Skip to main content

Competency for Diverse Populations

  • Chapter
  • First Online:
Handbook of Clinical Psychology in Medical Settings

Abstract

The USA is an increasingly diverse nation. The USA currently comprises 50.7 % women and 49.3 % men with the following ethnic breakdown: 4.7 % Asian American/Pacific Islanders, 12.8 % African Americans, 15.4 % Latina/os, 65.6 % European Americans, and 1.0 % Native Americans. Poor people make up 13.2 % of the US population, with people of color, especially African Americans and some Latina/os, disproportionately likely to live in or near poverty. The numbers of people who are lesbian, gay, or bisexual are estimated at about 3.5 % of the population, but the number of transgendered people is impossible to calculate. The diversity of the USA is likely to keep increasing due to immigration rates, an ever-widening gap between the rich and the poor, and various social movements leading to increased acceptance of interethnic marriage, identification as a sexual minority, and other shifts.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 229.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 299.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. US Census Bureau. State and county quick facts: USA. U.S. Census Bureau. http://quickfacts.census.gov/qfd/states/00000.html. Published 2008. Accessed: 24 Feb 2010.

  2. U.S. Census Bureau. Poverty in the United States: 2000. Washington DC: U.S. Census Bureau;2003.

    Google Scholar 

  3. Romero AP, Baumle AK, Badgett MVL, Gates GJ. Census snapshot: United States. Los Angeles: The Williams Institute;2007.

    Google Scholar 

  4. Morrow SL, Hawxhurst DM, Montes de Vegas AY, Abousleman TM, Castaneda CL. Toward a radical feminist multicultural therapy: renewing a commitment to activism. In: Toporek RL, Gerstein LH, Fouad NA, Roysircar G, Israel T, editors. Handbook for social justice in counseling psychology: leadership, vision, and action. Thousand Oaks:Sage Publications; 2006. p. 231–47.

    Google Scholar 

  5. Betancourt JR. Cultural competence. Marginal or mainstream movement? N Engl J Med. 2004;351(10):953–5.

    Article  CAS  PubMed  Google Scholar 

  6. Jackson ML. Multicultural counseling: historical perspectives. In: Ponterotto JG, Casas JM, Suzuki LA, Alexander CM, editors Handbook of multicultural counseling. Thousand Oaks: Sage;1995:p. 3–16.

    Google Scholar 

  7. Pedersen P. A handbook for developing multicultural awareness. 3rd ed. Alexandria: American Counseling Association; 2000.

    Google Scholar 

  8. Sue S, Zane N, Hall GCN, Berger LK. The case for cultural competency in psychotherapeutic interventions. Annu Rev Psychol. 2009;60:525–48.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Whaley AL, Davis KE. Cultural competence and evidence based practice in mental health services. Am Psychol. 2007;62(6):563–74.

    Article  PubMed  Google Scholar 

  10. Sanchez-Hucles J, Jones N. Breaking the silence around race in training, practice, and research. Couns Psychol. 2005;33(4):547–58.

    Article  Google Scholar 

  11. Nutt Williams E, Barber JS. Power and responsibility in therapy: integrating feminism and multiculturalism. J Multicult Couns Devel. 2004;32:390–401.

    Google Scholar 

  12. Williams CB. Counseling African American women: multiple identities-multiple constraints. J Couns Dev. 2005;83:278–83.

    Article  Google Scholar 

  13. World Health Organization. Gender disparities and mental health: the facts. World Health Organization. http://www.who.int/mental_health/prevention/genderwomen/en/. Published 2010. Accessed: 15 Feb 2010.

  14. Iwamasa GY, Bangi AK. Women’s mental health research: history, current status, and future directions. In: Mio JS, Iwamasa GY, editors. Culturally diverse mental health: the challenges of research and resistance. New York: Routledge; 2003:p. 251–68.

    Google Scholar 

  15. World Health Organization. Women’s mental health: an evidence based review. Geneva: WHO; 2000.

    Google Scholar 

  16. Thurer SL. The end of gender: a psychological autopsy. New York: Routledge; 2005.

    Google Scholar 

  17. Gainor KA. Including transgender issues in lesbian, gay and bisexual psychology: Implications for clinical practice and training. In: Greene B, Croom GL, editors. Education, research, and practice in lesbian, gay, bisexual, and transgendered psychology: a resource manual. Thousand Oaks: Sage Publications; 2000:p. 131–60.

    Chapter  Google Scholar 

  18. Striepe MI, Tolman DL. Mom, dad, I’m straight: the coming out of gender ideologies in adolescent sexual-identity development. J Clin Child Adolesc Psychol. 2003;32(4):523–30.

    Article  PubMed  Google Scholar 

  19. Hancock KA. Lesbian, gay, and bisexual psychology: past, present, and future directions. In: Mio JS, Iwamasa GY, editors. Culturally diverse mental health: the challenges of research and resistance. New York: Routledge; 2003:p. 289–307.

    Google Scholar 

  20. Dalal F. Race, colour and the processes of racialization: new perspectives from group analysis, psychoanalysis and sociology. New York: Brunner-Routledge; 2002.

    Google Scholar 

  21. Omi M, Winant H. Racial formation in the United States: from the 1960s to the 1990s. New York:Routledge; 1994.

    Google Scholar 

  22. Lu FG, Lim RF, Mezzich JE. Issues in the assessment and diagnosis of culturally diverse individuals. In: Oldham JM, Riba MB, editors. Review of psychiatry. Vol 14. Washington DC: American Psychiatric Press, Inc; 1995:p. 477–509.

    Google Scholar 

  23. Phinney JS. Ethnic identity and acculturation. In: Chun KM, Organista PB, Marin G, editors. Acculturation: advances in theory, measurement and applied research. Washington, DC:American Psychological Association; 2003. p. 63–81.

    Google Scholar 

  24. Phinney JS. The multi-group ethnic identity measure: A new scale for use with adolescents and adults from diverse groups. J Adolesc Res. 1992;7:156–76.

    Google Scholar 

  25. Flores MT. Demographics: Hispanic populations in the United States. In: Flores MT, Carey G, editors. Family therapy with Hispanics: toward appreciating diversity. Boston: Allyn & Bacon; 2000:p. 297–311.

    Google Scholar 

  26. Sue DW, Sue D. Counseling the culturally diverse: theory and practice. 4th ed. Hoboken:Wiley; 2003.

    Google Scholar 

  27. Mio JS, Barker LA, Tumambing J. Multicultural psychology: understanding our diverse communities. 2nd ed. Boston: McGraw Hill; 2009.

    Google Scholar 

  28. Takeuchi DT, Alegria M, Jackson JS, Williams DR. Immigration and mental health: diverse findings in Asian, Black and Latino populations. Am J Public Health. 2007;97:11–12.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Kohatsu EL. Acculturation: current and future directions. In: Carter RT, editor. Handbook of racial-cultural psychology and counseling: theory and research. Hoboken:Wiley; 2005;Vol. 1:p. 207–31.

    Google Scholar 

  30. Berry J. Conceptual approaches to acculturation. In: Chun KM, Organista PB, Marin G, editors. Acculturation: advances in theory, measurement and applied research. Washington DC:American Psychological Association; 2003. p. 17–38.

    Google Scholar 

  31. Tropp LR, Erkut S, Coll CG, Alarcon O, Garcia HAV. Psychological acculturation: development of a new measure for Puerto Ricans on the U.S. mainland. Educ Psychol Meas. 1999;59(2):351–67.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Neimann YF. Stereotypes about Chicanas and Chicanos: implications for counseling. Couns Psychol. 2001;29(1):55–90.

    Article  Google Scholar 

  33. Ponton MO, Ardila A. The future of neuropsychology with Hispanic populations in the United States. Arch Clin Neuropsychol. 1999;14(7):565–80.

    CAS  PubMed  Google Scholar 

  34. Carbonell SI. An assessment practice with Hispanics in Minnesota. In: Dana RH, editor. Handbook of cross-cultural and multicultural personality assessment. Mahweh:Lawrence Erlbaum Associates, Publishers; 2000. p. 547–72.

    Google Scholar 

  35. Villarruel AM, Portillo CJ, Kane P. Linguistic competency: implications for nursing practice. Paper prepared for National Alliance for Hispanic Health Cultural Competency Series Project; March 1998.

    Google Scholar 

  36. Allen BJ. Social class matters. In: Ferber A, Jimenez CM, O’Reilly HA, Samuels DR, editors The matrix reader: examining the dynamics of oppression and privilege. Boston: McGraw Hill;2009:p. 61–77.

    Google Scholar 

  37. American Psychological Association, Task Force on Socioeconomic Status. Report of the APA Task Force on Socioeconomic Status. Washington, DC: APA;2007.

    Google Scholar 

  38. Hudson CG. Socioeconomic status and mental illness: tests of the social causation and selection hypotheses. Am J Orthopsychiatry. 2005;75(1):3–18.

    Article  PubMed  Google Scholar 

  39. U.S. Census Bureau. The 65 years and over population: 2000. Washington DC: U.S. Census Bureau;2001.

    Google Scholar 

  40. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Text Revision. Washington DC: American Psychiatric Association;2000.

    Google Scholar 

  41. American Psychological Association. Guidelines for psychological practice with older adults. Am Psychol. 2004;59(4):236–60.

    Article  Google Scholar 

  42. Cashwell CS, Young JS. Integrating spirituality and religion into counseling: an introduction. In: Cashwell CS, Young JS, editors. Integrating spirituality and religion into counseling: a guide to competent practice. Alexandria: American Counseling Association;2005:p. 1–9.

    Google Scholar 

  43. Wulff DM. The psychology of religion: an overview. In: Shafranske EP, editor. Religion and the clinical practice of psychology. Washington DC:American Psychological Association; 1996. p. 43–70.

    Chapter  Google Scholar 

  44. Cervantes JM, Parham TA. Toward a meaningful spirituality for people of color: lessons for the counseling practitioner. Cultur Divers Ethnic Minor Psychol. 2005;11(1):69–81.

    Article  PubMed  Google Scholar 

  45. Keyes CIM. Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health. Am Psychol. 2007; 62(2):95–108.

    Article  PubMed  Google Scholar 

  46. Oquendo MA, Ellis SP, Greenwald S, et al. Ethnic and sex differences in suicide rates relative to major depression in the United States. Am J Psychiatry. 2001;158(10);1652–8.

    Article  CAS  PubMed  Google Scholar 

  47. Baumeister H, Harter M. Prevalence of mental disorders based on general population surveys. Soc Psychiatry Psychiatr Epidemiol. 2007;42(7):537–46.

    Article  PubMed  Google Scholar 

  48. Owens GP, Riggle EDB, Rostosky SS. Mental health services access for sexual minority individuals. Sex Res Social Policy. 2007;4(3);92–9.

    Article  Google Scholar 

  49. Office of Minority Health. African American Profile. Office of Minority Health. http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=3&lvlid=23. Published 2009. Accessed: 15 Feb 2010.

  50. Centers for Disease Control and Prevention. Welcome to WISQARS. Centers for Disease Control. http://www.cdc.gov/ncipc/wisqars/. Published 2006. Accessed: 15 Feb 2010.

  51. Office of Minority Health. American Indian/Alaska Native Profile. Office of Minority Health. http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=52. Published 2009. Accessed: 15 Feb 2010.

  52. U.S. Department of Health and Human Services. Native American Indians: fact sheet. U.S. Department of Health and Human Services. http://mentalhealth.samhsa.gov/cre/fact4.asp. Published 1999. Accessed: 15 Feb 2010.

  53. U.S. Department of Health and Human Services. Asian American/Pacific Islanders: Fact sheet. U.S. Department of Health and Human Services. http://mentalhealth.samhsa.gov/cre/fact2.asp. Published 1999. Accessed: 15 Feb 2010.

  54. Office of Minority Health. Hispanic/Latino Profile. Office of Minority Health. http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=54. Published 2009. Accessed: 15 Feb 2010.

  55. U.S. Census Bureau. Educational attainment: 2000. Washington DC: US. Census Bureau;2003.

    Google Scholar 

  56. U.S. Department of Health and Human Services. Latinos/Hispanics Americans: Fact sheet. U.S. Department of Health and Human Services. http://mentalhealth.samhsa.gov/cre/fact3.asp. Published 1999. Accessed: 15 Feb 2010.

  57. Fortuna L, Perez D, Canino G, Sribney W, Alegria M. Prevalence and correlates of lifetime suicidal ideation and attempts among Latino subgroups in the United States. J Clin Psychiatry. 2007;68:572–81.

    Article  PubMed Central  PubMed  Google Scholar 

  58. Orley J. Psychological disorders among refugees: some clinical and epidemiological considerations. In: Marsella AJ, Bornemann T, Ekblad S, Orley J, editors. Amidst peril and pain: the mental health and well-being of the world’s refugees. Washington DC: American Psychological Association;1994:p. 193–206.

    Google Scholar 

  59. Malgady RG, Costantino G. Symptom severity in bilingual Hispanics as a function of clinician ethnicity and language of interview. Psychol Assess. 1999;11(2):186–97.

    Article  Google Scholar 

  60. Hwa-Froelich DA, Westby CE. Considerations when working with interpreters. Commun Disord Q. 2003;24(2):78–85.

    Article  Google Scholar 

  61. Diaz-Loving R. Contributions of Mexican ethnopsychology to the resolution of the etic-emic dilemma in personality. J Cross Cult Psychol. 1998;29(1):104–18.

    Article  Google Scholar 

  62. Scott KM, Von Korff M, Alonso J, et al. Age patterns in the prevalence of DSM-IV depressive/anxiety disorders with and without physical co-morbidity. Psychol Med. 2008;38(11):1659–69.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  63. Hughes CC, Wintrob RM. Culture-bound syndromes and the cultural context of clinical psychiatry. In: Oldham JM, Riba MB, editors. Review of psychiatry. Vol. 14. Washington DC: American Psychiatric Press, Inc; 1995:565–97.

    Google Scholar 

  64. Lee J, Sue S. Clinical psychology and culture. In: Matsumoto D, editor. The handbook of culture and psychology. Oxford:Oxford University Press; 2001. p. 289–308.

    Google Scholar 

  65. Kessler RC, Demler O, Frank RG, et al. Prevalence and treatment of mental disorders, 1990 to 2003. N Engl J Med. 2005;352(24):2515–23.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  66. Acevedo-Polakovich ID, Reynaga-Abiko G, Garriott PO, et al. Beyond instrument selection: cultural considerations in the psychological assessment of U.S. Latinas/os. Prof Psychol Res Pr. 2007;38(4):375–84.

    Article  Google Scholar 

  67. D’Andrea M, Daniels J, Heck R. Evaluating the impact of multicultural counseling training. J Couns Dev. 1991;70:143–50.

    Article  Google Scholar 

  68. Sodowsky GR, Taffe RC, Gutkin TB, Wise JL. Development of the multicultural counseling inventory: a self-report measure of multicultural competence. J Couns Psychol. 1994;41:137–48.

    Article  Google Scholar 

  69. La Fromboise TD, Coleman HLK, Hernandez A. Development and factor structure of the cross-cultural counseling inventory-revised. Prof Psychol Res Pr. 1991;22:380–8.

    Article  Google Scholar 

  70. Hays PA. Addressing cultural complexities in the practice: Assessment, diagnosis and therapy. 2nd ed. Washington DC: American Psychological Association; 2008.

    Google Scholar 

  71. Rodriguez N, Myers HF, Morris JK, Cardoza D. Latino college student adjustment: Does an increased presence offset minority-status and acculturative stresses? J Appl Soc Psychol. 2000;30:1523–50.

    Article  Google Scholar 

  72. Rodriguez N, Myers HF, Mira CB, Flores T, Garcia-Hernandez L. Development of the multidimensional acculturative stress inventory for adults of Mexican origin. Psychol Assess. 2002;14(4):451–61.

    Article  PubMed  Google Scholar 

  73. Miville ML, Koonce D, Darlington P, Whitlock B. Exploring the relationships between racial/cultural identity and ego identity among African Americans and Mexican Americans. J Multicult Couns Devel. 2000;28(4):208–25.

    Article  Google Scholar 

  74. Ramirez M III. Multicultural/multiracial psychology: Mestizo perspectives in personality and mental health. Northvale: Jason Aronson Inc.;1998.

    Google Scholar 

  75. Reynaga-Abiko G. Towards a culturally relevant assessment of psychopathology with Mexicans/Mexican Americans. Unpublished doctoral dissertation, Pepperdine University, Malibu; 2005.

    Google Scholar 

  76. Suinn RM, Borrayo EA. The ethnicity gap: the past, present, and future. Prof Psychol Res Pr. 2008;39(6):646–51.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Geneva Reynaga-Abiko PsyD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Reynaga-Abiko, G., Schiffner, T. (2014). Competency for Diverse Populations. In: Hunter, C., Hunter, C., Kessler, R. (eds) Handbook of Clinical Psychology in Medical Settings. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09817-3_10

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-09817-3_10

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-09815-9

  • Online ISBN: 978-0-387-09817-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics