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DIVERSITY AND CULTURAL COMPETENCE

Introduction

Diversity is a critical area of competence for psychologists.  One of the main goals of our psychology internship is "preparing professional psychologists who aspire to cultural competence in their practice." To insure that we meet this important training goal our program has built in several curriculum steps.  First, Interns engage in a process of self-reflection regarding their own personal/cultural history in three important activities early in the internship year. First, each intern is invited to provide a personal history at the beginning of the Psychotherapy Process Seminar. Interns over spend 30 minutes or more describing their lives and how they came to be doctoral psychology interns. This process not only serves to help interns begin to know each other, but also reflect on how their history affects their attitudes, biases, and practices as clinicians. The second early activity focused on self-reflection regarding cultural diversity is the Self-Assessment of Cultural Competence. Interns complete this assessment at the beginning of the training year, and it is intended to help form an on-going discussion of cultural/diversity sensitivity/awareness with the intern’s overall supervisor. The self- assessments are revisited at the six-month marker.    

Additionally, during their first rotation, interns are required to complete the Clinical Skills Verification Exam, where they are observed completing a diagnostic interview via video recording and then present a case conceptualization. Interns are then evaluated by two faculty members on a range of competencies. Intern performance is reviewed to assure that their conceptualization directly addresses the pertinent cultural/diversity data and the impact of this data in guiding the conceptualization of the case and the development of the treatment plan. If interns are identified as needing further development in this area, then additional training and supervision are provided until the intern meets expectations in this area.

To increase knowledge of diversity related issues, interns are required to attend a yearly diversity workshop. Topics for workshops vary year-to-year based on the speaker. Recent diversity workshops have focused on exploring privilege in in psychotherapy, LGB identity development, overcoming stigma, transgender resilience and health, and cultural responsive formulation and intervention.

In the Diagnostic/Treatment Seminar, when a patient is discussed, there is a cultural diversity component in which the interns identify cultural/diversity factors that could be contributing to the patient’s symptoms or would affect the patient’s treatment. Interns are assessed by faculty regarding their cultural competence during this seminar and given feedback at the mid- and end-of-year evaluations.

In the Professional Issues Seminar, there are explicit diversity-focused didactics included in the curriculum covering varying aspects of culture such as race/ethnicity, LGBT, religion, class, age, political party, region, and military/veteran status. Interns are assessed by faculty regarding their cultural competence during this seminar and given feedback at the mid- and end-of-year evaluations.

All supervisors are required to teach/model awareness of/competency in the clinical applications of individual and cultural diversity.  In addition, supervisors are required to ensure that interns are provided with ample opportunities to work with diverse patient populations.  It should be noted that supervisors are encouraged to attend yearly diversity trainings held by the internship to help facilitate supervisor familiarity and comfort with diversity issues. Additionally, most supervisors are licensed in the Georgia, which requires 6 hours of diversity focused continuing education during the first two years of licensure. Intern evaluations of supervisor performance provide feedback to supervisors in regard to the demonstration of competencies related to cultural and individual differences and diversity so that growth edges can be identified and developed.

Given the wide-range of patient populations included as part of this internship (e.g., transgender patients, HIV-positive patients, veterans, adolescents and children, patients with serious mental illness, forensic patients) it is inevitable that interns will work with patients that individuals whose group membership, demographic characteristics, and/or worldviews differ from theirs. However, to assure that interns are exposed to a diverse range of patients, interns turn in Consultation and Therapy Logs that track several diversity characteristics (e.g., ethnicity, gender, age).  Supervisors help interns to gain awareness of these differences and any potential conflicts as they gradually move towards independent practice with these groups. Supervisors also provide ongoing feedback to interns in regard to the demonstration of competencies related to cultural and individual differences and diversity so that growth edges can be identified and developed.