Multicultural competencies: What are we measuring?

An analysis of KwaZulu-Natal clinical psychologists’ multicultural experience

In this article, perspectives of South African clinical psychologists (based in KwaZulu-Natal) regarding multicultural issues in clinical practice and training are presented. The discussion focuses on emergent themes from 13 qualitative semi-structured interviews. Themes from interviews were analysed using thematic analysis and techniques from a grounded theory approach. While the study focused on a number of contextual multicultural issues both in service delivery and in training, this article documents the experiences of clinical psychologists regarding multicultural challenges and concerns, as well as approaches and capacities used to improve service delivery in this area. These perspectives are important in the multicultural and multilingual South African context, where there is limited literature in this area as well as related aspects such as cultural competency. There are many different belief systems as well as historical and sociopolitical factors that may influence how clinicians and individuals presenting for treatment may understand their experience and symptoms. This article seeks to document some of the challenges this may present in terms of service delivery in this context. Understandings of the term cultural competence as well as suggestions (primarily as noted by participants) to address the gap between training, competencies, and the realities of service delivery are also presented. Questions and considerations for future research are also raised.

Multicultural Competence as a Common Factor in the Process and Outcome of Counseling

Much research has been conducted on multicultural competence (MCC) over the past four decades, though there is still a need to conduct further research into the role of MCC within actual counseling relationships and in relation to additional variables. The present survey study was designed to better elaborate on the relationship between MCC and several common factor therapy and outcome variables within counseling relationships. Findings indicated that MCC was more strongly correlated with all measured variables (except perceived change) within counseling relationships where client and/or counselor identified as BIPOC than in White–White client counselor dyads. MCC was associated with higher ratings on the other measured variables regardless of client–counselor race or ethnicity. Finally, path analysis supported a model where MCC (a therapist factor) influenced process factors, which in turn influenced therapeutic outcomes. The results provide support for the importance of MCC to the process and outcome of counseling, particularly for BIPOC clients.

South African clinical psychologists’ multicultural clinical and supervisory experience

The study documents some of the multicultural challenges experienced by South African clinical psychologists and how these are addressed within the context of clinical practice, supervision, and training. This mail survey of 241 clinical psychologists registered with the Health Professions Council of South Africa during the year 2015, explored everyday clinical and supervisory practices. Multicultural training experiences were also studied. Findings indicated that multicultural challenges were experienced by 74.3% of respondents in clinical practice and by 34.3% of participants involved in supervision of clinicians and/or interns. Difficulties were related to cultural belief systems, language, specific therapeutic and supervisory obstacles, as well as socio-political and economic issues. Approaches employed to address these challenges primarily involved the use of therapeutic processes, positioning, and paradigms. An emphasis on lifelong learning processes was also present. Although evidence for multicultural competency and orientation was apparent in addressing these difficulties, findings suggest a need for more awareness and in-depth training in these areas.