Todd Wilson Dunn and Dr. Tim Smith, Counseling Psychology and Special Education

The past two decades have seen a proliferation in the amount of publications on multicultural counseling. For example, over 1000 published reports investigating multicultural counseling and the cultural contexts of psychology have appeared in psychological literature since 1995. Many of these studies have identified serious flaws in traditional methods of helping minority populations with emotional or psychological disturbances, while demonstrating that alternative “culturally sensitive” methods can improve treatment outcomes. Although the sudden proliferation of literature on multicultural counseling clearly indicates growing popular interest in the topic, responsible scientific practice dictates that any body of literature should be systematically evaluated and synthesized to inform future research efforts and extant theory (Cooper, 1998). Because no such systematic evaluation of literature currently exists, there is a clear and pressing need for a meta-analytic review on the topic of multicultural counseling.

For the purpose of this study, the rather broad topic of multicultural counseling is dissected into thirteen categories to facilitate a more detailed investigation. In this report, the specific topic of multicultural training is reviewed through meta-analytic methodology, while the remaining topics (e.g., therapist-client match, biases of the counselor, acculturation of client, etc.) are reviewed in later studies.

In response to research indicating the need of mental health practices to adequately meet the needs of minority populations (Sue, & Sue, 1999), most mental health professions now require training to insure effective multicultural service toward clients. Ethical codes indicate that professionals should be knowledgeable and skilled in their work with clients from diverse backgrounds (American Counseling Association, 1995; American Psychological Association, 1992). However, as noted earlier, no comprehensive review of the literature has been conducted to verify the effectiveness of multicultural training. The primary goals of this research report are to review the effectiveness of multicultural training in counseling and to provide a critique useful for future research and efforts at forming culturally sensitive mental health treatment.

Method

To obtain relevant published and unpublished studies examining the effects of multicultural training in counseling through 2001, an exhaustive literature search of seven electronic literature databases (e.g., Medline, PsycInfo, Sociofile, ERIC, etc.) was followed by manual searches of citations. Multiple search terms were used to capture the broadest possible sample of relevant articles, and three professionals who have published extensively in the field were consulted to identify unpublished papers and conference presentations. A team of undergraduate and graduate students collaborated efforts to code data from the articles in teams of two. If disagreements in coding occurred, they were resolved via a third wave of coding. Highly structured coding sheets were used by coders in extracting relevant demographic data and individual effect sizes that were aggregated into standardized mean differences (d) and combined over studies. Cohen (1992) operationally assigned d three effect size categories, small (d = .20), medium (d = .50), and large (d = .80).

Results

Over 100 studies addressing the issue of multicultural training were revealed; of which 64 studies met criteria for inclusion in the meta-analysis (they contained data on multicultural training outcomes). The omnibus effect size for all 64 studies was d = .57, indicating a moderately strong tendency for mental health professionals to increase in multicultural knowledge and skills and decrease in their racial biases as a function of training. However, the results were found to be heterogeneous. The variability among individual studies was such that the effect of training is apparently moderated by other factors including: (1) educational level, therapists with fewer years of education gained more as a function of training; (2) race, European Americans gained more as a function of training than did other ethnic groups; (3) year and quality of study, recent studies and studies of higher quality tended to have lower effect sizes than older, lower quality studies; and (4) quality of training, higher quality training generally led to better outcomes.

Conclusion and Implications

Multicultural training is moderately effective in reducing trainee bias and increasing knowledge and skills. Results indicate, as is the case with nearly all training, that those who have the least experience gain the most as a result of training. Similarly, higher quality training yields better outcomes.

This report provides future research efforts and practicing mental health professionals with a synthesized review of multicultural training effects on counseling. In so doing, justification is provided to programs and organizations that require multicultural training. To obtain professional exposure, these results have been presented at the 2002 Annual Conference of the American Counseling Association in New Orleans, LA, and at the 2002 First Annual Brigham Young University Undergraduate Psychology Research Conference in Provo, UT.

References

1. American Counseling Association (1995). ACA Code of Ethics and Standards of Practice. Baltimore, MD: American Counseling Association.
2. American Psychological Association. (1992). Ethical principles of psychologists and code of conduct. American Psychologist, 47(12), 1597-1611.
3. Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155-159.
4. Cooper, H. (1998). Synthesizing Research: A Guide for Literature Reviews (3rd ed.). Thousand Oaks, CA, US: Sage Publications, Inc.
5. Sue, D. W., & Sue, D. (1999) Counseling the Culturally Different: Theory and Practice (3rd ed.). New York, NY, US: John Wiley & Sons, Inc.