Ibrahim and Schroeder’s (1990) psychoeducational approach.

[Q3] Based on the research in the text, highlight one intervention a counselor may utilize to advocate for a multiracial adolescent client. [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Henriksen and Maxwell (2016) suggested that in assessing the concerns of adolescents of multiracial descent, counselors should be cognizant of potential conflicts related to major psychosocial tasks of development in adolescence.



The level of support of family and others of significance to the adolescent should be established from the start of the counseling process.



Perceptions and views of family members should also be assessed, along with the perceptions, views, and level of accessibility and connection with extended family members.



Counselors must assist adolescent multiracial clients in exploring all aspects of their racial identity to help them develop a positive self-image.



Other strategies that are useful for assisting adolescents of multiracial descent with exploring their racial identity and developing a positive self-concept include focused discussions, bibliotherapy, and homework assignments.



Role-playing, journaling, storytelling, and behavioral goal setting may also be helpful for this age group.

Chapter 15 Test Items Multiple Choice 1.

The term population.

has not been typically used to discuss or describe the multiracial

a. mixed race b. multicultural c. biracial d. multiple heritage 2.

The multiracial population includes a. interracial couples. b. multiracial individuals. c. multiracial families. d. All of the above.

The earliest documented interracial relationships in American society were between a. indigenous female inhabitants and early White male settlers. b. African slaves and indigenous inhabitants. c. White male settlers and Asian female immigrants. d. None of the above.

The first anti-miscegenation laws were enacted in a. 1619. b. 1664. c. 1958. d. 1967.

The Supreme Court’s landmark Loving v. Virginia decision occurred in a. 1896. b. 1948. c. 1967. d. 1954.

Hypodescent is also known as a. mixed race. b. the one-drop rule. c. monoracial identity. d. multiple heritage.

was NOT established as a multiracial organization. a. Interracial/Inter-cultural Pride b. Association of Multi-Ethnic Americans c. National Association for the Advancement of Colored People d. Project RACE

The compromised classification change for the 2000 Census allowed a person to check a. a multiracial category. b. two or more races. c. other. d. Hispanic.

Of the 9 million people identified as being of two or more races in the 2010 Census, 4.2 million were identified as being a. over the age of 50 years. b. between ages 30 to 40 years. c. under the age of 18 years. d. between ages 20 to 30 years.

10. Which of the following statements regarding regional patterns of interracial marriage is true? a. Interracial marriage rates tend to be highest in the western United States. b. Interracial marriage rates tend to be lowest in the southern United States. c. Both of the above. d. None of the above. 11.

did NOT propose an early model of the identity development process of multiple heritage individuals. a. Root b. Marcia c. Poston d. Kich

12. The Root (1998) ecological identity model derived from her work with multiple heritage individuals with backgrounds. a. African American b. Native American c. Asian d. Latino 13. Prevailing societal images suggest that interracial couples are only a. Native American and White.

b. Latino and Asian. c. Asian and Black. d. Black and White. 14.

are individuals whose biological parents or whose lineage are of two or more different socially constructed racial backgrounds. a. Interracial couples b. Multiracial families c. Multiracial individuals d. None of the above

15. Which of the following gave rise to systems of racial, economic, and sociopolitical hierarchies? a. Notions of White racial purity b. Notions of White superiority c. A desire to exert power and control over Black Americans and Native Americans d. All of the above 16. The first multiracial organization was a. Interracial/Inter-cultural Pride (I-Pride). b. Project RACE. c. Association of Multi-Ethnic Americans. d. National Association for the Advancement of Colored People. 17. A multiracial civil rights movement emerged during the a. 1940s. b. 1950s and 1960s. c. 1970s. d. 1980s and 1990s. 18. Which of the following organizations lobbied for a multiracial category for the 2000 U.S. Census? a. Association of Multi-Ethnic Americans (AMEA) b. Project RACE c. Both of the above d. None of the above 19. Early models of multiracial identity development used a(n) on the racial identity development of the individual. a. linear model b. stage perspective c. ecological approach

and focused solely

d. All of the above 20. The Root Ecological Framework for Understanding Multiracial Identity Development includes a. family and personal characteristics. b. social, psychological, and cognitive development factors. c. environmental factors. d. All of the above. 21.

is concerned with the perception of one’s multiple racial identities as unique and separate from one another. a. Racial conflict b. Racial distance c. Racial integration d. Multiracial identity

22.

is concerned with one’s perception of the existence of conflict between their multiple racial identities. a. Racial conflict b. Racial distance c. Racial integration d. Multiracial identity

23. Multiracial individuals with levels of racial distance and are deemed as having high multiracial identity integration.

levels of racial conflict

a. low; low b. low; high c. high; low d. high; high 24. The achievement of a positive racial and cultural identity and self-concept for individuals depends on a. individuals’ support systems. b. how concerns are managed. c. the individuals’ strengths and inner resources. d. All of the above. 25.

entails altering the expression of one’s racial/ethnic identity depending upon the environmental context. a. Shifting racial/ethnic expression b. Racial resistance c. Seeking community

d. Racial ambiguity 26.

is indicative of multiracial individuals’ quest to find and to connect with others with whom they share similar worldview experiences and values. a. Shifting racial/ethnic expression b. Racial resistance c. Seeking community d. Racial ambiguity

27.

is the act of defying traditional social norms and conventions of race perpetuated in U.S. society in response to inquiries about one’s racial/ethnic identity. a. Shifting racial/ethnic expression b. Racial resistance c. Seeking community d. Racial ambiguity

28.

concerns the physical features and appearance that for many multiracial individuals result in comments and questions by others regarding their racial/ethnic backgrounds and identity. a. Shifting racial/ethnic expression b. Racial resistance c. Seeking community d. Racial ambiguity

29.

speaks to the essence of not fitting in, or feeling marginalized and unaccepted by any of one’s identity groups. a. Seeking community b. Feeling like an outsider c. Racial resistance d. All of the above.

30. Which of the following contributes to the negative perceptions of interracial couples in the United States? a. Historical myths b. Stereotypes c. Misinformation d. All of the above. 31. According to the Multicultural and Social Justice Counseling Competencies, the domain requires counselors to take action by engaging in ongoing selfmonitoring of assumptions and biases held toward multiple heritage individuals. a. counselor self-awareness

b. client worldview c. counseling relationship d. counseling and advocacy interventions 32. The domain of the Multicultural and Social Justice Counseling Competencies calls upon counselors to intervene with and on behalf of clients at multiple levels. a. counselor self-awareness b. client worldview c. counseling relationship d. counseling and advocacy interventions 33. The domain of the Multicultural and Social Justice Counseling Competencies requires that counselors be self-aware, knowledgeable, skilled, and action-oriented in understanding the impact and influence of the counseling relationship. a. counselor self-awareness b. client worldview c. counseling relationship d. counseling and advocacy interventions 34. Counselors play critical roles in conversations regarding

with their clients.

a. race b. identity c. discrimination d. All of the above. 35. Which of the following resources for counselors focus on affirming and empowering multiracial individuals? a. Root’s ecological framework model b. The Bill of Rights for People of Mixed Heritage c. The Multiracial Oath of Social Responsibility d. All of the above. 36. Researchers suggest that can help multiracial couples explore their level of relationship satisfaction, the relationship dynamics, their communication effectiveness, and their level of commitment. a. psychodynamic theory b. narrative therapy c. Gestalt therapy d. All of the above. 37. The model emphasizes the need that partners in interracial marriages have to be validated by self and one’s partner. a. ecological

b. narrative therapy c. self-validation d. emotional maintenance 38. The Interracial Couple Questionnaire a. can be used to help couples explore and understand each partner’s perceptions and experiences around the interracial relationship. b. takes each partner’s cultural context into consideration. c. can determine assets, strengths, and potential for growth in the relationship. d. All of the above. 39. To promote a healthy racial identity in multiracial children, it is suggested that parents a. talk openly and age-appropriately with their children about their racial makeup, appearance, and identity. b. avoid talking about their own racial experiences. c. only share positive stories about multiracial identity with their children and avoid addressing difficult concerns. d. All of the above. 40.

involves giving expressions or acts of racism immediate acknowledgment and attention, insisting that the perpetrator be held accountable and responsible. a. Pushing back b. Pulling back c. Both of the above d. None of the above

41. When assessing a multiracial child’s presenting concerns, the counselor should consider a. the child’s developmental age or stage. b. the child-rearing practices of the parents. c. familial and racial/ethnic issues. d. All of the above. 42. Individual and group counseling that takes a college students with multiple heritages.

approach can be most useful for

a. psychodynamic b. psychoeducational c. task d. All of the above 43.

involves recognizing when it may be more advisable to take a less confrontational approach to dealing with an expression or act of racism. a. Pushing back

b. Pulling back c. Both of the above d. None of the above 44. A(n) helps partners to develop empathic understanding for each other as they work together to examine and explore culturally based attitudes, behaviors, and expressions. a. ecomap b. genogram c. validation-gram d. None of the above 45. Which of the following strategies can be used to manage issues that arise regarding couples’ cultural and racial differences? a. Creating a ―we‖ b. Framing differences c. Emotional maintenance d. All of the above

Extended Response 1.

What is the value of examining your own attitudes, perceptions, and beliefs regarding race mixing, and how might this exploration influence your work with interracial couples, multiracial individuals, and multiracial families?

What was most significant about the Supreme Court Case, Loving v. Virginia?

What is the significance of providing individuals the option to select ―two or more races‖ to define themselves on the Census and other government agency forms?

How might knowledge of the diverse combinations of interracial couples, multiracial individuals, and families inform professional practice?

How might Root’s (2002) ecological framework for understanding multiracial identity offer a more complete perspective from which to view the issues and concerns of multiple heritage individuals and families and the impact of these on identity development?

How might your knowledge of Root’s six themes assist you in assessing the presenting issues and concerns of a multiple heritage client?

What is it about physical appearance or phenotype that makes it a salient identity across the lifespan?

What factors may be important in the assessment of the strength(s) of an interracial couple’s relationship?

What is the value of assessing the influence of salient cultural worldview variables (e.g., gender roles, communication, expression of emotion, parenting styles) when interracial partners or couples present for counseling?

10. Choose two of the multiracial identity development models presented in the chapter, and identity the stages of each.

11. Identify and discuss a few of the historical myths, stereotypes, and misinformation that contribute to negative perceptions of interracial couples and families. 12. Describe at least two counseling and advocacy interventions for counseling multiracial couples. 13. Identify ways in which parents and counselors can help promote a healthy racial identity in multiracial children. 14. Discuss the importance of the following resources for counselors regarding knowledge and advocacy efforts for multiracial clients: The Bill of Rights for People of Mixed Heritage and the Multiracial Oath of Social Responsibility. 15. Describe the self-validation model and its usefulness for partners in interracial marriages.

Chapter 15 Test Answer Key ANSWER KEY: Chapter 15 Test (Multiple Choice) 1. b 2. d 3. a 4. b 5. c 6. b 7. c 8. b 9. c 10. a 11. b 12. c 13. d 14. c 15. d 16. a 17. d 18. c 19. b 20. d 21. b 22. a 23. a 24. d 25. a 26. c 27. b 28. d 29. b 30. d 31. a 32. d

33. c 34. d 35. d 36. b 37. c 38. d 39. a 40. a 41. d 42. b 43. b 44. c 45. d

Chapter 16 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach 4th Edition

Danica G. Hays University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents

Chapter 16: Spiritual Diversity

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 16: Spiritual Diversity Chapter 16 Learning Outcome Quizzes Learning Outcome 16.1: Articulate current trends in attitudes and practices associated with religion and spirituality. [Q1] A set of beliefs and experiences held by an individual that results in a connection with others is known as which of the following? 1. Open space 2. Spirituality [correct] 3. A collaborative relationship 4. A positive relationship [Feedback for Answer Choice 1] Open space is not a counseling-specific term and is not relevant in this context. [Feedback for Correct Answer 2] An individual’s spirituality can be defined as a set of beliefs and experiences that result in connection with others. [Feedback for Answer Choice 3] A collaborative relationship is an ongoing process rather than a set of beliefs or experiences. [Feedback for Answer Choice 4] A positive relationship is a statistical term in which one variable increases when another variable increases. [Q2] A set of organized, denominational, and public behaviors used to enact spiritual beliefs is known as which of the following? 1. Reflective causation 2. A ritual route 3. Fundamentalism 4. Religion [correct] [Feedback for Answer Choice 1] Reflective causation is not a counseling-specific term. [Feedback for Answer Choice 2] A ritual route is not a counseling-specific concept.

[Feedback for Answer Choice 3] Fundamentalism is a type of religion, but this answer choice is too specific, and another answer choice is a better fit for this question. [Feedback for Correct Answer 4] Religion is a set of organized, denominational, and public behaviors used to enact spiritual beliefs. [Q3] Individuals who identify as ―spiritual but not religious‖ can be separated into which two categories? 1. Inadvertent and disdainful 2. Accepting and self-righteous 3. Accepting and disdainful [correct] 4. Inexperienced decliners and experienced decliners [Feedback for Answer Choice 1] Some individuals who identify as ―spiritual but not religious‖ can be categorized as disdainful when they have negative feelings regarding religious organizations. However, there is not a formal category of individuals who are inadvertently spiritual but negate religion. [Feedback for Answer Choice 2] Some individuals who identify as ―spiritual but not religious‖ can be categorized as accepting, but individuals who do not practice religion are not formally categorized as self-righteous. [Feedback for Correct Answer 3] Individuals who identify as ―spiritual but not religious‖ can be categorized as disdainful (when they have negative feelings toward religion) or accepting of their own and others’ experiences and beliefs. [Feedback for Answer Choice 4] Individuals who identify as ―spiritual but not religious‖ can be categorized as inexperienced decliners who have never been to church, but experienced decliners would fall under the categories of disdainful, accepting, or rejecting. [Q4] What is the most common religion in the United States? 1. Islam 2. Christianity [correct] 3. Judaism 4. Catholicism [Feedback for Answer Choice 1] Only about 0.9% of the U.S. population identifies as Muslim.

[Feedback for Correct Answer 2] Almost three-fourths of the United States identifies as Christian. [Feedback for Answer Choice 3] Only about 2% of individuals in America identify as Jewish. [Feedback for Answer Choice 4] There are many types of Christian religions, and Catholicism is just one kind. As such, Christianity is larger than the portion of Christians who identify as Catholic. Learning Outcome 16.2: Define relevant terms associated with religion and spirituality. [Q1] Which is the oldest known religion? 1. Christianity 2. Buddhism 3. Hinduism [correct] 4. Taoism [Feedback for Answer Choice 1] Christianity began about 2,000 years ago. [Feedback for Answer Choice 2] Buddhism began about 2,500 years ago. [Feedback for Correct Answer 3] Hinduism started about 5,200 years ago. [Feedback for Answer Choice 4] Taoism began about 2,600 years ago. [Q2] The yin yang is a Taoist symbol that represents which of the following? 1. Opposites [correct] 2. Healing relationships 3. Nirvana 4. Chi [Feedback for Correct Answer 1] The yin yang symbol is half black and half white; the symbol represents opposites. [Feedback for Answer Choice 2] The concepts of yin and yang are relevant to healing relationships, but the symbol itself is not specifically tied to relationships.

[Feedback for Answer Choice 3] Individuals reach Nirvana when they are freed from the cycle of birth and death. [Feedback for Answer Choice 4] Chi is a primal life force or energy. [Q3] This is the second largest religion in the United States: 1. Judaism [correct] 2. Christianity 3. Taoism 4. Islam [Feedback for Correct Answer 1] Almost 2% of Americans identify as Jewish, making it the second largest religion in the United States. [Feedback for Answer Choice 2] More than two-thirds of Americans identify as Christian, making it the largest religion in the United States. [Feedback for Answer Choice 3] Less than 1% of Americans identify as Taoists. [Feedback for Answer Choice 4] Almost 1% of Americans identify as Muslim, making it the third largest religion in the United States. [Q4] Buddhism, Hinduism, and Taoism are all: 1. Eastern religions. [correct] 2. Western religions. 3. inexperienced decliners. 4. issues of spiritual bypass. [Feedback for Correct Answer 1] Buddhism, Hinduism, and Taoism originated in Asia, which lies to the east of the first time zone. As such, these religions are called Eastern religions. [Feedback for Answer Choice 2] Western religions are native to areas that lie to the west of the first time zone. Buddhism, Hinduism, and Taoism each originated in parts of Asia, which is to the east, not the west, of the first time zone.

[Feedback for Answer Choice 3] Inexperienced decliners are individuals who do not participate in organized religion. This term does not directly apply to a specific religion, such as Buddhism or Taoism. [Feedback for Answer Choice 4] Spiritual bypass is a term used to describe a phenomenon in which individuals trust in a higher power to solve their problems but do not take the necessary steps to support this effort. Learning Outcome 16.3: Describe basic tenets of major world religions. [Q1] The Four Noble Truths are among the most prominent teachings within Buddhism. Which of the following is one of The Four Noble Truths? 1. Panna 2. Dukkha [correct] 3. Sila 4. Samadhi [Feedback for Answer Choice 1] Panna the first major category of the Eightfold Path. This category includes right view and right attention. [Feedback for Correct Answer 2] Dukkha is the first Noble Truth of Buddhism. This teaching holds that all existence is unsatisfactory and filled with suffering. [Feedback for Answer Choice 3] Sila is the second major category of the Eightfold Path. This category includes right speech, right discipline, and right livelihood. [Feedback for Answer Choice 4] Samadhi is the third major category of the Eightfold Path. This category includes right effort, right mindfulness, and right concentrations. [Q2] What type of religion is Hinduism? 1. Henotheistic [correct] 2. Nontheistic 3. Polytheistic 4. Pandeistic [Feedback for Correct Answer 1] Hinduism is a henotheistic religion, meaning that Hindus recognize a single deity, but also recognize other gods and goddesses as facets, forms, manifestations, or aspects of that supreme God.

[Feedback for Answer Choice 2] Nontheistic beliefs or attitudes reflect an absence in a belief in a god or gods. This term does not reflect Hinduism, since Hindus recognize a single deity, but also recognize other gods and goddesses. [Feedback for Answer Choice 3] Hinduism is sometimes mistakenly referred to as a polytheistic religion; however, it is henotheistic. meaning that Hindus recognize a single deity, but also recognize other gods and goddesses as facets, forms, manifestations, or aspects of that supreme God. [Feedback for Answer Choice 4] Hinduism is one of the world’s oldest religions, while the doctrine of Pandeism was developed in the 18th century. [Q3] The religion of Sikhism teaches that journey to God is complete with five stages. Which of the following stages refers to the experience of wisdom and beauty? 1. Dharam khand 2. Gian khand 3. Sharan khand [correct] 4. Karam khand [Feedback for Answer Choice 1] Dharam khand is the first stage on the Journey to God and refers to the recognition of one’s spiritual duty. [Feedback for Answer Choice 2] Gian khand is the second stage on the Journey to God and refers to acquisition of divine knowledge. [Feedback for Correct Answer 3] Sharan khand is the third stage on the Journey to God and refers to the experience of wisdom and beauty. [Feedback for Answer Choice 4] Karam khand is the fourth stage on the Journey to God and refers to divine grace and power. [Q4] Which of the following concepts refers to the commitment of Taoists to avoid actions that go against the natural order or Tao? 1. Te 2. Chi 3. Yin/Yang 4. Wu-wei [correct]

[Feedback for Answer Choice 1] Te refers to the life power that is the living expression of the Tao. [Feedback for Answer Choice 2] Chi refers to the life-force energy that is beyond intellectual understanding. [Feedback for Answer Choice 3] Yin/Yang is a symbol that represents opposites, most notably the masculine and feminine, that work together to bring wholeness. [Feedback for Correct Answer 4] Wu-wei refers to the commitment of Taoists to avoid actions that go against the natural order or Tao. Learning Outcome 16.4: Identify common themes across religious traditions. [Q1] The text proposes seven tenets which are considered central to all religions. The work of which of the following scholars was adapted to develop these seven central tenets? 1. Chödrön (2013) 2. Maslow (1993) 3. Wayne (2013) 4. Wilber (2001) [correct] [Feedback for Answer Choice 1] Chödrön (2013) is cited as a supporting source for Tenet 6: Rebirth or Enlightenment Results in the End of Suffering. [Feedback for Answer Choice 2] Maslow (1993) is cited as a supporting source for Tenet 5: If This Path Is Followed, the Result is Rebirth or Enlightenment. [Feedback for Answer Choice 3] Wayne (2013) is cited as a supporting source for Tenet 4: There Is a Path to Liberation. [Feedback for Correct Answer 4] The authors of this chapter acknowledge that Wilber’s (2001) work was adapted to develop their ―seven tenets are considered to be central to all religions.‖ [Q2] Which of the following is a mindfulness-based practice associated with the Path to Liberation? 1. Yoga 2. T’ai Chi 3. Breath Prayer [correct] 4. Loving Kindness Meditation

[Feedback for Answer Choice 1] Yoga is a body-centered practice. [Feedback for Answer Choice 2] T’ai Chi is a body-centered practice. [Feedback for Correct Answer 3] Breath Prayer is a mindfulness-based practice. [Feedback for Answer Choice 4] The Buddhist practice of Loving Kindness Meditation is considered a heartfulness-based practice. [Q3] Which of the following Tenets describes the process of experiencing a ―death‖ of the old self and emergence of a new, more fully authentic, self? 1. Tenet 4 2. Tenet 5 [correct] 3. Tenet 6 4. Tenet 7 [Feedback for Answer Choice 1] Tenet 4: The path to liberation involves transcendence of the individual self or personal ego. [Feedback for Correct Answer 2] Tenet 5 describes the process of experiencing a ―death‖ of the old self and emergence of a new, more fully authentic, self. [Feedback for Answer Choice 3] Tenet 6 holds that suffering occurs when we resist the physical, emotional, and psychological pain in life. [Feedback for Answer Choice 4] Tenet 7 describes the stage of rebirth or enlightenment—and the resulting end suffering—which leads to expressions of mercy, love, and compassion. [Q4] Which of the following reflects a heartfulness-based practice associated with the Path to Liberation? 1. T’ai Chi 2. Breathwork 3. Centering prayer 4. Loving Kindness Meditation [correct]

[Feedback for Answer Choice 1] T’ai Chi is an example of a body-centered practice. [Feedback for Answer Choice 2] Breathwork is another example of a body-centered practice. [Feedback for Answer Choice 3] The Centering Prayer is an example of a mindfulness-based practice. [Feedback for Correct Answer 4] The Buddhist practice of Loving Kindness Meditation is considered a heartfulness-based practice. The conscious practice of forgiveness is another example of this practice. Learning Outcome 16.5: Articulate counseling considerations for working with spiritually diverse clients. [Q1] Which type of counselor denies the sacred truths and spiritual values of some or all of his or her clients? 1. Rejectionist [correct] 2. Exclusivist 3. Constructivist 4. Pluralist [Feedback for Correct Answer 1] A rejectionist counselor denies the sacred truths of some or all clients. [Feedback for Answer Choice 2] An exclusivist counselor only acknowledges his or her own sacred truths as valuable or correct. [Feedback for Answer Choice 3] A constructivist counselor allows clients to create their own set of spiritual truths and values. [Feedback for Answer Choice 4] A pluralist counselor acknowledges that there are many different spiritual values and sacred truths. [Q2] Which of the following is an example of a transformational spiritual experience? 1. Counseling 2. A near-death experience [correct] 3. Spiritual bypass 4. Finding meaning in life

[Feedback for Answer Choice 1] Although counseling can be very meaningful, it is an ongoing process rather than a specific experience. [Feedback for Correct Answer 2] An individual who almost dies might report a transformational spiritual experience. [Feedback for Answer Choice 3] An individual who trusts in a higher power for guidance through difficult times but does not take the necessary actions to overcome such difficulties is engaging in spiritual bypass. [Feedback for Answer Choice 4] Although individuals might find meaning through a transformational spiritual experience, there must be a specific incident to qualify as a transformational spiritual experience. [Q3] Counselors recognize that clients’ spiritual beliefs can have which of the following effects? 1. Enhance well-being [correct] 2. Eliminate presenting problems 3. Limit their worldviews 4. Create conflict within the counseling relationship [Feedback for Correct Answer 1] Individuals can sometimes gain strength and mental health resiliency from their healthy spiritual experiences. [Feedback for Answer Choice 2] Spiritual beliefs can serve as a source of strength but may also exacerbate, rather than eliminate client issues. Some mental health difficulties can be complicated by an individual’s spiritual beliefs. For example, a gay man who does not believe that homosexuality is spiritually acceptable might experience greater mental health difficulties than a gay man who spiritually accepts homosexuality. [Feedback for Answer Choice 3] Counselors must take steps to respect the religious worldview of clients. Instead of viewing spiritual beliefs as limiting, counselors should seek to understand how an individuals’ experiences and beliefs are closely connected to their spiritual beliefs and, thus, informs their worldview. [Feedback for Answer Choice 4 Counselors should work diligently to bracket their own beliefs and provide a therapeutic environment that seeks to safeguard against the imposition of their personal values. [Q4] Which of the following is considered a spiritual counseling approach? 1. Constructivist [correct]

2. Systemic 3. Humanist 4. Structural [Feedback for Correct Answer 1] A constructivist approach to spiritual counseling allows each client to create his or her own unique spiritual belief system. This approach to spiritual counseling upholds clients’ autonomy and is nondiscriminatory. [Feedback for Answer Choice 2] Systemic counseling typically refers to the theories and approaches used with couples and families. This orientation acknowledges the importance and influence of spirituality within family systems; however, it is not considered a spiritual counseling approach. [Feedback for Answer Choice 3] A humanistic counselor looks at the whole person and emphasizes the client’s positive traits, healthy behaviors, and capacity for nurturing growth and fulfillment within themselves. While a humanistic counselor may incorporate spirituality within sessions—if it is recognized as a client strength or resource—this theoretical orientation, strictly speaking, is not considered a spiritual counseling approach. [Feedback for Answer Choice 4] A structural counseling approach, like other systemic theories, acknowledges the importance and influence of spirituality within family systems; however, it is not considered a spiritual counseling approach.

Chapter 16 Application Exercises Application Exercise 16.1: Spirituality and Religion Learning Outcome 16.2: Define relevant terms associated with religion and spirituality. [URL TITLE] Travis with His Counselor

[Q1] Use Pearson eText Video Example 16.1 to answer the following question. Pay particular attention to the roles that spirituality and religion play in Travis’s life. Using what you have learned from the video and the research in the text, reflect on the relationship between spirituality and religion. How do you conceptualize Travis’s presenting concern? [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

At one point, religion and spirituality seemed to go hand in hand for Travis. He had a rich spiritual life that was authentically experienced and expressed in his religious practices.

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Travis seems to engage in religious behavior in order to deepen his spiritual connection and process of exploration.

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Something might have occurred in his life to make his spiritual needs outgrow the reach of his current/previous religious practices.

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It does not seem as though Travis has had a negative experience with religion, but it does seem as though he is beginning to view spirituality and religion as separate entities.

[Q2] Use Pearson eText Video Example 16.1 to answer the following question. Pay particular attention to the roles that spirituality and religion play in Travis’s life. What counseling competencies from the Association for Spiritual, Ethical, and Religious Values in Counseling (A SERVIC) might be helpful when working with Travis? [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

The counselor should be able to explain the interaction and relationship between spirituality and religion.

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The counselor recognizes that the client beliefs about spirituality are central to their worldviews.

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Counselors actively explore their own spiritual beliefs and how those affect the ways clients are viewed.

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Counselors seek consultation and collaboration when they are not fully able to understand a client’s views on spirituality and religion.

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Counselors can merge theories of spiritual development and human development.

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Professional counselors respond to client needs surrounding spirituality with acceptance and openness.

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Counselors gather spiritual information from the client.

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Counselors integrate clients’ religious and spiritual values into competent assessment, diagnosis, and treatment practices.

[Q3] How do your religious and spiritual views affect the way you view others? [Q3 MODEL RESPONSE] Your answer might include any of the following: 

I currently or have in the past had a ―hand-in-hand‖ relationship with religion and spirituality, in which my spiritual views and religious practices aligned nicely.

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I currently walk or have walked the path of Jungian pretending, in which I go through the motions of religious practice but have limited spiritual experiences.

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I currently identify or have identified as spiritual but not religious. I have or have not had a bad experience with religion that has contributed to my current views.

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When clients come to me for spiritual issues, I feel uneasy discussing such issues because of a lack of knowledge and competence in this area.

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When clients come to me for spiritual issues, I tend to believe that my way of viewing religion and spirituality is correct.

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When clients come to me for spiritual issues, I help them tell their stories, and I believe that we can hold different but equally valid religious beliefs.

Application Exercise 16.2: Counselor Worldview Learning Outcome 16.5: Articulate counseling considerations for working with spiritually diverse clients. [Q1] It is important to understand how the spiritual and religious beliefs of a counselor affect the therapeutic relationship and process. Based on the research discussed in the text, discuss how counselors can competently help clients translate their spiritual experiences to make meaning in their lives. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Counselors can approach their work with spiritual issues from a constructivist lens in which clients are encouraged to tell their unique stories.

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Counselors can approach clients’ spiritual issues through a pluralist lens in which the counselor believes many different religious and spiritual beliefs are true and valid for different individuals.

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Counselors should avoid rejectionist or exclusivist approaches in which the client’s beliefs are ignored or discarded as invalid.

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Counselors can help clients make sense of and derive meaning from their spiritual experiences and beliefs.

[Q2] Based on the research discussed in the text, discuss how counselors can competently help clients transform to higher levels of spiritual development. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

The counselor should take care to understand his or her own primary approach to understanding spirituality: translational or transformational.

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Counselors working with clients who wish to have transformative experiences should know that transformations often come as the result of life-changing events or breakthroughs.

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Counselors should accept and value every client’s unique spiritual and religious experiences.

[Q3] Based on the research discussed in the text, what should counselors keep in mind regarding the concept of spiritual bypass? [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Spiritual bypass is a phenomenon in which individuals focus on spiritual growth as a method for creating psychological healing.

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Spirituality is an important component of overall mental health and wellness, but it is not the only facet that must be addressed in counseling.

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In spiritual bypass, spiritual beliefs often allow individuals to avoid the cognitive and emotional aspects of their problems.

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Spiritual bypass can result in repression of displeasing emotions, compulsive goodness, rejection of others’ differing spiritual values, and loss of personal responsibility.

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Counselors should validate the importance of religion and/or spirituality in clients’ lives while encouraging them to work on their thoughts, feelings, relationships, and behaviors as separate components of holistic wellness.

Application Exercise 16.3: Client Worldview Learning Outcome 16.5: Articulate counseling considerations for working with spiritually diverse clients.

[Q1] According to the ASERVIC competencies, how should counselors approach communication with clients regarding spiritual and religious issues? [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Counselors should respond to clients’ discussion of spirituality or religion with a nonjudgmental attitude of openness, acceptance, and support.

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Counselors should work to understand the religious/spiritual symbols and terminology that resonate with the client and use those in session.

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Counselors know when it is therapeutically relevant to discuss religious or spiritual themes.

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Counselors avoid imposing their own religious or spiritual values on a client.

[Q2] According to the ASERVIC competencies, how should counselors approach diagnosis and treatment with clients regarding spiritual and religious issues? [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Counselors recognize that clients’ spiritual and/or religious views have the capacity to enhance their wellness. Counselors recognize that clients’ spiritual and/or religious views have the capacity to exacerbate their mental health challenges.

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Counselors set reasonable and realistic goals that align with clients’ spiritual and religious beliefs.

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Counselors are able to modify therapeutic interventions to include clients’ spiritual/religious perspectives or to address clients’ spiritual/religious needs.

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Counselors utilize spiritual/religious practices (e.g., prayer) as therapeutic techniques when appropriate.

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Counselors utilize current research and theory in order to inform their practice when working with clients who have spiritual and/or religious needs.

[Q3] What are some common aspects of all religions? [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

There is some intangible entity that humans commonly refer to as spirit.

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Some collective aspect of the spirit resides within each individual.

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Most people view the spirit as an external entity, and it is important to integrate the simultaneous existence of the spirit within.

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There is some set path to liberation, which looks unique for each individual but might follow some general trends.

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Enlightenment comes as the result of following a path to liberation.

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Enlightenment ends suffering through mercy and compassion.

Chapter 16 Test Items Multiple Choice 1.

According to the 2014 General Social Survey, without doubt.

% of Americans believe in a God

a. 13 b. 36 c. 84 d. 58 2.

Of Americans,

% identify as Christian.

a. 21.2 b. 70.6 c. 53.1 d. 63.5 3.

Demographic studies of religion suggest that the United States, comprising 22.8% of the population.

is the second largest group in

a. Judaism b. Islam c. Nonreligious or secular d. Buddhism 4.

Spirituality is difficult to define because a. it is highly personal. b. it is developmental. c. in some ways, it cannot be fully captured in language. d. All of the above.

The

aspect of religion is primarily concerned with beliefs.

a. dogmatic b. translative c. transformative d. All of the above. 6.

A healthy spiritual life helps a person a. avoid undesirable emotions. b. not have any undesirable emotions. c. fully experience all of our emotions non-judgmentally. d. feel good all of the time.

That some people participate in organized religion to avoid having a religious experience was a notion put forward by a. Sigmund Freud. b. William James. c. Albert Ellis. d. Carl Jung.

The teachings of Siddhartha Gautama inform practitioners of a. Judaism. b. Buddhism. c. Taoism. d. Confucianism.

Within the Buddhist tradition, the scriptures considered by many to most closely follow the Buddha’s own words is known as the a. Pali Canon. b. Theraveda Canon. c. Mahayana Canon. d. Vajrayana Canon.

10. ―Suffering is due to craving or clinging to the wrong things.‖ This statement is consistent with the of Buddhism. a. First Noble Truth b. Second Noble Truth c. Third Noble Truth d. Fourth Noble Truth 11. The oldest known religion is a. Judaism. b. Buddhism. c. Wiccan. d. Hinduism. 12. Hinduism is considered a henotheistic religion, meaning that adherents to Hinduism worship a. multiple deities. b. nature. c. one deity with many facets or aspects. d. only a single deity.

13. The belief that all actions have moral consequences that one must accept as part of life is known as a. samsara. b. karma. c. samatha. d. vippasana. 14. Within Hinduism, the individual soul is referred to as a. Brahman. b. Shaman. c. Shiva. d. Atman. 15. The fundamental text of Taoism attributed to Lao-Tzu is a. Wu-Wei. b. I Ching. c. Tao Te Ching. d. Wu Tang. 16. Within the Taoist tradition, the life force energy is known as a. Chi. b. Ki. c. Prana. d. Wu-wei. 17. The Analects are a compilation of writings within a. Buddhism. b. Taoism. c. Jainism. d. Confucianism. 18. Within the Confucianist tradition, the practice of quiet sitting is primarily intended to a. empty the mind of all thoughts. b. reduce the ―clutter‖ and ―noise‖ of the mind. c. open the heart. d. make the mind receptive to knowledge. 19. The largest religion, in terms of numbers of adherents, in the world is a. Christianity. b. Hinduism. c. Buddhism.

d. Judaism. 20. The sect of Muslims that is primarily concerned with mysticism is a. Sunni. b. Shi’ite. c. Sufi. d. Shi’a. 21. The first pillar of Islam, known as Islam’s creed that ―There is no God but God, and Mohammed is His prophet‖ is known as the a. jihad. b. Shahadah. c. Pilgrimage. d. Rumi. 22. Islam’s holy month is called a. Mecca. b. Ramaja. c. Omaja. d. Ramadan. 23. The second largest religion in the United States is a. Christianity. b. Islam. c. Judaism. d. Buddhism. 24. The Jewish New Year is known as a. Yom Kippur. b. Tishri. c. Najri. d. Rosh Hashanah. 25. A counselor who advocates for a particular belief system with clients is best referred to as a. rejectionist. b. pluralist. c. constructivist. d. unethical. 26. Spirituality is a. unique and idiosyncratic. b. dynamic and evolving.

c. comprises beliefs, practices, and experiences held by an individual. d. All of the above. 27. Which of the following is true concerning religion and spirituality? a. It is impossible to be spiritual and not religious. b. The relationship between spirituality and religion is never complementary. c. Some people participate in religion to avoid religious experiences. d. People who are spiritual but not religious can never respect the importance of religion to others. 28. The eightfold path is a key component of a. Judaism. b. Buddhism. c. Sikhism. d. Islam. 29. Karma refers to a. the belief that all actions have moral consequences. b. a Hindu festival celebrating the Four Vedas. c. the name of a Taoist deity. d. a garment worn by Islamic women. 30.

refers to aspects of spiritual experience (e.g., beliefs, creeds, dogma) that are used as a framework to find meaning and purpose in life, while is more complex and often involves physical, emotional, cognitive, and spiritual breakthroughs. a. Translation; transformation b. Transformation; translation c. Religion; spirituality d. Spirituality; religion

31.

is not a subgroup of Islam. a. Sufis b. Samsara c. Sunnis d. Shi’ites

32. Which of the following is NOT one of the seven tenets central to all religions? a. Reincarnation is unavoidable. b. Rebirth or enlightenment results in the end of suffering. c. Spirit, by whatever name, exists. d. There is a path to liberation. 33. The counselor is exhibiting which approach to religion/spirituality in the following quote?

Counselor: ―Although you practice Judaism, I think you would really benefit from hearing about the principles of Buddhism.‖ a. Constructivist b. Pluralist c. Exclusivist d. Rejectionist 34. Which of the following statements is NOT true of counselors who take a constructivist approach to working with spiritual issues? a. Constructivists believe in an absolute reality. b. Constructivists believe that truth is constructed in interactions with others. c. Constructivists focus on the quality of constructions rather than agreement between themselves and their clients. d. Constructivists work within their client’s belief system and worldview. 35. When a counselor and client come from a shared religious reality, the counselor may assume to know the client’s worldview without assessment. This is a particular problem within the approaches. a. pluralist and rejectionist b. constructivist and exclusivist c. constructivist and rejectionist d. pluralist and exclusivist 36. The impositional approach refers to a. clients sharing religious views with their counselor. b. counselors applying a religious or spiritual framework to a client who is atheist or nonreligious. c. counselors assuming they know clients’ worldview because they are of the same religion. d. counselors’ avoidance of discussing religion or spirituality in counseling. 37. Regarding ethical competence when working with religious and spiritual aspects in counseling, counselors should a. avoid the discussion of religious and spiritual issues. b. consider only translation. c. consider only transformation. d. consider both translation and transformation when working with religious and spiritual aspects in counseling. 38. Spiritual bypass refers to a. counselor avoidance of discussing spiritual issues with a client. b. attempts to heal psychological wounds by working only at the spiritual level.

c. client avoidance of discussing spiritual or religious issues in counseling. d. disdain for religions different from one’s own. 39. Which of the following is not an important competency for counselors working with religious and spiritual issues according to ASER VIC? a. Ability to explain the difference between religion and spirituality b. Demonstration of sensitivity and acceptance for a variety of religious and spiritual expressions c. Ability to assess the relevance of religious and spiritual domains in client issues d. Possess knowledge of all religious belief systems 40.

emphasizes unity and the avoidance of the Five Cardinal Vices. a. Sikhism b. Taoism c. Judaism d. Christianity

41. ― ‖ refers to an individual who has never been exposed to the spiritual life or religious community. a. Rejecter b. Accepting c. Inexperienced decliner d. Disdainful 42. The Confucian belief in ren refers to a. the fact that all existence is unsatisfactory and filled with suffering. b. the idea that one’s present life is only most recent in a chain of lives. c. representation of opposites working together to bring wholeness. d. character of excellence comprising altruistic behavior. 43. In the United States the largest religious group is a. no religious affiliation followed by Christianity. b. Islam followed by no religious affiliation. c. Christianity followed by no religious affiliation. d. Christianity followed by Judaism. 44.

refers to the intentional setting aside of the counselor’s personal values in order to provide ethical and appropriate counseling to all clients. a. Ethical competence b. Ethical bracketing c. Ethical supervision d. Ethical boundary

45.

Extended Response 1.

Describe at least three ways a religious and spiritually encapsulated counselor could potentially harm a client.

Discuss how the Eightfold Path of Buddhism could be integrated into the counseling process with a client who is open to this belief system.

Discuss ways in which clients in spiritual bypass might present in counseling. Further, describe possible approaches to working with such clients that would challenge the bypass.

Discuss at least three circumstances under which a counselor might need to refer a client based on limits of counselor competence when working with religious and spiritual issues.

Consider the differences between spirituality and religion. How would you present each concept to a client and articulate the differences?

Why is it important for counselors to assess the spiritual and religious aspects of clients’ lives? What are ways in which this assessment can be conducted?

Is it possible for a client to be religious but not spiritual? Explain. What might a client of this type require from a counselor?

What are some considerations for counselors working with clients who are spiritual but not religious? Describe the possible subgroups of clients in this category and expand upon the unique considerations and assessment questions for each subgroup.

Choose three religious groups described in the chapter and discuss important considerations for working with a member of each group in the counseling setting.

10. Describe three aspects common to all religions. How does each aspect inform counseling with spiritual or religious issues? 11. Amhad is a middle-aged man seeking counseling for issues of grief and loss that surfaced as a result of his wife’s death. Amhad tells his counselor that his struggle centers around his anger toward Allah for ―taking‖ his wife. How would a counselor from each of the four approaches to client spiritual issues (rejectionist, exclusivist, constructivist, and pluralist) respond to Amhad? 12. A female client in her mid-thirties struggling with alcoholism refuses to consider the option of attending Alcoholic Anonymous groups, working the 12 steps, or obtaining a sponsor. Rather she tells her counselor she only wants to pray about her alcoholism and wait for God to intervene. Provide a case conceptualization of this client using a spiritual bypass framework. What steps would you take in your work with this client? 13. When a client and counselor have differing religious and spiritual beliefs, what considerations are to be made? Consider the ASERVIC competencies and provide explanations for the value of at least three competencies in this situation.

14. What are possible pitfalls for counselors who do not consider themselves to be religious or spiritual? What are possible pitfalls for counselors who consider themselves to be religious and spiritual? 15. What does it mean to be ethically competent when integrating spirituality and religion into the counseling process? Identify ethical codes and competencies counselors should follow.

Chapter 16 Test Answer Key ANSWER KEY: Chapter 16 Test (Multiple Choice) 1. d 2. b 3. c 4. d 5. b 6. c 7. d 8. b 9. a 10. b 11. d 12. c 13. b 14. d 15. c 16. a 17. d 18. d 19. a 20. c 21. b 22. d 23. c 24. d 25. d 26. d 27. c 28. b 29. a 30. a 31. b 32. a

33. c 34. a 35. d 36. b 37. d 38. b 39. d 40. a 41. c 42. d 43. c 44. b 45. a

Chapter 17 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach 4th Edition

Danica G. Hays University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents

Chapter 17: Using Counseling Theories in Multicultural Contexts

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 17: Using Counseling Theories in Multicultural Contexts Chapter 17 Learning Outcome Quizzes Learning Outcome 17.1: Describe the connection of privileged and marginalized statuses and worldview. [Q1] The extent to which the general trends of a culture vary among members of that culture is known as which of the following? 1. Within-group difference [correct] 2. Significance 3. Cultural variation 4. Power [Feedback for Correct Answer 1] Members in a specific cultural group might have some values and beliefs in common, but everyone sees things in diverse ways based on a variety of factors and life experiences. As such, individuals within a specific group are likely to have some similarities and some unique differences, known as within-group differences. [Feedback for Answer Choice 2] Significance is a statistical term that indicates a certain result was not likely a chance occurrence. Within-group differences can be significant, but significance does not refer solely to within-group differences; it can refer to a multitude of statistical findings (e.g., correlations and between-group differences). [Feedback for Answer Choice 3] Cultural variation is a general term that refers to ways in which some cultures are different from others. [Feedback for Answer Choice 4] Power is a statistical term that indicates enough data was collected to produce significant results if they are present. [Q2] Which of the following is a component of theoretical orientation? 1. Serves as a starting point for clinical work [correct] 2. Promotes counselor self-awareness 3. Provides diagnostic criteria 4. Proposes a comprehensive understanding of human development

[Feedback for Correct Answer 1] A counselor’s theoretical orientation can serve as a starting point for clinical work. [Feedback for Answer Choice 2] A counselor’s theoretical orientation provides a framework for conceptualizing and addressing client issues. Self-awareness, on the other hand, is a component of ethical practice and professional identity. [Feedback for Answer Choice 3] Counseling theory serves as a decision-making model and helps us organize what a client is saying, it provides us with direction for our questioning, and it helps us make sense of our work as counselors. However, it the Diagnostic and Statistical Manual of Mental Disorders that provides the criteria for rendering a diagnosis. [Feedback for Answer Choice 4] The complexity of human development and functioning cannot be captured by a single theory. The suitability and effectiveness of a particular theory will vary based on client issues, cultural background, among other considerations. [Q3] Which theory would be least appropriate for working with multicultural clients? 1. Person-centered theory 2. Narrative theory [correct] 3. Adlerian theory 4. Cognitive-behavioral theory [Feedback for Answer Choice 1] All clients are multiculturally different, and person-centered theory can be used as a nondirective approach to understanding the client and guiding the client toward congruence. [Feedback for Correct Answer 2] Narrative therapy may be adapted to meet the diverse needs of multicultural clients. However, the theory’s emphasis on language, symbolic thinking, and viewing the client as the expert, may not be suitable for clients with limited language proficiency or from backgrounds that view the clinician as the expert and, consequently, desire a more directive and traditional approach. [Feedback for Answer Choice 3] All clients are multiculturally different, and Adlerian theory can be used to help clients move from a felt minus to a felt plus. [Feedback for Answer Choice 4] All clients are multiculturally different, and cognitive-behavioral theory can be used to help clients identify and reframe irrational cognitions. [Q4] Which of the following terms refers to a set of personal constructs created within the context of family, culture, and society?

1. Representation 2. Human nature 3. Worldview [correct] 4. Reflection [Feedback for Answer Choice 1] A representation can refer to a variety of concepts related to mental health and is not necessarily specific to personal constructs. [Feedback for Answer Choice 2] Human nature is a general concept that applies to all individuals. [Feedback for Correct Answer 3] An individual’s worldview is a set of personal constructs created within the context of family, culture, and society. [Feedback for Answer Choice 4] Counselors and clients engage in an ongoing process of reflection, but reflection is not necessarily tied to the concept of personal constructs. Learning Outcome 17.2: Understand how stereotypes, discrimination, power, privilege, and oppression influence perspectives on change, treatment, and counseling theory. [Q1] Which theory is rooted in feminist theory and incorporates aspects of social advocacy? 1. Cognitive-Behavioral Theory 2. Multicultural Counseling and Therapy 3. Empowerment Theory [correct] 4. Psychodynamic Theory [Feedback for Answer Choice 1] Cognitive-behavioral theory is one of the first three forces in counseling, but it did not stem from feminist theory. [Feedback for Answer Choice 2] The theory of multicultural counseling and therapy accounts for counselor and client contexts, but it is not specifically linked with feminist theory. [Feedback for Correct Answer 3] Empowerment theory helps clients harness their own talents and autonomy in order to achieve their mental health goals and this theory is rooted in feminist theory. [Feedback for Answer Choice 4] Psychodynamic theory is one of the first three forces in counseling, but it did not stem from feminist theory.

[Q2] Which theory takes into account the cultural context of both counselor and client? 1. Psychodynamic Theory 2. Cognitive-Behavioral Theory 3. Multicultural Counseling and Therapy [correct] 4. Empowerment Theory [Feedback for Answer Choice 1] Psychodynamic theory is not historically a multiculturally responsive theory, and counselors should follow the process of multicultural theoretical adaptation in order to use psychodynamic theory effectively. [Feedback for Answer Choice 2] Cognitive-behavioral theory is not historically a multiculturally responsive theory, and counselors should follow the process of multicultural theoretical adaptation in order to use psychodynamic theory effectively. [Feedback for Correct Answer 3] The theory of multicultural counseling and therapy was developed in order to account for the cultural context of the counselor and client. [Feedback for Answer Choice 4] Empowerment theory is used to help individual feels as though they are capable of reaching their mental health goals, but it does not specifically account for counselor and client contexts. [Q3] The process of multicultural theoretical adaptation includes which four steps? 1. Determine assumptions, identify limitations, simplify concepts, diversify interventions [correct] 2. Determine the problem, identify values, change the framework, diversify interventions 3. Determine assumptions, identify change mechanisms, diversify interventions, evaluate 4. Determine assumptions, identify target area, identify change mechanisms, diversify interventions [Feedback for Correct Answer 1] Any theoretical orientation can be multiculturally responsive if the counselor first identifies assumptions and limitations of the theory, finds the key elements of the theory that support clients toward their goals, and then shifts theoretical interventions according to client needs. [Feedback for Answer Choice 2] Although it would be helpful for multicultural counselors to identify client problems and values and shift their frameworks and interventions accordingly, this process does not explain exactly how counselors would adapt their theoretical interventions so that they are multiculturally responsive.

[Feedback for Answer Choice 3] Although this chain of counselor behaviors would be helpful, these behaviors do not explain exactly how counselors would adapt their theoretical interventions so that they are multiculturally responsive. [Feedback for Answer Choice 4] Although this chain of counselor behaviors would be helpful, these behaviors do not explain exactly how counselors would adapt their theoretical interventions so that they are multiculturally responsive. [Q4] As a counselor, you strive to foster an affirming environment in which clients can practice assertiveness, self-advocacy, and new ways of relating to the cultural context in which they live. Your clinical approaches reflect which of the following theoretical orientations? 1. Alternative Theory 2. Empowerment Theory 3. Family Systems Theory 4. Relational-Cultural Theory [correct] [Feedback for Answer Choice 1] Alternative theory is not a counseling-specific term. However, practices such as meditation and yoga are considered alternative therapies. [Feedback for Answer Choice 2] Empowerment Theory is implemented through three actions, namely: taking social action, along with developing a critical consciousness and positive identity. [Feedback for Answer Choice 3] Family Systems Theory is an umbrella term that describes the myriad of theoretical approaches to working with couples and families. Moreover, the qualities listed above are not explicitly articulated by a particular family systems theory approach. [Feedback for Correct Answer 4] A therapist operating from a Relational-Cultural perspective will strive to foster an affirming environment in which clients can practice assertiveness, self-advocacy, and new ways of relating to the cultural context in which they live. Learning Outcome 17.3: Engage in reflective and critical thinking skills to gain insight into assumptions, worldviews, values, beliefs, biases, and privileged and marginalized statuses. [Q1] Multicultural counseling is defined as which of the following? 1. The integration of cultural identities within the counseling process. [correct] 2. Helping clients see the world as the counselor sees the world. 3. Identifying ways in which clients can adapt to mainstream culture.

4. Changing harmful systems that impact the client. [Feedback for Correct Answer 1] Multicultural counseling asserts that every individual is unique, and competent counselors help clients explore, identify, and enact their own unique identities through the counseling process. [Feedback for Answer Choice 2] Counselors are not allowed to discriminate against their clients and are responsible for celebrating every client’s unique diversity. As such, it would eliminate clients’ autonomy if counselors were to force them to see the world in ways that are inconsistent with their beliefs or unnatural for them. [Feedback for Answer Choice 3] Clients are encouraged to find their own unique identities, which may or may not align with mainstream culture. If clients’ identities do not align with mainstream culture, their unique identities should be celebrated. [Feedback for Answer Choice 4] Changing harmful systems that impact the client is an aspect, rather than the definition, of multicultural counseling. It is better suited as the definition of social justice counseling. [Q2] To be effective, multicultural counselors must maintain an awareness of which of the following? 1. Their own clinical strengths 2. Their clients’ cultural values and biases [correct] 3. Universally appropriate intervention strategies 4. The effectiveness of traditional counseling approaches [Feedback for Answer Choice 1] Rather than resting on one’s clinical strengths, counselors should strive to understand their own cultural values and biases so that they can intentionally limit the influence of such constructs in their practice. [Feedback for Correct Answer 2] Counselors should learn their client’s cultural values and beliefs so that counseling conceptualization and intervention can be adapted accordingly. [Feedback for Answer Choice 3] Since there are no universal approaches to helping all clients, counselors should adapt their counseling interventions based on clients’ cultural needs. [Q2 Feedback to Correct Answer] A traditional approach to counseling is only one of many strategies for helping clients. Counselors must be well-versed with a variety of approaches—including integrative and alternative therapies—to ensure that clinical interventions and goals align with each client’s cultural values and appropriately meet their needs.

[Q3] Which of the following is one of the five contextual suppositions of the Ntu approach to psychotherapy? 1. Values-driven [correct] 2. Community-focused 3. Actualization 4. Alignment [Feedback for Correct Answer 1] The Ntu approach to psychotherapy is values driven. Using an Afrocentric worldview, Ntu counselors assume that contribution to family and community is essential, and clients’ behaviors are assessed in terms of this contribution. [Feedback for Answer Choice 2] The Ntu approach to psychotherapy is family-focused rather than community-focused. It is assumed that the entire family is with the client even when an individual presents alone for counseling. [Feedback for Answer Choice 3] Operating from the five contextual suppositions of the Ntu approach, Phillips (1990) described five distinct phases in Ntu psychotherapy through which the client and counselor collaborate. Actualization is the third phase described by Philips (1990) and consists of putting into practice the changes learned during the preceding phase (alignment). [Feedback for Answer Choice 4] Alignment is the third phase and core of Ntu counseling. Alignment can be alternatively characterized as congruence in that consistency among thoughts, behaviors, and feelings are sought so that family members experience one another and the presenting challenge from a common base. [Q4] Indigenous ways of knowing (IWOK) is an example of a(n): 1. grand theory 2. alternative therapy [correct] 3. eclectic technique 4. mindfulness approach [Feedback for Answer Choice 1] Grand theories in counseling seek to integrate all dimensions of human experience into a single overarching theoretical framework. Typically, these grand theories incorporate many different models for counseling and spawn variations on a particular theme. [Feedback for Correct Answer 2] Indigenous ways of knowing (IWOK) is a non-Western approach and, as such, is example of an alternative therapy.

[Feedback for Answer Choice 3] The term eclectic technique refers to the use or integration of various techniques drawn from a range of traditional counseling theories. [Feedback for Answer Choice 4] While Indigenous ways of knowing (IWOK) is a non-Western approach, it is not considered a mindfulness approach.

Chapter 17 Application Exercises Application Exercise 17.1: Exploring Counselor and Client Worldviews Learning Outcome 17.1: Describe the connection of privileged and marginalized statuses and worldview. [Q1] Briefly explain the scope and purpose of using a worldview assessment with clients. [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

The information gained from worldview assessments is best viewed as informative rather than predictive.



Clients might have a tendency toward particular worldviews, and those are more indicative of a psychological, emotional, or ecological state of being rather than some inherent personality trait.



Assessments used to explore specific dimensions of worldview such as spirituality or conditions of worldviews such as after a trauma also help counselors understand their clients.



Assessments that characterize overall worldview can be formal and informal.



Measuring experience with microaggression may also be useful when understanding a client’s perspective as it relates to their culturally minoritized experience.

[Q2] Explain the important role that counselor and client worldviews play in selecting culturally appropriate counseling approaches. [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Gladding (2018) noted a link between a counselor’s personal helping philosophy and sound counseling theory, and in this way, as worldview expands from the individual to larger groups, theory can be born.



It has been suggested that most, if not all, of the counseling theories and techniques are derived from personal worldviews.



To remain multiculturally competent in their application of theory, counselors need to understand the worldview of their clients as well as the worldview supported by other relevant theories (e.g., developmental, career, and systemic) and strive to find an effective balance.

[Q3] Ethical practice with diverse clients is important in the profession of counseling. Which ACA (2014) ethical codes are relevant to counseling practice with diverse individuals?

[Q3 MODEL RESPONSE] Your answer might include any of the following: 

A.2.c. Developmental and Cultural Sensitivity



A.4.b. Personal Values



A.10.e. Bartering



A.11.b. Values within Termination and Referral



B.1.a. Multicultural/Diversity Considerations



B.5.b. Responsibility to Parents and Legal Guardians



C.2.a. Boundaries of Competence



C.5. Nondiscrimination

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E.8. Multicultural Issues/Diversity in Assessment



F.2.b. Multicultural Issues/Diversity in Supervision



F.7.c. Infusing Multicultural Issues/Diversity



F.11. a–c. Multicultural/Diversity Competence in Counselor Education and Training Programs



H.5.d. Multicultural and Disability Considerations

Application Exercise 17.2: Culturally Responsive Counseling Approaches Learning Outcome 17.2: Understand how stereotypes, discrimination, power, privilege, and oppression influence perspectives on change, treatment, and counseling theory. [Q1] What are the professional values of the counseling profession, according to the ACA Code of Ethics (2014)? [Q1 MODEL RESPONSE] Your answer should include the following: 

―Enhancing human development throughout the life span‖



―Honoring diversity and embracing a multicultural approach in support of the worth, dignity, potential, and uniqueness of people within their social and cultural contexts‖



―Promoting social justice‖



―Safeguarding the integrity of the counselor–client relationship‖



―Practicing in a competent and ethical manner‖

[Q2] Discuss some of the attitudes, beliefs, knowledge, and skills counselors need in order to provide culturally appropriate intervention strategies.

[Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Counselors respect clients’ religious/spiritual views, especially taboos and rituals.



Counselors respect and broach topics associated with instances of both pride and injustice/oppression in the heritage of indigenous populations.



Counselors respect helping networks that are established within specific cultures (e.g., tribal councils, churches) and collaborate with them as possible and ethical.



Counselors value bilingualism and do not discriminate against people who know two or more languages/cultures.



Counselors have knowledge of generic characteristics of certain cultures, and they use this information to test hypotheses about an individual.



Counselors do not use general knowledge of cultures to stereotype or prejudge.



Counselors acknowledge institutionalized racism and actively identify it when relevant in a client’s story, taking care to consider all relevant factors simultaneously.



Counselors understand the psychometric properties of validity, reliability, and norming samples and interpret test results in accordance with a client’s culture.



Counselors understand a client’s family/community structures, hierarchies, values, and beliefs.



Counselors should identify and advocate against discriminatory practices that negatively affect a client’s mental health.

[Q3] What are the basic guidelines a counselor should follow when adapting their approaches to meet the dynamic needs of clients? [Q3 MODEL RESPONSE] Your answer should include the following: 

Determine the assumptions of the theory.



Identify the limitations of the theory as indicated by the client’s unique culture.



Simplify the theory into three to five main themes or concepts.



Diversify interventions to meet the client’s unique needs.

Application Exercise 17.3: Alternative Approaches to Treating Mental Health Learning Outcome 17.3: Engage in reflective and critical thinking skills to gain insight into assumptions, worldviews, values, beliefs, biases, and privileged and marginalized statuses. [Q1] Discuss some of the ways that Western counseling approaches conflict with the beliefs other cultures hold about health and wellness.

[Q2 MODEL RESPONSE] Your answer should include some of the following points: 

The phenomenon that mind, body, and spirit are separated and compartmentalized is a Western view of mental health.



In many cultures, mental health is incorporated in religious or spiritual belief systems.



The functions of the mind are linked to the characteristics of the soul, and in this way, problems of conscious are conceptualized as problems of conscience.



Other cultures believe that the problems of an individual are linked more often to their role and participation in a larger social group or society than to intrapersonal dynamics.



It is important to recognize that all cultures have unique approaches to healing and establishing one’s mental well-being.

[Q2] Select one of the non-Western or alternative therapies listed in the chapter and explain how you might utilize this approach in your future clinical work. [Q2 MODEL RESPONSE] Students may select Naikan therapy, Morita therapy, Ntu Psychotherapy, mediation, Yoga, Ayurveda, Buddhist psychology, or Indigenous ways of knowing (IW OK). Answers will vary based on the interests, motivations, career aspirations, and/or cultural background of the respondent. [Q3] Highlight some of the gaps in the current literature on multicultural counseling theory and suggest a prospective topic for further study. [Q3 MODEL RESPONSE] 

The counseling profession needs to further investigate the theories upon which we rely for the development of standardized assessments, methods for assessment validation, and client outcomes related to inclusive practices.



Better understand how clinical and theoretical decision making influences the therapeutic alliance.



Study how humility, competence, and other cultural relational factors influence client symptom experience as well as their satisfaction with and willingness to engage in mental health care.

Chapter 17 Test Items Multiple Choice is founded on one’s experiences.

1. a. Culture b. Theory

c. Both of the above. d. None of the above. 2.

Which of the following accurately describes theory? a. It cannot encompass all human experiences. b. It belongs to us as counselors. c. It seeks to provide an all-encompassing response. d. All of the above.

Theoretical orientation describes both a. our rationale and our action. b. our client and our plan of action. c. ourselves as counselors and our clients. d. our personal beliefs and the beliefs of our clients.

According to the Kluckhohn and Strodbeck theoretical model, which of the following are value orientations? a. Human nature b. Human activity c. Time sense d. All of the above.

Which of the following is NOT one of the nine assumptions counselors use to create and support their approaches to counseling? a. holism/elementalism b. constitutionalism/rationalism c. subjectivity/objectivity d. homeostasis/heterostasis

facilitates stronger client-counselor alliance and counselor empathy. a. Active listening b. Congruence in worldviews c. Openness to other’s worldviews d. The counselor’s experience

Theory has typically been characterized as a collection of a. interrelated ideas. b. constructs. c. principles. d. All of the above.

Exclusion of the targeted culture from a counseling theory may result in a. misdiagnosis. b. misunderstanding of particular meanings of concepts and behaviors. c. clients running the risk of being considered deficient. d. All of the above.

A person’s comprises personal constructs that are created within familial, cultural, and societal contexts. a. worldview. b. theory. c. culture. d. nature.

10.

have been called the greatest unifier and the greatest divider of people. a. Worldviews b. Religion and Spirituality c. Languages d. Values and morals

11. Religious and spiritual beliefs affect a. how one defines mental health. b. thoughts, emotions, and motivation for behavior. c. worldview. d. All of the above. 12. When applying a theory to counseling it is important to a. ask the client which theory they prefer. b. consider how the theory interacts with the client’s beliefs about the divine. c. consider how the counselor’s beliefs can be imposed upon the client. d. be open to using many theories at the same time. 13. Governments a. set parameters for what it means to be an accepted member of society. b. influence laws to reinforce lifestyle choices. c. are direct expressions of worldviews.

d. All of the above. 14.

is a social system with the greatest potential for shaping notions of mental health. a. Family b. Government c. Religion d. Culture

15. Which of the following would NOT be a helpful question in determining the role of family within a particular society? a. What constitutes a family? b. How are family relations connected with social status? c. Who are the parents of the client? d. How are families created? 16. Most of the major theories have been developed to serve a. the greater populations of the world. b. White, middle-class men of European heritage. c. all cultures who support counseling. d. adults between the ages of 25 and 55. 17. Grand theories in counseling a. evolve and adapt over time. b. seek to integrate all dimensions of human experience. c. incorporate many different models. d. All of the above. 18. To be culturally responsive in counseling, a. clients must be willing to divulge a great deal of information to the counselor. b. counselors must be self-aware of their own cultural identities and cultural contexts for their approach to counseling. c. counselors should ignore any views that differ from the client’s. d. All of the above. 19.

allows a counselor to remain grounded in their client conceptualization while exploring new ways to apply theory. a. Culturally responsive counseling b. Eclecticism c. Theoretical adaptation d. Morita therapy

20. Multicultural Counseling and Therapy (MCT) includes a. feminist theory. b. Afrocentric theory. c. indigenous healing practices. d. All of the above. 21. The practice of Naikan therapy has been shown to be effective in treating a. anxiety. b. alcoholism. c. anorexia nervosa. d. All of the above. 22. In therapy, clients are encouraged to consider how their behavior and attitudes contribute or detract from a greater social system. a. Morita b. Ntu c. Naikan d. humanistic-existential 23. The goal of Ntu psychotherapy is to a. create a sense of holism in one’s life. b. restore harmony, genuineness, and interconnectedness. c. restore a sense of belonging to society. d. None of the above. 24. Which of the following is NOT one of the distinct phases of Ntu psychotherapy? a. alignment b. actualization c. restoration d. synthesis 25. In the phase of Ntu psychotherapy, congruence of thoughts, behaviors, and feelings is the goal. a. harmony b. alignment c. actualization d. synthesis 26. Both are founded on persons’ experiences. So as people experience more, including one another, their theoretical orientations change. a. health and dysfunction b. beliefs and insight

c. culture and theory d. thoughts and behavior 27. For counselors, the phrase theoretical orientation best describes our a. rationale and our action. b. purpose and our direction. c. research and our practice. d. None of the above. 28. Many people become aware of their motivation for living or their personal theory for life a. following a traumatic event. b. while in counseling. c. at times of change or crisis. d. All of the above. 29. A person’s worldview can be best characterized as a. founded exclusively on cultural expectations. b. explanations, motivations, or reasons for living their lives. c. motivation for transformation. d. mutable and transient. 30. A person’s worldview is typically constructed from all of the following value orientations EXCEPT a. human nature. b. person/nature relations. c. social relations. d. family structure. 31. When clients do not fit the cultural expectations for a particular theory a. they are beyond help. b. they should not seek counseling. c. they could be inaccurately viewed as deficient from the start. d. counselors are advised to improvise. 32. All of the following social systems affect clients understanding of mental health EXCEPT a. religion. b. government. c. family. d. All of the above affect a client’s understanding of mental health.

33. The fourth force in counseling has been characterized as a. transpersonal. b. integrative. c. multicultural. d. All of the above. 34. Counseling theories generally are developed in and support a particularly worldview. a. Westernized b. evolved c. individualized d. collective 35. The concept of a grand theory is best described as a. integrating all dimensions of human experience into a single overarching theoretical framework. b. incorporating many different models for counseling and spawning variations on a particular theme. c. Both of the above. d. None of the above. 36. The process of theoretical adaptation includes a. Eliminate Assumptions, Identify Limitations, Codify Concepts, and Interventions. b. Illuminate Assumptions, Specify Limitations, Evaluate Clients, and Diversify Interventions. c. Eliminate Assumptions, Specify Limitations, Evaluate Clients, and Diagnose Interventions. d. Determine Assumptions, Identify Limitations, Simplify Concepts, and Diversify Interventions. 37. Contextual–systemic models of theory and intervention are supported by a. constructivist paradigms. b. positivist paradigms. c. post-positivist paradigms. d. All of the above. 38. Multicultural counseling and therapy (MCT) has been presented as that encompasses many different conceptual models and approaches to counseling. a. a model for counseling b. a meta-theory c. an intervention d. an evaluative method

39. The practice of encourages individuals to consider their roles in and reliance on larger social systems and engage inward reflection for greater understanding and appreciation for the benefits of an external system. a. Naikan b. mediation c. yoga d. counseling 40.

therapy is a culturally contextualized approach to counseling that emphasizes the importance of self-in-relation. a. Person-centered b. Morita c. Group d. Jungian

41. The concept of comes from Central Africa (Bantu) and refers to universal energy or sense of being that is shared by all things. a. Naikan b. Ayurveda c. Prana d. Ntu 42. The primary goal for is to balance all systems in the individual and a wide variety of treatments are integrated at both the individual and environmental levels. a. Naikan b. Ayurveda c. Prana d. Ntu 43. Empowerment theory a. has roots in feminist theory. b. has roots in multicultural theories. c. allows counselors to incorporate social advocacy into their sessions. d. All of the above. 44.

focuses on the shift from working for clients to working with clients toward a more complete picture of traditionally underserved populations. a. Empowerment theory b. Relational-cultural theory c. Meta-theory d. Meditation

45. All of the following are considered alternative therapies EXCEPT a. yoga b. Ayurveda c. empowerment theory d. indigenous ways of knowing (IWOK)

Extended Response 1.

Explain grand theory and list the grand theories in counseling.

Define culturally responsive counseling and explain why it is important in today’s society.

Define theoretical adaptation and eclecticism and explain how the two terms are related.

List the six propositions of Multicultural Counseling and Therapy (MCT).

Explain Naikan therapy and give examples of effective treatment topics.

Compare and contrast Naikan therapy with Morita therapy.

Describe the process of Ntu psychotherapy.

What are some of the challenges related to integrating traditional counseling theories with cultural variables?

Discuss and provide support for the following statement: ―Theory is something that belongs to us as counselors.‖

10. How does a client’s worldview impact the counseling relationship? 11. How does a counselor’s worldview impact the counseling relationship? 12. Describe the connection between counseling theory and personal worldview. 13. How does theory attempt to provide a comprehensive explanation for human experience? 14. Describe some of the challenges that arise when worldviews of counselors and clients differ. 15. How do the social systems of religion, government, and family influence clients and shape a culture’s understanding of mental health? 16. Describe what is meant by the following statement: Limiting theoretical and treatment options to approaches based solely on Western worldviews can prove to be both useless and potentially harmful to some clients. 17. Identify and describe at least three of the alternative therapies presented in the chapter.

Chapter 17 Test Answer Key ANSWER KEY: Chapter 17 Test (Multiple Choice) 1. c 2. d 3. a 4. d 5. b 6. b 7. d 8. d 9. a 10. b 11. d 12. b 13. d 14. a 15. c 16. b 17. d 18. b 19. c 20. d 21. d 22. a 23. b 24. c 25. b 26. c 27. a 28. d 29. b 30. d 31. c 32. d

33. d 34. a 35. c 36. d 37. a 38. b 39. a 40. b 41. d 42. b 43. d 44. b 45. c

Chapter 18 Test Item File Danica G. Hays and Bradley T. Erford

Developing Multicultural Counseling Competence: A Systems Approach 4th Edition

Danica G. Hays University of Nevada, Las Vegas

Bradley T. Erford Peabody College at Vanderbilt University

ISBN-10: 0137474148 ISBN-13: 9780137474141

Table of Contents

Chapter 18: Multicultural Diagnosis and Conceptualization

Learning Outcome Quizzes

Application Exercises

Test Items

Test Answer Key

Chapter 18: Multicultural Diagnosis and Conceptualization Chapter 18 Learning Outcome Quizzes Learning Outcome 18.1: Understand ethnic and gender considerations that relate to mental health diagnoses. [Q1] The practice of applying cultural competence to multicultural diagnosis and conceptualization first calls upon counselors to adopt what type of orientation? 1. Culturally humble [correct] 2. Culturally sensitive 3. Culturally aware 4. Culturally flexible [Feedback for Correct Answer 1] The practice of applying cultural competence to multicultural diagnosis and conceptualization first calls upon counselors to adopt a cultural humility orientation. [Feedback for Answer Choice 2] Cultural sensitivity is a byproduct of cultural humility. [Feedback for Answer Choice 3] Cultural awareness, like cultural sensitivity, is a byproduct of cultural humility. [Feedback for Answer Choice 4] Counselors must practice flexibility is their conceptualization and treatment of the diverse and intersecting identities of their clients. However, this flexibility starts with and is rooted in a cultural humility orientation. [Q2] In the absence of an awareness of the client’s context, a counselor risks engaging in the unethical practice of: 1. appearing incompetent. 2. imposing their beliefs. [correct] 3. misunderstanding the client. 4. inadvertently breaking confidentiality. [Feedback for Answer Choice 1] The ACA Code of Ethics (2014) instructs counselors to develop an awareness of the client’s context to safeguard against imposing their values, rather than to avoid appearing incompetent. [Feedback for Correct Answer 2]

In the absence of an awareness of the client’s context, a counselor risks engaging in the unethical practice of ―imposing their values, attitudes, beliefs, and behaviors‖ that may be ―inconsistent with the client’s goals or discriminatory in nature‖ (ACA, 2014, p. 5). [Feedback for Answer Choice 3] Counselors should make every effort to understand their client’s issues and perspectives; however, a misunderstanding is not an ethical violation. [Feedback for Answer Choice 4] The absence of this awareness of the client’s context is not typically a precipitating factor associated with breaking confidentiality. [Q3] As a strengths-based profession, counselors are committed to seeing problems developmentally and the medical model. 1. ascribe to 2. disregard 3. are suspicious of 4. know and use [correct] [Feedback for Answer Choice 1] As a strengths-based profession, counselors are committed to seeing problems developmentally; however, they do not ascribe to the medical model. [Feedback for Answer Choice 2] While counselors do not ascribe to the medical model, they do not disregard it. Counselors are trained to know and use the medical model in circumstances when this approach is necessary for client treatment. [Feedback for Answer Choice 3] While counselors do not ascribe to the medical model, they are not suspicious of it. Counselors are trained and competent to utilize this model when clinically appropriate. [Feedback for Correct Answer 4] As a strengths-based profession, counselors are committed to seeing problems developmentally. While they do not ascribe to the medical model, they know it and use it. [Q4] Conducting clinical assessments in a culturally competent manner is an ethical mandate. Counselors must make efforts to avoid clinical assessments that are: 1. collaborative. 2. multidimensional. 3. oversimplified. [correct] 4. socio-historical. [Feedback for Answer Choice 1] 2 Copyright © 2023, 2018, 2014 by Pearson Education, Inc. All Rights Reserved.

Culturally competent counselors take appropriate steps to work collaboratively with clients in the assessment and conceptualization process. [Feedback for Answer Choice 2] Suite and colleagues (2007) contend that counselors must be willing to utilize clinical assessments that are ―contextual and multidimensional…‖ (p. 883). [Feedback for Correct Answer 3] Suite and colleagues (2007) contend that counselors must be willing to utilize clinical assessments that are ―…fashioned on the complexity of the historical experience of each client, and not on oversimplification and reductionism‖ (p. 883). [Feedback for Answer Choice 4] Multiculturally competent counselors work with clients during the assessment process to evaluate and conceptualize how socio-historical events shape the worldview and experiences of clients. Learning Outcome 18.2: Discuss and understand ethical challenges to multicultural diagnosis and conceptualization. [Q1] Which of the following significantly affected the way counselors diagnose mental disorders by moving away from the categorical, axial system to dimensional assessments? 1. DSM - IV 2. DSM - IV -TR 3. DSM-5 [correct] 4. DSM - III [Feedback for Answer Choice 1] The DSM - IV utilized a categorical, axial system of diagnosing mental disorders. [Feedback for Answer Choice 2] The DSM - IV -TR retained the categorical, axial system of diagnosing mental disorders. [Feedback for Correct Answer 3] The DSM-5 significantly affected the way counselors diagnose mental disorders by moving away from the categorical, axial system to dimensional assessments. [Feedback for Answer Choice 4] The DSM - III retains the dimensional assessment framework first introduced in the original DSM. [Q2] A categorical classification approach works best when members of a diagnostic class are: 1. heterogeneous. 2. homogeneous. [correct] 3 Copyright © 2023, 2018, 2014 by Pearson Education, Inc. All Rights Reserved.

3. overlapping. 4. co-occurring. [Feedback for Answer Choice 1] A categorical classification approach works best when members of a diagnostic class are homogeneous. [Feedback for Correct Answer 2] A categorical classification approach works best when members of a diagnostic class are homogeneous. [Feedback for Answer Choice 3] A categorical classification approach works best when there are clear boundaries between diagnostic categories; however, this has not always been the case for certain DSM categorical diagnoses, with many frequently overlapping. [Feedback for Answer Choice 4] According to Jacobson and Newman (2017), the existence of excessive diagnostic comorbidity has been recognized as a significant limitation and challenges the validity of the diagnostic categories themselves. [Q3] The information than the

approach to diagnosis yields a greater amount of clinical classification system.

1. dimensional, categorial [correct] 2. categorical, dimensional 3. categorical, axial 4. axial, dimensional [Feedback for Correct Answer 1] The dimensional approach to diagnosis yields a greater amount of clinical information than the categorial classification system. [Feedback for Answer Choice 2] The categorical approach to diagnosis yields a lesser amount of clinical information than the dimensional classification system. [Feedback for Answer Choice 3] The categorial approach to diagnosis is also known as the axial approach. Thus, each approach yields the same amount of clinical information. [Feedback for Answer Choice 4] The axial approach to diagnosis is also known as the categorical approach. As such, the axial approach to diagnosis yields a lesser amount of clinical information than the dimensional classification system. [Q4] 4 Copyright © 2023, 2018, 2014 by Pearson Education, Inc. All Rights Reserved.

One long overdue emerging measure included in the DSM-5 is the cultural formulation interview (CFI). Research investigating the specific clinical benefits that the CFI provides when working with a diverse client base can best be described as: 1. qualitative. 2. quantitative. 3. mixed. 4. scarce. [correct] [Feedback for Answer Choice 1] Very few studies have investigated the specific clinical benefits that the CFI provides when working with a diverse client base. However, the results of qualitative studies are not generalizable and, thus, could not provide insight into the clinical benefits of CFI. [Feedback for Answer Choice 2] Very few studies have investigated the specific clinical benefits that the CFI provides when working with a diverse client base. However, the results of future quantitative studies will be able to offer insights into the clinical benefits of CFI. [Feedback for Answer Choice 3] Very few studies have investigated the specific clinical benefits that the CFI provides when working with a diverse client base, so there are not enough data to even generate mixed findings. [Feedback for Correct Answer 4] Research investigating the specific clinical benefits that the CFI provides when working with a diverse client base can best be described as scarce. Learning Outcome 18.3: Describe the role of culture with respect to views of normality, abnormality, and psychopathology. [Q1] Some argue that the changes made to the DSM-5 regarding depression and bereavement may increase the potential for clinicians to normal reactions to a universal human experience. 1. pathologize [correct] 2. minimize 3. oversimplify 4. contextualize [Feedback for Correct Answer 1] Some argue that the changes made to the DSM-5 regarding depression and bereavement may increase the potential for clinicians to pathologize normal reactions to a universal human experience. [Feedback for Answer Choice 2]

Some argue that the changes made to the DSM-5 regarding depression and bereavement may increase the potential for clinicians to pathologize and, thus, render an exaggerated response to a client’s normal reaction to a universal human experience. [Feedback for Answer Choice 3] Some argue that the changes made to the DSM-5 regarding depression and bereavement may increase the potential for clinicians to pathologize normal reactions to a universal human experience, which would not constitute an oversimplification. [Feedback for Answer Choice 4] Contextualizing client issues is an important component of the diagnostic process. [Q2] The application of diagnostic criteria to cultural groups for which they were not developed and have never been validated is called a fallacy. 1. assessment 2. category [correct] 3. cultural 4. deductive [Feedback for Answer Choice 1] Assessment fallacy is not a counseling-specific concept or term. [Feedback for Correct Answer 2] The application of diagnostic criteria to cultural groups for which they were not developed and have never been validated is called a category fallacy. [Feedback for Answer Choice 3] Cultural fallacy is not a counseling-specific concept or term. [Feedback for Answer Choice 4] The term deductive fallacy is typically used in the fields of philosophy. As such, it is not a counseling-specific concept or term. [Q3] Research indicates that Black individuals are with depression.

with psychosis and

1. overdiagnosed, underdiagnosed [correct] 2. underdiagnosed, overdiagnosed 3. overdiagnosed, misdiagnosed 4. misdiagnosed, overdiagnosed [Feedback for Correct Answer 1] Research indicates that Black individuals are overdiagnosed with psychosis and underdiagnosed with depression. 6 Copyright © 2023, 2018, 2014 by Pearson Education, Inc. All Rights Reserved.

[Feedback for Answer Choice 2] Research does not indicate that Black individuals are underdiagnosed with psychosis and overdiagnosed with depression. [Feedback for Answer Choice 3] Research does not indicate that Black individuals are overdiagnosed with psychosis and misdiagnosed with depression. [Feedback for Answer Choice 4] Research does not indicate that Black individuals are misdiagnosed with psychosis and overdiagnosed with depression. [Q4] The Navajo diagnosis of a ―Dissociative episode characterized by a period of brooding followed by an outburst of violent, aggressive, or homicidal behavior‖ is called: 1. Amok 2. Cafard 3. Mal de pelea 4. Iich’aa [correct] [Feedback for Answer Choice 1] Amok is the Malaysian diagnosis of a ―Dissociative episode characterized by a period of brooding followed by an outburst of violent, aggressive, or homicidal behavior.‖ [Feedback for Answer Choice 2] Cafard or cathard is the diagnosis for the above-mentioned condition in Laos, the Philippines, Polynesia, and Papua New Guinea. [Feedback for Answer Choice 3] Mal de pelea is the diagnosis for the above-mentioned condition in Puerto Rico. [Feedback for Correct Answer 4] The Navajo diagnosis of a ―Dissociative episode characterized by a period of brooding followed by an outburst of violent, aggressive, or homicidal behavior‖ is called Iich’aa. Learning Outcome 18.4: Articulate feminist challenges and considerations for multicultural diagnosis and conceptualization. [Q1] Adolescent boys are often overdiagnosed with which of the following disorders? 1. Attention-deficit/hyperactivity disorder 2. Intermittent explosive disorder 3. Antisocial personality disorder 4. Conduct disorders [correct] [Feedback for Answer Choice 1] 7 Copyright © 2023, 2018, 2014 by Pearson Education, Inc. All Rights Reserved.

Children under age 13 years are often overdiagnosed with attention-deficit/hyperactivity disorder. [Feedback for Answer Choice 2] Intermittent explosive disorder is one of the three disorders that correlates with problematic behavior that continues into adulthood. [Feedback for Answer Choice 3] Antisocial personality disorder is another one of the three disorders that correlates with problematic behavior that continues into adulthood. [Feedback for Correct Answer 4] Adolescent boys are often overdiagnosed with conduct disorders and substance-use disorders. [Q2] Feminists contend that diagnostic labels can have stigmatizing effects and argue that the assumptions embedded in both the International Classification of Diseases (ICD) and the DSM are: 1. ableist and ageist. 2. ableist and antiquated. 3. sexist and racist. [correct] 4. sexist and antiquated. [Feedback for Answer Choice 1] Rather than arguing that the assumptions embedded in both the International Classification of Diseases (ICD) and the DSM are ableist and ageist, feminists contend that these assumptions are classist, sexist, racist, and homophobic. [Feedback for Answer Choice 2] Rather than arguing that the assumptions embedded in both the International Classification of Diseases (ICD) and the DSM are ableist and antiquated, feminists contend that these assumptions are classist, sexist, racist, and homophobic. [Feedback for Correct Answer 3] Feminists contend that diagnostic labels can have stigmatizing effects and argue that the assumptions embedded in both the International Classification of Diseases (ICD) and the DSM are classist, sexist, racist, and homophobic. [Feedback for Answer Choice 4] Rather than arguing that the assumptions embedded in both the International Classification of Diseases (ICD) and the DSM are sexist and antiquated, feminists contend that these assumptions are oppressive and lack cultural sensitivity due to being sexist as well as racist, classist, and homophobic. [Q3] Men are more likely than women to be diagnosed with: 1. Bipolar I 8 Copyright © 2023, 2018, 2014 by Pearson Education, Inc. All Rights Reserved.

2. Borderline Personality Disorder 3. Avoidant Personality Disorder 4. Obsessive-compulsive Personality Disorder [correct] [Feedback for Answer Choice 1] Prevalence for Bipolar I is equal in both men and women (APA, 2013). [Feedback for Answer Choice 2] Personality disorders occur more frequently in men than women, with the exceptions of borderline personality disorder (75% female; APA, 2013). [Feedback for Answer Choice 3] Avoidant Personality Disorder is equally prevalent between the sexes (APA, 2013). [Feedback for Correct Answer 4] Obsessive-compulsive Personality Disorder is observed twice as often in men than women (AP A, 2013). [Q4] Women are more likely than men to be diagnosed with: 1. Bipolar I 2. Borderline Personality Disorder [correct] 3. Avoidant Personality Disorder 4. Obsessive-compulsive Personality Disorder [Feedback for Answer Choice 1] Prevalence for Bipolar I is equal in both men and women (APA, 2013). [Feedback for Correct Answer 2] Personality disorders occur more frequently in men than women, with the exceptions of borderline personality disorder (75% female; APA, 2013). [Feedback for Answer Choice 3] Avoidant Personality Disorder is equally prevalent between the sexes (APA, 2013). [Feedback for Answer Choice 4] Obsessive-compulsive Personality Disorder is observed twice as often in men than women (AP A, 2013). Learning Outcome 18.5: Identify how the process of diagnosis and conceptualization can be informed from a multicultural lens. [Q1] According to Drummond and colleagues (2016), prior to classifying the client under a particular diagnosis, counselors should reflect on the potentiality that a client’s presenting concerns could stem from: 9 Copyright © 2023, 2018, 2014 by Pearson Education, Inc. All Rights Reserved.

1. relational issues. 2. everyday life stressors. 3. culturally based explanations. [correct] 4. overuse of alcohol or drugs. [Feedback for Answer Choice 1] While relational issues may influence a client’s presenting concerns, the writing of Drummond and colleagues (2016) emphasizes the importance of reflecting on culturally based explanations for a client’s issues. [Feedback for Answer Choice 2] While everyday life stressors may influence a client’s presenting concerns, the writing of Drummond and colleagues (2016) emphasizes the importance of reflecting on culturally based explanations for a client’s issues. [Feedback for Correct Answer 3] Drummond and colleagues (2016) suggested that prior to classifying the client into a taxonomic scheme, such as a diagnosis, counselors should reflect on the potentiality that a client’s presenting concerns could stem from culturally based explanations. By incorporating this information, counselors are able to make more accurate interpretations of the psychological functioning of clients from diverse backgrounds. [Feedback for Answer Choice 4] Substance use disorders can certainly influence a client’s presenting concerns; however, the writing of Drummond and colleagues (2016) does not focus on this issue. Instead, the authors choose to emphasize the importance of reflecting on culturally based explanations for a client’s issues. [Q2] In the literature, much of the critical discourse around professionals’ use of the DSM has focused on: 1. problems. [correct] 2. solutions. 3. outcomes. 4. effectiveness. [Feedback for Correct Answer 1] In the literature, much of the critical discourse around professionals’ use of the DSM has focused on problems rather than solutions. [Feedback for Answer Choice 2] In the literature, much of the critical discourse around professionals’ use of the DSM has focused on what ―not to do‖ versus ―what to do,‖ on problems rather than solutions. [Feedback for Answer Choice 3]

In the literature, much of the critical discourse around professionals’ use of the DSM has focused on problems rather than outcomes. [Feedback for Answer Choice 4] In the literature, much of the critical discourse around professionals’ use of the DSM has focused on what ―not to do‖ versus ―what to do‖ to ensure effectiveness. [Q3] As new information becomes available over time, diagnoses should rather than . 1. narrow, expand 2. expand, narrow 3. remain static, continue to evolve 4. continue to evolve, remain static [correct] [Feedback for Answer Choice 1] As new information becomes available over time, diagnoses should continue to evolve. [Feedback for Answer Choice 2] As new information becomes available over time, diagnoses should continue to evolve. [Feedback for Answer Choice 3] As new information becomes available over time, diagnoses should not remain static. Instead, counselors must be willing to embrace this new information and allow their diagnosis to evolve accordingly. [Feedback for Correct Answer 4] As new information becomes available over time, diagnoses should continue to evolve rather than remain static. [Q4] Magnavita (2016) contends that the relevance of is undermined when behaviors that do not conform to a Western model are interpreted as abnormal or maladaptive. 1. culture [correct] 2. methodological rigor 3. World Health Organization 4. universal diagnostic categories [Feedback for Correct Answer 1] Magnavita (2016) contends that the relevance of culture is undermined when behaviors that do not conform to a Western model are interpreted as abnormal or maladaptive. [Feedback for Answer Choice 2]

Kirmayer and Minas (2000, p. 447) argue that ―the homogenization and standardization of world cultures and traditions of healing…‖ has resulted in increased methodological rigor, but a loss of diversity. [Feedback for Answer Choice 3] Magnavita (2016) did not comment on the relevance of the World Health Organization. It is important to note, however, that in the fifth edition of the DSM, a stronger alignment has been made between DSM diagnostic codes and those adopted by the World Health Organization in the ICD. [Feedback for Answer Choice 4] Historically, cultural and diagnostic scholars seem to pursue two different poles or models: one suggests that there are universal diagnostic categories and descriptors that apply regardless of situational and cultural factors. Magnavita (2016) holds the second perspective and emphasizes the critical responsibility to consider culture throughout the assessment and diagnostic process.

Chapter 18 Application Exercises Application Exercise 18.1: Power Balances Learning Outcome 18.2: Discuss and understand ethical challenges to multicultural diagnosis and conceptualization. [URL TITLE] Exchange between Client and Counselor [Q1] Use Pearson eText Video Example 18.2 to answer the following question. Pay particular attention to the exchange between the counselor and client. Using what you have learned from the video and the research in the text, what power dynamics may be present in this counseling relationship? [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Counselors hold more power in the therapeutic relationship than clients.



The ethnic identities of counselor or client might place a certain gender in a more powerful position.



The counselor and client appear to be roughly the same age, which limits a power differential due to age.



The client appears to be White, which typically is associated with greater levels of power and privilege than non-White individuals.

[Q2] Use Pearson eText Video Example 18.2 to answer the following question. Using what you have learned from the video and the research in the text, what are some strategies that counselors might use to overcome power differentials in the therapeutic relationship? [Q2 MODEL RESPONSE] Your answer could include any of the following: 

Seeking supervision/consultation



Researching cultural values of the client



Addressing power differentials with the client



Remaining mindful of personal biases when engaging in case conceptualization and treatment planning

[Q3] Use Pearson eText Video Example 18.2 to answer the following question. Using what you have learned from the video and the research in the text, at what point might it be important for the counselor to broach the subject of power and privilege with this client? 13 Copyright © 2023, 2018, 2014 by Pearson Education, Inc. All Rights Reserved.

[Q3 MODEL RESPONSE] Your answer might include any of the following: 

Power and privilege should be broached if it is therapeutically relevant.



The counselor should take care to move at the client’s pace in session.



The counselor should address power and privilege in the counseling relationship if it forms a parallel process with other aspects of the client’s life (e.g., at work or at home).

Application Exercise 18.2: Multiculturally Sensitive Assessment and Diagnosis Learning Outcome 18.5: Identify how the process of diagnosis and conceptualization can be informed from a multicultural lens. [Q1] To identify and eliminate prejudices in the therapeutic relationship, it is important for counselors to conduct multiculturally sensitive assessment and diagnosis. What should you, as a professional counselor, proactively bring into awareness when creating a diversity-sensitive diagnosis? [Q1 MODEL RESPONSE] Your answer should include some of the following points: 

Commit to understanding your personal biases and stereotypes.



Find ways to overcome your personal biases and stereotypes.



Commit to ongoing awareness about cultural encapsulation.



Continually question assumptions regarding what is usual or normal in terms of gender, age, and ethnicity.



Conduct a holistic assessment before issuing a diagnosis.



Engage in ongoing assessment to adjust diagnoses as needed.



Avoid jumping to conclusions based on a client’s cultural membership.

[Q2] To identify and eliminate prejudices in the therapeutic relationship, it is important for counselors to conduct multiculturally sensitive assessment and diagnosis. What should you, as a professional counselor, proactively bring into your knowledge base when creating a diversitysensitive diagnosis? [Q2 MODEL RESPONSE] Your answer should include some of the following points: 

Use assessment scales that have been validated with a client’s cultural group.



Remember that mental health symptoms manifest differently depending on cultural memberships.



Remember that mental health symptoms have different meanings in certain cultures.



Be aware of the conflicts that may exist between people of different cultures.



Be aware of conflicts that may exist between cultural values and governmental laws.



Avoid research conclusions that do not include information regarding marginalized populations (e.g., women, ethnic minorities).

[Q3] To identify and eliminate prejudices in the therapeutic relationship, it is important for counselors to conduct multiculturally sensitive assessment and diagnosis. What should you, as a professional counselor, proactively bring into your skill base when creating a diversity-sensitive diagnosis? [Q3 MODEL RESPONSE] Your answer should include some of the following points: 

Assess the client’s cultural identity.



Assess the cultural meaning of a client’s presenting problems.



Increase the client’s understanding of the diagnosis and treatment.



Carefully describe and account for relevant cultural phenomena related to the diagnosis.



Consider the way that family, work, and community factors contribute to the clients’ presenting problems.



Attend to client reports of somatic complaints, which might be important for accurate diagnosis.



Collaborate with clients when planning treatment goals and approaches.



Adjust non-verbal communication according to client customs.



Collaborate with relevant healers and authorities from the client’s culture.



Use relevant cultural symbols in counseling when appropriate.



Increase the client’s sense of control in counseling when relevant.



Attend to factors that might affect gender and other diverse expressions.



Avoid misdiagnosis, underdiagnosis, and overdiagnosis whenever possible.

Application Exercise 18.3: Putting It in Action Learning Outcome 18.5: Identify how the process of diagnosis and conceptualization can be informed from a multicultural lens. [Q1] The American Counseling Association (2016) ethical code C.2.a. states, ―multicultural counseling competency is required across all counseling specialties.‖ What about this quote stands out to you? [Q1 MODEL RESPONSE] Your answer might include any of the following or anything else that resonates with you as a unique, multicultural counselor: 

I want to maintain an awareness of my thoughts, feelings, and behaviors regarding my own culture.



I want to maintain an awareness of each of my clients’ thoughts, feelings, and behaviors regarding culture.



All people are multiculturally different.



All counseling is, in a sense, multicultural counseling.



To practice my job ethically, I must always keep in mind my own cultural biases and work to understand others’ boundaries and work toward an empathic, holistic relationship with clients.



I am committed to multiculturally sound practice, and I value all diversity factors, visible or invisible, equally.

[Q2] What is one thing you learned from this text? Which one concept resonates with you the most? It could be a concept you really appreciate, one that you still need to learn more about, or a concept that you find validating or helpful. [Q2 MODEL RESPONSE] The possibilities are endless— your answer to this question is uniquely your own. [Q3] How will you apply the multicultural knowledge you have gained in your professional practice? [Q3 MODEL RESPONSE] Your answer might include an endless number of combinations. Please actively seek information about diversity in counseling and apply it across the lifetime of your career.

Chapter 18 Test Items Multiple Choice 1.

impact(s) the concept of normalcy in the diagnosis of individuals who are receiving mental health services. a. Culture b. Gender c. Risk of the abuse of power by practitioners d. All of the above.

In North America, practitioners’ constructs of personality and psychopathology reflect White, male, Anglo-Germanic, Protestant individuals who are formally educated and middle class. This is an example of a. culture bound variables in diagnosis. b. social comparison in diagnosis. c. culture and gender sensitivity in diagnosis. d. the founding fathers variable of diagnosis.

Overdiagnosis has been common for members of the following populations except a. White males. b. African Americans. c. lesbians. d. gay men.

Feminist analysis requires the client to be responsible for a. solving presenting concerns to a large degree. b. providing all information regarding the presenting concern. c. providing information regarding his/her cultural norms. d. receiving quality care and visiting the national mental health organization websites to understand the process.

The perspective asserts that the anger, depression, and discontent that result from the challenging and stressful life circumstances of women or other disadvantaged groups are reframed as medical or psychiatric symptoms. a. cross-cultural b. gender c. feminist d. collectivist

c. men in general. d. women in general. 7.

Women have higher prevalence rates of a. substance abuse. b. sexually related disorders. c. anxiety disorders. d. general medical conditions.

Regarding prevalence rates and diagnosis among school age children, a. there are greater differences between boys and girls in the elementary years. b. girls have higher rates of diagnosis in the elementary years. c. there is no difference between girls and boys during the adolescent years. d. boys are more frequently diagnosed in the elementary years.

According to the feminist perspective, early versions of the DSM as well as subsequent versions have been influenced by masculine-based assumptions regarding health and illness. This assumption is an example of a. gender bias in diagnosis. b. sex bias in diagnosis. c. female bias in diagnosis. d. male bias in diagnosis.

10. According to research, sex bias in diagnosis results in women having higher prevalence rates of disorders due to social conventions rather than medical disease. a. mood b. impulse control c. sexually related d. personality 11. Research on diagnosis and sex differences have found that social positions influence a. the clinical presentation of individuals based upon whether they are in subordinate or dominant positions. b. the social condition of an individual but don’t influence the presentation of symptoms. c. only men’s presentation of symptoms. d. neither women nor men in the adult years. Social positions are only a variable in adolescents. 12. If a counselor is going to provide a comprehensive assessment, the counselor should consider instead of solely identifying the criteria of various disorders and selecting the best fit. a. referring to a clinician’s thesaurus to look up all areas related to the possible diagnosis b. presenting the current symptoms the client possesses to a clinical team for a 18 Copyright © 2023, 2018, 2014 by Pearson Education, Inc. All Rights Reserved.

collaborative decision from all clinical team members c. understanding the ―total‖ person (mind and body) of the individual who is seeking services d. understanding insurance procedures before providing the client with a diagnosis 13. Should a practitioner be the only individual who provides information regarding a client’s diagnosis when conducting a comprehensive assessment? a. Yes, the practitioner has worked with the client and is abreast of the clinical interview data. b. No, the practitioner should include all involved in the clinical relationship, including the client. c. Yes, the practitioner can do so if the practitioner is abreast of all cultural considerations. d. No, the practitioner must have the diagnosis approved by the clinical director of the organization to ensure all areas of the assessment have been evaluated and the diagnosis is appropriate. 14. Diagnosis is best described as a. a constructive, dynamic process of meaning making which should incorporate all descriptions and explanations of the presenting concern. b. a process that requires the understanding of the DSM and the ability to provide the appropriate diagnosis. c. a static, logical process in which the practitioner provides a diagnosis based upon the client’s presenting concern. d. a procedure that requires a significant number of clinical hours to ensure the practitioner has the appropriate skills. 15. The universal diagnostic model implies that all diagnostic categories and descriptions a. can be applied to all people regardless of situations and cultural variables. b. cannot be applied to all people regardless of situations and cultural variables. c. should apply to all sexes regardless of situations, or sex and gender role variables. d. should not be applied to all sexes regardless of situations and cultural variables. 16. The culturally specific diagnostic model states that all diagnostic categories and descriptions a. can be applied to all people regardless of situations and cultural variables. b. cannot be applied to all people regardless of situations and cultural variables. c. should apply to all sexes regardless of situations, or sex and gender role variables. d. should not be applied to all sexes regardless of situations and cultural variables. 17. An accurate assessment of emotion or behavior is NOT possible without an assessment of a. DSM criteria. b. feminist perspective. c. cultural schemas. 19 Copyright © 2023, 2018, 2014 by Pearson Education, Inc. All Rights Reserved.

d. DSM prevalence rates for a disorder. 18. Mental health professionals’ ethical codes prohibit discrimination on the basis of a. age. b. race. c. disability. d. All of the above. 19. Framing the normal difficulties and developmental struggles of everyday life in a negative way is referred to as a. psychologizing. b. pathologizing. c. patholocating. d. psycholocating. 20. With regard to sampling bias, all but which of the following has been raised as a concern? a. Research has ignored many of the people most in need of counseling services. b. Sampling has included a disproportionate representation of the sexes. c. The validity of the DSM’s personality disorders is strong. d. Sampling bias raises questions about who has the power to define illness and, thus, social control. 21. Culture does all of the following EXCEPT a. interprets the beliefs and customs of a social group. b. explains how individuals cope with distress. c. prescribes or determines a diagnosis. d. predicts how certain people may be misdiagnosed. 22. According to a feminist model, diagnostic labels and impressions can be influenced by all of the following stereotypes EXCEPT a. etiology of disorder assumptions. b. racist assumptions. c. homophobic assumptions. d. classist assumptions. 23. Young girls’ disorders are often overlooked or untreated because of a. the lack of ability to observe young girls’ distress when it is present due to internalized issues. b. the traditional notion that it is less important for girls to succeed academically. c. Both of the above. d. None of the above. 24. Which of the following is an example of traditional gender roles? 20 Copyright © 2023, 2018, 2014 by Pearson Education, Inc. All Rights Reserved.

a. Women are emotional, less aggressive, and easily influenced. b. Men are strong, independent, and goal-oriented. c. Both of the above. d. None of the above. 25.

disorders are more likely to represent social conventions. a. Sleep b. Sexually related c. Personality d. Eating

26. All of the following are examples of ways that women’s contextual distress can be alleviated EXCEPT a. providing affordable, quality childcare. b. offering free education. c. opening up employment for women. d. changing the definitions of proper female behavior. 27. The DSM tends to focus more on a. explanations than problems. b. problems than solutions. c. resolutions than problems. d. All of the above. 28. When using the DSM,

should be considered during assessment.

a. individual symptoms b. family interactions c. functional abilities d. All of the above 29. Culturally sensitive assessment involves assessing a. cultural systems/structures. b. cultural values. c. gender socialization. d. All of the above. 30. Feminist theorists contend that all of the following causes of problems are overemphasized EXCEPT a. Social and cultural context b. Biology c. Personality traits 21 Copyright © 2023, 2018, 2014 by Pearson Education, Inc. All Rights Reserved.

d. Life experiences 31. The DSM-5 has significantly affected the way counselors diagnose mental disorders by replacing the system with assessments. a. dimensional; axial b. dimensional; categorical c. categorical and axial; dimensional d. None of the above 32. The DSM-5 contains more than 67 cross-cultural validation.

that will require score validation, including

a. multiple diagnoses b. emerging measures c. unspecified categories d. binary categories 33. Category fallacy is a. synonymous with binary classification. b. the application of diagnostic categories to cultural groups for which they were not developed and have never been validated. c. Both of the above. d. None of the above. 34. The is an emerging measure included in the DSM-5 that helps the clinician understand the cultural context and factors of the client’s presenting problem, as well as the client’s perception of the problem. a. cultural formulation interview b. work group c. binary classification system d. All of the above 35. A major criticism of the recently added diagnosis of disruptive mood dysregulation disorder (DMDD) is a. that the symptoms demonstrate typical childhood behavior. b. the serious underdiagnosis of the disorder. c. the similarities to borderline personality disorder. d. All of the above. 36. Children under the age of 13 are often disorder (ADHD), while adolescents are often substance use disorders.

with attention deficit/hyperactivity with conduct disorders and

c. overdiagnosed; underdiagnosed d. overdiagnosed; overdiagnosed 37. Women in North America are

men to experience depression in their lives.

a. as likely as b. twice as likely as c. four times as likely as d. less likely than 38. An environmental factor that may account for the high rates of depression and other disorders in women is a. the greater restrictiveness of women’s roles. b. a lack of social networks and supports. c. more frequent experiences of gender-based discrimination. d. All of the above. 39. Which of the following statements is NOT considered a potential benefit of diagnosis? a. Diagnosis contributes to a common language that facilitates communication among those involved in the clients’ treatment. b. Diagnosis provides a framework for describing complex phenomena. c. Diagnosis treats all clients the same with a universal perspective. d. Diagnosis increases one’s understanding of the symptoms. 40. Which of the following questions should culturally sensitive counselors ask themselves before diagnosing a client? a. What do I know (and not know) about this client’s cultural heritage? b. How acculturated is the client? c. What are my stereotypes, beliefs, and biases about this culture? d. All of the above. 41. Significant correlations have been found between premenstrual dysphoric disorder (PMDD) and history of a. sexual abuse. b. domestic violence. c. depression and anxiety. d. All of the above. 42. Feminists hold the position that a. personal issues should be separated from political or social aspects. b. the personal cannot be separated from the political or social. c. therapy is viewed as a social, not political, process. d. therapy is viewed as a political, not social, process. 23 Copyright © 2023, 2018, 2014 by Pearson Education, Inc. All Rights Reserved.

43. All of the following statements regarding sex bias in diagnosis are true EXCEPT a. Knowing a client’s sex may influence the diagnostic process. b. Female and male clients may receive different diagnoses even when they present with identical symptoms. c. Sex bias in diagnosis is decreasing consistently. d. Female clients who acted in unfeminine ways received strong negative reactions. 44. Culture is inextricably linked with a. normal behavior. b. abnormal behavior. c. Both of the above. d. None of the above. 45. Research indicates that African Americans have been with depression.

with psychosis and

a. underdiagnosed; underdiagnosed b. underdiagnosed; overdiagnosed c. overdiagnosed; underdiagnosed d. overdiagnosed; overdiagnosed

Extended Response 1.

What steps might you take to ensure the highest professional and ethical conduct when working with a client and considering diagnosis?

How will you address your own values when providing a client with a diagnosis? How will you keep from imposing your value and belief system on your client (consider your nonverbal behavior)?

When working with your client, how will you demonstrate a respect for diverse populations?

Some mental health professionals struggle with providing diagnoses to clients who are members of diverse populations for whom a history of misdiagnosis is prevalent. How will you address your feelings?

Review your professional code of ethics and discuss how the materials covered in this chapter impact your decisions about the ethical mandates on client assessment, diagnosis, and counseling members of diverse communities.

It is important to allow an individual who is seeking counseling services to share his/her culture. How could you initiate a discussion about culture and diversity while gathering assessment data?

List all of the variables to consider when conducting case conceptualizations and making diagnoses.

Select the theoretical orientation of your choice and discuss how your theoretical orientation can incorporate cross-cultural considerations in diagnosis and case conceptualizations.

the variables that make for sound ethical practice in diagnosis and case conceptualization. Consider areas of strength you have and areas of needed professional development. How will you seek professional development opportunities? 10. Describe culturally astute strategies for accurate assessment of a client’s affect or behavior. 11. Describe the ethical considerations (i.e., the cultural framework of the client’s identity, cultural explanations of illness, cultural meanings of adaptive functioning and social context, help-seeking behavior, and cultural elements in the counselor–client relationship) that, as a counselor, you will need to contemplate for a specific cultural group you wish to work with. 12. Reflect on your own cultural biases and assumptions regarding one or more cultures different than your own. 13. Provide one example of a situation of overdiagnosis, underdiagnosis, or misdiagnosis of a client, and discuss how this situation could have been avoided and can be resolved. 14. What do counselors need to know about sampling bias to be effective? 15. As a counselor, what do you think is a key element of culture that should be considered when making a diagnosis? Explain. 16. Give one example of how a diagnosis can affect a client in a negative way relative to his or her culture. 17. In addition to the DSM, what are other types of assessment tools and how can counselors use them to effectively diagnose a client? List the pros and cons of each.

Chapter 18 Test Answer Key ANSWER KEY: Chapter 18 Test (Multiple Choice) 1. d 2. a 3. a 4. a 5. c 6. c 7. c 8. d 9. b 10. d 11. a 12. c 13. b 14. a 15. a 16. b 17. c 18. d 19. b 20. c 21. c 22. a 23. c 24. c 25. c 26. b 27. b 28. d 29. d 30. a 31. c 32. b 26 Copyright © 2023, 2018, 2014 by Pearson Education, Inc. All Rights Reserved.

33. b 34. a 35. a 36. d 37. b 38. d 39. c 40. d 41. d 42. b 43. c 44. c 45. c