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A Framework for Multicultural Rehabilitation Counseling Research Daniel W. Wong, Ph.D. East Carolina University Demographic Trends It is projected by the year 2020, 30% of the new entrants into the labor force will be minorities. There is a higher incidence of work disabilities among minorities: – 13.7% of African Americans – 8.2% of Hispanic Americans – 7.9% of European Americans Minority individuals with disabilities who need VR services have been expanding in great numbers. Racial Bias Employer Biases – Racial inequality in the U.S. labor market is a persistent problem even today. Bertrand and Mullainathan (2004) published a study on racial bias in hiring in The American Economic Review. They sent 5000 fictitious resumes responding to 1300 help-wanted ads in Boston and Chicago newspapers and found significant bias against very African American sounding names: very European sounding names received 50 percent more callbacks for interviews. The racial gap is uniform across occupations and industries and is no different between small or large employers, or those that are listed as “Equal Opportunity Employers.” Racial Bias Counselor Bias – Inequitable treatment of people with disabilities from minority backgrounds has also been identified as a critical issue in vocational rehabilitation. The Rehabilitation Act Amendments of 1992 stated: “Patterns of inequitable treatment of minorities have been documented in all major junctures of the vocational rehabilitation process. As compared to European American Americans, a larger percentage of African-American applicants to the vocational rehabilitation system is denied acceptance.” Racial Bias Counselor Bias – Acceptance rate studies Several archival research studies of state VR agency data reported the existence of inequitable patterns of service delivery for African American consumers, and suggested that they are less likely to be accepted to VR services as compared to European Americans (Alston & Mngadi, 1992; Dzieken & Okocha, 1993; Feist-Price, 1995; Rehabilitation Act, 1992; Wilson, 2000). Racial Bias Counselor Bias – Acceptance rate studies Rosenthal, Ferrin, Wilson, and Wampold (2004) conducted a meta-analysis to examine the acceptance rate in aggregate studies in the rehabilitation counseling literature. They reported a common odds ratios of 1.54 suggests that the odds that European American consumers were accepted for VR services were about twice the odds for African American clients. Racial Bias Counselor Bias – Analogue Studies Rosenthal and Berven (1999) conducted a true-experimental study to examine the effects of client race on clinical judgment of European American graduate students in rehabilitation counseling. Two groups of European American students were asked to review case materials for an identical client with the exception of race. For one group, the hypothetical client was reported to be European American and for the other, African American. In the African American condition, the client was judged to have less potential for education and employment. Given that all case information was identical with exception to race, the group differences were attributed to racial bias. Racial Bias Counselor Bias – Comprehensive Review Studies Strohmer and Leierer’s (2000) reported that counselors are susceptible to several biases in working with clients: – systematic biases associated with specific client variables such as gender, age, race, sexual preference, social class, and disability type. – diagnostic overshadowing: giving undue weight on one salient variable, while disregarding or missing other important information – confirmatory bias: seeking confirmatory information while paying less attention to disconfirmatory information, even in the face of contradictory evidence Racial Bias Counselor Bias – Related Studies Wong, Chan, Cardoso, Lam, and Miller (2004) examined attitudes of graduate students in rehabilitation counseling toward people with disabilities. They found: (a) disability-related factors (disability type) were heavily involved in the preference-making process, and (b) attitude or preference formation was also significantly affected by other client characteristics unrelated to disability (education, age, and ethnicity). Racial Bias Counselor Bias – Related Studies For their predominantly European American female student sample, preferences for people with disabilities can be characterized as young college educated European American women with physical disabilities. European Americans were preferred to Latinos and Latinos were preferred to African Americans. African Americans were preferred to Native Americans and Native Americans were preferred to Asian Americans. Wong et al. concluded that students in their study are more comfortable with consumers who are similar to their own backgrounds and less with consumers from different backgrounds. Racial Bias Consequences of Racial and Disability Biases – Counselor biases based on selected characteristics of clients could contribute negatively to influence diagnostic impressions and decisions about eligibility determination, plan development, and service provision for their clients. Judgments regarding client potential may determine the educational and career opportunities that clients ultimately pursue, dramatically impacting their future direction and quality of life. Racial Bias Issues related to multicultural rehabilitation counseling research – A virtual absence of research and development efforts that provide the necessary tools for counselors and consumers from both the majority and minority groups to work together effectively. – Lack of a solid research base to systematically identify and evaluate those elements in rehabilitation counseling which empirically lead to equitable treatment of people with disabilities from minority backgrounds in the vocational rehabilitation process. Integrating Research and Practice A Framework for Multicultural Rehabilitation Counseling Research – Research to provide baseline information documenting equity/inequity of outreach and VR services for consumers from minority backgrounds. – Research to identify factors contributing to counselor biases and other discriminatory behavior. – Research to develop empirically validated models to improve working relationship between counselors and their minority consumers and rehabilitation outcomes. Integrating Research and Practice Level 1 Baseline Research – Differential acceptance rates. It is important to extend baseline research to examine the issue of acceptance rate to other minority groups. – Differential service patterns. It is important to study differential service patterns among successful and unsuccessful VR service recipients of varying degree of severity of disability and ethnicity backgrounds. – Counselor-consumer ethnicity match. It is important to study the effect of match on acceptance rates and differential service patterns. Integrating Research and Practice Proposed Level 1 Research R1 Study – Differential acceptance rates of VR services among European American, African American, Hispanic American, Asian American, and Native American VR applicants. R2 Study – The effect of counselor-consumer ethnicity match on acceptance rates among European American, African American, Hispanic American, Asian American, and Native American VR applicants. R3 Study – Differential service patterns among European American, African American, Hispanic American, Asian American, and Native American VR consumers. Integrating Research and Practice Level 2-Factors Contributing to Cultural-Sensitive Rehabilitation Counseling Practices The use of a model approach to identify factors contributing to successful cultural-sensitive rehabilitation counseling practices – Working alliance. Wampold found that 70% of counseling effects are due to the effects of common factors effect), while only 8% are due to specific ingredients (i.e., specific factors), with the remaining 22% partially attributed to individual client differences. – Common factors: goal setting, empathic listening, allegiance, and therapeutic alliance. Integrating Research and Practice Level 2-Factors Contributing to Cultural-Sensitive Rehabilitation Counseling Practices – Empathy was found to be the most significant predictor of multicultural counseling effectiveness. – Therapeutic alliance is related to: (a) the client’s affective relationship with the therapist; (b) the client’s motivation and ability to accomplish work collaboratively with the therapist; (c) the therapist’s empathic responding to and involvement with the client; and (d) client and therapist agreement about the goals and tasks of therapy. Integrating Research and Practice Level 2-Factors Contributing to Cultural-Sensitive Rehabilitation Counseling Practices – Discrepancy between counselor-consumer expectations for counseling and rehabilitation compromises working alliance, consumer satisfaction, and outcomes. Integrating Research and Practice Working alliance and counseling expectancies can be used effectively to minimize cultural biases in the counselor-consumer working relationship. Integrating Research and Practice Level 2 Research (continued)- 2. Racial Stereotypes and Clinical Judgment. Racial bias of counselors toward African American consumers is well documented. It is important to expand this line of research to examine racial biases of practicing VR counselors towards other minority groups. It is also important to incorporate variables identified as important in clinical judgment studies (especially in the diagnostic overshadowing topical area) to help us understand how information about the ethnicity of VR applicants and service recipients interact with other variables to influence the negative judgment of counselors from the majority background. Integrating Research and Practice Level 2 Research (continued)- – Wong et al. (2004) found that racial biases in the counselor-consumer relationship are influenced by the ethnicity of the counselors and consumers, educational level of the consumer, age of the consumers, and disability types of the consumers and must be studied and understood in a multidimensional framework. Wong et al. concluded an in-depth understanding of attitude formation will allow researchers to develop effective intervention strategies to help modify counselors-in-training as well as practicing counselors attitudes toward people with disabilities from different ethnicity backgrounds. Integrating Research and Practice Proposed Level 2 Research R4 – The effect of counselor-consumer match or mismatch on expectations about rehabilitation, working alliance, agreement and disagreement on rehabilitation goals and services, and consumer satisfaction. Integrating Research and Practice Proposed Level 2 Research R5 – Expanding Rosenthal et al.’s research to study racial biases among practicing VR counselors and to expand the levels of the ethnicity attribute to include Hispanics, Asian Americans, and Native Americans. Most importantly, we will use a computer-based case and caseload management simulation to study racial biases toward different rehabilitation consumers from various racial/ethnic backgrounds in terms of eligibility determination and plan development/intervention services. The computer simulation will assist us to better understand counselor decision-making factors influencing differential acceptance rate and differential service patterns that cannot be discerned from archival data. Integrating Research and Practice Proposed Level 2 Research R6 – To study factors influencing counselor attitudes toward minorities in the initial interview and the subsequent rehabilitation counseling process and how these factors can be used to train counselors to heighten their awareness of their cultural biases and to train consumers from minority background to modify counselor behaviors. Integrating Research and Practice Level 3 Research Evidence-Based Multicultural Rehabilitation Counseling Practice: A Model for Intervention and Training – Research conducted in Level 1 and Level 2 will form the foundation for the development of a cultural-sensitive rehabilitation counseling practice model to enhance rehabilitation outcomes by using salient and empirically supported constructs. Integrating Research and Practice Level 3 Research – Research conducted in Level 1 and Level 2 will form the foundation for the development of a cultural-sensitive rehabilitation counseling practice model to enhance rehabilitation outcomes by using salient and empirically supported constructs. It is reasonable to expect that counselors who incorporate these cultural-sensitive practice components into their practice might have more successful rehabilitation outcomes. Integrating Research and Practice Level 3 Research R7 – A training package will be developed based on a comprehensive review of the multicultural counseling and multicultural rehabilitation counseling literature, research generated from Level 1 and Level 2. An experimental research study will be conducted with a group of VR counselors to determine the effectiveness of the training package in modifying counselor multicultural counseling behaviors, improve working alliance, improve consumer satisfaction, and improve rehabilitation outcomes.
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