Multicultural competency in substance abuse treatment : The differences that make a difference

Abstract

Norway has become a multicultural society with an ever increasing global interdependence. With the increasing complexity and interdependence of economic, political and social affairs, similarities and differences among cultural groups are more evident. The substance abuse care services are multileveled and complex, with different service providers offering similar services in different setups. In addition, these services appear to have been tailored to suit the ethnic majority and are to some extent not culturally responsive to the needs of the ethnic minority clients.

It is, therefore, becoming a challenge to assume that mainstream therapeutic treatment services will be applicable to the ethnic minority, unless it culturally adapted. Clients have a right to access individually tailored treatment based on the client’s needs and situation. A single national treatment intervention is no longer acceptable as a viable concept for the treatment process. Norwegian treatment programmes and clinical practices should reflect aspects of diversity in order to meet the unique and distinct therapeutic needs of each ethnic minority client.

When the discussions of cultural competency arise; the question often asked is how does one become culturally competent? How can a therapist provide culturally competent interventions that can lead to a successful outcome? The findings indicate that applying culturally sensitive interventions in various stages of therapy, can offer an opportunity for the client and the therapist to deconstruct the hindering cultural constructions and reconstruct new and common realities. Culturally sensitive interventions, allows the therapist to acknowledge the client’s experience and worldview, and opens up possibilities for change according to the client’s goals. However, means to integrate cultural issues in each stage of counseling is virtually missing. In the context of a therapeutic relationship, the study suggests that the therapist should develop a position that interacts with the values, beliefs, experiences, responses and ideas of the client; and together they construct culturally sensitive therapeutic realities and solutions. As such, no psychotherapeutic treatment orientation could be more appropriate and legitimate than one that is multicultural, one that involves client’s own contribution.

This thesis attempted to investigate the application of social constructionist approaches in therapy. The major aim was to find out the qualitative effects of involving ethnic minorities’ own needs and contribution in psychotherapy. Semi-structured interviews with psychologists and ethnic minority clients formed the main source of data for this study.