Printer Friendly

Perceptions of multicultural counseling competency: integration of the curricular and the practical.

A national survey of counselor trainees was conducted to investigate variables that influence the development of perceived multicultural competencies. The development of multicultural counseling competencies from an integrative educational perspective was overviewed as a framework for empirically exploring these factors. The group differences on counselor trainees 'scores of perceived multicultural competence was explored based on clinical supervision, number of multicultural classes, and number of non- White clients. Results indicate that receiving clinical supervision related to multicultural issues and conducting counseling with more non-White clients interacted significantly with higher scores of multicultural competence. Such findings highlight current curricular and practical issues within mental health counselor education and frame the need for ongoing research that evaluates' our emphasis and commitment to multicultural counseling in the 21st century.


As the field of mental health counselor education has progressed, there has been more attention given to the study of multicultural counseling and the development of multicultural counseling competency. This is evident through the development of professional standards (CACREP, 2001), professional presentations, critical analysis of traditional theories, and scholarly publications (Arredondo, 1999; Dinsmore & England, 1996; Hill, 2004). In keeping with training standards developed by the Council for Accreditation of Counseling and Related Educational Programs (CACREP), graduate programs in mental health counseling have implemented at least one course in which the focus of the course content and curricular experience is centered on cultural foundations and multicultural issues. The literature reveals that to further promote the development of cultural competence for mental health counselor trainees, a variety of experiences is needed. The need to provide mental health counselor trainees with varied learning opportunities, both practical and clinical, is well supported within the literature (Arredondo, 1999; Dinsmore & England, 1996; Hill, 2004). As a result, there is a critical need for mental health counselor educators to enhance this experience for counselor trainees within the educational setting to increase the awareness, knowledge, and opportunity for skill development.

Robinson and Morris (2000) highlight the limitations inherent in a curricular model that endorses a one or two course format as being too narrow in scope. The authors encourage the need for expanded opportunities for the development of cultural competence through an increased integration of practical and intracurricular opportunities for counselor trainees. This is especially important within the scope of mental health and community agency specialty courses. Hills and Strozier (1992) point out that a one or two course format without continued integration across time may serve to reinforce the notion that multicultural counseling competency is linear and static in nature. This message does not clearly convey to mental health counselor trainees the complexity that is multicultural counseling, and it limits the application to specialty-based issues.

While the development and implementation of a course in cultural foundations meets CACREP standards, it sheds light on another glaring issue. Torres-Rivera, Phan, Maddux, Wilbur, and Garrett (2001) contend that one of the blocks to effective cultural training is the lack of distinction within the CACREP standards (CACREP, 2001) as to the direction and focus of multicultural training. Torres-Rivera et al. point out that within the supervision and practicum experiences, the standard (Section III [k]) does not clearly speak to the need to train counselors to work with multicultural populations. This ignores a critical part of the counselor trainee experience. In addition, the standard states that we must expose students to clientele that represent their community. Robinson and Morris (2000) agree that there are too few opportunities presented to counselors in training to work with a diverse group of clients in their clinical internship and practical settings. Current practice as delineated by Robinson and Morris seems to directly contradict providing an opportunity for mental health counselor trainees to work with more diverse clients (Arthur & Achenbach, 2002; Constantine, 1998; Fuertes, Bartolomeo, & Nichols, 2001; Robinson & Morris, 2000).

The Classroom Experience

To further foster the growth and learning of counselor trainees, Tyler and Guth (1999) found it critical that the counselor educator emphasize a focus on process versus content. The authors articulated that within the training process, the counselor educator must be sure to differentiate the focus on either process or content to fully expand the learning of the counselor trainees (Tyler & Guth, 1999). This approach was supported by Torres-Rivera et al. (2001) within the supervision experience to foster personal awareness. According to Torres-Rivera et al., an increase in personal awareness has the potential to increase multicultural awareness, knowledge, and general counseling skill. It was hypothesized that personal awareness is critical, due in part to its ties to personal development, and also because it is seen as an essential element that must be present for skill development to occur (Torres-Rivera et al.). Tyler and Guth suggest that helping the counselor trainee to focus on perceptions and process the feelings connected to an experience could allow for integration into consciousness, and as a result growth could occur. There is minimal research that explores how the presence of multicultural coursework influences the perceptions of multicultural competencies for counselor trainees. The question emerges: Is enrollment in and completion of multicultural coursework more strongly correlated with multicultural competence? Research needs to explore whether this variable or other factors influence the multicultural competence of counselor trainees. Further research is also needed in regard to the impact of multicultural supervision on perceived multicultural competence.

The Supervision Experience

Supervision is the primary vehicle through which emerging mental health counselors gain clinical and case conceptualization skills (Bernard & Goodyear, 1998). According to Bernard and Goodyear, multicultural counseling requires special attention within the supervision process because it is a process that must be explored and experienced both didactically and clinically. Mental health counselor educators have the ability to empower counselor trainees; as a result of this influence, it is imperative that instructional strategies be connected to life experiences with multiculturalism (Bhargava, Hawley, Scott, Stein, & Phelps, 2004; McCall, 1995; Morales, 2000) to enhance the development of multicultural counseling awareness, knowledge, and experiences that lead to skill development.

According to Gardner (2002), issues of concern related to the practicum experience for counselors in training include the lack of critical exploration and discussion of cultural differences combined with inadequate experiences working with a diverse client population. Gardner (2002) goes on to further illustrate that should multicultural concerns continue to be ignored, the counselor in training may find it difficult to develop an integrated professional identity. In defining a professional identity, Gardner highlights that awareness of culturally different clients and the impact of cultural bias influence counselors' reaction to and conceptualization of client concerns.

In a timely investigation of the counseling supervision experience, Fukuyama (1994) found that in-depth exploration of multicultural issues within the supervision experience was a critical aspect of training for predoctoral interns. It was found that such exploration allowed counselor trainees to further explore perceptions of multiculturalism within the supervision process. It was also found that this exploration expanded openness and feelings of support as well as provided further opportunity to engage in culturally relevant counseling. Following this, Constantine (2001) noted that research that had investigated the extent to which multicultural issues were explored and addressed revealed that subjects reported having a high level of multicultural counseling awareness and knowledge. Constantine further articulated that counselor supervisors play a critical role in bringing attention to multicultural issues within the supervision experience.

Current Status of Curricular and Practical Factors

The literature continues to highlight the need for empirical research that investigates the progress and development of multicultural counseling awareness, knowledge, and practical experiences for counselors, counselor educators, and counselor trainees alike (Ponterotto, Alexander, & Grieger, 1995; Pope-Davis, Reynolds, Dings, & Ottavi, 1994).

As we further investigate the roles of the curricular, experiential, and practical experiences on the development of future counselors, educators, and trainees, we must pay diligent attention to the salient and critical variables for growth toward multicultural competency (Vereen, Hill, & McNeal, 2004). Furr and Carroll (2003) state that to further provide experiences that illuminate the critical aspects of counselor development, educators are implored to investigate and determine the critical influences of counselor development. In response to this call, the purpose of this research is to explore the opportunities for the development of multicultural counseling competency for counselor trainees. Specifically, one research question guided this study: Are there group differences based on clinical supervision, number of multicultural classes, and number of non-White clients on counselor trainees' scores of perceived multiculrural competence? The implications of this research will address current curricular and practical issues within mental health counselor education and will frame the need for ongoing research that evaluates our emphasis and commitment to multicultural counseling in the 21st century.



The 700 subjects for this study were randomly selected from the population of 11,288 registered student members of the American Counseling Association (ACA). ACA is the largest national organization representing counselors and counselor trainees including members of the American Mental Health Counseling Association (AMHCA), and thus was selected as the sampling pool. The use of ACA also reflected an effort to include individuals who practice mental health counseling yet may not be members of AMHCA. Data used in the statistical analysis consisted of 198 respondents who completed the majority of the instruments and had omitted only one or two items on the demographic survey that did not jeopardize the integrity of the analysis. Therefore, the usable response rate for this study was 28.3%, which is consistent with survey research expectations (Heppner, Wampold, & Kivlighan, 2008). One hundred and sixty-one of the respondents were female (81.3 %), and 37 (18.7 %) of them were male. The age of the participants ranged from 22 to 68 years old with a mean of 36.22 and a standard deviation of 10.75. The subjects were predominantly enrolled in master's programs (N = 162, 82.7%). The degree programs of the remaining participants were: doctorate (N = 28, 14.3%), specialist (N = 3, 1.5%), and other (N = 3, 1.5%).

With regard to ethnic identification, the sample consisted of the following groups: Caucasian (N = 160, 81.6 %), African-American (N = 13, 6.6%), Hispanic (N = 8, 4.1%), Biracial/Multiracial (N = 5, 2.6%), Asian (N = 4, 2%), Native American (N = 2, 1%), and Other (N = 4, 2%). One hundred and eighty-one of the respondents identified themselves as heterosexual (91.9%), 8 identified themselves as homosexual (4.1%); and 7 identified themselves as bisexual (3.6%).

In relation to multicultural training factors, the majority of respondents received clinical supervision related to multicultural issues (N = 161, 83%); the remaining respondents reported that they had not received supervision about multicultural issues (N = 31, 15.7%). The majority of sample participants had completed one multicultural course (N = 113, 57.9%), 39 (20%) had completed two multicultural courses, 25 (12.8%) had completed three or more courses, and 18 (9.2%) had completed zero courses. There was much variation related to the number of clients who were non-White with whom participants had engaged in counseling. Thirty-nine participants (22.7%) had provided counseling with zero clients who were non-White, 68 participants (39.5%) had worked with 1 to 5 clients who were non-White, and 24 participants (14%) had worked with 6 to 10 clients who were non-White. Nine participants had provided counseling to both "11 to 15" (5.2%) and "16 to 20" (5.2%) clients who were non-White. Finally, 23 respondents (13.4%) had engaged in counseling with more than 20 clients who were non-White.


The instrumentation for this study included a demographic questionnaire and one survey, the Multicultural Awareness-Knowledge-Skills Survey (MAKSS; D'Andrea, Daniels, & Heck, 1991). The demographic questionnaire included items regarding sex, sexual orientation, ethnicity, current degree program, number of multicultural courses, number of non-White clients, and presence of clinical supervision related to multicultural issues.

The MAKSS is a 60-item survey that assesses the subject's multicultural awareness, skills, and knowledge. The survey consists of Likert-type responses that explore the respondents' self-rating of their current competency in the three domains. The MAKSS is composed of three subscales, Awareness, Knowledge, and Skills. Scores on each of these functioned as the dependent variables for the research question. The subscale of Awareness consists of 20 items. Examples of items in this subscale are: "The human service professions, especially counseling and clinical psychology, have failed to meet the mental health needs of ethnic minorities," "Counselors need to change not just the content of what they think, but also the way they handle this content if they are to accurately account for the complexity in human behavior," and, "One of the potential negative consequences about gaining information concerning specific cultures is that students might stereotype members of those cultural groups according to the information they have gained." The subscale of Knowledge also includes 20 items. Twelve of these ask for respondents to rate their level of understanding of terms such as "Pluralism" and "Cultural Encapsulation." The remaining 8 items assess the level of agreement or disagreement on issues such as "Research indicates that in the early elementary school grades girls and boys achieve about equally in mathematics and science."

The third subscale, Skills, also consists of 20 items. Items in this subscale ask respondents to rate their abilities and skills, such as "your ability to identify the strengths and weaknesses of psychological tests in terms of their use with persons from different cultural/racial/ethnic backgrounds." Other items focus on perceived competence with specific cultural groups, such as women, men, older adults, gay men, gay women, and handicapped persons.

Reliability documented in the literature for the MAKSS ranges from .75 (awareness subscale) to .96 (skills subscale) (D'Andrea et al., 1991). These reliability figures were computed based on the reliability coefficients for the original sample of 90 counselor trainees. Criterion-related validity has been supported by comparing pre- and post-test results. The results showed that the experimental groups had significantly higher scores on the MAKSS post-test as compared to the control group. The scores at pre-test did not differ significantly (D'Andrea et al., 1991).


The names and addresses of the sample population were obtained from the database of ACA. Each participant received an identification alphanumeric code to maintain the confidentiality of respondents. Follow-up consisted of sending a reminder postcard two weeks after the deadline to encourage completion of the survey.

Research Design and Data Analysis

Descriptive statistics on the subscale scores of the MAKSS were conducted. For the research question, a factorial multivariate analysis of variance (MANOVA) was utilized to compare the group mean differences of clinical supervision related to multicultural issues, number of multicultural classes, and number of non-White clients for some combination of dependent variables, namely the scores on the three subscales of the MAKSS. A factorial MANOVA was conducted because it allows the differentiation of groups in measures of dependent variables while maintaining an alpha level of .05. A MANOVA is a hardy procedure that allows for multiple dependent variables, repeated measures, and unequal cell sample sizes (Mertler & Vannatta, 2005).


For the Awareness subscale of the MAKSS, the mean was 55.67 with a standard deviation of 4.42. The mean and standard deviation for the Knowledge subscale were 55.40 and 5.63, respectively. The Skills subscale generated a mean of 57.35 and a standard deviation of 8.08.

The reliability coefficients for each subscale were computed to assess reliability. The Skills subscale had a reliability alpha coefficient of .77, the Knowledge subscale had an alpha coefficient of .75, and the Awareness subscale had an alpha coefficient of .58. To determine construct validity of the instrument, Pearson r correlations were computed among the subscales. Since each subscale purports to measure a dimension of multicultural competence, it is expected that there would be significant correlations among the subscales. As expected, the Awareness subscale had significant positive correlations with the Knowledge subscale (r = .56, p [less than or equal to] .001) and with the Skills subscale (r = .36, p [less than or equal to] .001). The Knowledge subscale had a significant positive correlation with the Skills subscale (r = .46, p [less than or equal to] .001).

To explore the influence on the multicultural competence of counselor trainees of clinical supervision related to multicultural issues, number of multicultural courses, and number of non-White clients, a factorial multivariate analysis of variance (MANOVA) was conducted. Initially, the tests of assumptions were evaluated to determine the robustness of the inferential statistic. Although there were some deviations to normality, they were not considered to impact the integrity of the statistical analysis because factorial MANOVAs are quite robust in the face of non-normality (Stevens, 1996). The assumptions of linearity and homogeneity of covariance were also satisfactorily met.

Interaction Effects

There were no significant interaction effects for clinical supervision and number of multicultural courses; number of multicultural courses and number of non-White clients; and clinical supervision, number of multicultural courses, and number of non-White clients. The combination of these variables did not produce any significant changes in the dependent variables. There was a significant interaction effect for clinical supervision related to multicultural issues and number of non-White clients (Wilks' Lamba = .88, F = 1.921, df = 9, 328, p = [less than or equal to] .05, [n.sup.2] = .04). The significant interaction effect becomes the most salient finding to be interpreted in the results and supersedes any main effect results.

Main Effects

Significance at the alpha level of .05 was found in this factorial MANOVA for the main effect of the variable of number of non-White clients, Wilks' Lambda = .83, F = 1.73, df = 15, 373, p [less than or equal to] .05. The effect size for this significant finding was .06. Results showed no main effects for clinical supervision (Wilks' Lambda = .99, F =. 191, df = 6, 270, p > .05) or for number of multicultural courses (Wilks' Lambda = .96, F = .633, df = 9, 328, p > .05).

Post Hoc Analysis

Post hoc analysis was conducted to determine the dependent variables that contributed most to the overall significant factorial MANOVA for the interaction effect of number of non-White clients and clinical supervision related to multicultural issues. Univariate follow-up tests were used to consider the interaction in relation to the Awareness, Knowledge, and Skills subscales of the MAKSS. The tests of between-subjects effects revealed no significant univariate relationship at the adjusted alpha level of .0167. The significant interaction results need to be interpreted as impacting a composite of the dependent variables of Knowledge, Awareness, and Skills domains of multicultural competence.

To provide some parameters for interpreting the results, the means of groups were evaluated related to the role of supervision related to multicultural issues and number of non-White clients. Consistently, the means for receiving clinical supervision related to multicultural issues were higher for each subscale than the means for not receiving clinical supervision related to multicultural issues (Awareness: mean for supervision = 55.91, mean for no supervision = 54.98; Skills: mean for supervision = 55.59, mean for no supervision = 54.44; Knowledge: mean for supervision = 57.72, mean for no supervision = 54.68). For number of clients who were non-White, the means measuring multicultural competence for all subscales tended to increase steadily as respondents conducted counseling with more clients who were non-White. For the Awareness subscale, the means were 53.58 for zero clients, 55.72 for "1 to 5 clients," 56.43 for "6 to 10 clients," 57.71 for "11 to 15 clients," 59.03 for "16 to 20 clients," and 57.04 for "20 or more clients." For the Knowledge and Skills subscales, the lowest group mean was associated with the "zero clients" category (53.23 and 53.18 respectively), while the highest group mean was for "20 or more clients" on the Knowledge subscale (m = 58.13) and for "16 to 20 clients" for the Skills subscale (m = 65.67). Thus, the interaction of receiving clinical supervision related to multicultural issues and conducting counseling with more non-White clients was significant in generating higher scores on the measures of multicultural competence.


The results of the current study challenge us to critically rethink how we train and supervise future mental health counselors and counselor educators. Within our society, we continue to see diversity and cultural differences emerge. As a result, the field of counselor education is challenged to train and supervise mental health counselors and counselor educators who are better able to practice and serve the client population that is reflective of our current societal makeup.

In this study, the salient variables influencing levels of multicultural counseling competence of counselor trainees were receiving clinical supervision related to multicultural issues and conducting counseling with non-White clients. The following recommendations respond to the findings of this study and are curricular, clinical, and research based.

1. Mental health counselor educators need to integrate multicultural discussions related to knowledge, skills, and awareness into the supervision process. This will facilitate doctoral and master's level supervisors to be more intentional in how they integrate multiculturalism into their supervisory experiences.

2. Mental health counselor education programs could provide training to onsite supervisors about how to better conduct clinical supervision related to multicultural issues.

3. A paradigm shift integrating multiculturalism into the supervision experience so that it expands beyond a cursory exploration of how culture has been addressed with clients should be explored. Mental health counselor education programs can support faculty development opportunities that reflect this paradigm shift and that generate practical strategies for accomplishing it.

4. Mental health counselor education programs need to be leaders in ongoing dialogue about how to create training experiences that promote the emergence of competent counselors.

5. Mental health counselor education programs are challenged to find ways to increase the exposure of counselor trainees to a more diverse client base within their training. For example, counselor educators need to be intentional in their recruitment of potential training sites and emphasize the necessity of their mental health students conducting counseling with a variety of clients.

6. Counselor educators can engage in future quantitative and qualitative research studies that explore how the multifaceted components of clinical supervision and engaging in counseling experiences with diverse clients specifically impacts competence.

The current study provides evidence of and support for the importance of integrating multicultural education into the practical and clinical supervision components of training for mental health counselor trainees, educators, and supervisors. What we suggest is that a more global and holistic approach to multicultural education, training, and supervision will provide better overall training than the current model used by many training programs where one didactic class provides the basis for multicultural training.

Identifying what global factors contribute to enhancing multicultural competence provides the necessary foundation to explore the complexities of factors that impact counselor competence. This study expands the current empirical literature on multicultural competence of counselor trainees and defines salient variables influencing competence. Accountability through research allows us to identify our strengths in achieving our educational goals and to promote our ongoing development. There is a need for ongoing research that continues to explore the complexity of multicultural competencies, training, and supervision beyond the current self-report measures. Also present is the growing need to explore new and creative ways to impart and implement the development of multicultural counseling competency in counselor trainees within the training process. What has yet to be explored is the ability of educators to fully integrate curricular, experiential, and practical experiences to more effectively prepare counselor trainees for work in our pluralistic society.


Arredondo, P. (1999). Multicultural counseling competencies as tools to address oppression and racism. Journal of Counseling and Development, 77, 102-108.

Arthur, N., & Achenbach, K. (2002). Developing multicultural counseling competencies through experiential learning. Counselor Education and Supervision, 42, 2-15.

Bernard, J. M., & Goodyear, R. K. (1998). Fundamentals of clinical supervision. Needham Heights, MA: Allyn and Bacon.

Bhargava, A., Hawley, L. D., Scott, C. L., Stein, M., & Phelps, A. (2004). An investigation of students' perceptions of multicultural education experiences in a school of education. Multicultural Education, 11, 18-22.

Constantine, M. G. (1998). Developing competence in multicultural assessment: Implications for counseling psychology training and practice. The Counseling Psychologist, 6, 922-930.

Constantine, M. G. (2001). Perspectives on multicultural supervision. Journal of Multicultural Counseling and Development, 29, 98-101.

Council for the Accreditation of Counseling and Related Programs (2001). CACREP accreditation standards and procedures manual. Alexandria, VA: Author.

D'Andrea, M., Daniels, J., & Heck, R. (1991). Evaluating the impact of multicultural counseling training. Journal of Counseling and Development, 70, 143-150.

Dinsmore, J. A., & England, J. T. (1996). A study of multicultural counseling training at CACREP-accredited counselor education programs. Counselor Education and Supervision. 36, 58-76.

Fuertes, J. N., Bartolomeo, M., & Nichols, C. M. (2001). Future research directions in the study of counselor multicultural competency. Journal of Multicultural Counseling and Development, 29, 3-12.

Fukuyama, M. A. (1994). Critical incidents in multicultural counseling supervision: A phenomeno-logical approach to supervision research. Counselor Education and Supervision, 34, 142-151.

Furr, S. R., & Carroll, J. J. (2003). Critical incidents in student counselor development. Journal of Counseling and Development. 81, 483-489.

Gardner, R.M.D. (2002). Cross-cultural perspectives in supervision. Western Journal of Black Studies, 26, 98-106.

Heppner, P. P., Wampold, B. E., & Kivlighan, D. M. (2008). Research design in counseling. Belmont, CA: Thomson Brooks/Cole.

Hill, N.R. (2004). Promoting and celebrating multicultural competence in counselor trainees. Counselor Education and Supervision, 43, 39-51.

Hills, H. I., & Strozier, A. L. (1992). Multicultural training in APA-approved counseling psychology programs: A survey. Professional Psychology,: Research and Practice, 23, 43-51.

McCall, A. (1995). Constructing conceptions of multicultural teaching: Preservice teachers' life experiences and teacher education. Journal of Teacher Education, 46, 340-350.

Mertler, C. A., & Vannatta, R. A. (2005). Advanced and multivariate statistical methods. Glendale, CA: Pyrczak Publishing.

Morales, R. (2000). Effects of teacher preparation experiences and students' perceptions related to developmentally and culturally appropriate practices. Action in Teacher Education, 22, 67-75.

Ponterotto, J. G., Alexander, C. M., & Grieger, I. (1995). A multicultural competency checklist for counseling training programs. Journal of Multicultural Counseling and Development, 23, 11-20.

Pope-Davis, D. B., Reynolds, A. L., Dings, J. G., & Ottavi, T. M. (1994). Multicultural competencies of doctoral interns at University counseling centers: An exploratory investigation. Professional Psyhology: Research and Practice, 25, 466-470.

Robinson, D. T., & Morris, J. R. (2000). Multicultural counseling: Historical context and current training considerations. Western Journal of Black Studies, 24, 239-259.

Stevens, J. (1996). Applied multivariate statistics for the social sciences. Mahwah, NJ: Lawrence Erlbaum Publishers.

Torres-Rivera, E., Phan, L. T., Maddux, C., Wilbur, M. P., & Garrett, M. T. (2001). Process versus content: Integrating personal awareness and counseling skills to meet the multicultural challenge of the twenty-first century. Counselor Education and Supervision, 41, 28-40.

Tyler, M. J., & Guth, L. J. (1999). Using media to create experiential learning in multicultural and diversity issues. Journal of Multicultural Counseling and Development, 27, 153-169.

Vereen, L. G., Hill, N. R., & McNeal, D. T. (2004). Are we preparing counselors to be culturally competent? A national survey assessing multicultural competencies. Paper presented at the Rocky Mountain Association for Counselor Education and Supervision Conference, Breckenridge, CO.

Linwood G. Vereen and Nicole R. Hill are affiliated with the Department of Counseling at Idaho State University. Donell T. McNeal is affiliated with Preston Junior High School in Fort Collins, Colorado. Correspondence concerning this article should be addressed to Linwood G. Vereen, Idaho State University, Department of Counseling, 921 S. 8th Ave, Stop 8120, Pocatello, Idaho. E-mail:
COPYRIGHT 2008 American Mental Health Counselors Association
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2008 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Author:Vereen, Linwood G.; Hill, Nicole R.; McNeal, Donell T.
Publication:Journal of Mental Health Counseling
Article Type:Report
Geographic Code:1USA
Date:Jul 1, 2008
Previous Article:A qualitative study of potential suicide risk factors in returning combat veterans.
Next Article:Superficial self-harm: perceptions of young women who hurt themselves.

Related Articles
Cultural Sensitivity and Cognitive Therapy in Thailand.
A critical analysis of the Multicultural Counseling Competencies: implications for the practice of mental health counseling. (Practice).
Comprehensive guidance and counseling programs and the development of multicultural student-citizens.
Multicultural Counseling Competencies = ethical practice.
Counseling the linguistically and culturally diverse student: meeting school counselors' professional development needs.
Investigating school counselors' perceived multicultural competence.
Metacognition and multicultural competence: expanding the culturally appropriate career counseling model.
Mental health counselor qualities for a diverse clientele: linking empathy, universal-diverse orientation, and emotional intelligence.
School counselors' self-perceived Asian American counseling competence.
The school-wide cultural competence observation checklist for school counselors: an exploratory factor analysis.

Terms of use | Copyright © 2017 Farlex, Inc. | Feedback | For webmasters