Domain VI: Implement and Evaluate Culturally Responsive and Socially Just Change Processes
CC16 Microlevel Change
Engage in culturally responsive and socially just change processes at the microlevel (i.e., individuals, couples, and families) in collaboration with clients
Core Competency 16 of the CRSJ counselling model (Collins, 2018) addresses microlevel interventions in which the focus of change is on the individual client, the couple, or the family. Even when it is most appropriate for learners to collaborate with clients to co-construct change processes at the microlevel, a contextualized and systemic lens on intervention is essential (Winslade, 2018). Each microlevel intervention below supports cultural responsivity and takes into account the lived experiences of marginalization, othering, cultural oppression, and other forms of social injustice that clients may encounter. Both the direction for and the process of implementing change occur in collaboration with the client. The list of microlevel interventions below is certainly not exhaustive; rather, it emerged through my own research and my review of case studies related to multicultural counselling and social justice. I encourage learners to continually expand their repertoire of change processes to support CRSJ counselling practices.
The first few microlevel change strategies focus on pragmatic supports, often positioned outside the scope of practice of counsellors; however, addressing these social determinants of health is often essential with clients who face multiple marginalization (Rimke, 2016). Then I introduce a number of interventions that draw on feminist and Indigenous practices to collaborate with clients to critically analyze these social determinants of health through consciousness-raising, deconstruction, or decolonization. The narrative therapy processes of storying and re-storying support clients’ reconstruction of cultural identities and relationalities. With Indigenous clients, integration of Indigenous practices may enhance identity reconstruction. The next cluster of change processes calls forth the ways in which clients continue to successfully navigate their lives and care for their own needs, even in the face of sociocultural oppression and reminds learners of the need for a deep commitment to affirming diversity and social justice in practice. Clients with multiple, intersecting, nondominant identities may also benefit from support in reconciling conflicting values, cultural identities, and sociocultural contexts.
As we shift the lens for defining client presenting concerns and envisioning change processes to include the contexts of clients lives, we are faced as counsellors with the need to think outside the box in terms in terms of our professional identity and roles. Consider the story of Jason below.
Jason has just turned 18. At a time when many of his friends are celebrating their rite of passage into more independence and freedom, Jason suddenly finds himself staring ahead at mountain of obstacles just to survive on a day-to-day basis. Jason has just completed high school where he was actively involved on the student council, was one of the popular guys, and excelled academically. He has been accepted into several universities locally and away from home. However, on his 18th birthday, he is considered an adult, and he loses access to almost all of the services that have helped him thrive as a young person with a disability. At high school, he has had an aide with him full-time, and a disability services van picks him up in the morning and takes him home at night. He has had access to a physiotherapist within the school who works with him one period per day. As he watches his friends prepare themselves for the adult world and set their sights on colleges and universities across the country, the reality of his much narrower options begins to sink in. His parents both work in the service industry; they put in long hours to make sure that he and his able-bodied brother have what they need. However, it has been government funding for youth with disabilities that has made it possible for him to attend the local high school with his friends. Now that funding will no longer exist. His dad has also recently become quite ill with emphysema, and it is unclear whether he will be able to continue working. Jason has come to you ostensibly for career and life counselling as part of the transition supports services at the school. However, it is clear from the moment he enters the room that this is not the Jason you are used to; instead he appears deflated, stressed, and noncommunicative. He saw a guy in a wheelchair living on the street on the way to school this morning, and he is suddenly convinced that this is his destiny.
Consider how your role as school counsellor might be influenced by embracing pragmatic support and responsiveness to basic subsistence needs within your repertoire of change strategies. Alternatively, consider how you might be optimally helpful to Jason if you decide not to embraces these broader systems level interventions. In either case, how might you actively engage and empower Jason as a co-collaborator in the change process?
[Permanent link: https://mem.on-linelearning.ca/crsjcounselling/chapter/cc16/#destiny]
I often use an externalizing technique from narrative therapy to shift clients’ understanding and relationship with the problem. I invite the client to first draw and then interview the problem. When working with a client, emphasize that there is no right or wrong way to do it. Nor is there any judgement on the quality of the drawing. The idea is to remove as much stress related to perfectionism from around this activity as possible. Let the client know that their drawing could include abstract or more concrete representations and that it is completely up to them. Follow these steps to try out the activity yourself:
- Gather a few pieces of blank paper (in case you wish to draw more than one picture or want to start over). Provide crayons, markers, color pencils, and watercolour paint and brushes so there are options for various media.
- Get in touch with the problem you are experiencing. Attend to your feelings. Close your eyes and tune into your body.
- Create an image of the problem (If you are doing this with a client, stay quiet so that the client can focus on drawing. It may help to play some very soft, relaxing music if a client would benefit from this addition.)
- Once you have finished the drawing, choose a title for it. (For example, clients have chosen titles such as “Doom” or “Crazy Brain” or “Black Abyss.”)
- Prop the drawing onto a third chair so that you can see the image.
- Then interview [insert name of the drawing] and answer as if you are speaking for [insert name of drawing]. Some questions may not have answers and are used for reflection. Here is a list of common interview questions that may facilitate shifts in your experience and relationship with the problem:
- [Name of drawing], what is the first and smallest sign that you are present in [client]?
- [Name], when did you first enter [client’s] life?
- [Name], has there been early seedlings of you even earlier in [client’s] life?
- [Name], in what ways do you serve [client]?
- [Name] are there things that happen that decrease your presence in [client’s] life?
- [Name] are there things that happen that increase your presence in [client’s] life?
- [Name], what would happen to [client] if you disappeared?
Externalizing questions such as these treat the problem outside of the client rather than as an internal flaw. It can stimulate conversations about the problem in creative ways that provide novel insight to client’s experiences.
The process of deconstruction is common to feminist and narrative traditions. Included in the broad umbrella of deconstruction are gender role analysis, power analysis, and class analysis, for example.
Before engaging in the class discussion, review the steps in the feminist practice of gender role analysis (adapted from Worell and Remer, 2003).
- Elucidate messages received through gender role socialization.
- Analyze critically the positive and negative consequences of these gendered narratives.
- Reflect on the degree to which these messages have been internalized.
- Select actively from those gendered messages, the ones the client wants to maintain or discard.
- Co-construct change processes to facilitate these preferred outcomes.
Then, reflect critically on the vignette below.
Anna is a professional athlete competing in events on both the national and international level. She presents as bright, articulate, and confident. She changed the focus of her athletic endeavors following a serious ski accident eight years ago, in which she broke her back and lost the use of her legs. She now competes as a snow boarder in paraplegic events.
She talks comfortably about her accident and the process of rebuilding her life. She has lots of social supports and resources. She has been completing her graduate education in health studies, while training rigorously for upcoming sporting events.
When you ask what has brought her to the counselling session, she hesitates and then explains that she is struggling to get back into dating. She has a lot of positive relationships with male friends, but even if she is interested in something more, things never seem to move in that direction. She seems to have become “one of the boys,” which she enjoys, but this is not enough. Before her accident, she had no difficulty in this area, and always had a boyfriend or a number of guys that she was dating casually.
Anna notes that most her current social relationships revolve around sports, and the athletes involved in the paraplegic games are predominantly men. She does have a few close female friends who are very supportive, but she has not talked with them in depth about her concerns.
Work together as a class to apply the principles of gender role analysis to your discussion, based on the following prompts:
- In what ways might the gendering of professional sports and of women with disabilities come into play in this scenario?
- How might the intersections of gender and ability be playing out in Anna’s lived experiences?
- What broader sociocultural discourses related to gender and ability might you consider exploring with Anna?
- What types of gendered assumptions might you need to attend to so that you don’t bring them forward into your relationship with Anna?
- How might this analysis of gender support Anna in moving forward with her goals?
Each person should make up a case scenario that demonstrates how power might play out for Sarah. Be creative and extend this story in any direction you like.
Sarah is 79 years old. She lives on her own with three cats in a small bungalow in the inner city. Sarah’s husband died three years ago. Both of their parents narrowly escaped the Holocaust in Germany. They never had any children.
Share your stories with each other, and apply the following steps in power analysis, adapted from Worell and Remer (2003).
- Engage the client in critical analysis of the nature and basis of power.
- Examine together differential access to various types of power, including the influence of cultural identities/relationalities and social location.
- Encourage deconstruction of the ways in which sociocultural narratives, social norms, experiences of cultural oppression, and intersections of various *isms have influenced the client’s access to, and internalization of, messages related to the use of power.
- Engage in a cost-benefit analysis to empower client agency in self-selecting personal power strategies they want either to foster or eliminate.
Reflect critically on how the differences in your stories impacted the application of power analysis. Step back to consider how your own position of power within the client–counsellor relationship may have influenced the direction of your stories or the process of your analysis.
[Permanent link: https://mem.on-linelearning.ca/crsjcounselling/chapter/cc16/#agereligion]
Consider the definition of decoloning praxis by Hellson (2015, para. 3) of the WAVAW Rape Crisis Centre: “Decolonization is unlearning Colonization . . . it’s changing the conversation from ‘us and them’ to ‘we’.” Then watch the video created by this organization to demonstrate how a decolonizing approach can be integrated into all forms of service delivery with Indigenous peoples. As you watch the video, make a list of principles or practices that support decolonization.
Consider the organization where you currently work (or imagine the context of your future counselling practice). Apply your list of decolonizing practices or principles to this context. Be as specific and practical as you can to bring this concept to life and to reinforce your learning.
Many of the principles for working with Indigenous peoples are drawn from their unique values and worldview, which are grounded in Indigenous spirituality.
- For non-Indigenous participants, examine critically how you might extricate yourselves from the oppressive legacies of your own cultures and spirituality/religions to create space to fully honour Indigenous cultural and spirituality in our counselling practices? How might you sensitize yourselves to the continued processes colonization in counselling and psychology practice so that you can interrupt ongoing psycholonization of Indigenous clients?
- For Indigenous participants, in what ways do you see colonization expressed through the presenting concerns of your clients? What healing principles or practices, either traditional or Western, are most helpful in raising consciousness about the lingering effects of colonization with your clients?
Be very specific in identifying potential examples of psycholonization carried forward by uncritical examination of worldviews and suggest ways these could be addressed and/or alternative assumptions or practices brought to the fore. Together, generate a set of draft principles that you might use in your own practices.
Watch the YouTube video, Our Lives – The Boy Who Will Never Grow Old.
The video provides insights about young adults living with life-limiting conditions. As you watch the video, notice their strength, resilience, and courage. Pay careful attention to your reactions and feelings to lives lived with profound and progressive disabilities. Consider the implications for how you approach work with young adults with life-limiting conditions or other clients for whom you may not automatically be inclined to adopt a focus on strengths and resiliency.
Consider the conversations below between counsellor and client below. Draw on the skills of critical thinking, cognitive complexity, reflective practice, and cultural humility (see Core Competency 8) to critique these interactions from an affirmative practice perspective (Singh & Dickey, 2017). These conversations go in entirely difference directions based primarily on assumptions and values positioning of each counsellor. You may want to debrief this activity with a peer to see what they identified as non-affirmative in the first column and affirmative in the second.
|Counsellor: Welcome Ms McDonald. Please have a seat and make yourself comfortable.
Client: Thanks. Please call me Alex.
Counsellor: I have reviewed your intake form and notice there is some information that you didn’t complete. I’m wondering if we can review the form together to ensure that I have a complete picture as we get started.
Client: I might be more comfortable sharing certain information once we get to know each other a bit better. Perhaps you could tell me a bit more about how you work with your clients to start.
Counsellor: Sure, it is important for you to feel comfortable with my theoretical approach to counselling so that you can see if that is a good fit for you. I work from what we call a humanistic perspective, which means that I treat people holistically, attending to the social contexts of their lives. I believe that, although our behaviour is influenced by our environment, we all have free will, make conscious choices, and strive to create meaning in life.
Client: I don’t know if I agree that everyone has the same choices available to them. I sometimes feel like I am squeezed into a box where I can hardly breathe or move, let alone make an active choice to find meaning in my life.
Counsellor: I think a lot of my female clients feel like that when they are juggling so many different roles and responsibilities, particularly when their children are young.
Client: I don’t have children [with hesitation] yet, but I know some of my female friends feel like that. For me, the sense of being squeezed happens more in my work environment where I can’t seem to break out of others’ expectations for me. I feel like I should have been chosen instead of Sam in the last round of promotions.
Counsellor: It sometimes tricky to figure out how to position ourselves in a way that gets us noticed in the right ways within a work environment. Have you taken any training to prepare you for job advancement within your organization? I know that many women still feel like they need to work much harder than men to attain the same opportunities.
Client: My skill set it pretty strong.
Counsellor: Great. There are also other qualities and interpersonal dynamics that influence how well we build networks with our colleagues and position ourselves within the organizational structure. If you were to step back and observe yourself as if you were a fly on the wall at work, how would you describe what you see?
Client: I would see someone who feels misunderstood and who doesn’t quite fit in, but also doesn’t really want to fit it.
Counsellor: How do you think the not-fitting-in is working for you in terms of your career goals?
|Counsellor: Welcome Alexandra. Do you go by your given name or is there another way you would like me to address you?
Client: My friends call me Alex.
Counsellor: Welcome, Alex. I usually start out with new clients by sharing some of my personal and professional values to communicate that this is a safe space for everyone. In particular, I actively affirm basic human rights related to Indigeneity, gender, gender identity, sexual orientation, age, ability, socioeconomic status, and religion. I know that is mouthful, but it is important for you to know that all aspects of your identity will be respected and honoured through the counselling process.
Client: I didn’t answer the gender question on the intake form, because I get so angry when only two options for gender are provided.
Counsellor: Thanks for being honest with me. There is no excuse for that, so I won’t try to make one. I can tell you that these agency forms are all currently under review, and I intend to make sure that they are gender inclusive. You should also know that you have a right to not answer any question I ask, although I will do my best not to make cisgender or other biased assumptions in our conversations.
Client: OK. Thanks.
Counsellor: I am wondering if you reacted in this way from a personal place or as an ally for people who express nondominant gender identities. If you don’t want to talk about that, then perhaps you could give me a bit of a sense of what brought you to counselling today.
Client: In the group of friends that I am part of, we try not make gender so central to how we present ourselves and interact with each other. I refer to myself as queer, both in terms of gender identity and sexual orientation, but my girlfriend is definitely female-identified. I left the significant other blank too on the intake form [pause] just in case.
Counsellor: I’m glad you feel comfortable sharing this with me now, because it helps me get a sense of the context of your life and where your sources of social support might lie. I might ask you more about your community of friends if it seems important later on. For now, I’m wondering what prompted you to seek out counselling?
Client: I’m struggling with some things at work and don’t seem to be able to figure out a way to resolve them. Specifically, I feel like I am being passed over for promotion even though I am more qualified that some of the others.
Counsellor: OK. I often find it helps me to understand the challenge better if we spend some time looking at both specific incidents and also some of the broader organizational culture issues that might come into play in these situations. It is possible that there are organizations norms that are putting you at a disadvantage. How does that approach fit for you?
Client: It might help me understand the dynamics a bit better and figure out what this is really about. So, yes, let’s give that a try.
Once you have carefully reviewed these two counsellor–client dialogues, write a list of 4–5 questions or statements that you might use in your initial conversations with new clients to communicate an affirmative practice stance. If this seems too abstract, you might want to envision a client with whom taking an affirmative stance would be particularly difficult and make the questions or statements specific to them. How might you adjust your approach if you were working with a child? What adaptations might be necessary to communicate these messages when working with someone with a cognitive disability? Next, create a checklist of other contextual factors (e.g., the counselling environment, the intake process, the accessibility or range of services) that you might want to consider before you even meet a client, because they can also communicate messages about cultural safety.
[Permanent link: https://mem.on-linelearning.ca/crsjcounselling/chapter/cc16/#affirmation]
[Note to instructors: You may want to find a way for students to share initial responses anonymously to facilitate honest dialogue.]
Share with your peers a Yes, but . . . statement about the human rights and positioning in society of LGBTTQI persons and communities. For example:
- Yes, I think that gays and lesbians should be protected from discrimination . . .
- But, we also have to think about the children they adopt—is it fair to them not to have a normal family?
Be as honest as you can about your lingering challenges (biases?) and be open and inviting of feedback from your peers. Feel free to be creative in how you express your Yes, but . . . expression.
If you can’t come up with an honest Yes, but . . . of your own, please discuss this with your instructor. They may permit you to identify one that you can use, which you have heard from others in your personal or professional life.
Next, provide feedback to your peers by drawing on the scientific evidence about diversity in sexuality, emergent consensus on professional values, counsellor identity development, and so on (e.g., not your personal opinions!). The goal is to develop an informed counter-argument for the Yes, but . . . statement.
[Permanent link: https://mem.on-linelearning.ca/crsjcounselling/chapter/cc16/#yesbut]
Meet Nathi, a first-generation immigrant from central Africa. She and her husband, Chimaobi, immigrated to Canada through the support of a Christian NGO that helps believers facing persecution in war-torn countries migrate to Canada. Nathi is an extrovert. She immediately makes friends in both her cultural community and among the women she works with at the hair salon in town. She has become part of a women’s group attached to a liberal Christian church that is addressing poverty and homelessness in the area.
Nathi has blossomed in this new environment and is discovering strengths and skills she didn’t realize she possessed. However, as she moves away from more traditional and culturally defined gender roles, Chimaobi has noticed, and this is creating tension in their relationship. He has become verbally abusive and aggressive in trying to prevent her from participating in these activities. As she finds herself increasingly alienated from her new friends and colleagues as a result, she slips into depression, has difficulty sleeping, and starts to experience panic attacks. She is torn between the expectations of her cultural and traditional faith practices and her experiences and opportunities in this new world.
How might you go about helping Nathi to resolve her ambivalence and navigate the tensions between old and new worlds? In a situation where there is potential abuse or violence, most counsellors would not see the couple together, at least initially, so assume you are working alone with Nathi at this point. Critique the practices you come up with and those of your peers carefully in terms of cultural responsivity and social justice (noting any potential tensions between these foundation principles).
[Permanent link: https://mem.on-linelearning.ca/crsjcounselling/chapter/cc16/#tensions]
This activity is something you can do with a partner, suggest to a client, or imagine for yourself. Identify a judgment or criticism you or others are feeling in the moment and follow these visualization steps:
- Describe a context in which you experience that judgement or criticism.
- Visualize the details of that situation. What do you anticipate from others? What do you experience in the moment?
- Invite the judgment or criticism into full awareness including mind, body, and emotions.
- Imagine that you are standing in front of a full-length mirror and picture the negative, bad self you reflected in the eyes of your critics. Let yourself feel the judgment or criticism in the moment.
- Use your full force to kick and smash the mirror with your legs (you may actually want to stand up and physically kick down the metaphorical mirror).
- Watch the glass explode and see the judgement and self-criticism shatter and fall away.
I often collaborate with clients to compose a list of signs and strategies to increase awareness and help reduce anxiety or depression. This activity can also include family members as a way to increase support for the client. Try this out with a personal challenge; I will use depression to illustrate the steps.
- Decide if you experience 2, 3, or 4 levels of depression. (I find most clients indicate three levels.)
- Create three columns on the page, and add the headers: Level 1, Level 2, and Level 3. (Add Level 4, if necessary.)
- Write down what you notice in the first signs of depression (Level 1). Common responses include feeling impatience with oneself and others, feeling critical of everything and everybody, stopping activities of self-care.
- Fill in the second level. Typical examples include: backing out of social engagements, retreating from friends and family, wanting to sleep and stay in bed, feelings of hopelessness.
- Complete the third level (e.g., unable to sleep, wishing to exit life, not eating, not caring about personal hygiene, feeling that others would be better off without you).
- With each level of the depression, identify strategies to help you slow down the progression to the next level. (It is important to inform clients that depression and anxiety are not linear and discrete in their development; however, listing of levels allows us to demystify and break down depression or anxiety in identifiable ways.)
- A Level 1 strategy may be to ensure that you get enough sleep, phone a certain compassionate friend, or increase exercise and meditation practices.
- Level 2 strategies may include asking a significant other to go for a long walk and sharing how you are feeling, enlisting support of others, or making an appointment with a counsellor.
- Level 3 strategies may include taking a few days off from work to rest and sleep, asking directly for help and support from a significant other, seeing a counsellor as soon as possible.
It is important to remember that for some clients, intensified suicidality may be indicated in Level 3 or 4. It is always important to ask clients about suicidal thoughts when discussing the higher level signs.
[Permanent link: https://mem.on-linelearning.ca/crsjcounselling/chapter/cc16/#signs]
Although we are capable of immense personal growth on our own, it is important to have people who can help us celebrate our growth! This exercise is meant to support you in identifying and discerning who those people are, in your precious life.
Take a moment to consider the people in your life who light you up. Those are your balcony people. These are people who are there in the good times and bad, and most importantly, they are the ones who remind you of your personal strengths, when you forget.
Next, take a moment to consider the people in your life who tend to bring you down. Those are your basement people. They are the ones who will meet you when you are feeling down and out, and they will keep you there. They may also be the ones who question your dreams and abilities.
Draw a line down the middle of a piece of paper. On the left side, put the name or initial of a balcony person in your life. On the right side, put the name or initial of a basement person in your life. Now, focusing on one person at a time, close your eyes and tap into how you feel when you are with that person. Open your eyes and list 5–10 words that describe how you feel when you are interacting with your balcony. Then do the same for your basement person.
Take a moment to reflect on these list and to consider the implications for building a network of effective social support. Consider also your own influence on significant others in your life. Finally, how might you ensure that you are a balcony person for every client you work with.
[Permanent link: https://mem.on-linelearning.ca/crsjcounselling/chapter/cc16/#discernment]
Collins, S. (2018). Embracing cultural responsivity and social justice: Re-shaping professional identity in counselling psychology [Epub version]. Victoria, BC: Counselling Concepts. Retrieved from http://www.counsellingconcepts.ca
Hellson, C. (2015, Oct. 14). A look into decolonizing praxis. Retrieved from Women Against Violence Against Women website: http://www.wavaw.ca/a-look-into-decolonizing-praxis/
Rimke, H. (2016). Introduction – Mental and emotional distress as a social justice issue: Beyond psychocentrism. Studies in Social Justice, 10, 4-17. Retrieved from http://brock.scholarsportal.info/journals/SSJ
Singh, A. A., & Dickey, L. M. (2017). Introduction. In A. Singh & L. M. Dickey (Eds.). Affirmative counseling and psychological practice with transgender and gender nonconforming clients (pp. 3-18). Washington, DC: American Psychological Association. Retrieved from http://dx.doi.org/10.1037/14957-001
Winslade, J. (2018). Counseling and social justice: What are we working for? In C. Audet & D. Paré (Eds.) Social justice and counseling: Discourse in practice (pp. 16-28). New York, NY: Routledge.