Thesis[1]

SELF-PERCEIVED MULTICULTURAL COMPETENCY A Thesis Presented to the Faculty of California State University, Stanislaus In Partial Fulfillment of the Requirements for the Degree of Masters of Science in Psychology By Kelley Joan Herrin May 2005 iv CERTIFICATION OF APPROVAL SELF-PERCEIVED MULTICULTURAL COMPETENCY by Kelley Joan Herrin Dr. Harold Stanislaw Date Professor of Psychology Dr. Gina Pallotta Date Associate Professor of Psychology Dr. Todd Nelson Date Associate Professor of Psychology iii ACKNOWLEDGMENTS It would be impossible to acknowledgeable, by name, all of the people who inspired me to conduct this study. I would like to first say that this study was conducted to honor the ethnically diverse population that I have the privilege to counsel. It has been because of all of my professors guidance, cultural coursework, training, supervision, and self-searching that I am able to continually aspire to understand my clients as they educate me on their particular needs in treatment. To God, thank you for everything. To my sponsor Diana Rogers I will, one day at a time, be grateful for the hope you inspire in me and your unconditional love. To Miranda Palmer, thank you for pointing me in the right direction exactly when I needed it. I would like to give a special thank you to my sweet Isabella for her patience. One day you will understand why I was so busy working on “homework.” I want you to know that your dreams really can come true. For my mother, due to your constant encouragement, the seemingly unattainable goal of completing my education has come true for me. Thank you. I would like to thank my father for always being there for me, in times of joy and in times of hardship. To Dan, thank you for encouraging me to begin this very rewarding journey and for believing in me. To my thesis chair, Dr. Harold Stanislaw, thank you for your patience. Your expertise and guidance have truly held this study together. iv TABLE OF CONTENTS PAGE Acknowledgements .................................................................................................................... iii List of Tables .............................................................................................................................. vi Abstract...................................................................................................................................... vii CHAPTER I. Introduction............................................................................................................ 1 Multicultural Counseling Competency………………………………………... 1 Multicultural Competency-A Legal and Ethical Issue…………………........ 1 Why is Multicultural Counseling Competency so important? ........................ 3 How does Multicultural Competence relate to treatment? .............................. 4 Definition of Multicultural Counseling Competency ...................................... 5 Multicultural Competency as it relates to treatment ........................................ 7 Factors that Contribute to Developing Cultural Competency ......................... 8 Methods Utilized to Enhance the Development of Multicultural Competency ...................................................................................................... 10 Purpose of the Present Study............................................................................ 11 Hypotheses…………………………….………………………………............. 16 Hypothesis One…………………………………………………................... 16 Hypothesis Two…………………………………………….......................... 17 Hypothesis Three……………………………………………….................... 17 II. Method ................................................................................................................... 18 Experimental Design.............................................................................................. 18 Materials.......................................................................................................... 18 Multicultural Awareness-Knowledge-Skills Survey (MAKSS) ................ 18 Marlow-Crowne Social Desirability Scale ................................................. 18 Mandatory Multicultural Counseling Course ............................................. 20 Personal Information Questionnaire…………………………………….. 20 Participants and Procedure………………………………………............ 22 Analysis............................................................................................................. 22 III. Results................................................................................................................... 23 Demographics………………………............................................................ 23 Hypotheses ...................................................................................................... 23 Hypothesis One ........................................................................................ v Hypothesis Two........................................................................................ Hypothesis Three...................................................................................... V. Discussion .............................................................................................................. General Discussion.......................................................................................... Limitations of the Study.................................................................................. Conclusion....................................................................................................... References Cited......................................................................................................................... 50 Appendices ................................................................................................................................ 51 A. Informed Consent................................................................................................... 53 B. Participant Questionnaire....................................................................................... C. Multicultural Awareness-Knowledge-Skills Survey ............................................ D. Marlow-Crowne Social Desirability Scale............................................................ E. Self-Perceived Multicultural Competency Debriefing ......................................... vi LIST OF TABLES TABLE PAGE 1. Academic Status, Ethnicity, and Sexual Orientation of Participants. .................. 2. SDS and MAKSS Awareness (A), Knowledge (K), Skills (S), and Overall (O) scores for undergraduates .................................................................. 3. SDS and MAKSS Awareness (A), Knowledge (K), Skills (S), and Overall (O) scores for graduates............................................................................ 4. MAKSS Awareness (A), Knowledge (K), Skills (S), and Overall (O) scores as a function of minority group membership............................................. vii ABSTRACT The United States has evolved into an ethnically diverse country. Counselors have an ethical obligation to aspire to be aware of, knowledgeable about, and have the skills to be competent when counseling persons of differing ethnicities. Graduate programs generally assume that professionals will be able to meet this obligation if they complete a multicultural course. A similar desire for multicultural awareness and understanding exists at the undergraduate level, where many universities require students to complete a multicultural course. To determine the impact of multicultural coursework, undergraduate and graduate students at California State University, Stanislaus were administered the Multicultural Awareness-Knowledge-Skills Survey (MAKSS). Undergraduate students who had completed, or were in the process of completing, a multicultural course did not report significantly different scores on the MAKSS or its subscales than undergraduate students with no multicultural coursework. Graduate students who had completed, or were in the process of completing, a graduate-level multicultural course reported significantly higher scores on the overall MAKSS, and the Skills subscale, than graduate students who had not yet taken a graduate-level multicultural course. However, the overall MAKSS scores were no longer significant, while the Skills scores remained significant, after taking into account differences in socially desired responding. Students who identified themselves as homosexual or belonging to an ethnic minority group did not report significantly higher MAKSS scores than non-minority students. This failure to replicate the findings of previous studies may have been due to methodological factors. Utilizing a pre-test post-test design, and limiting the study to graduate students as participants, may have reported different results. 1 CHAPTER I INTRODUCTION The United States has been referred to as a melting pot when describing the immigration and assimilation of people from many diverse countries into one country. Culture is defined as the predominating attitudes and behavior that characterize the functioning of a group or organization (American Heritage Dictionary, 2000). Cultures can be categorized by country of origin, gender, sexual orientation, state of residence, or any other defining characteristics. Mental health professionals work with people from varying groups. As such, many cultures are represented. To adequately address these differing cultures, mental health professionals are often required to have training in counseling persons from different cultures. Research into the efficacy of multicultural training helps to ascertain the strengths and weaknesses of the training provided. The purpose of this study is to examine required current standards of multicultural competence necessary for mental health professionals, to explore previous research conducted, and to examine whether students perceive themselves to be multiculturally competent after receiving training. Multicultural Counseling Competency Multicultural Competency-A Legal and Ethical Issue Multicultural competence is recognized among mental health professional organizations as an ethical issue. The American Psychological Association’s (APA) Ethical Principles of Psychologists and Code of Conduct (2003), the National Association of Social Workers (NASW), and California Marriage and Family Therapist Association (CAMFT) include specific guidelines regarding the counseling of different cultural groups. APA categorizes ethics into standards that are rules set down for psychologists that must be adhered to, and are enforced. According to the APA (2003), a requirement for psychologists is that they must exhibit competency when working in any professional capacity. APA (2003) states that competence requires “education, training, supervised experience, consultation, study, or professional experience.” In regards to 2 multicultural competence, the APA states that the understanding of multicultural differences “is essential for effective implementation of … services or research” (p. 5). NASW ethical standards also include multicultural competency requirements regarding understanding the differences, strengths, and functions of cultures in order to provide effective treatment (NASW, 2004). In addition, CAMFT addresses the need for Marriage and Family Therapists (MFTs) to maintain awareness of how the therapist’s own cultural “identity, values, and beliefs affect the process of therapy” (CAMFT, 1997). In addition to the minimum requirements for cultural competency, the above identified professional organizational standards have aspirational goals, such as: elimination of prejudice (APA, 2003), ending social injustice (NASW, 2004), and continued cultural education and experience (APA, 2003; CAMFT, 1997). Therefore, it is a counselor’s ethical duty to aspire to understand all cultures. Aspirational goals are a necessary component for a counselor’s continued professional growth. It is implicit that the goal of becoming multiculturally competent is strived for continually. For a counselor to be multiculturally competent, training must be implemented. It is a counselor’s ethical duty to strive for and achieve the ability to respect, as well as be effective in implementation of techniques in therapy to persons of all cultures. Why is Multicultural Counseling Competency so important? The United States is an ethnically diverse country. Ethnicities in this study will be identified as they are described by the United States Census Bureau. With a 14% decrease in the percentage of the non-Hispanic White population from 1996, the United States Census Bureau (USCB) identified the Hispanic population as being the largest minority and the Asian population as the fastest growing population in the U.S. (USCB, 2000). The African American population comprised 12.3% of the U.S. population in 2000, while American Indians accounted for 0.9%. It is also important to note that 2.4% of the U.S. population in 2000 identified themselves as being of two or more races. 3 As the ethnic makeup of the United States continues to change, so does the cultural makeup. As such, mental health professionals’ client populations are constantly changing and becoming more culturally diverse, requiring mental health professionals to be competent in working with diverse populations (Sodowsky, Taffe, Gutkin, & Wise, 1994). In addition to the changes evident across the United States, individual states have constantly evolving and differing ethnic and cultural compositions. California is one example of a state with a diverse ethnic background. According to the USCB (2003), persons who were identified as being Asian grew by 72% from the years 1990 to 2000. Over half of the Asian population are reported as residing in California, New York, and Hawaii alone. In 2003, California’s population was estimated to be made up of 11% Asians, and 34% of Hispanic or Latino origin (UCSB, 2003). When becoming knowledgeable about any specific ethnic group, a counselor not only must take into account differences between ethnic groups but also differences within ethnic groups (McGoldrick, Giordano, & Pearce, 1996). The USCB identifies Asian and Pacific Islanders to be inclusive of Chinese, Japanese, Hmong, Vietnamese, Loatians, Cambodians, Asian Indians, Filipinos, Koreans, Native Hawaiians, and Samoans (UCSB, 2003. p. 1). In the United States, the Hispanic population made up 13.5% of the total population. Half of the Hispanic population reported residing in California and Texas alone. The USCB defines Hispanic as including Mexicans, Puerto Ricans, Cubans, South and Central Americans, and others. Although a person may be considered Hispanic or Asian (as stated above) there are more specific groups, within these groups, that a person may identify with. Within the broad group of Asian/Pacific Islanders, a person may identify more closely with the Filipino culture rather than the Korean culture, for example. In addition, there may be within group differences such as dialects, gender roles, differences in relating to a dominant culture, and religion that may have implications for treatment (McGoldrick et al.). It is evident that the ethnic make-up of the United States is changing. Consequently, individual states vary in their cultural make-up depending on which ethnicities reside in which state. These 4 differences must be addressed when acknowledging the need for a counselor to be multiculturally competent. How does Multicultural Competence relate to treatment? An essential element of treatment is the assessment and diagnosis of a client’s presenting issue, hence the development of the Diagnostic and Statistical Manual for Mental Disorders-IV-TR (DSM-IV-TR; American Psychiatric Association, 2002). The DSM-IV-TR is used primarily for diagnosing presenting symptoms. However, it is not used to determine the etiology or the mode of appropriate treatment. Sue and Sue (2003) suggest two ways that counselors approach the assessment, diagnosis, and treatment of a presenting issue: cultural universality and cultural relativism. Cultural universality suggests that cultures exhibit disorders similarly and treatments prove equally effective across cultures. Conversely, the cultural relativism approach focuses on how differently disorders present, and respond to treatment, within the client’s cultural context. Sue and Sue point out that although mental health disorders are not culturally discriminatory, it is necessary to understand each disorder’s origin, as well as how differing modes of treatment may be impacted by a person’s ideas, customs, skills, and the arts specific to his or her culture. In essence, although the United States may be inclusive of many different ethnicities, each ethnic group has specific cultural differences. It is these cultural differences that the therapist must attend to for treatment to be as effective as possible. According to the United States Surgeon General’s supplement (2001), mental health practices should be driven by empirical evidence. But, due to a lack of research on differing modes of treatment specific to different cultures, it would be difficult, if not impossible, to determine which treatments are most effective for specific groups. However, there is a small body of research reporting that different cultures respond differently to the modes and administration of treatments, such as medication (Opolka, Rascati, Brown, & Gibson, 2004), mental health services (Lam & Sue; 2001; Lawson & Strickland, 2004), and drug and alcohol services (Castro & Garfinkle, 2003). Definition of Multicultural Counseling Competency 5 This study concentrates primarily on multicultural competency as it relates to the counseling field. However, the importance of multicultural competency is not specific to the counseling field. Several areas have been identified, through research, as needing to address multicultural competency. These areas include developing an instrument that can evaluate diversity awareness to assist in training employees in business environments (Dahm, 2003), addressing how to train career counselors to be multiculturally competent (Swanson & O’Brien, 2002), acknowledging the importance for social work professionals to understand oppression and value diversity (Schmitz, Stakeman, & Sisneros, 2001), as well as the need for understanding diverse ethnic populations when working specifically with families of children with developmental disabilities (Krohn, 1999). Sue and Sue (2003) have identified three areas in particular, which, if continually aspired to on a consistent basis, will lead to multicultural competence. A culturally competent therapist is always in the process of being aware of personal values, biases, stereotyping tendencies, and labeling, as well as personal limitations. To be culturally competent it is also necessary to attempt to understand the views of the client as they are identified as specific to certain cultures. In addition, a culturally competent therapist will consistently attempt to adjust therapeutic interventions to be sensitive to, and consistent with, the cultural views of the client. Sue and Sue accurately state that “These three goals make it clear that cultural competence is an active, developmental, and ongoing process and that it is aspirational rather than achieved” (p.18). Many factors contribute to a counselor’s competence when counseling persons of one specific or of several combined ethnicities. Multicultural Counseling Competency (MCC) has been broken down into specific components by Sue, Arrendondo, and McDavis (1992). Sue et al. identify the minimal requirements that should be met to work towards aspiring to be culturally competent. Characteristics of a competent counselor are cultural self-awareness, understanding the worldview of the client, and culturally relevant interventions, strategies, and techniques. Each of these characteristics has three dimensions: beliefs and attitudes, knowledge, and skills. In effect, according to Sue et al., the three characteristics 6 times the three dimensions equals nine total areas of competency that must be addressed before a counselor can aspire to be identified as culturally competent. Peterson, Coleman, Dobbins, and Boyce (2002) state that a culturally competent counselor must possess enough awareness, knowledge, and skill not only to diagnose but to also utilize effective treatment strategies to offset the effects of what these authors describe as “the client’s cultural embeddedness” (p. 344). Cultural competency is not only about understanding the client’s needs from the client’s cultural viewpoint but, perhaps more importantly, it is about respecting the client’s need to continue thoughts, feelings, and behaviors specific to a particular culture while assisting the client in addressing how to successfully work, and live in close proximity, with individuals who are culturally different from themselves. In addition, there are several areas that contribute to counselor effectiveness once cultural competency has been addressed. Cultural competency helps establish the counselor-client relationship, which increases the possibility of the client receiving a higher level of care. In addition, by incorporating the clients’ cultural views with respect to their health care, the client is more likely to feel respected by the counselor, thus increasing rapport and collaboration. Once rapport and a collaborative relationship have been established, this will, in turn, enhance the client’s self-efficacy and how responsive the client will be in therapy (Peterson et al., 2002). Multicultural Competency as it relates to treatment As stated above, there are between groups, as well as within group, cultural differences that must be taken into account when treating clients of different ethnicities. Asians, Hispanics, and non-Hispanic Whites are the primary ethnicities reported by the Census Bureau (2000) as residing in the state of California. According to McGoldrick et al. (1996) there are cultural differences for all of these ethnicities that should be addressed before proceeding with treatment. Specifically, there are within group differences such as “migration history, population, language, religion, education level, occupation, income, degree of acculturation, preferred residential location, political involvement, and so forth” (McGoldrick et al., p. 227). Aviles (2003) noted that a multicultural assessment process should take into account factors such as level of 7 enculturation, racial and ethnic identity development, acculturation, social characteristics, oppression and sociopolitical factors, racism and discrimination, language, and individual characteristics. In addition, according to Aviles (2003) to competently assess clients a counselor must be knowledgeable about their own culturally specific way of communicating and interacting. A counselor should also be educated about cultural differences and be willing to let the client educate the counselor during the assessment process and throughout treatment. Aviles (2003) also reported that cultural differences should be assessed in every client, and the counselor may feel some biases as a result of this assessment and realize that this is normal and may dissipate as more is learned about different cultures. There are consistent between group differences when counseling the Asian versus the Hispanic population, such as religious preferences, family relations and gender roles, intimacy and sexuality, and educational and career issues (Inman & Tewari, 2003). For example, McGoldrick et al. (1996) reported that 90% of Mexican Americans are affiliated with Roman Catholicism. In contrast, Asians may come from a Christian, Buddhist, Shinto, or Muslim religious background. In reference to treatment, a therapist will want to assess for external support systems for both cultures. However, as stated above, Asians and Hispanics differ significantly in relation to their religious preferences. A multiculturally competent therapist will attend to these between and within group differences in order to practice counseling ethically, as well as to match the treatment to the client. Factors that Contribute to Developing Cultural Competency As noted above, although there is a lack of a significant amount of research in assessing what exactly contributes to MCC, several researchers have attempted to study this area of importance as it relates to training students. By remaining consistent with Sue’s definition of cultural competency, the first step would be for students to be knowledgeable about their own culture as well as be aware of their beliefs and attitudes in reference to their own culture. As several researchers have noted, counselor self awareness is a necessary starting place in developing cultural competency (Abreu, 2001; Ben-David & Amit, 1999; Richardson & Molinaro, 1996; Robinson, et al., 1997; Sue & Sue, 1992). 8 Promoting awareness of one’s own cultural beliefs may produce a certain amount of resistance, due to the fact that students may have to acknowledge characteristics of their culture that may include prejudices and inconsistencies. As Abreu (2001) noted, “an experiential educational approach capitalizing on affect may activate a defensive rather than an open frame of mind, inhibiting rather than promoting personal learning” (p. 490). Abreu continues to note that racial prejudice and biases oftentimes are not conscious processes. Abreu suggests that didactic exercises be utilized, at the same time that experiential instruction is implemented, to assist students in bringing to their awareness possible biases and prejudices that they may have. After utilizing the didactic exercises suggested in this article, Abreu reports that students are much more receptive to participating in classroom activities and discussions (p. 506). Once counselors have begun to understand their own culture, including its possible prejudices and biases, the groundwork has been laid for an understanding of a client’s culture. From an academic perspective, this can be achieved by implementing courses designed to assist in educating students about different cultures. As previously stated, cultural competency is a state a counselor aspires to achieve, not something that can be learned by simply taking a college course. Awareness of one’s own culture, as well as the differing cultures of a client, is an ongoing process. Moreover, being aware of one’s own culture is not to be taken lightly if a counselor aspires to be as effective as possible. Knowledge, beliefs and attitudes contribute to whether a counselor’s skills are effectively utilized in interventions. Understanding the beliefs and attitudes, and being knowledgeable about, persons of differing ethnicities contributes to a counselor’s understanding of what skills are needed to implement effective interventions with clients (Peterson et al., 2002). Methods Utilized to Enhance the Development of Multicultural Competency Several areas of training have been addressed as avenues to implement when promoting multicultural competency in students. The importance of mentoring (Santiago-Rivera & Moody, 2003), supervision (Faubert & Locke, 2003), case conceptualization (Uchison, 2003), the development of ethnic 9 specific awareness and understanding (Aviles, 2003; Inman, 2003), and the need for administrators and faculty to address and develop multicultural competencies in students (Kwan & Taub, 2003) are all necessary components to identify when addressing training that may enhance multicultural competency. The most widely researched area of the development of MCC has focused on the effects of multicultural courses on students’ self-perceived competence. D’Andrea, Daniels, and Heck (1991) studied the effects of multicultural courses on self-perceived multicultural counseling competencies. In addition, these researchers were interested in whether the number of hours of multicultural instruction would affect self-perceived multicultural counseling abilities. Ninety-six graduate students, in counseling education programs, accounted for three separate investigations. Participants were from the Western United States (predominantly Asian), and from the Southeastern part of the United States (predominantly White). Participants were administered the Multicultural Awareness-Knowledge-and Skills Survey (MAKSS) prior to and after completing the mandatory multicultural counseling course. The MAKSS utilized for this study consisted of 60 items. The primary researcher was the instructor of three multicultural counseling courses and two control courses that were taught to the participants. In Investigation 1, 19 Asian participants completed a multicultural course that resulted in a total of 45 hours of direct training completed in 15 weeks. In Investigation 2, 18 Asian participants completed a multicultural course that resulted in a total of 36 hours of direct training completed in 6 weeks. In Investigation 3, 27 White participants completed a multicultural course that resulted in a total of 42 hours of direct training completed in three weekends. A similar control group was not available for Investigation 3 (D’Andrea et al. 1991). D’Andrea et al. did not describe the characteristics of the control group. D’Andrea et al. (1991) concluded in their study that students perceived themselves as more multiculturally competent after completing the mandatory multicultural counseling course, regardless of their ethnicity. D’Andrea et al. addressed participants’ overall higher self-perception of multiculturally competency after completing the multicultural course, and suggested that this study offers “preliminary results that indicate future counselors perceive their multicultural counseling training to be beneficial 10 regardless of their cultural background or diversity in their geographical locations” (p. 148). Pretest scores on the MAKSS showed no significant differences between control and treatment groups for either Investigation 1 or 2, but all three treatment groups perceived themselves as more multiculturally competent than the control groups after completing the counseling course. D’Andrea et al. note that the number of hours of training did not affect the participants’ levels of self-perceived multicultural competency. As a final note, D’Andrea et al. (1991) did not offer possible explanations why self perceived multicultural competency did not differ between the Asian versus White participants. A direct comparison would not have been possible due to the fact that most of the participants were Asians in Investigation 1 and 2 and White in Investigation 3. Upon reviewing the study further, this researcher notes that in Investigation 3, which involved mostly White participants, the mean difference between pre-test and post-test MAKSS scores for self perceived awareness was –4.17. In Investigations 1 and 2, which involved predominantly Asian participants, the mean difference was -3.74 and –4.27, respectively. Thus, Asian participants perceived themselves as less multiculturally aware than the White participants in Investigation 1, but more multiculturally aware in Investigation 2. The results were more consistent for the area of skills. Here, the mean change score in Investigation 1 (-3.14) and Investigation 2 (-3.31) was greater than the mean change score in Investigation 3 (-2.62), suggesting that Asian participants perceived themselves as more multiculturally competent than White participants. The opposite pattern emerged for multicultural knowledge; change scores were greater in Investigation 3 (-5.81), mostly White participants, than in Investigation 1 (-4.66) and Investigation 2 (-4.42), mostly Asian participants. Thus, while ethnicity differences may exist for individual subscales, no consistent differences in overall self perceived multicultural competency were seen between Asians and Whites. However, it should be noted that Investigations 1-3 differed not just in the ethnicity of the participants, but in several other respects, as well (such as the hours of instruction). Pope-Davis, Reynolds, Dings, and Nielson (1995) randomly mailed the Multicultural Counseling Inventory (MCI) to 520 graduate students attending American Psychological Association approved clinical 11 and counseling psychology programs in the United States. They received 344 responses. Pope-Davis et al. concluded that counseling psychology students perceived them selves as being more multiculturally competent than did clinical psychology students on the MCI. Most importantly, Pope-Davis et al. reported that this difference was a result of counseling students receiving a greater number of multicultural counseling courses than the clinical students. An average of 1.6 multicultural counseling courses was completed by the counseling students, while the clinical students completed an average of 0.9 courses. Pope-Davis also noted that multicultural courses, in addition to supervision, might have contributed to higher Knowledge and Awareness scores for the clinical psychology students. The MAKSS has also been administered to undergraduate students. In two separate studies (Estrada, Durlak, & Juarez, 2002; Robinson & Bradley, 1997) the MAKSS was administered to undergraduate students in a pre-test, post-test design to both a treatment and a control group. In both studies, there were no significant differences in self-perceived multicultural counseling competencies between control and treatment groups prior to taking a multicultural course. After taking the mandatory multicultural course, treatment groups in both of the studies reported increased multicultural counseling competencies, whereas the control group scores did not differ, because the mandatory course did not focus on counseling skills. However, in the Estrada et al. (2002) study, the treatment group did not report a significant improvement in their self-perceived multicultural counseling skills. To highlight the importance of studying the effects of implementing mandatory multicultural counseling courses for undergraduates, Robinson and Bradley (1997) note in their discussion that, “Undergraduate classes in multicultural issues provide a foundation for focusing graduate level courses on multicultural counseling skills and techniques, and therefore allow graduate courses to focus more exclusively on skill development” (p. 287). A student’s ethnicity has been shown to be a contributing factor to self-perceived multicultural counseling competency. Sodowsky, Kuo-Jackson, Richardson, and Corey (1998) received responses to the MCI from 176 participants. The participants were doctoral psychologists, predoctoral interns, master’s level counselors, doctoral practicum students, master’s practicum students, and bachelor’s level counselors from 12 APA-approved counseling centers in the United States. Participants identified themselves as White, Black, Asian, and Hispanic. Sodowsky et al. (1998) reported that Hispanics had a significantly higher score on the MCI than Whites did. It was also reported that Whites had the lowest MCI score among all four groups. In addition, with the use of descriptive statistics, Sodowsky et al. stated that Blacks had higher scores than Whites on the Relationship subscale of the MCI; Blacks, Hispanics and Asians had higher scores than Whites on the Awareness subscale; and Hispanics and Asians had higher scores on the Knowledge subscale than Whites did. Sodowsky et al. attributed Black, Hispanic, and Asian participants’ self-perceived multicultural competency as being higher than Whites due to “their greater familiarity with multicultural issues than Whites. This is perhaps because they live multicultural lives” (p. 261). Although Pope-Davis et al. (1995) found that counseling students perceived themselves as more multiculturally competent than clinical students, they also noted that being a “student of color” was significantly correlated with clinical psychology graduate students’ scores on the Knowledge subscale of the MCI (p. 327). These findings seem to be in direct contradiction to the D’Andrea et al. (1991) findings that White participants rated themselves as more multiculturally knowledgeable on the MAKSS than the Asian participants. In addition, Pope-Davis et al. reported that persons of color in both the clinical and counseling programs perceived themselves as more multiculturally competent on both the Awareness and Relationship subscales of the MCI. Pope-Davis et al. found this to be of great importance, given the fact that there were no significant correlations with perceived multicultural competence and gender or age of the participants. Yet again, D’Andrea et al. findings differed somewhat showing that White participants perceived themselves more multiculturally aware than the Asian participants in Investigation 1, but less aware than the Asian participants in Investigation 2. Due to the discrepancies in research regarding ethnicity, this study will also focus on participants’ ethnicity as it relates to their self perceived multicultural counseling competencies 13 Purpose of the Present Study Multicultural counseling competency is a necessary component for treatment to be effective. The American Psychological Association (APA), the National Association of Social Workers (NASW), as well as the California Marriage and Family Therapist Association (CAMFT) have each made specific contributions to stressing the importance of addressing multicultural competency. It is not only necessary to stress the importance of multicultural competence, it is also necessary to research what factors contribute to developing multicultural competence. Due to the vast, ever changing differences in the ethnic make-up of the United States, the importance of multicultural counseling competency cannot be overstated. It is a therapist’s ethical duty to aspire to be aware of personal values and beliefs, as well as the client’s values and beliefs as they relate to ethnicity and culture. With the acknowledgement and understanding of the differences between cultures, the counselor can then implement the appropriate techniques that will enhance and contribute to the effectiveness of therapy. The purpose of the present study was to determine if Psychology undergraduate students who had taken a required multicultural course perceived themselves as more multiculturally competent than Psychology undergraduate students who had not taken a multicultural course. In addition, the purpose of the present study was to determine if Psychology-Counseling graduate students who had taken a required multicultural course perceived themselves as more multiculturally competent than Psychology-Counseling graduate students who had not taken the required cultural course. If students who have completed a multicultural course do perceive themselves as more multiculturally competent, this finding would enhance the empirical evidence that has been stated above. This research would also be in direct support of requiring multicultural courses to enhance cultural awareness in undergraduate, as well as graduate, students. Most of the previously reviewed studies have controlled for social desirability (Constantine, 2001; Constantine et al., 2000; Kim et al., 2003; Sodowsky et al., 1998). Assessing for social desirability assists in distinguishing true multicultural awareness from mere impression management. Under varied 14 circumstances there may exist a tendency for a participant in a study to respond to items in what may be perceived as a socially desirable manner. In this particular study, which addresses a participants selfasseesse competency to be multiculturally aware and sensitive to differences, participants may be motivated to respond in a manner in which they feel others would perceive them as more sensitive than they actually may be. Participants may feel that a positive response is expected regarding how they should be answering an item. In addition, participants may be answering items based on their perceptions of competencies and not necessarily on actual performance. In other words, an item may be answered based on how multiculturally aware a participant would like to be and not based on how the participant actually behaves. (Lee & Darnell, 2002; Pope-Davis et al., 1995). Therefore, the present research will control for socially desired responding. Hypotheses Hypothesis One After controlling for the tendency to respond in a socially desirable manner, it is hypothesized that undergraduate students would perceive themselves as having a higher level of cultural awareness, knowledge, and skills on the Multicultural Awareness, Knowledge, and Skills Survey if they had completed, or were in the process of completing, a required multicultural course. Previous studies have reported that completing at least one required multicultural course undergraduate students perceived themselves as more multiculturally competent (Estrada et al., 2002; Robinson & Bradley, 1997) Hypothesis Two After controlling for the tendency to respond in a socially desirable manner, it is hypothesized that graduate students would perceive themselves as having a higher level of cultural awareness, knowledge, and skills on the Multicultural Awareness, Knowledge, and Skills Survey if they had completed, or were in the process of completing, a required graduate level multicultural course. Several studies have suggested that graduate students perceive themselves to be more multiculturally competent after completing a required multicultural course (D’Andrea et al., 1991; Pope-Davis et al., 1995; Sodowsky et al., 1998). 15 Hypothesis Three It is hypothesized that students who identify themselves as belonging to a minority ethnic group will exhibit greater self-perceived multicultural competency than those who identify themselves as belonging to a White ethnic group. APA Code of Ethics recognizes that the sexual orientation of a client needs to be considered when addressing the ethical treatment of a client. Therefore, it was also hypothesized that students who identified themselves as non-heterosexuals, on the participant questionnaire, would exhibit greater self-perceived multicultural competency than those who identified themselves as heterosexual. Researchers have suggested that there are differences between ethnicities when reporting self perceived multicultural competency (Pope-Davis et al., 1995; Sodowsky et al., 1998). 16 CHAPTER II METHOD Materials The forms in the packet included instructions, two copies of the informed consent, a debriefing statement, and a 7-item demographic information questionnaire (see Appendix C). The packet consisted of the Multicultural Awareness-Knowledge-Skills Survey (MAKSS) (Kim, Cartwright, Asay and D’Andrea, 2003) and the Social Desirability Scale (Strahan & Gerbasi, 1972). There are several instruments that have been researched extensively, and utilized in many studies, that assess multicultural counseling competence. For the purposes of this study, four instruments were considered for possible implementation. These instruments were the Cross Cultural Counseling Inventory Revised (CCCI-R), the Multicultural Counseling Awareness Scale-B (MCAS:B), the Multicultural Counseling Inventory (MCI), and the Multicultural Awareness-Knowledge-Skills Survey (MAKSS). Each of these instruments have been carefully reviewed in several different studies. All were found to assess for multicultural beliefs and attitudes, knowledge, and skills. All of these instruments and their respective scales showed adequate to excellent internal reliability (Constantine & Ladanay, 2000; Lee & Darnell, 2002; Ponterotto, Rieger, Barrett & Sparks, 1994). This study assessed how aware psychology students are of their own ethnicity as well as that of other persons, how knowledgeable they are about persons of ethnicities other than their own, and how skillful they perceived themselves to be when working with persons of different ethnicities. Because the CCCI-R, the MCAS:B, and the MCI questions are specifically directed to graduate students who have already counseled clients, it was felt that these instruments would not be suitable for undergraduate psychology students, many of whom may not be entering the field of counseling. Thus, the MAKSS was chosen as the most suitable instrument for this study. This study examined the impact of university coursework on multicultural awareness. The MAKSS is ideally suited for this purpose, because it was specifically designed to assess whether academic 17 interventions, addressing students’ multicultural awareness, have an effect on students’ awareness, knowledge, or skills in this area. Multicultural Awareness-Knowledge-Skills Survey (MAKSS) The original MAKSS was designed as a self-report 60-item instrument. According to Ponterotto et al. (1994), the MAKSS assesses “the effect of instructional strategies on students’ multicultural counseling development” (p. 321). D’Andrea et al., (1991) reported that the MAKSS was developed “to assess changes in a person’s level of multicultural counseling development” (p. 148). It contained three subscales that were measured separately. Each subscale was measured by utilizing two different 4-point Likert scales that ranged from; 1 = very limited or 1 = strongly disagree to 4 = very aware or 4 = strongly agree. The three subscales were multicultural counseling awareness, multicultural counseling knowledge, and multicultural counseling skills. The 60-item MAKSS has been reported as having a coefficient alpha for internal consistency of .75 for the Awareness subscale, .90 for the Knowledge subscale, and .96 for the Skills subscale. The coefficient alpha for the total scale was not reported (D’Andrea et al. 1991). The MAKSS was revised by Kim, Cartwright, Asay and D’Andrea, (2003). Although questions were deleted, the subscales and Likert ratings have remained intact. The new 33-item MAKSS included 10 items for the Awareness subscale, 13 items for the Knowledge subscale, and 10 items for the Skills subscale. Consistent with the original 60-item MAKSS, the 33-item MAKSS subscales assess three main areas. The Awareness subscale assessed “awareness of personal attitudes toward minority clients.” The Knowledge subscale assessed “knowledge about minority clients,” and the Skills subscale assessed “crossculttura communication skills” (Lee & Darnell, 2002, p. 289). The 33-item MAKSS was reported by Kim et al. (2003) as having a coefficient alpha for internal consistency of .80 for the Awareness scale, .87 for the Knowledge scale, and .85 for the Skills subscale (p.171). The coefficient alpha for the total 33-item scale was .81. Although the coefficient alphas for the 33-item Knowledge and Skills subscales were somewhat less reliable than the 60-item instrument the coefficient alpha for the 33-item Awareness scale increased. Overall, Kim et al. reported that the scores for 18 the 33-item scale had “adequate to good reliability across two separate samples” (p.175). The 33-item version of the MAKSS was chosen for the present study instead of the 60-item version, because the 33-item version yields a relatively high coefficient alpha (.81) and takes less time to complete than the 60-item scale (see Appendix C). Marlow-Crowne Social Desirability Scale In reference to the tendency for participants to answer items in a socially desirable way, it was decided to utilize an instrument that assessed whether a participant was answering items in what the participant believes would be a socially desirable manner. The original Marlow-Crowne Social Desirability Scale (SDS) was a self-report 33-item instrument (Crowne & Marlow, 1961). According to Kim et al. (2003), the SDS was designed to “assess the tendency of research participants to respond in culturally sanctioned and valued ways” (p. 165). Internal consistency coefficients have ranged from .73 to .88 (Paulhus, 1991). Strahan and Gerbasi (1972) revised the SDS to consist of 20 items. Reliability coefficients for the 20-item instrument were reported as ranging from .73 to .83 (Strahan & Gerbasi, 1972). For the purposes of this study, the 20-item instrument, assessing whether a participant is responding in what they perceive to be a socially acceptable manner, was implemented (see Appendix D). Mandatory Multicultural Counseling Course According to California State University Stanislaus 2003-2005 Catalog (CSUSC), undergraduate students are required to complete a 3 unit multicultural requirement. Classes that satisfy the multicultural requirement “addresses multicultural, ethnic studies, gender, or nonwestern cultures issues” in the coursework (CSUS Catalog, p.71). This research concentrated on whether or not an undergraduate student had completed the mandatory course. According to the CSUS Catalog, graduate students are required to complete coursework including Seminar in Multicultural Counseling (PSYC 5850) in order to satisfy requirements to obtain their Master’s degree in Psychology/Counseling. It was whether a graduate student had completed the PSYC 5850 course that this research concentrated on. 19 Personal Information Questionnaire A 7-item questionnaire was utilized to identify participants’ gender, age, whether the participant was an undergraduate or graduate student, and to identify their major. Participants were asked to indicate their ethnicity. Choices included White, Black, Hispanic, American Indian, Asian, Pacific Islander, and other (participants were asked to indicate what race or races). Participants were asked what their sexual orientation is and choices included heterosexual, bisexual, gay, lesbian, and other. Participants were given a list of required multicultural courses as indicated by the CSUSC (see Appendix C) and asked to indicate which courses they had completed or were currently taking. Participants and Procedure Eighty undergraduate students were recruited by requesting participation during class time in undergraduate Psychology courses. It was estimated that at least eighty undergraduate students would participate in this study. A packet complete with two copies of the consents, the MAKSS and the SDS, and debriefing was distributed to each student. Packets were completed during class time. Packets were collected by this researcher. Forty graduate students were recruited by placing a packet complete with two copies of the consents, the MAKSS and the SDS, and debriefing in each students graduate box (located on the second floor of the Classroom Building, room 234-C). It was estimated that at least forty graduate students would participate in this study. Packets were collected by this researcher. Graduate students who had completed coursework but who had not graduated were mailed the consent, questionnaires and debriefing via regular United States mail. A packet containing two copies of the informed consent, an instruction sheet, a 6-item demographic questionnaire, the MAKSS, the SDS, a debriefing statement (placed in a sealed envelope to be read after the completion of the questionnaires), and an envelope to return the materials as applicable (self-addressed stamped envelopes were included in the packets being mailed) were distributed. Packets were given to undergraduate students in the classroom and graduate students had packets placed in their on campus 20 mailbox or mailed. The MAKSS was placed before the SDS in the packet so that the MAKSS would be completed first. The students received the packet in either their campus mailbox or via the United States Post Office mail. Students were requested to return the completed materials within two weeks of receiving them. The informed consents were placed in a separate envelope from the materials to ensure anonymity. If no responses were received after two weeks, those students were eliminated from the study. Analysis Data collected from the questionnaires was to be analyzed by utilizing multiple regression analysis. 21 CHAPTER III RESULTS Demographics Questionnaire packets were distributed to 182 undergraduate students. Completed questionnaire packets were returned by 126 undergraduate students (69% response rate). A total of 92 graduate packets were distributed. There were 77 packets placed in graduate mailboxes and 15 mailed to graduate students. Completed questionnaire packets were returned by 19 graduate students (21% response rate). The combined response rate for undergraduate and graduates was 53%. The demographics of participants who participated in this study are as follows: participants were female (77%), undergraduates and White (See Table 1). Slightly more than half of the participants identified themselves to be an ethnicity other than White. The ethnicity percentages total more than 100, because several participants identified themselves as belonging to more than one ethnic group. Participants who identified themselves as homosexual totaled 1% (n = 2). In addition, 21% of participants indicated pursuing a career in counseling or social work. Almost half of the participants (48%) noted that they had not taken a multicultural course. Participants reported having completed up to 8 multicultural courses (M = 1.05, SD = 1.55). Participants rated themselves in the mid point range (near 2.5) on all three MAKSS subscales as well as on the entire MAKSS (See Tables 2 and 3). Thus, participants did not perceive themselves as particularly strong, or particularly weak, in multicultural competence. Estrada et al. (2002) reported similar scores in their study, with the exception of the Skills subscale where the mean score was close to 1. 22 Table 1 Academic Status, and Ethnicity of Participants. Demographic Status Percentage n Academic Status Undergraduates 87% 126 Graduates 13% 19 Ethnicity White 48% 69 Hispanic 18% 26 Asian 11% 16 American Indian 2% 3 Black 3% 5 Pacific Islander 1% 2 Assyrian 1% 2 Not Indicated 1% 1 Multiple Ethnicities 14% 21 White and one or more other ethnicities 81% 17 Hispanic and one or more other ethnicities 52% 11 Asian and one or more other ethnicities 14% 3 American Indian and one or more other ethnicities 43% 9 Black and one or more other ethnicities 19% 4 Pacific Islander and one or more other ethnicities 10% 2 23 Table 2 SDS and MAKSS Awareness (A), Knowledge (K), Skills (S), and Overall (O) scores for undergraduates. Scale Completed/Taking No Multicultural Multicultural Course Course Taken n M (SD) n M (SD) SDS 62 9.45 (3.69) 63 10.69 (3.31) MAKSS-A 62 2.78 (0.26) 63 2.73 (0.27) MAKSS-K 62 2.84 (0.49) 63 2.82 (0.39) MAKSS-S 62 2.49 (0.63) 63 2.58 (0.59) MAKSS-O 62 2.70 (0.35) 63 2.71 (0.31) Table 3 SDS and MAKSS Awareness (A), Knowledge (K), Skills (S), and Overall (O) scores for graduates. Scale Completed/Taking No Multicultural Multicultural Course Course Taken n M (SD) n M (SD) SDS 11 9.88 (3.43) 7 5.43 (3.10) MAKSS-A 12 2.59 (0.20) 7 2.69 (0.36) MAKSS-K 12 3.08 (0.40) 7 2.75 (0.26) MAKSS-S 12 3.11 (0.37) 7 2.50 (0.38) MAKSS-O 12 2.93 (0.23) 7 2.63 (0.27) Hypotheses Hypothesis One It was hypothesized that undergraduate students who had taken or were currently taking a multicultural course, would have higher self perceived multicultural competence. Independent t-tests were 24 utilized to assess if there was a difference in the level of multicultural competence reported by undergraduate students who had completed or were currently taking a multicultural course, and undergraduate students who had not yet taken a multicultural course (Table 2). Undergraduate students who had completed, or were in the process of completing a multicultural course did not differ significantly from undergraduate students who had not yet taken a multicultural course; t(123) = 0.15, p = .88 for the overall MAKSS score. Undergraduate students who had completed, or were in the process of completing, a multicultural course did not report significantly different scores for social desirability, than undergraduate students who had not yet taken a multicultural course; t(122) = 0.11, p = .07. The group differences for the Skills, Awareness and Knowledge scores also remained non-significant; t(123) = 0.81, p = .42 for Skills, t(123) = 0.96, p = .34. for Awareness, t(123) = 0.21, p = .84 for Knowledge. Thus, hypotheses one was not supported. Hypothesis Two It was hypothesized that graduate students who had taken or were currently taking a required multicultural course, would have higher self perceived multicultural competence. Independent t-tests were utilized to assess if there was a difference in the level of multicultural competence reported by graduate students who had completed or were currently taking a graduate-level multicultural course, and graduate students who had not yet taken a graduate-level multicultural course (Table 3). Graduate students who had completed, or were in the process of completing, a graduate-level multicultural course reported significantly higher MAKSS Skills scores and overall MAKSS scores than graduate students who had not yet taken a graduate-level multicultural course; t(17) = 3.41, p < .01 for Skills, t(17) = 2.61, p = .02 for the overall score. There was no significant difference for the Awareness or Knowledge subscales; t(17) = 0.34, p = .74 for Awareness, t(17) = 1.97, p = .07 for Knowledge. Graduate students who had completed, or were in the process of completing, a graduate-level multicultural course reported significantly higher social desirability scores than graduate students who had 25 not yet taken a graduate-level multicultural course; t(16) = 2.78, p =.01. After controlling for social desirability in a multiple regression analysis, the difference between the two groups of students for the Skills scores remained statistically significant; t(15) = 2.10, p = .05. However, the difference between the two groups in the overall MAKSS scores was no longer significant; t(15) = 1.00, p = .34. The group differences for the Awareness and Knowledge scores also remained non-significant; t(15) = 1.16, p = .26 for Awareness, t(15) = 0.55, p = .59 for Knowledge. Thus, hypotheses two was supported on the Skills subscale of the MAKSS. However, hypothesis two was not supported on the Awareness, and Knowledge subscales, as well as on the entire MAKSS.. Hypothesis Three It was hypothesized that minority students would have higher self perceived multicultural competence than non-minority students. Independent t-tests were utilized to determine if students who identified themselves as belonging to a minority ethnic group exhibited higher self-perceived multicultural competency than non-minority students (see Table 4). Students who identified themselves as belonging to a minority ethnic group did not report significantly different scores on the entire MAKSS than non-minority students, t(143) = 0.18, p = .86. The group differences for the Skills, Awareness and Knowledge scores also remained non-significant; t(143) = 0.87, p = .39 for Skills, t(143) = 0.24, p = .81 for Awareness, t(143) = 0.96, p = .39 for Knowledge. Thus, hypotheses two was not supported 26 Table 4 MAKSS Awareness (A), Knowledge (K), Skills (S), and Overall (O) scores as a function of minority group membership. Scale Non-minority Minority n M (SD) n M (SD) MAKSS-A 69 2.74 (0.25) 76 2.73 (0.29) MAKSS-K 69 2.81 (0.45) 76 2.88 (0.42) MAKSS-S 69 2.63 (0.62) 76 2.54 (0.59) MAKSS-O 69 2.73 (0.33) 76 2.72 (0.32) 27 CHAPTER IV DISCUSSION This study attempted to ascertain if undergraduate students perceived themselves to be more multiculturally competent if they had completed or were currently enrolled in a multicultural course. Results indicated that there was no significant difference between undergraduate students who had not completed a multicultural course, and students who had completed or were in the process of completing, a multicultural course. These results were consistent for all of the subscales as well as the entire MAKSS. In addition, graduate students who had completed or were in the process of completing the required graduate-level multicultural course perceived themselves as more multiculturally competent on the Skills subscale and the entire MAKSS than students who had not taken the required graduate-level multicultural course. After controlling for social desirability, the difference between the two groups of students for the Skills scores remained statistically significant. However, the difference between the two groups in the overall MAKSS scores was no longer significant after controlling for social desirability. Robinson et al. (1997) specifically noted that undergraduate courses emphasize awareness and knowledge of cultural differences and similarities and graduate courses build on this while focusing more on training counseling skills. This is perhaps the most important finding of this study that graduate students who completed or were in the process of completing the required graduate-level multicultural course self perceived to have multiculturally competent skills that are integral to their future professions. The group differences for the Awareness and Knowledge scores remained non-significant. However, responses on the knowledge subscale increased from M = 2.75 for participants who had not taken a multicultural course to M = 4.08 for participants who had completed or were currently taking a required multicultural course. In addition, scores on the awareness subscale dropped from M = 4.69 for students who have taken a required multicultural course to M = 2.59 for completed or currently taking a required multicultural course. The awareness scores possibly fell due to the increased awareness in deficiencies in meetings the needs of minorities that are highlighted while taking a multicultural course. 28 There was no significant difference between students who identified themselves as non-White and students who identified as White and self-perceived multicultural competency. These results were consistent for all of the subscales and for the entire MAKSS. The small sample size of participants who identified themselves as homosexual prevented testing of the impact of this variable. Future studies accessing larger populations of self identified homosexuals can further explore self perceived multicultural competency. In prior studies, when utilizing a pre-test, post-test design graduate and undergraduate students reported higher self-perceived multicultural competence, on the entire MAKSS, after completing a multicultural course (D’Andrea et al. 1991; Estrada et al. 1997). In the D’Andrea et al. study, statistically significant findings were reported by graduate students in the post treatment group for all of the subscales as well. However, undergraduate students in the treatment group of the Estrada et al. study did not report a significant improvement in their self-perceived multicultural counseling skills after completing the multicultural course. Undergraduates do not have the same academic background as graduate students in regards to counseling skills, therefore it is conceivable why they would not report having self-perceived multiculturally competent skills. As noted above, graduate students in this study, after controlling for social desirability, continued to self-perceive as multiculturally competent on the skills subscale. It would appear that students, after starting or completing a graduate level multicultural course, have a greater tendency to respond in what would be a socially desirable way. However, results did not remain statistically significant on the entire MAKSS after controlling for social desirability indicating that students were answering in a socially desirable way. It would have been interesting to note what D’Andrea et al. (1991), and Estrada et al. (1997) would have reported had they controlled for social desirability. Two studies, in particular, report differing results after controlling for social desirability. Constantine et al. (2000) controlled for social desirability in their study with doctorate-level, masters-level, and bachelors-level students. Constantine et al. reported significant results that as Social Desirability scores went up so did the scores on the Knowledge subscale of the MAKSS. Sodowsky et al. 1998 reported that, 29 after controlling for social desirability, statistically significant results remained the same in regards to doctoral and non-doctoral students self-perceived as more multiculturally competent on the Multicultural Counseling Inventory after completing multicultural courses. In regards to ethnicity, prior studies have suggested that ethnicities differ in their responses to self-perceived multicultural competency (D’Andrea et al., 1991; Pope-Davis et al., 1995; Sodowsky et al., 1998). However, there are many discrepancies, as noted earlier, between studies. D’Andrea et al. (1991) reported that all students in their study perceived themselves as being more multiculturally competent, on the entire MAKSS, after completing a multicultural course regardless of their ethnicity. However, Sodowsky et al. (1998) reported that Hispanics had a significantly higher score on the entire MCI than White participants reported. Over half of the 145 participants in this study identified themselves as non-White (52%). What makes the findings in this study interesting is that in the Sodowsky et al. study 6% of participants identified themselves as Hispanic while 71 % self-identified as White. Due to a large sample size and more of an even distribution of White versus non-White participants in this study it could be argued that the results in this study do show that there are no differences in self-perceived multicultural competence in regards to ethnicity. In effect participants in this study who self-identified as non-White self-perceived as neither more nor less multiculturally competent than White participants. Limitations of the Study It should be noted here, first of all, that a self report measures a participants perceptions of their characteristics. Self reports measure perceptions that participants have of their characteristics. The possibility exists that although results did not indicate that students perceived themselves to be multiculturally competent they actually were. On this same note, had participants perceived themselves to be multiculturally competent the results would still be inconclusive as to whether they are actually multiculturally competent. There are many interesting points to be highlighted as a result of this study not having significant results in almost all areas. By the time a student reaches graduate status the importance of aspiring to be 30 multiculturally competent when working with clients should be evident. However, an undergraduate may not always be aware of this importance, especially an undergraduate who is not pursuing a career in the counseling field. Only 21% of undergraduates in this study reported that they were pursuing a career in counseling or social work. Therefore, it is perhaps not surprising that the undergraduate participants tended towards not perceiving themselves as particularly multiculturally competent, as indicated by mean scores near the midpoint on the response scale (2.5). What was not expected was for undergraduate students, who had completed or were in the process of completing a multicultural course, to have almost the same responses as students who had not taken a course at all. As noted above, undergraduate students do not have the same academic background as do graduate students. Some of the terms used in the MAKSS may have been misinterpreted by undergraduates. Estrada et al. (2002) report that the MAKSS was originally designed for graduate-level participants in counselor education programs. For example, for question #18 on the MAKSS, “In counseling, clients from different ethnic/cultural backgrounds should be given the same treatment that White mainstream clients receive.” An undergraduate student may read the term “treatment” and misunderstand this to mean to treat clients fairly and not be prejudicial. The answer would be to agree. However, a graduate student may read the word “treatment” and define it as meaning to utilize the same techniques in treatment. The response would be to disagree because techniques may be different depending on a client’s ethnic background. So, asking whether clients should receive the same “treatment” may mean different things to different readers depending on their academic background. Therefore, the responses would be very different. Misinterpretations such as the one noted above could have resulted in a failure to find a significant improvement in MAKSS scores after completing, or being in the process of completing, a multicultural course. For participants to report self-perceived multicultural competency on the MAKSS they must be able to accurately interpret the MAKSS questions. In addition, it was hypothesized that self perceived minorities would self perceive as more multiculturally competent. For the same reason, the large sample size of undergraduate students may have affected the outcome of this hypothesis. 31 There were several limitations in this study when reviewing the results for graduate students. One of the limitations was the response rate (21%). Indeed, the MAKSS Knowledge score had a higher mean for students who were taking or had completed a graduate multicultural course than for those who had not taken a graduate multicultural course. With a larger sample size this difference might well have been statistically significant. If this study were to be repeated, there were several changes that would be implemented. As noted above, two studies that utilized the MAKSS did so in a pre-test post-test design (D’Andrea et al. 1991; Estrada et al. 2002). D’Andrea et al. administered the MAKSS to graduate students before and after they had taken a multicultural course. Estrada et al. administered the MAKSS to undergraduate students before and after they had taken a multicultural course. Both studies had a control group. Both studies reported that students perceived themselves as more multiculturally competent after completing a multicultural course. If this study were to be repeated it would be suggested that the MAKSS be administered prior to students taking a specific multicultural course and after having completed the same course. It would be preferable to include a control group as well. As noted above, the academic background of an undergraduate versus a graduate student may affect responses. Pope-Davis et al. (1995) administered the MCI to graduate students and reported that participants who had completed more multicultural courses perceived themselves as more multiculturally competent. In addition, D’Andrea et al. (1991) and Estrada et al. (2002) utilized undergraduate or graduate participants. If possible, due to different academic backgrounds, this researcher would suggest limiting the participants to either undergraduate or graduate students, but not both. It would also be interesting to compare students currently enrolled in a multicultural counseling course with those who had completed this requirement. Conclusion Results from this study indicate that undergraduate students who had completed, or were in the process of completing a multicultural course, did not report being more multiculturally competent than 32 undergraduate students who had not yet taken a multicultural course. Graduate students who had completed, or were in the process of completing, a graduate-level multicultural course reported significantly higher MAKSS Skills scores and overall MAKSS scores than graduate students who had not yet taken a graduate-level multicultural course. After controlling for social desirability, the difference between the two groups of graduate students for the Skills scores remained statistically significant. However, the difference between the two groups in the overall MAKSS scores was no longer significant. In addition, students who identified themselves as non-White did not perceive themselves to be more or less multiculturally competent than White students. Due to the changing ethnic make-up of the United States, and California in particular, it is evident that counseling students need the necessary coursework, training, and supervision to aspire to be multiculturally competent when working with clients. The results of this study suggest that completing or currently taking a cultural course does not significantly increase students awareness, knowledge, and skills more than students who have never taken a cultural course. Although pre-test post-test designs have reported that cultural coursework contributes to multicultural competency, what other measures should be implemented to ensure that students are receiving the proper training? Prior research has shown that mentoring, supervision, case conceptualization, the development of ethnic specific awareness and understanding, and the need for administrators and faculty to address and develop multicultural competencies in students are some of the key points to address. Unfortunately, there is no one specific solution to developing multicultural competency. Rather, all of the suggestions noted should be implemented. Being aware of one’s own ethnicity and not encouraging a client to educate on theirs does not result in effective counseling. Not being aware of one’s own biases and prejudices yet encouraging a client to educate on theirs will not result in an effective counselor. Being aware of one’s own biases and prejudices as well as the clients does not always mean a counselor is knowledgeable about what techniques to utilize specific to the clients needs. A students training should 33 address the importance of awareness, knowledge and skills in regards to counseling ethnically diverse clients. Perhaps one suggestion would be a requirement for students to interview their peers. As Abreu (2001) has suggested, a didactic approach assists students in bringing to their awareness possible biases and prejudices that they may have. 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Sue (Eds.), Theory and method of multicultural counseling competency assessment (pp. 283-299). New York: Kluwer Academic/Plenum Publishers. Crowne, D. P. & Marlow, D. (1961). A new scale of social desirability independent of psychopathology. Journal of Consulting Psychology, 24, 349-354. McGoldrick,. M., Giordano, J., & Pearce, J.K. (1996). Ethnicity & family therapy (3rd ed.). New York: The Guilford Press. National Association of Social Workers. (2004) Retrieved October 29, 2004 from http://www.socialworkers.org/pubs/code/code.asp Opolka, J. L., Rascali, K. L., Brown, C. M., & Gibson, P. J. (2004). Ethnicity and prescription patterns for haloperidol, risperidone, and olanzapine. Psychiatric Services, 55, 151-156. Paulhus, D. L. (1991). Measurement and control of response bias. In J. B. Robinson, P.R. Shaver, & L. S. Wrightsman, (Eds.), Measures of personality and social psychological attitudes (pp. 15-59). San Diego, CA: Academic Press. Peterson, F., Jr., Coleman, F., Dobbins, J. 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Alexandria, VA: Association for Multicultural Counseling and Development. United States Census Bureau. (2003). Annual estimates of the population by race alone and Hispanic or Latino origin for the United States and States: July 1, 2003. Retrieved October 29, 2004 from http://www.census.gov/popest/states/asrh/tables/SC-EST2003-04.pdf U. S. Department of Health and Human Services (2001). Mental Health: Culture, Race, and Ethnicity-A Supplement to Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services. APENDICIES 41 Appendix A Informed Consent 1. I understand that this study involves research about how well people think they will perform as counselors and relating that to personal characteristics. If I agree to participate, I will be asked to complete three questionnaires. One asks how I think I will perform as a counselor, another asks general questions about how I would feel or act in specific situations, while the third asks about my personality characteristics (such as my age, my ethnicity, and the courses I have taken.) 2. I understand that my participation in this study is completely voluntary and I may withdraw my participation for any reason without penalty. 3. I understand that participation in this research does not guarantee any benefits to me. 4. I understand that if I agree to participate, the study will last about 20 minutes. 5. I understand that I will be given additional information after my participation is complete. 6. I understand that all data from this study will be protected from inappropriate disclosure and will be accessible only to Dr. Harold Stanislaw and Kelley Herrin, student researcher. 7. I understand that, if I wish, I may obtain written information about the outcome of the research at the end of the academic year. 8. The present research is designed to reduce the possibility of any negative experiences as a result of participation. Risks to participants are kept to a minimum. However, if my participation in this study has caused me concerns, anxiety, or otherwise distressed me, I understand that I may contact the Student Counseling Center for an appointment to discuss my concerns (667-3381). 9. The possible benefits of participation in the present research are that participants may learn more about psychological research procedures and hypotheses, and how psychological experiments are conducted. 10. I understand that I will be provided with a copy of this form. 11. I understand that I may contact the experimenter Kelley Herrin through my research supervisor Dr. Harold Stanislaw at 667-3213 in the department of psychology at CSUS if I have any questions or concerns regarding my participation in this study. If I have any questions about subject’s rights, I may contact Dr. Diana Demetrilius, Director, Office of Grants and Sponsored Programs, CSU Stanislaus, (209) 667-3493. 12. I have freely consented to participate in scientific research being conducted by Kelley Herrin. I attest that I am at least 18 years old. SIGN NAME: _______________________________________ DATE: _____________________________________________ 42 Appendix B PARTICIPANT QUESTIONNAIRE PLEASE COMPLETE THE FOLLOWING INFORMATION 1. Your Gender: _____Male _____ Female 2. Your Age: _____ years 3. Are you an _____ undergraduate or a _____ graduate student? 4. Please indicate your major: Psychology _______ Liberal Studies________ Sociology________ Other_______________________________ 5. Please indicate your general ethnic group. If you wish, please provide a more specific description. Select all that apply: White _____ Specify ________________________________ Black _____ Specify ________________________________ Hispanic _____ Specify ________________________________ American Indian _____ Specify ________________________________ Asian _____ Specify ________________________________ Pacific Islander _____ Specify ________________________________ Other (please indicate) ______________________________________________________ 6. Your sexual orientation: Heterosexual _____ Bisexual _____ Gay _____ Lesbian _____ Other (please indicate) ____________________________ 43 7. Please indicate which courses you have completed or are currently taking: Semester Currently Completed Taking Anthropology 2060 – Intro to Cultural Anthropology __________ __________ Anthropology 3000 – Anthropology and Modern Issues __________ __________ Anthropology 3900 – Women: A Cross-Cultural View __________ __________ Anthropology 4165 – The Family in Cross-Cultural Perspective __________ __________ Anthropology 4211 – The World In Change __________ __________ Art 2525 – Art History Survey – Non-Western __________ __________ Cognitive Studies 4350 – The Information of Meaning __________ __________ Communication Studies 3550 – News From The Front Media and Public Perception __________ __________ Communication Studies 4160 – Intercultural Communication __________ __________ Criminal Justice 3315 – Hate Crimes __________ __________ English 3940 – Multicultural American Literature __________ __________ English 4530 – Gender and Sexuality in Literature __________ __________ Ethnic Studies 4200 – The Minority Experience __________ __________ Ethnic Studies 4350 – Multiculturalism: From Bias To Reality __________ __________ Gender Studies 3320 – The Sociology of Men and Society __________ __________ 44 Semester Currently Completed Taking Gender Studies 3444 – Gender and Sexuality in The Middle East __________ __________ Gender Studies 3700 – Ethnic and Gender Politics __________ __________ Gender Studies 3900 – Women: A Cross Cultural View __________ __________ Gender Studies 4350 – Multiculturalism: From Bias To Reality __________ __________ Gender Studies 4530 – Gender and Sexuality in Literature __________ __________ Gender Studies 4600 – Philosophy and Feminism __________ __________ Gender Studies 4750 – Comparative World Women: Perceptions of Gender __________ __________ Geography 2020 – Intro to Cultural Geography __________ __________ Geography 3010 – Cultural Geography __________ __________ Geography 3330 – Ethnic Geography __________ __________ Geography 3580 – Cultural Ecology of Southeast Asian Peoples __________ __________ Geography 4050 – Restorative Human Ecology __________ __________ Health 4300 – Family Health __________ __________ History 1010 – World Civilizations I __________ __________ History 1020 -World Civilizations II __________ __________ History 3090 – Contemporary World History __________ __________ History 3400 – The Great Teachings __________ __________ 45 Semester Currently Completed Taking History 4750 – Contemporary World Women: Perceptions of Gender __________ __________ Multidisciplinary Studies 3400 – Latin-American Cultures __________ __________ Music 2000 – Music of World Cultures __________ __________ Philosophy 4450 – Eastern Philosophy: Concepts, Methods, and Context __________ __________ Politics and Public Administration 2030 – Global Politics __________ __________ Politics and Public Administration 3444 – Gender and Sexuality in the Middle East __________ __________ Politics and Public Administration 3700 – Ethnic and Gender Politics __________ __________ Politics and Public Administration 3810 – Multicultural Community Building and Conflict Resolution __________ __________ Psychology 3444 – Gender and Sexuality in the Middle East __________ __________ Psychology 5850 – Seminar in Multicultural Family Counseling __________ __________ Sociology 3250 – Social Issues in Cross-Cultural Perspective __________ __________ Sociology 3320 – The Sociology of Men and Society __________ __________ Sociology 4010 – Race and Ethnic Relations __________ __________ Semester Currently 46 Completed Taking Theatre 3170 – Real World Theatre: Comic Improvisation __________ __________ Theatre 4550 – American Theatre __________ __________ If you have taken a course similar to the multicultural courses listed above at another university, please indicate what that course was:____________________________________ ____________________________________________________________________________ 8. Please indicate your career goal: Counselor____________________ Social Worker__________________ Not sure______________________ Other_________________________ 9. Please indicate the number of Psychology units you have completed to date:____________ 47 Appendix C Multicultural Awareness-Knowledge-Skills Survey Please imagine that you are a counselor who meets with clients on a regular basis. Answer the questions below based on your current knowledge, and how you would expect this knowledge to affect how you interact with clients. Please circle one answer that most applies to you. Skills Subscale: 1. How would you rate your ability to effectively consult with another mental health professional concerning the mental health needs of a client whose cultural background is significantly different from your own? 1 = very limited 2 = limited 3 = good 4 = very good 2. How well would you rate your ability to accurately assess the mental health needs of lesbian women? 1 = very limited 2 = limited 3 = good 4 = very good 3. How well would you rate your ability to accurately assess the mental health needs of older adults? 1 = very limited 2 = limited 3 = good 4 = very good 4. How well would you rate your ability to accurately assess the mental health needs of gay men? 1 = very limited 2 = limited 3 = good 4 = very good 5. How well would you rate your ability to accurately assess the mental health needs of persons who come from very poor socioeconomic backgrounds? 1 = very limited 2 = limited 3 = good 4 = very good 6. How well would you rate your ability to identify the strengths and weaknesses of psychological tests in terms of their use with persons from different cultural/racial/ethnic backgrounds? 1 = very limited 2 = limited 3 = good 4 = very good 7. How well would you rate your ability to accurately assess the mental health needs of men? 48 1 = very limited 2 = limited 3 = good 4 = very good 8. How well would you rate your ability to accurately assess the mental health needs of individuals with disabilities? 1 = very limited 2 = limited 3 = good 4 = very good 9. How well would you rate your ability to effectively secure information and resources to better serve culturally different clients? 1 = very limited 2 = limited 3 = good 4 = very good 10. How well would you rate your ability to accurately assess the mental health needs of women? 1 = very limited 2 = limited 3 = good 4 = very good Awareness Subscale: 11. Promoting a client’s sense of psychological independence is usually safe goal to strive for in most counseling sessions. 1 = strongly disagree 2 = disagree 3 = agree 4 = strongly agree 12. Even in multicultural counseling situations, basic implicit concepts such as “fairness” and “health” are not difficult to understand. 1 = strongly disagree 2 = disagree 3 = agree 4 = strongly agree 13. How would you react to the following statement? In general, counseling services should be directed toward assisting clients to adjust to stressful environmental situations. 1 = strongly disagree 2 = disagree 3 = agree 4 = strongly agree 14. While a person’s natural support system (i.e., family, friends, etc.) plays an important role during a period of personal crises, formal counseling services tend to result in more constructive outcomes. 1 = strongly disagree 2 = disagree 3 = agree 4 = strongly agree 15. The human service professions, especially counseling and clinical psychology, have failed to meet the mental health needs of ethnic minorities. 49 1 = strongly disagree 2 = disagree 3 = agree 4 = strongly agree 16. The effectiveness and legitimacy of the counseling profession would be enhanced if counselors consciously supported universal definitions of normality. 1 = strongly disagree 2 = disagree 3 = agree 4 = strongly agree 17. Racial and ethnic persons are underrepresented in clinical and counseling psychology. 1 = strongly disagree 2 = disagree 3 = agree 4 = strongly agree 18. In counseling, clients from different ethnic/cultural backgrounds should be given the same treatment that White mainstream clients receive. 1 = strongly disagree 2 = disagree 3 = agree 4 = strongly agree 19. The criteria of self-awareness, self-fulfillment, and self discovery are important measures in most counseling session. 1 = strongly disagree 2 = disagree 3 = agree 4 = strongly agree 20. The difficulty with the concept of “integration” is its implicit bias in favor of the dominant culture. 1 = strongly disagree 2 = disagree 3 = agree 4 = strongly agree Knowledge Subscale: 21. At the present, how would you rate your understanding of the following term? “ethnicity” 1 = very limited 2 = limited 3 = aware 4 = very aware 22. At the present, how would you rate your understanding of the following term? “culture” 1 = very limited 2 = limited 3 = aware 4 = very aware 23. At the present, how would you rate your understanding of the following term? “multicultural” 1 = very limited 2 = limited 3 = aware 4 = very aware 24. At the present, how would you rate your understanding of the following term? “prejudice” 1 = very limited 2 = limited 3 = aware 4 = very aware 25. At the present, how would you rate your understanding of the following term? “racism” 50 1 = very limited 2 = limited 3 = aware 4 = very aware 26. At the present, how would you rate your understanding of the following term? “transcultural” 1 = very limited 2 = limited 3 = aware 4 = very aware 27. At the present, how would you rate your understanding of the following term? “pluralism” 1 = very limited 2 = limited 3 = aware 4 = very aware 28. At this point in your life, how would you rate your understanding of the impact of the way you think and act when interacting with persons of different cultural backgrounds? 1 = very limited 2 = limited 3 = aware 4 = very aware 29. At the present time, how would you rate your understanding of the following term? “mainstreaming” 1 = very limited 2 = limited 3 = aware 4 = very aware 30. At the present time, how would you rate your understanding of the following term? “cultural encapsulation” 1 = very limited 2 = limited 3 = aware 4 = very aware 31. At this time in your life, how would you rate yourself in terms of understanding how your cultural background has influenced the way you think and act? 1 = very limited 2 = limited 3 = aware 4 = very aware 32. How well do you think you could distinguish “intentional” from “accidental” communication signals in a multicultural counseling situation? 1 = very limited 2 = limited 3 = aware 4 = very aware 33. At the present time, how would you rate your understanding of the following term? “contact hypothesis” 1 = very limited 2 = limited 3 = aware 4 = very aware 51 Appendix D Marlow-Crowne Social Desirability Scale Please read each statement and decide whether you feel in general that it is mostly true as applied to you or mostly false. Please circle the appropriate letter (T=true, F=False) directly to the right of each statement. Answer “True” to positively stated questions if they are true as often or more often than stated. For example, answer “True” to “occasionally I play poker” if you play poker occasionally or more often. 1. I never hesitate to go out of my way to help someone in trouble. 1. T F 2. I have never intensely disliked someone. 2. T F 3. I sometimes feel resentful when I don’t get my way. 3. T F 4. I like to gossip at times. 4. T F 5. There have been times when I have felt like rebelling against people in authority even though I knew they were right. 5. T F 6. I can remember “playing sick” to get out of something. 6. T F 7. There have been occasions when I have took advantage of someone. 7. T F 8. I’m always willing to admit it when I make a mistake. 8. T F 9. I always try to practice what I preach. 9. T F 10. I sometimes try to get even rather than forgive and forget. 10. T F 11. When I don’t know something I don’t at all mind admitting it. 11. T F 12. I am always courteous, even to people who are disagreeable. 12. T F 13. At times I have really insisted on having things my own way. 13. T F 14. There have been occasions when I have felt like smashing things. 14. T F 15. I would never think of letting someone else be punished for my wrong doings. 15. T F 16. I never resent being asked to return a favor. 16. T F 17. I have never been irked when someone expressed ideas very different from my own. 17. T F 18. There have been times when I was quite jealous of the good fortune of others. 18. T F 19. I am sometimes irritated by people who ask favors of me. 19. T F 20. I have never deliberately said something that hurt someone’s feelings. 20. T F 52 Appendix E SELF-PERCEIVED MULTICULTURAL COMPETENCY DEBRIEFING Thank you for your conscientious participation in today's study. The information you have provided will help to determine if students perceive themselves as more multiculturally competent after taking a multicultural course. The first questionnaire assessed self-perceived multicultural counseling competency. Three areas of perceived competency were assessed. These areas were multicultural counseling awareness, multicultural counseling knowledge, and multicultural counseling skills. The second questionnaire assessed whether a participant was answering items in what the participant believes would be a socially desirable manner. This is a questionnaire commonly utilized when assessing a participant’s perceptions of their self. Research has shown that graduate, as well as undergraduate students perceive themselves to be more multiculturally competent after taking a multicultural course. This study also researched whether non-White students perceived themselves to be more multiculturally competent than White students. Research is inconclusive when looking specifically at the differences in responses in regards to the ethnicity of the participant. All the information we collected in today's study will be completely confidential, and there will be no way of identifying your responses in the data archive. We are not interested in any one individual's responses; rather, we want to look at the general patterns that emerge when the data are aggregated together. Your participation today is greatly appreciated and will help psychologists discover whether multicultural counseling courses are adequately preparing students to be multiculturally competent. We ask that you do not discuss the nature of the study with others that may later participate in it, as this could affect the validity of our research conclusions. If you would like to learn more about this research topic, we suggest the following references: D’Andrea, M., Daniels, J., & Heck, R (1991). Evaluating the impact of multicultural counseling training. Journal of Counseling & Development, 70, 143-150. Pope-Davis, D. B., Reynolds, A. L., Dings, J. G., & Nielson, D. (1995). Examining multicultural competencies of graduate students in psychology. Professional Psychology: Research and Practice, 26, 322-329. Thank you again, Kelley Herrin