Multicultural Counseling Competencies: Guidelines in Working with Children and Adolescents.

The application of multicultural counseling competency guidelines toward children and adolescents has been lacking in the counseling literature. This article uses a case vignette to illustrate the application of multicultural counseling competency to work with children and adolescents. A five-step model is proposed to guide counselors in considering multicultural issues in conceptualization and the development of appropriate treatment interventions. ********** Andrew was an 11-year-old Asian American. Because over the past year he was growing disruptive and uncooperative, his parents enrolled him in a 2-week, therapy-focused day camp during the summer. His parents felt the experience was positive for him, and suggested he continue individual therapy. Some of his reported "problems" included fighting with his mother in the morning when getting ready for school, not stopping his playing of video games when it was time for dinner, and some lying and stealing. He also wet his bed several times a week, but would try to hide the sheets in the wash. During the initial interview for counseling, background information gathered provided some clues to Andrew's "disruptive" behaviors. Andrew is ethnically Chinese, but was adopted by his parents when he was 2 years old from a woman in the United States. He is the youngest of four adopted children, all of whom are women, the oldest in the family being 23 years old. Andrew's behaviors became chaotic when his father disclosed to his family that he had terminal lung cancer with only about a year to live. During camp, Andrew's behavior moderated, and during his individual sessions he was cooperative, lucid, and warm. However, as his father's illness worsened and he had to be hospitalized, Andrew's behavior became erratic. At one point, Andrew was hospitalized for 2-weeks in a behavior-intensive child evaluation ward. Afterwards, Andrew described the experience as "ok." When his father died, he came into counseling but was inattentive and withdrawn. Attempts to speak with him typically resulted in his glancing to the floor. The only interaction that was possible for several weeks after the death was to play HORSE with a Neff basketball during the therapy hour. Individual therapy progressed well for 2-years until the counselor was transferred. When the transfer was brought up in counseling with Andrew, he became withdrawn again, but was willing to talk about his sadness and his hope to continue an email relationship with the therapist. The first author was his therapist at the time and this was his first experience working with children. His previous training in a master's and a doctoral program included a course on child counseling, several courses in multicultural counseling, and active participation on multicultural research. The case of Andrew is used to illustrate the various layers of culture with which counselors are sometimes faced when working with children and adolescents. Counselors are sometimes trained to be multiculturally competent (e.g., knowledge, awareness, and skills; Sue, Arredondo, & McDavis, 1992), but in therapy, it is important to understand how to focus on culture and how to use it to the clinician and client's benefit (Sherraden & Segal, 1996). That is, being multiculturally competent does not always imply introducing and using culture in therapy, but to have the knowledge, awareness, and skills to know when and how culture can be best used. It is also important to consider multiculturalism as encompassing of all forms of culture such as gender, race, sexual orientation, age, and so on (Stone, 1997), rather than just race and ethnicity as a way to consider the array of cultural issues clients bring to therapy. Because cases like Andrew's represent a complex mixture of cultural issues and clinical symptoms, counselors may be faced with a score of questions such as: How are cultural issues relevant? …