Black female clients perceptions and attrition. Predictors of satisfaction with counseling: Racial and ethnic, minority clients attitudes toward counseling and ratings of their counselors general and, http://dx.doi.org/10.1037/0022-0167.49.2.255, Constantine, M. G. (2007). 113-141). It is apparent the importance of crossing the lines in multi cultural competency, unless we prepare the children in the early stages of life to accept each other, the need for therapeutic care will continue to be a part of intensive training for professional multi cultural competent counselors. Psychological Bulletin, 56, 81-105. Client and therapist, Owen, J., Reese, R. J., Quirk, K., & Rodolfa, E. (2013). Constantines (2002) study of clients of color (N= 112) at a college counseling center found that clients perceptions of their counselors (trainees) MCC and general counseling competencies predicted their satisfaction with treatment. Sue, S. (1998). (Eds.). Journal of Multicultural Counseling and Development, 44, Ridley, C. R., & Shaw-Ridley, M. (2011). Your email address will not be published. Although MCC have been widely endorsed and implemented in professional organizations and training programs (Constantine & Ladany, 2000; Worthington et al., 2007), there is a dearth of empirical research evaluating the influence of multicultural competencies on psychotherapy processes and outcomes with real clients (Ridley & Shaw-Ridley, 2011; Worthington et al., 2007; Worthington & Dillon, 2011). (Eds.). In J. G. Ponterotto, Atkinson, D. R., & Matsushita, Y. J. Culture and the development of eating disorders: A tripartite model. In this tripartite model, three dimensions ( beliefs and attitudes, knowledge, and Limitations of MCC research include the effectiveness of existing measures, use of indirect variables to measure MCCs and psychotherapy outcome, use of self-report measures, scant inclusion of real clients, and lack of diversity in participants. These changes demand that counselors and therapists prepare to effectively serve the needs of these diverse populations. The definitions and dimensions of MCC continue to be defined and redefined, along with models counselors can use to develop their MCCs. Journal of Counseling Psychology, 58, 10-15. doi:10.1037/a0022177, Worthington, R. L., Soth-McNett, A. M., & Moreno, M. V. (2007). Sodowsky, G. R., Taffe, R. C., Gutkin, T. B., & Wise, S. L. (1994). Position paper: Cross-cultural counseling competencies. SHANNONHOUSE, LAURA R., Ph.D. Convergent and discriminant validation by the. Handbook of multicultural counseling competencies. Wade, P., & Bernstein, B. L. (1991). 639-669). A. E., Schreier, B. Evaluating the impact of multicultural, http://dx.doi.org/10.1002/j.1556-6676.1991.tb01576.x. Development and initial validation of a brief mental health outcome measure. The tripartite model of multicultural counseling competency has activated organizational emphasis on improving counselor abilities to work with diverse clients. Some limitations of using self-report measures include the possible influence of social desirability, political correctness, and attitudinal and attributional biases (Worthington et al., 2007). Gim, R. H., Atkinson, D. R., & Kim, S. J. Kim, Li, and Liangs (2002) study (N= 78) on Asian American clients (recruited from undergraduate psychology and Asian American studies courses) experiences in psychotherapy showed that clients reported higher working alliance and higher therapist empathic understanding when their therapists used interventions that sought immediate resolution of problems rather than focusing on gaining insight through exploration. A meta-analysis of multicultural. Microaggressions and women in short-term psychotherapy: Initial evidence. Multicultural competence, as defined by D. W. Sue (2001), is obtaining the awareness, knowledge, and skills to work with people of diverse backgrounds in an effective manner. specializing in cross-cultural counseling. Harm of Cultural Incompetence Tripartite Model Awareness to Diversity ACA Code of Ethics (2014)/NASP Principles for Professional Ethics (2010) Cultural Competence Multicultural and Social Justice Counseling Competencies Enhancing Personal Awareness Objectives 1.Participants will learn the ethical significant of Multicultural Support for the validity of the Kluckhohn and Murray model is first reviewed. Now in its 4 th edition, Counseling Psychology remains one of the leading, trusted introductory texts orienting students to this expansive and dynamic field. When they do seek mental health care, they are more likely to be underdiagnosed and undertreated for affective disorders, overdiagnosed and overtreated for psychotic disorders, and less likely to receive newer and more comprehensive care (Agency for Healthcare Research and Quality [, 2013; Greenberg & Rosenheck, 2003). Smedley, B. D., Stith, A. Y., & Nelson, A. R. American Psychological Association. Understanding this, I believe could be implemented in elementary school. The results indicated that clients perceptions of microaggression had a negative relationship with therapeutic alliance, even after controlling for clients psychological well-being, number of sessions, and therapist racial and ethnic identity. Professional School Counseling 1:5 June 1998 ASCA 9. Cooper's tripartite characterization of global politics is tied to geography and the colonialist legacy (1999) differs from Cooper (2000), in that the former argues that the three governing principles of global politics coexist even in one society with varying. Thompson, C. E., Worthington, R., & Atkinson, D. R. (1994). This comprehensive overview of the entire field of counseling psychology surveys key professional practices and issues, interventions, science and research, and general basic concepts. Jessica Gonzalez, Sejal M. Barden, Julia Sharp Exploring client outcomes is a primary goal for counselors; however, gaps in empirical research exist related to the relationship between client outcomes, the working alliance, and counselor characteristics. Sodowsky, G. R., Taffe, R. C., Gutkin, T. B., & Wise, S. L. (1994). Journal of Mental Health Counseling, 23(4), 357-372. the most influential tripartite model of cultural competence developed by D. W Sue, Arredondo and . Shim, R. S., Baltrus, P., Bradford, L. D., Holden, K. B., Fresh, E., & Fuller, L. E. (2013). Owen, J., Tao, K., & Rodolfa, E. (2010). Clients perceptions of their psychotherapists multicultural orientation. Author of Cultural Competence in Trauma Psychology. (2011). Disadvantages in mental health care among African, Journal of Health Care for the Poor and Underserved, 20, Kim, B. S. K., Cartwright, B. Y., Asay, P. A., & DAndrea, M. J. A brand new, fully updated edition of the most widely-used, frequently-cited, and critically acclaimed multicultural text in the mental health field This fully revised, 8th edition of the market-leading textbook on multicultural counseling comprehensively covers the most recent research and theoretical formulations that introduce and analyze emerging important multicultural topical . When counselors acquire (a) awareness of one's own enculturation and related (2013, May). Administration and Policy in Mental Health and Mental Health Services Research, 31, 31-43. doi:10.1023/A:1026096123010, Greenberg, L. S., Watson, J. C., Elliot, R., & Bohart, A. C. (2001). However, the results of this study did indicate that higher perceptions of microaggressions were predictive of weaker therapeutic alliance and lower ratings of MCC and general counseling competence. D. W. Sue, Arredondo, and McDavis (1992) defined MCC as counselors having the awareness of their own worldviews, biases, and beliefs related to racial and ethnic minorities, understanding the worldviews of individual clients, and acquiring and using culturally responsive interventions and strategies in their work with clients. (2010) found that female clients reports of gender-based microaggressions had a negative association with therapeutic alliance and therapy outcomes. Moreover, clients perception of their counselors MCC predicted satisfaction beyond the variance previously accounted for by general counseling competencies (Constantine, 2002). This finding supports evidence from other empirical studies that found therapists are often inaccurate in their assessment of therapeutic alliance and treatment outcomes, suggesting the need for improvement in research, education, and training to enhance therapists ability to accurately assess therapeutic alliance and treatment progress. Similar to the definition of MCC, there are many conceptualizations of MCC. structure of the Cross-Cultural Counseling Inventory-Revised. There are three main models of multiculturalism of which will briefly explain above.show more content. *Articulate your role as a counselor in becoming familiar with the characteristics and concerns of diverse populations and integrating culturally supported behaviors that promote optimal . Japanese-American acculturation, counseling style,counselor ethnicity, and perceived counselor credibility. Greenberg et al. counselor race, and Black womens cultural mistrust and self-disclosures. Microaggressions and women in short-term, Ponterotto, J. G., Fuertes, J. N., & Chen, E. C. (2000). Still, therapists exhibit difficulties with accurately assessing both therapeutic alliance and empathy in clinical practice (Greenberg et al., 2001). Multicultural counselingcompetencies research: A 20-year content analysis. In a study with 232 clients and 29 therapists, Owen, Imel, et al. My first hypothesis is that the Flow Theory concept, The Systems Model of Creativity will help explain conflicts in Multicultural Counseling Movement described by Sue and Sue (2008). This category only includes cookies that ensures basic functionalities and security features of the website. Measurement and Evaluation in Counseling and Development, 36(3), 161-180. https://doi.org/10.1080/07481756.2003.11909740, Kim, B. S. K., Li, L. C., & Liang, T. H. (2002). When they do seek mental health care, they are more likely to be underdiagnosed and undertreated for affective disorders, overdiagnosed and overtreated for psychotic disorders, and less likely to receive newer and more comprehensive care (Agency for Healthcare Research and Quality [, 2013; Greenberg & Rosenheck, 2003). This website uses cookies to improve your experience while you navigate through the website. In 2014, the U.S. population by race was represented by 62.2% of non-Latina/o Whites, while multiracial individuals and racial and ethnic minorities represented 37.8% (Colby & Ortman, 2014). Evaluating the impact of multicultural counseling training. When the client perceives the therapist as multiculturally competent, the client is more likely to have a strong therapeutic alliance with the therapist (Tao et al., 2015). Tripartite Framework Individual Level Group . (1992). Sue, D. W., Arredondo, P., & McDavis, R. J. Journal of Counseling Psychology, 62(4), 568-578. doi:10.1037/cou0000106. Although there has been growth in research and services on the health and mental health needs of racial and ethnic minorities, racial and ethnic minority populations in the U.S. suffer disproportionally from mental health disparities (Dillon et al., 2016; Holden et al., 2014;Smedley, Stith, & Nelson, 2003). Alliance in action: A new. Building multicultural competency is not an easy task and is a life-long journey and yet taking on this charge is critical if we are to ethically serve all of our students. Japanese-American acculturation, counseling style. These guidelines, ethical principles, and codes suggest that it is unethical for counselors and psychologists to provide services to culturally diverse populations if they have not had any education and training in multicultural competencies. The literature on alliance and psychotherapy outcomes indicate that stronger therapeutic alliance is associated with improved outcomes (Owen, 2012; Owen, Tao, et al., 2011; Owen, Reese, Quirk, & Rodolfa, 2013; Zilcha-Mano & Err. 352 pp. They found that 53% of clients reported experiencing racial and ethnic microaggressions from their therapists, and 76% of those clients reported that the microaggressions were not addressed as part of therapy. Multicultural counseling is a term used to describe a specific type of counseling practice that acknowledges how various aspects of a patient's cultural identity might influence their mental health. Scale. Psychotherapy, 48(3), 274-282. doi:10.1037/a0022065, Owen, J., Tao, K., & Rodolfa, E. (2010). Writings on multicultural counseling competence usually imply that it exists for one of . education an awareness One of envelops the of most and a . Psychotherapy relationships that work II. Multidimensional Model for Developing Cultural Competence33 Figure 3. Although the need for multicultural competencies has been widely accepted and multicultural competency guidelines have been widely implemented in professional psychological organizations and training programs (Worthington, Soth-McNett, & Moreno, 2007), there is still surprisingly little empirical research (Worthington et al., 2007) that directly examines the effectiveness of multicultural competencies (MCC), and the validity of the widely used tripartite model of MCC (Sue et al., 1982). http://dx.doi.org/10.1037/0022-0167.38.4.473. When someone is battling with a substance use disorder (a drug or alcohol addiction), it . Beginning with a Foreword by Derald Wing . 2013). In the early 1920s, the counseling profession consisted primarily of a. mental health counseling. Effects of Asian American client adherence, to Asian cultural values, session goal, and counselor emphasis of client expression on, http://dx.doi.org/10.1037/0022-0167.49.3.342. Client and therapistvariability in clients perceptions of their therapists multicultural competencies. Multicultural training, theoretical orientation, empathy, and. Characterizing depression and comorbid medical conditions in African American womenin a primary care setting. For example, the design of colours of flags of . (2013, May). Although the MCC tripartite framework continues to receive support and is implemented across a host of training programs . Some direct measures use specific MCC models to assess therapist MCC by focusing on the therapists skills and interventions, while indirect measures focus on concepts related to MCC, such as engaging in microaggressions or measuring cultural humility (Tao et al., 2015). van Ryn, M., & Fu, S. S. (2003). Journal of CounselingPsychology, 63(1), 57-66. doi:10.1037/cou0000118, Elliott, R., Bohart, A. C., Watson, J. C., & Greenberg, L. S. (2011). This theory includes three aspects of multicultural competency: knowledge, awareness, and skills. Paved with good intentions: Do public health and human service providers contribute to racial/ethnic disparities in health? The Skilled Counselor Training Model (SCTM) The Skilled Counseling Training Model (SCTM) is a skillsbased training program that promotes attainment of skills through the use of modeling, mastery, persuasion, arousal, and supervisory feedback (Smaby, Maddux, Torres-Rivera, & Zimmick, 1999). d. All of the above. A., Nadkarni, L. I., Henderson Metzger, L., & Rodolfa, E. R. (2010). Ottavi, T. M., Pope-Davis, D. B., & Dings, J. G. (1994). Sue and colleagues (1992) described the three dimensions of culturally competent counselors as: 1) being aware of their own values, beliefs, and worldviews, and limitations that might impact their work with a culturally different client; paying special attention to the impact ethnocentrism might have on their work with racially, ethnically, and otherwise culturally different clients; 2) making a genuine effort to understand the clients values, beliefs, and worldviews, and how those impact the clients life; the counselor approaches this in a nonjudgmental manner and accepts the clients worldviews as a valid way of life; 3) and possessing the skills and interventions necessary for working with the culturally different client, as well as practicing them in their work with the particular client (Sue et al. Handbook of Multicultural Counseling Competencies draws together an expert group of contributors who provide a wide range of viewpoints and personal experiences to explore the identification and development of specific competencies necessary to work effectively with an increasingly diverse population. Development of the, Multicultural Counseling Inventory. Multicultural counseling competencies and standards: A call to the profession. Racial and ethnic minorities are also more likely to leave treatment prematurely and less likely to seek mental health care (Holden & Xanthos, 2009). Sue, D. W., Carter, R. T., Casas, J. M., Fouad, N. A., Ivey, A. E., Jensen, M., & Vazquez-Nutall, E. (1998). = 19) and found that clients perceptions of microaggressions in therapy, therapist MCC, and therapists general counseling competence were not significantly associated with client satisfaction. A dyadic study of multicultural counseling competence. Therapist-reported alliance: Is it really a predictor of outcome? Some studies indicate that there is a positive relationship between multicultural competencies and therapy outcomes (Atkinson & Lowe, 1995; Ponterotto, Fuertes, & Chen, 2000), while others indicate a lack of association or weak relationship between therapists multicultural competencies and treatment outcome (Owen, Leach, et al., 2011; Tao et al., 2015). Another critique of MCC measures is that some self-report measures of MCC might be assessing counselors self-efficacy in multicultural counseling instead of MCC (Constantine & Ladany, 2000; Ottavi, Pope-Davis, & Dings, 1994). Multicultural Guidelines: An ecological Approach, to context, identity, and intersectionality, . As the acceptance of MCC has grown over the last three decades, there have been many conceptual and indirect empirical research on MCC (Ridley & Shaw-Ridley, 2011; Worthington et al., 2007). Psychotherapy relationships that work II. Journal of Counseling Psychology, 38, 9- 15. doi:10.1037/0022-0167.38.1.9, Worthington, R. L., & Dillon, F. R. (2011). zuriz, 2015; Zilcha-Mano et al., 2015). 247-282). Effects of Asian American client adherence to Asian cultural values, session goal, and counselor emphasis of client expression oncareer counseling process. Projections of the size and composition of the U.S. population 2014 to 2060, . . Kitaoka, S. K. (2005). Their latest guidelines for building multicultural competence emphasize a tripartite framework . Cornish, J. Journal of Counseling Psychology, 41(2), 155-161. doi: 10.1037/0022-0167.41.2.155, van Ryn, M., & Fu, S. S. (2003). A tripartite model of ego functioning: Values and clinical research applications. Washington, DC: The National Academies Press. Constantine, M. G. (2002). Using class discussions, videos, experiential experiences, and classroom assignments, this course utilizes the tripartite model of multicultural awareness, knowledge, and skills as an organizing framework, leading to three primary course objectives: (1) To enhance multicultural awareness. Sue and colleagues (1982) developed the tripartite model of MCCs that include attitudes and beliefs, knowledge, and skills. Derald Wing Sue and David Sue have researched multiculturalism for 30+ years. Unequal treatment: Confrontingracial and ethnic disparities in health care. Systemic alliance in individual therapy: Factor analysis of the ITASSF and the relationship with therapy outcomes and termination status. Cornish and colleagues (2010) defined MCC as, the extent to which a psychotherapist is actively engaged in the process of self-awareness, obtaining knowledge, and implementing skills in working with diverse individuals (p. 7). ), Multicultural assessment in counseling and clinical psychology (pp. However, much of the empirical MCC literature includes studies with flaws in their methodologies (Ridley & Shaw-Ridley, 2011), measures with poor validity (Kitaoka, 2005), and an overreliance on analogue studies, college student populations, and indirect measures (Worthington & Dillon, 2011; Worthington et al., 2007). In a meta-analysis of 20 independent samples,Tao, Owen, Pace, and Imel (2015)foundstrong and positive effects of client perceptions of therapist MCC on important psychotherapy processes (r= .58 to .72), such as therapeutic alliance, and a moderate relationship between MCCs and psychotherapy outcomes (r= .29). Journal of Counseling Psychology, 58, 1-9. doi:10.1037/a0021496, Owen, J., Reese, R. J., Quirk, K., & Rodolfa, E. (2013). The role of ethnicity, cultural knowledge, and conventional techniques in counseling and psychotherapy. He stressed that MCC is possessing culture-specific skills needed to work effectively with clients from specific populations. Likewise, Owen, Tao, Leach, and Rodolfa (2011), focused on the behavior of the counselor, and defined MCC as a way of doing that evaluates the counselors ability to apply their multicultural awareness and knowledge in counseling (p. 274). Given that APA and training programs endorse multicultural competencies, it is important to conduct further research on its effectiveness using stronger measures and real clients from diverse backgrounds. The attributes of cultural competence were identified using a tripartite model: (1) awareness of one's own personal beliefs, values, biases, and attitudes, (2) awareness . The existent trend of implementing mindfulness-based programs (MBPs) into public education came along with an increasing scientific record regarding the definitional construct of mindfulness, effects of various mindfulness-based interventions and their basic mechanisms. Arredondo, P., Toporek, R., Brown, S. P., Jones, J., Locke, D. C., Sanchez, J., & Stadler, H. (1996). Washington, DC: American Psychological Association. It is mandatory to procure user consent prior to running these cookies on your website. Farook, M. W. (2018). Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. (2011) found that clients ratings of microaggressions had a negative relationship with treatment outcomes. The strong correlations between therapist MCC and psychotherapy process suggest that the two processes might occur simultaneously. Great article! competencies research: A 20-year content analysis. The therapeutic relationship. (2016) also developed multicultural and social justice counseling competencies that offer guidance for counselors in practice and research. Retrieved from https://archive.ahrq.gov/research/findings/nhqrdr/nhdr12/index.html, American Counseling Association. Similar to the definition of MCC, there are many conceptualizations of MCC. Psychotherapy Bulletin, 53(4), 48-58. (2003). In a meta-analysis of 20 independent samples,Tao, Owen, Pace, and Imel (2015)foundstrong and positive effects of client perceptions of therapist MCC on important psychotherapy processes (. Counselors and clients both bring to the therapeutic relationship a constellation of identities, privileged and marginalized statuses, and cultural values, beliefs and biases to which counselors need to attend. As noted, Sue and colleagues (1992) conceptualization of MCCs include three dimensions: 1) beliefs and attitudes, 2) knowledge, and 3) skills (Sue et al., 1982, Sue et al., 1992). (2017). https://www.counseling.org/knowledge-center/ethics. . The model is based on a 3 4 5 design that allows for the systematic identi-fication of cultural competence in several different combinations. Exclusive nature of Multiculturalism Sociopolitical Nature of Counseling/Therapy The Nature of Multicultural Counseling Competence. Multicultural Competence and the Working Alliance as Predictors of Client Outcomes. (2003). These findings suggest that therapist biases can cause ruptures in the therapeutic relationship and may impact treatment outcomes and client attrition, particularly when the ruptures are not repaired (Owen, Tao, et al., 2014; Owen et al., 2010). (1992). Their study also indicates that after controlling for social desirability, there was no association between the reported MCC and multicultural case conceptualization ability (Constantine & Ladany, 2000). Operationalization of the multicultural counseling competencies. The results of this study found that training accounted for increased client satisfaction and client attrition for both Black and White counselors, and that ethnic matching did not account for client perception of therapist MCC and psychotherapy outcomes. (2001) found discrepancies in the ability to assess empathy in treatment among clients, observers, and therapists. http://dx.doi.org/10.1037/0022-0167.39.4.515. As the MCC literature has grown over the last three decades, scholars have raised concerns about the limitations of the empirical studies in the current literature. Journal of Counseling Psychology, 49(2), 255-263.http://dx.doi.org/10.1037/0022-0167.49.2.255, Constantine, M. G. (2007). of multicultural competence: (a) specific racial/cultural group perspectives, (b) components of cultural competence, and (c) foci of cultural competence. Although there has been growth in research and services on the health and mental health needs of racial and ethnic minorities, racial and ethnic minority populations in the U.S. suffer disproportionally from mental health disparities (Dillon et al., 2016; Holden et al., 2014;Smedley, Stith, & Nelson, 2003). This study was conducted to present a model of the relationship between health anxiety and perceived stress with moral distress containing the mediating role of distress tolerance in emergency department nurses. Multi-cultural counseling competency is then defined as "the ability to integrate multi-cultural and culture-specific awareness . 2 Pages. identifying moderators of the alliance-outcome association. Therapist-reported alliance: Is it really a predictor of outcome? Journal of Health Care for the Poor and Underserved, 20(2), 17-23. doi:10.1353/hpu.0.0155, Kim, B. S. K., Cartwright, B. Y., Asay, P. A., & DAndrea, M. J. helping role and process that uses modalities and defines goals consistent with the life experiences and cultural values of clients, recognizes client identities to include individual, group, and universal dimensions, advocates the use of universal and culture specific strategies and roles in the healing . However, clients ratings of therapeutic alliance mediated the relationship between clients perceptions of microaggressions in therapy and treatment outcomes. Toward culturally centered integrative care for addressing mental health disparities, Holden, K. B., & Xanthos, C. (2009). The overall disparities in mental healthcare have been associated with a lack of cultural competency (Holden et al., 2014; Holden & Xanthos, 2009; Shim et al. Holden, K., McGregor, B., Thandi, P., Fresh, E., Sheats, K., Belton, A., & Satcher, D. (2014). Constantine, M. G. (2002). Worthington, R. L., & Dillon, F. R. (2011). Tripartite Model of Personal Identity Three levels of identity Individual level Every person is totally unique Group level Every person is like some others Universal level Every person is like all others Clinical psychologists can recognize all three levels for any client. Culture sensitivity training and counselors race: Effects on. Owen et al. I am responding to your post as a 69 year old Afro-Caribbean female. Counseling . Multicultural counseling competencies: An analysis ofresearch on clients perceptions: Comment on Owen, Leach, Wampold, and Rodolfa(2011). Disadvantages in mental health care among African Americans. New York: Wiley. Multicultural and social justice counseling competencies: Guidelines for the counselingprofession. Tao, K. W., Owen, J., Pace, B. T., & Imel, Z. E. (2015). Data from the 2010 United States (U.S.) Census indicated that foreign-born individuals represented 13.3% of the U.S. population, some 42.3 million people (Colby & Ortman, 2014). The factor structure underlying. The therapeutic relationship. Ponterotto, J. G., Rieger, B. T., Barrett, A., Harris, G., Sparks, R., Sanchez, C. M., & Magids, D. (1996). National health disparities report. Google Scholar. Cornish and colleagues (2010) defined MCC as, the extent to which a psychotherapist is actively engaged in the process of self-awareness, obtaining knowledge, and implementing skills in working with diverse individuals (p. 7). Still, therapists exhibit difficulties with accurately assessing both therapeutic alliance and empathy in clinical practice (Greenberg et al., 2001). Shim, R. S., Baltrus, P., Bradford, L. D., Holden, K. B., Fresh, E., & Fuller, L. E. (2013). In J. G. Ponterotto. The therapeutic alliance and its relationship to alcoholism treatment participation and outcome. b. the background of patterns, languages, psych The implication of the study is counselors has to have the ecological competences that could lead the counselor to the multicultural thinking paradigm, as well as the development of the systemic intervention framework. Due to these results, Constantine and Ladany (2000) recommend the use of social desirability measures in MCC studies that use existing self-report measures. Dillon, F. R., Odera, L., Fons-Scheyd, A., Sheu, H.-B., Ebersole, R. C., & Spanierman, L. B. According to S. Sue (1998), MCC is the ability to appreciate diverse cultures and populations, and the ability to effectively work with culturally diverse individuals. Eating Disorders, 12(2), 139-156. Empathy. (1991). They proposed that 1) culturally competent mental health providers are aware of their own beliefs, attitudes, values, and worldviews that might impact their work with their clients; 2) they have the knowledge of beliefs, attitudes, values, and worldviews that are common to the specific populations they work with; and 3) they have the skills necessary to work with diverse populations (Sue et al., 1982).