1. Alex Zamora, LMSW November 9, 2011 Cultural Competency: Ethical considerations on reaching Idaho’s Latino population

2. Goal for this morning 1. Reflect on the importance of cultural competency as outlined in various codes of ethics 2. General understanding of key components of Idaho’s Latino community Specifically how this issue can influence treatment

3. Two types of ethical reasoning 1. Intuitive ethical judgment Gut feeling 2. Critical-Evaluative ethical judgment Deliberate Problem solving followed by ethical principles

4. Fundamental ethical principles Autonomy Freedom and dignity Nonmaleficence Do no harm Beneficence Responsibility to do good Fidelity Faithfulness to truth Justice Obligation to act fairly

5. Promise of Justice ACA preamble: “…Association members recognize diversity in our society and embrace a cross-cultural approach in support of worth, dignity, potential, and uniqueness of each individual.” APA Principle D: Respect of People’s Rights and Dignity “Psychologists are aware of and respect cultural, individual, and role differences… based on age, gender, gender identity, race, ethnicity, culture, national origin…” NASW 1.05 Cultural Competence and Social Diversity “Social workers should understand culture and its function in human behavior…”

6. Misinterpretation 1. Failure to take culture into account 2. Failure to acknowledge intra-culture differences

7. Idaho

8. Since 2000, Latino population… Grew by 73% (approx. 176,000 total)

9. Population Breakdown -23.9% in Canyon County, 35.4 Caldwell 22.9 Nampa -7.1% in Ada County 7.1% Boise 6.8% Meridian -14.9% in Payette County -16.8% in Washington County

10. What are we dealing with? 34% youth poverty rate $18,000 median annual income 34% without health insurance 28.9% academically ineligible to join the military

11. Cultural Value Concepts Machismo Dictates that men show power via strength and decision-making Marianismo Concept purity and moral strength Family system Loyalty and protection of family

12. Biculturalism Juncture of two cultures Median age of Idaho Latino? 22 years old

13. Treatment Address the juncture Deconstruct meta-narratives Apply personal therapy modalities

14. Remember our promise of Justice? ACA preamble: “…Association members recognize diversity in our society and embrace a cross-cultural approach in support of worth, dignity, potential, and uniqueness of each individual.” APA Principle D: Respect of People’s Rights and Dignity “Psychologists are aware of and respect cultural, individual, and role differences… based on age, gender, gender identity, race, ethnicity, culture, national origin…” NASW 1.05 Cultural Competence and Social Diversity “Social workers should understand culture and its function in human behavior…”

15. Case Study Juan is a 20 year old second-generation Mexican-American living outside of Boise. His parents were originally from Texas, and migrated to Idaho for work and made it a permanent home. His mother and father have been married for 25 years. Mom has never worked outside of the home and Dad works in agriculture. Dad has always been aggressive, occasionally engaging in domestic violence. Juan is scared of his dad. Juan is seeking mental health treatment because he continuously having difficulties with significant others, always ending relationships when he feels they get “too serious.”

16. References Falicov, C. J. (2010). Changing Constructions of Machismo for Latino Men in Therapy: “The Devil Never Sleeps.” Family Process, 49(3), 309-329. Organista, K. C. (2009). New Practice Model for Latinos in Need of Social Work Services. Social Work, 54(4), 297- 305. Torres, L. & Rollock, D. (2009). Psychological Impact of Negotiating Two Cultures: Latino Coping and Self- Esteem. Journal of Multicultural Counseling and Development, 37, 219-228. Welfel, E.R. (2010). Ethics in counseling and psychotherapy: Standards, research, and emerging issues (4 th ed.). Belmont, CA: Brooks/Cole.