Ethical Dilemmas in Multicultural Counseling

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  • Et h ical D i lemmas in M u I t icu It u ral Cou nsel i ng

    Maria Sadeghi, Jerome M. Fischer, and Sean G. House

    In a random survey of counselors working with socioracial minority clients ( N = 256), multicultural ethical dilemmas were rated according to frequency encountered and significance. Comparisons of counselors ratings of multicultural ethical dilemmas determined specific dilemmas relevant to counselors in various professional settings.

    En una encuesta hecha al azar de consejeros/as que trabajan con clientes de minorias socioraciales (N= 256), se clasificaron dilemas eticos multiculturales de acuderdo con s u frecuencia y significancia. Las comparaciones de las clasificaciones de 10s dilemas eticos multiculturales subrayaron aquellos dilemas especificamente importantes para consejeros/as en varios escenarios profesionales.

    ounseling today continues to move toward a cultural pluralism that embraces unity in diversity (Axelson, 1999). To provide the most C effective services to clients from diverse backgrounds, counselors need

    to be trained in and to have experience with multicultural counseling. Arredondo et al. (1996) described multicultural counseling as the prepara- tion and practices that integrate multicultural and culture-specific awareness, knowledge, and skills into counseling interactions.

    Although cross-cultural counseling has existed since the beginning of the profes- sion, studies show that counseling has not been as effective with ethnically differ- ent clients as with mainstream clients (S. Sue, 1977; S. Sue & Zane, 1987). A pos- sible explanation for the ineffectiveness of cross-cultural counseling could be the lack of culturally sensitive material taught in counseling programs (Arrendondo, 1985; Ponterotto & Casas, 1987; Smith, 1982; D. W. Sue et al., 1982). Although multicultural counseling has become the hottest topic in counseling in the past decade, the quality of training is still inadequate (Arredondo, 1994; Atkinson, 1994; Pedersen, 1994; Ridley, Mendoza, & Kanitz, 1994). The majority of coun- selor training programs fail to adequately recognize the ramifications of culture or to address issues that pertain to ethnic minorities (D. W. Sue & Sue, 1990). If counselors lack sufficient training in multicultural counseling it is likely that

    they also lack the skills to deal with ethical issues presented by clients with multicultural backgrounds. Pedersen (1997) stated that most counselors have

    Maria Sadeghi, Idaho Deparlment of Heallh and Welfare; Jerome M. Fischer and Sean G. House, College ofEducalion, University of Idaho. Zlis article was based on [he firs[ authors doctoral disserlalion, whit% was chaired by the second author. Correspondence concerning this arlicle should be addressed loJerome M. Fischer, University of Idaho, College of Educalion, Counseling d School Psychology, MOSCOW, ID 83844 (e-mail: j$scher@uidaho.edu).

    JOURNAL OF MULTICULTURAL COUNSELING AND DEVELOPMENT July 2003 VOl. 31 179

  • not been sufficiently prepared to interpret the ethical guidelines with sensitiv- ity to racial and ethnic minority groups.

    Until relatively recent times, counseling predominantly came from a Euro- American perspective (Pedersen, 1997). The textbooks, research findings, and psychological theories often contained culture-specific assumptions. Some of these assumptions include a universal definition of what constitutes normal behav- ior, individualism as preferable to collectivism, independence as more desirable than dependence, an emphasis on understanding linear thinking where each cause has an effect and each effect has a cause, and the paradigm wherein coun- selors change an individual to fit the system rather than changing the system to fit the individual.

    Conjointly with counseling theories, approaches to counseling ethics have origi- nated from the Euro-American ethical theories of utilitarianism, Kantianism, and liberal individualism. These ethical theories were adapted to the biomedi- cal field by Beauchamp and Childress (1994) and to the field of counseling by Kitchener (1984). The foundation of these ethical approaches are principle ethics (Cottone & Claus, 2000).

    A multicultural counseling perspective has emerged of late that seeks to build its theories with a focus on pluralism in order to ensure that no single political, economic, or special interest agenda is promoted. Furthermore, the study of traditional theories in counseling and psychotherapy has been changed to in- clude their adaptation to cultural diversity (Axelson, 1999).

    Likewise, counseling ethics have moved toward embracing a multicultural perspective. Past ethical approaches have not been effective because tradi- tional ethical theories generally ignore race, ethnicity, and cultural diversity. Most theories are based on a utilitarian and Kantian moral agent operating in a vacuum without individuality as influenced by culture (Hinman, 2001). Rec- ognizing the cultural encapsulation of traditional counseling theories and ap- proaches to ethics, Pedersen (1997) challenged the counseling profession to refine its codes of ethics to make them more relevant to socioracial minority clients. Meara, Schmidt, and Day (1996) incorporated virtue ethics, with its sensitivity to a culturally diverse communitys wisdom and moral sense, as a complement to Euro-American principle ethics. Lastly, Cottone (2001) pro- posed a social constructivist model of ethical decision making in counseling that embraces a social context that encompasses a diverse worldview, both for the client as well as the counselor.

    Although recent efforts have been made, there is a paucity of ethics education materials for counselors regarding multicultural issues (Casas, Ponterotto, & Gutierrez, 1986; Cayleff, 1986; Fitzgerald & Nutt, 1986; Goodyear, Crego, &

    Johnston, 1992; Ibrahim & Arredondo, 1986; Jordan & Meara, 1990; Kitchener, 1992; Meara et al., 1996; Pope & Vetter, 1992; Welfel, 1992). This lack of multicultural ethical training suggests a need to develop multicultural ethics education materials for counselors. Furthermore, guidance for developing such

    180 JOURNALOF MULTICULTURAL COUNSELING AND DEVELOPMENT July 2003 Vol. 31

  • materials could be obtained from an understanding of the types of ethical dilem- mas that multicultural counselors encounter.

    The purpose of this study was to identify the specific types of ethical dilem- mas relevant to counselors who work with multicultural clients. Specifically, this study sought to answer the following research questions:

    1. What are the multicultural dilemmas most frequently encountered by counselors?

    2. How do counselors rate the significance of ethical dilemmas for inclu- sion in training materials designed to prepare counselors for dealing with multicultural ethical dilemmas?

    3. What multicultural ethical dilemmas are frequently encountered and significant for inclusion in training materials relevant to counselors working at various professional settings.

    od DEVELOPMENT OF THE INSTRUMENT

    The Multicultural Counseling Ethical Dilemma Survey (MCEDS) was de- veloped for this research by the first and second authors. A modified Delphi method of research, which combines a qualitative and quantitative meth- odology, was used (Linstone & Turoff, 1975). The first stage of the process was to obtain relevant multicultural dilemmas. A qualitative process was used to interview 24 counselors. These counselors worked predominantly with socioracial minority clients, and the counselors had professional ex- perience ranging from preservice internship to 20 years. The interview process yielded 15 multicultural ethical dilemmas. In addition to the inter- view process, a review of relevant counseling and psychology literature identified 4 additional multicultural ethical dilemmas. Through this quali- tative review process, the researchers compiled a total of 19 multicultural ethical dilemmas. The second stage of the Delphi method was to validate the data collected,

    using a quantitative process. This was accomplished through the content va- lidity ratio process (Cohen, Swerdlik, & Phillips, 1996). The 19 multicultural ethical dilemmas were rated for inclusion in the MCEDS by 10 nationally recognized counselor educators and professionals with expertise in the field of multicultural counseling. The professionals reviewed the 19 dilemmas and indicated whether each had validity as a multicultural ethical dilemma. The professionals rated each item for inclusion in the survey instrument using a Likert-type scale as follows: 1 = essential, 2 = use@ but not essential, and 3 = not essential. The following formula was used to compute the validity ratio:

    JOURNAL OF MULTICULTURAL COUNSELING AND DEVELOPMENT July 2003 Vol. 31 181

  • ne- N / 2 CVR= N / 2

    where CVR= content validity ratio, ne= number of professionals indicating that the ethical dilemma was essential, and N= total number of professionals.

    For significance at the .05 level and inclusion in the MCEDS, each multicultural ethical dilemma would have met the criteria of a CVR of .62 or higher (Cohen et al., 1996). Of the original 19 multicultural ethical dilemmas obtained from the qualitative process, 8 were retained for inclusion in the MCEDS.

    The third stage was to construct the survey instrument and conduct a pilot study. The MCEDS consisted of eight multicultural ethical dilemmas; survey respondents were asked to rate each dilemma on two Likert-type scales. The first scale asked respondents to rate the frequency with which they had en- countered the multicultural ethical dilemma in the following manner: 1 = never, 2 = once a year, 3 = once every 6 month, 4 = once a month, or 5 = once a week The second scale asked respondents to rate the significance of the dilemma to be used in preparation of counselors to deal with multicultural ethical dilemmas in the following manner: 1 = not significant, 2 = slightly signzficant, 3 = moderately significant, 4 = significant, or 5 = very signzjkant.

    A pilot study was conducted that consisted of sending the MCEDS to 25 randomly selected American Multicultural Counseling and Development (AMCD) members. These individuals were removed from the data set from which the research sample for the larger study would be drawn. All 25 surveys were returned. The MCEDS was refined in terms of language of the ethical dilemmas and instructions to respondents based on these responses.

    Finally, after completing the survey (N= 256), to determine internal consis- tency and to estimate the reliability and construct validity of the MCEDS, a Cronbachs alpha of .82 was computed.

    PARTICIPANTS

    The survey was sent to a random sample of 813 individuals out of a population of 3,080 AMCD members.

    Out of 813 surveys distributed, 256 usable questionnaires were returned, rep- resenting a 31% return rate.

    The majority (59%) of participants were Caucasian (see Table 1). The second largest group who responded to the survey were African American (23%).

    More than two thirds (68%) of the respondents (N= 256) had between 5 and 21 years of professional experience. Participants were asked what percentage of their client population included members of ethnoracial multicultural groups. Fifty-four percent responded that between 10% and 65% of their client popu- lation included members of ethnoracial multicultural groups. Another 25O/o indicated that more than two thirds (66%) of their client population included multicultural groups.

    182 JOURNAL OF MULTICULTURAL COUNSELING AND DEVELOPMENT July 2003 Vol. 31

  • TABLE 1

    Respondents Ethnicity/Race

    Number of Respondents Percentage of Multicultural Group ( n = 251) Respondents Caucasian 149 59 African American 58 23 Hispanic 20 8 Asian Americanb 7 3 American Indian 3 1 Other 14 6

    Hispanic identified subgroups included Mexican, Venezuelan, Puerto Rican, Latino, and Columbian individuals. bAsian American identified subgroups included Chinese, Filipino, and Japanese. American Indian identified subgroups included Lakota Sioux individuals. dother identified sub- groups included Appalachian, Arabic, biracial, Italian, and North European individuals.

    Participants ( N = 256) were asked to indicate their level of training in both multicultural counseling and ethics. Respondents reported that approximately two thirds (62%) had taken a university/college course in multicultural coun- seling and had received some additional training. Very few (2%) had received no training. More than half (53O/o) had taken a university/college course in ethics and had received subsequent training.

    Respondents (n = 253) reported their primary professional settings as follows: public agency = 17%, school = 22%, rehabilitation = 2010, university/college = 15Ok0, private = 20%, drug and alcohol = 5%, career = 4%, and other = 15O/o. The other category included professional designations of counselor educator, medi- cal setting, psychiatric hospital, pastoral counseling, hospice, and social work.

    FREQUENTLY ENCOUNTERED MULTICULTURAL DILEMMAS

    Frequencies and percentages of respondents ratings were calculated in order to determine the most frequently encountered multicultural ethical dilemmas. The overall results for the first research question are presented in Table 2.

    SIGNIFICANCE OF MULTICULTURAL ETHICAL DILEMMAS FOR INCLUSION IN TRAINING MATERIALS

    Frequencies and percentages of respondents ratings were calculated in order to deter- mine the most si@cant multicultural ethical dilemmas that should be included in training materials. The results for the second research question are presented in Table 3.

    COMPARISONS OF COUNSELORS RATINGS OF MULTICULTURAL ETHICAL DILEMMAS

    Exploratory comparisons of counselors ratings based on their professional set- tings demonstrated that public agency counselors significantly encountered

    JOURNALOF MULTICULTURAL COUNSELING AND DEVELOPMENT July 2003 Vol. 31 183

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