|
Article Excerpt
Because of the devastating effects of natural and human-made disasters, there is an increasing global need for mental health professionals to provide disaster relief outreach services (Guha-Sapir, Hargitt, & Hoyois, 2004; Herman, 1997; U.S. Committee for Refugees and Immigrants, 2006; Walter, 2005). Mental health professionals are responding to disasters, including hurricanes in the United States and earthquakes in Armenia (Kalayjian, 1995). The counseling profession has begun to foster a global counselor identity through endeavors such as the global mental health facilitator designation established by the National Board for Certified Counselors International (2007). However, the counseling profession has not developed an initiative that places counselors at the forefront of providing disaster response services on a global level. Cultural competence involves three primary attributes: (a) the therapist's awareness of her or his own worldview, (b) the therapist's development of an understanding of the client's worldview, and (c) the therapist's development of culturally appropriate clinical interventions (Sue & Sue, 2003). By creating culturally competent disaster outreach experiences, counselors can provide disaster mental health services to communities in need. In this way, the counseling profession can carry out its expressed commitment to social justice (Kiselica & Robinson, 2001) and cultural competence (Arredondo et al., 1996). The purpose of this study was to expand counselors' knowledge of cultural competence, using critical consciousness (Freire, 2000) as a framework, when engaged in disaster relief counseling services.
* Review of the Literature
In the response to the aftermath of Hurricane Katrina in the Gulf Coast region of the United States, the American Counseling Association (ACA) referred approximately 20% of the mental health counselors who were deployed by the Substance Abuse and Mental Health Services Administration (Kennedy, 2006). ACA's executive director, Richard Yep, recognized that not all mental health professionals deployed to the Gulf Coast were adequately trained. Some of those deployed lacked skills in trauma and crisis counseling and an awareness of the role of a postdisaster mental health worker.
Mental health and disaster response professionals agree that both preparation and cultural competence are necessary in effective disaster responses (Halpern & Tramontin, 2007). Findings of the Institute of Medicine's Committee on Responding to the Psychological Consequences of Terrorism indicated that mental health professionals often do not have disaster response experience or training (cf. Reid et al., 2005). Furthermore, there is a notable absence of literature establishing the practice of and training for cultural competencies in disaster relief (Mollica et al., 2004). This suggests that current disaster preparation may be insufficient. Moreover, it is crucial that counselors become more culturally competent so that they can better meet the increasing need for disaster response within global and multicultural contexts.
The Need for Culture-Centered Disaster Response
Critical in the successful assessment, conceptualization, and treatment necessary for a client's progress is an understanding of the cultural, social, and historical context of the presenting problems (Goodman & West-Olatunji, 2008). Issues of macrosystemic oppression and historical trauma contextualize individuals' predilections toward not only the counseling experience, but also the counselor (Cross, 1998; Harrell, 2000). Understanding sociocultural conditions facilitates the conceptualization of the needs of individuals in ethnically diverse and low-income communities (West-Olatunji, 2008). Multicultural counseling research suggests that there are differences in the cultural orientations between dominant and nondominant individuals (Atkinson, 2004; Holdstock, 2000; Ibrahim, Roysircar-Sodowsky, & Ohimshi, 2001; Roysircar, Arredondo, Fuertes, Ponterotto, & Toporek, 2003; Sue & Sue, 2003). Clients' adherence to their own cultural orientations influences the types of coping strategies they use. Thus, counseling interventions that are informed by cultural values can increase efficacy by intentionally incorporating these strategies (Pedersen & Ivey, 1993). Furthermore, counselors' personal biases can limit their cultural competence and reduce their efficacy with culturally diverse clients (Constantine, 2002).
Training for Critical Consciousness
Critical consciousness involves the ability to reflect on one's personal biases in working collaboratively with individuals and community stakeholders to take action and transform existing obstacles to a satisfactory quality of life (Freire, 2000). Critical consciousness has been used in educational training programs and community development initiatives to foster awareness, empowerment, and social justice ideals (Harden, 1996; Watts, Williams, & Jagers, 2003). This praxis-oriented perspective establishes counselors as critical coinvestigators with the community they are serving (Nelson & Neufeldt, 1998). Thus, critical consciousness can serve as a vehicle for the development of empowerment and cultural competence. Infusing the principles of critical consciousness into counselor training for disaster response prepares clinicians for current and future disasters service.
The process of becoming critically conscious begins with reflection and the development of awareness (Harden, 1996). During this process, awareness of personal biases and a deeper understanding of complex social issues develop (Ginwright & Cammarota, 2002; Hernandez, Almeida, & Dolan-del Vecchio, 2005; McKnight, 2004; Sakamoto & Pitner, 2005). This awareness engenders transformation in interpersonal relationships whereby counselors seek more collaborative and empowering relationships with their clients (McKnight, 2004; Sakamoto & Pitner, 2005). The development of critical consciousness may also allow counselors to work collectively with colleagues, thereby transforming the experience of working in a group into one of reciprocity, engagement, and growth (Campbell & MacPhail, 2002; Gay & Kirkland, 2003).
The theory of critical consciousness has been used in the counseling profession and in other professions as a tool for the development of cultural competence and social justice ideals (Alschuler, 1986; Hanna, Talley, & Guindon, 2000). The process of increasing awareness through reflection is critical in the development of cultural competence because it can liberate individuals from socially embedded and often unconscious hegemonic views (D'Andrea, 2005; Ivey & Collins, 2003). Freire's (2000) theory has been used to facilitate critical thinking and to engender...
|
