Counseling the Culturally Diverse Theory and Practice, 9th Edition by Derald Wing Sue, David Sue, He

TEST BANK FOR Counseling the Culturally Diverse Theory and Practice, 9th Edition Derald Wing Sue, David Sue, Helen A. Neville, Laura Smith

Chapter 1: Obstacles to Cultural Competence & Cultural Humility: UnderstandingResistance to Multicultural Training Test Questions Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 1 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will also find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Question 1 Question Type: True/False Question: The journey to becoming a competent culturally sensitive counselor in working with diverse populations is not complex as humans have innate characteristics that are relatively consistent across cultures with similar hopes and dreams that mark their humanness.

Answer: False Solution: According to the authors, becoming culturally competent in working with diverse populations is a complex interaction of many dimensions that involves broad theoretical, conceptual, research, and practice issues. Moreover, the journey will be filled with obstacles to self-exploration, to understanding yourself as a racial/cultural being, and to understanding the worldview of those who differ from you in race, gender, ethnicity, sexual orientation, and other sociodemographic characteristics. The subject matter in this book and course requires the reader to explore biases and prejudices, a task that often evokes defensiveness and resistance.

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 2 Question Type: Multiple Selection Question: Becoming culturally competent in mental health practice demands that nested or embedded emotions be openly experienced in which of the following sociodemographic dimensions of difference? a. race

b. c. d. e.

culture gender sexual orientation only a and b

Answer: a, b, c, d Solution: The authors point out that the journey to becoming culturally competent therapists is filled with obstacles to self-exploration, to understanding oneself as a racial/cultural being, and to understanding the worldview of those who differ from others in terms of race, gender, ethnicity, sexual orientation, and other sociodemographic dimensions.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 3 Question Type: Text Entry Question: The three types of resistance that are often encountered by students studying diversity training are: _______________, __________________, ________________. a. cognitive; emotional; behavioral b. psychological; physiological; emotional c. dissonance; isolation; invalidation d. physical; emotional; spiritual Answer: a Solution: The authors report that in work with resistance to diversity training, research reveals how it is likely to be manifested in three forms: cognitive resistance, emotional resistance, and behavioral resistance (Sue, 2015, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 4 Question Type: Essay Type Question: Identify at least three emotions you experienced as you read the reactions of the four students. Reflect on why you feel those emotions surfaced.

Solution: Responses will vary but, according to the authors, one of the greatest concerns of instructors is the strong emotive reactions of students to the material: grief, anger, depression, and guilt in working through the content.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 5 Question Type: True/False Question. The burden to become multiculturally competent rests on the trainees from dominant culture as in most cases they have been the ones to marginalize, stereotype, and oppress minority cultures. Thus, it is the responsibility of the dominant culture to help rectify this in raising awareness and also in becoming competent in working with diverse populations.

Answer: False Solution: Understanding multicultural counseling competence applies equally to trainees from dominant and marginalized groups and to helping professionals.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 6 Question Type: Multiple Selection Question: According to Kiselica (1999, as cited in Sue 8th edition), White psychologists avoid topics of race because a.

It may reveal their own prejudices and biases b.

They are racked with guilt over the way people of color have been treated c.

They are fearful of being labeled a racist or blamed for the oppression d. a and c only Answer: a, b, c Solution: Kiselica, a White psychologist who addresses his own ethnocentrism and racism, contends that these topics (ethnocentrism and racism) are subjects that most Whites tend to avoid. He adds that most shy away from discussing these issues for many reasons. He posits that Whites are racked with guilt over the way people of color have been treated in our nation. Whites fear that they will be accused of mistreating others, and particularly fear being called the ―R‖ word—racist. Many grow uneasy whenever issues of race emerge. Whites tend to back away, change the subject, respond defensively, assert their innocence and ―color blindness,‖ and deny that they could possibly be ethnocentric or racist. (Kiselica, 1999, as cited in Sue 8th edition).

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 7 Question Type: Essay Type Question: Describe recent conversations you have had about diversity. What were the settings for those conversations to occur? What was the makeup of those participating in the discussion?

Solution: Responses will vary but, according to the authors, the powerful feelings aroused in some

students prevent them from being open to diversity issues, and from making classroom discussions on the topic a learning opportunity. Instead, conversations on diversity become ―shouting matches‖ or become monologues rather than dialogues.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 8 Question Type: Essay Type Question: How has your worldview shaped you? Consider, for example, the country you were born in, the family you had, the home or neighborhood you lived in or school you attended, opportunities you had, and any religious affiliation and how have each of these areas and/or others helped form you as a person?

Solution: Responses will vary but, according to the authors, each of these areas will influence the worldview. To become multiculturally competent counselors they must understand the client’s worldview but they must first understand their own. As a counselor or therapist working with culturally diverse clients, understanding differences in worldviews is an important first step to becoming culturally competent. However, to recognize the differences or similarities, one must first examine their own understanding of themselves and how their worldview has shaped them as persons.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 9 Question Type: True/False Question: In order to be a culturally competent therapist, one should avoid personal feelings and previous experiences with race, culture and gender and therefore be free to explore the client’s experience with prejudices or racism.

Answer: False Solution: The journey to cultural competence requires an emotional awakening in the area of one’s knowledge, beliefs, attitudes, and behaviors related to race, culture, ethnicity, gender, and other diverse groups. Furthermore, the authors state that becoming culturally competent in counseling/mental health practice demands that nested or embedded emotions associated with race, culture, gender, and other sociodemographic differences be openly experienced and discussed.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 10

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Question Type: Multiple Selection Question. The authors state that in multicultural counseling, best practice dimensions operate at which of the following levels? a. individual b. familial c. group d. institutional e. societal Answer: a, b, c, d, e Solution: The authors state that the Practice Dimensions of Multicultural Counseling/Therapy integrates multicultural premises developed from the first two parts into the domain of clinical work. In that it reviews, analyzes and points to best practices in working with diverse populations at the individual, familial, group, institutional, and societal levels.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 11 Question Type: Text Entry Question. The subject matter in this book and course requires you to explore your _______ and __________ a task that often evokes ___________ and ______________.

Answer: biases; prejudices; defensiveness; resistance Solution: The authors posit that the subject matter in this book and course requires you to explore your biases and prejudices, a task that often evokes defensiveness and resistance. Furthermore, they state that it is important to recognize personal resistance to the material, to explore its meanings, and to learn about yourself and others. They add that sometimes what is revealed about you may prove disturbing, but having the courage to continue is necessary to becoming a culturally competent counselor or therapist.

Bloom’s Level: Application Difficulty Level: EASY

Question 12 Question Type: Essay Type Question: What current news stories demonstrate the different reactions to racism between dominant and marginalized group members?

Solution: Responses will vary but may include current news stories making headlines and the strong protests and responses from both dominant and marginalized group members.

Bloom’s Level: Synthesis Difficulty Level: HARD

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Question 13 Question Type: True/False Question: When counselors explore their own emotional reactions to race and culture, feelings such as defensiveness and anger can be destructive and are better left untouched.

Answer: False Solution: The subject matter in this book and course requires you to explore your biases and prejudices, a task that often evokes defensiveness and resistance. Furthermore, it is important to recognize personal resistance to the material, to explore its meanings, and to learn about yourself and others. Sue (2011, as cited in Sue 8th edition) adds that it is these intense feelings that often block our ability to hear the voices of those most oppressed and disempowered. Moreover, Sue 8th edition states that how we, as helping professionals, deal with these strong feelings can either enhance or impede a deeper understanding of ourselves as racial/cultural beings and our understanding of the worldviews of culturally diverse clients.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 14 Question Type: Multiple Choice Question: Microaggressions are best described as a. minor offenses that are typically unintentional and thus harmless in nature b. the everyday slights, put-downs, invalidations, and insults directed toward a group c. racist statements that cause minimal harm because they are micro in nature as opposed to macro d. feelings of inferiority that racism and prejudice cause minority groups e. underlying anger that oppressed groups feel but do not allow to surface Answer: b Solution: Microaggressions are the everyday slights, put-downs, invalidations, and insults directed toward socially devalued group members by well-intentioned people who are unaware that they have engaged in such biased and harmful behaviors. Furthermore, a lifetime of microaggressions can have a major harmful impact on the psychological well-being of victims.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 15 Question Type: Text Entry Question: For practicing professionals and trainees in the helping professions, understanding the

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differing _________ of our culturally diverse clients is tantamount to effective multicultural counseling.

Answer: worldviews Solution: The authors point out that the journey to becoming culturally competent therapists is filled with obstacles to self-exploration, to understanding oneself as a racial/cultural being, and to understanding the worldview of those who differ from others in terms of race, gender, ethnicity, sexual orientation, and other sociodemographic dimensions. Likewise, as a counselor or therapist working with culturally diverse clients, understanding differences in worldviews is an important first step to becoming culturally competent.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 16 Question Type: Essay Type Question: Have you ever been a victim of racial prejudice, racial profiling, or microagression? If so, what emotions did that provoke in you?

Solution: Responses will vary but may include anger, sadness, disgust, fear.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 17 Question Type: True/False Question: The four students reading the textbook all reacted in relatively similar fashion to the material, indicating the authors were successful in producing a politically correct textbook without ―tiptoeing‖ around the emotionally charged topics.

Answer: False Solution: Both White students reacted with anger and resentment and believe that the authors are unjustly accusing U.S. Society and White Americans of racism. The White students claim the authors are themselves ―racist‖ but of a different color, whereas the two students of color felt heard, liberated, and validated. In addition, they describe the book content as ―honest‖ and ―truthful,‖ indicating that their lived experiences were finally validated rather than silenced or ignored.

Bloom’s Level: Analysis Difficulty Level: HARD

Question 18 Question Type: Text Entry

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Question: One of the greatest concerns of instructors is the strong emotive reactions of students to the material. Some of these reactions may include: _____________, _______________, _________, ____________. a. b. c. d.

depression; withdrawal; anger; guilt grief; anger; depression; guilt hate; inferiority; aggression; cognitive dissonance passive aggression; anger; overcompensation; guilt

Answer: b Solution: The authors state that one of the greatest concerns of instructors is the strong emotive reactions of students to the material: grief, anger, depression, and guilt in working through the content. This has been a perennial issue for students and instructors since the first edition, which was published in 1981. The authors state that they have been aware from the beginning that CCD is very likely to elicit strong emotions among readers because the content of the book challenges racial, gender and sexual orientation realities and traditional therapeutic beliefs. On one hand, CCD can be said to have accomplished one of its major goals by indicating that cultural competence is more than an intellectual exercise, and that it must include dealing with strong and powerful nested and hidden emotions and biases on the part of the helper. On the other hand, these powerful feelings can become so intense in students and arouse defensiveness, guilt, and anxiety to such an extent that they prevent self-exploration, which is a vital component of cultural competence in the helping professions.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 19 Question Type: True/False Question: Anger is the primary subjective emotion encountered by White trainees exposed to multicultural content and its implications.

Answer: False Solution: Anxiety is the primary subjective emotion encountered by White trainees exposed to multicultural content and its implications. However, anger is a common emotion expressed, but it is not the primary emotion, according to the authors. The authors share that instructors of multicultural counseling utilizing the text indicate that the content of the book challenges many White students about their racial, gender and sexual orientation realities, and that the book’s writing style (passionate, direct, and hard-hitting) also arouses deep feelings of defensiveness, anger, anxiety, guilt, sadness, hopelessness, and a multitude of other strong emotions in many.

The authors add that unless properly processed and understood, these emotions act as roadblocks to exploring issues of race, gender, and sexual orientation.

Bloom’s Level: Synthesis Difficulty Level: HARD

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Question 20 Question Type: Text Entry Question: Marginalized group members often sense _______________ from the dominant culture. a. emotional invalidation b. emotional isolation c. emotional dissonance d. emotional affirmation Answer: a Solution: The authors describe how many people of color describe how their thoughts and feelings about race and racism are often ignored, dismissed, negated, or seen as having no basis in fact by majority group members. They are often told that they are misreading things, overly sensitive, unduly suspicious, or even paranoid when they bring up issues of bias and discrimination; in other words, they are ―crazy‖ to think or feel that way.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 21 Question Type: Essay Type Question: Did you experience any positive feelings when you read this chapter? What did those mean for you?

Solution: According to Sue 8th edition, reading and digesting the content of this book may prove difficult and filled with powerful feelings for the reader. Students who have taken a course on multicultural counseling/therapy or multicultural mental health issues have almost universally felt both positive and negative feelings that affect their ability to learn about diversity issues. It is important not to allow those emotions to go unacknowledged or to avoid exploring the psychological meanings they might have.

Bloom’s Level: Analysis and synthesis Difficulty Level: HARD

Question 22 Question Type; True/False Question: As can be seen from the students’ reactions to the text, many marginalized group members react equally strongly as their White counterparts when issues of oppression are raised.

Answer: True Solution: This is especially true when their stories of discrimination and pain are minimized or neglected. Their reality of racism, sexism, and homophobia, they feel, is relatively unknown or

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ignored by those in power because of the discomfort that pervades such topics. Worse yet, they contend that many well-intentioned majority persons seem disinclined to hear the personal stories of suffering, humiliation and pain that accrue to persons of color and other marginalized groups in our society (Sue, 2015, as cited in Sue 8th edition).

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 23 Question Type: Multiple Selection Question: The author states as a ―people of color‖ he directs his anger not at White Americans or the country but rather at a.

White supremacy b. the government, which imposes inequality in its practices c.

White Western society d. ethnocentrism e.

White privilege f. a and d g. all of the above Answer: f Solution: The authors write that as people of color, we must realize that our enemies are not White Americans, but White supremacy! Additionally, by extension, our enemy is not White Western society, but ethnocentrism.

Bloom’s Level: Analysis Difficulty Level: HARD

Question 24 Question Type: Text Entry Question. The Impact and Social Justice Implications of Counseling and Psychotherapy discusses the need to recognize that counseling and psychotherapy may represent a _________ of race relations, gender relations, and other unequal status relations in our larger society.

Answer: microcosm Solution: Part II of the text reads that the Impact and Social Justice Implications of Counseling and Psychotherapy discusses (a) the need to acknowledge the political bases of Western European approaches; (b) the necessity to recognize that counseling and psychotherapy may represent a microcosm of race relations, gender relations, and other unequal status relations in our larger society; and (c) how the modern forms of bias (microaggressions) may affect both the psychological health of socially marginalized groups and our and their standard of living.

Bloom’s Level: Application Difficulty Level: HARD

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Question 25 Question Type: Essay Type Question: According to Todd and Abrams (2011, as cited in Sue 8th edition), understanding our own reactions to issues of diversity, multiculturalism, oppression, race, gender, and sexual orientation is equally important to our development as counselors/therapists. After reading this chapter, how do you plan to use this information in your profession?

Solution: Todd and Abrams (2011, as cited in Sue 8th edition) state that understanding our own reactions to issues of diversity, multiculturalism, oppression, race, gender, and sexual orientation is equally important to our development as counselors/therapists. Sue 8th edition points out that this understanding can be quite anxiety provoking, especially when we are asked to confront our own biases, prejudices and stereotypes. They add that the old adage ―counselor or therapist, know thyself‖ is the basic building block to cultural competence in the helping professions.

Bloom’s Level: Synthesis Difficulty Level: HARD

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Chapter 2: Multicultural Counseling and Therapy (MCT) Test Questions Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 2 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will also find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Question 1 Question Type: True/False Question: The client/therapist interchange between Dr. D and Gabriella presented in Chapter 2 provides the reader with a good example of a multiculturally competent therapist addressing a concern of a client from another cultural group.

Answer: False Solution: According to Sue 8th edition the therapy session between Dr. D and Gabriella illustrates the importance of cultural awareness and sensitivity in mental health practice. They point out a marked worldview difference between that of the White therapist and the Latina client Gabriella. These differences reflect the therapist’s belief in the universality of the human condition. They also reflect the belief that disorders are similar and cut across societies. Dr. D demonstrated a lack of knowledge of Latina/o culture and task orientation. In addition Dr. D failed to pick up clinical clues provided by the client. He seemed unaware of the influence of sociopolitical forces in the lives of this marginalized group members, and lack of openness to professional limitations.

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 2 Question Type: Multiple Selection Question: Homo sapiens share many similarities such as a. b. c. d. e.

biological factors physical similarities common life experiences such as birth, death, love, sadness self-awareness the ability to use symbols such as language

Answer: a, b, c, d, e

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Solution: The authors postulate that because we are members of the human race and belong to the species Homo sapiens, we share many similarities. Universal to our commonalities include (a) biological and physical similarities, (b) common life experiences (birth, death, love, sadness and so forth), (c) self-awareness, and (d) the ability to use symbols, such as language.

Bloom’s Level: Knowledge Difficulty Level: Easy

Question 3 Question Type: Multiple Choice Question: When counselors unwittingly impose monocultural standards without regard for differences in race, culture, gender, and sexual orientation, they may be engaging in: a. fair and equitable practice b. cultural competent practice c. cultural oppression d. none of the above Answer: c Solution: Sue and Sue remind the reader in the clinical implications that a multicultural therapist (MCT) should not disregard differences and should be careful not to impose the conventional helping role and process on culturally diverse groups. Such actions may constitute cultural oppression.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 4 Question Type: Text Entry Question: ―____________ the __________‖ often happens when the norms and values of Western European concepts of mental health are imposed universally upon culturally diverse clients.

Answer: ―Blaming the Victim‖ Solution: The authors emphasize that there is the very real danger of cultural oppression, resulting in ―blaming the victim‖ when the norms and values of Western European concepts of mental health are imposed universally upon culturally diverse clients.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 5 Question Type: Essay Type Question: Define etic and emic perspectives.

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Answer: Etic: A culturally universal perspective, meaning that concepts can be considered universal and equally applicable across cultures.

Emic: A culturally specific perspective, meaning that lifestyle, cultural values, and worldviews affect the expression and determination of behavior.

Bloom’s Level: Comprehension Difficulty Level: Medium

Question 6 Question Type: True/False Question: Most of the mental health disorders in the DSM-5 are transcultural, meaning the symptoms manifest with similar presentations across cultures, making diagnosing more systematic.

Answer: False Solution: As was the case in the transcript between Dr. D and Gabriella, Dr. D’s training has taught him that disorders such as panic attacks, depression, schizophrenia, and sociopathic behaviors appear in all cultures and societies, and minimal modification in their diagnosis and treatment is required. This type of training teaches that Western concepts of normality and abnormality can be considered universal and equally applicable across cultures (Arnett, 2009; Howard, 1992; Suzuki, Kugler, & Aguiar, 2005, as cited in Sue 8th edition). However, this is an example of etic or culturally universalistic thinking.

Sue 8th edition reports that many multicultural psychologists operate from an emic position, which is culturally specific thinking, and challenge these assumptions. In Gabriella’s case, they argue that lifestyles, cultural values, and worldviews affect the expression and determination of behavior disorders (Ponterotto, Utsey, & Pedersen, 2006, as cited in Sue 8th edition.

Furthermore, they stress that all theories of human development arise within a cultural context and that using the Euro-American values of normality and abnormality may be culture-bound and biased (Locke & Bailey, 2014, as cited in Sue 8th edition.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 7 Question Type: Multiple Selection Question: What might be some characteristics of cultural incompetence? a. insensitivity to needs of culturally diverse clients b. demonstrate arrogant or contemptuous attitudes c. have little understanding of their own cultural biases and prejudices d. do not accept or respect cultural differences e. discriminatory practices

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Answer: a, b, c, d, e Solution: In the section on harm that may come from cultural incompetence, the authors describe several characteristics of an incompetent therapist. They surmise, however, that although there are disagreements over the definition of cultural competence, many of us know cultural incompetence when we see it. They further this by emphasizing that we can recognize this by its ―horrendous outcomes‖ or by the human toll it takes on our marginalized clients. Multicultural specialists have described Western-trained counseling/mental health professionals in very unflattering terms: (a) They are insensitive to the needs of their culturally diverse clients; do not accept, respect and understand cultural differences; are arrogant and contemptuous; and have little understanding of their prejudices (Ridley, 2005; Thomas & Sillen, 1972, as cited in Sue 8th edition.

They add that discriminatory practices in mental health delivery systems are deeply embedded in the ways in which the services are organized and in how they are delivered to minority populations and are reflected in biased diagnoses and treatment, in indicators of dangerousness, and in the type of people occupying decision-making roles (Parham et al., 2011; Cross, Bazron, Dennis, & Isaacs, 1989, as cited in Sue 8th edition.

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 8 Question Type: Multiple Choice Question: Which of the following is likely to be a perspective of a culturally competent helping professional? a.

The role of counselor should be broadened to include teaching, consulting, and advocacy. b.

Providing advice and suggestions are not effective forms of helping with people of color. c.

The problems that people of color experience with discrimination and racism are beyond the scope of counseling practice. d.

An individualistic counseling approach is the most effective form of meeting the needs of people of color.

Answer: a Solution: The helping role and process of Multicultural Therapy (MCT) broadens the roles that counselors play and expands the repertoire of therapy skills considered helpful and appropriate in counseling. The more passive and objective stance taken by therapists in clinical work is seen as typically only one method of helping. Moreover, teaching, consulting, and advocacy can supplement the conventional counselor or therapist role.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 9 Question Type: Text Entry

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Question: The basic building blocks of cultural competence in clinical practice are ______________, _______________ and _______________. a. b. c. d.

acceptance; diversity; awareness knowledge; skills; awareness openness; awareness; acceptance none of the above

Answer: b Solution: Sue 8th edition states that on a personal developmental level, multicultural counseling competence is defined as the counselor’s acquisition of awareness, knowledge, and skills needed to function effectively in a pluralistic democratic society (ability to communicate, interact, negotiate, and intervene on behalf of clients from diverse backgrounds) on an organizational/societal level. Furthermore, it is defined as advocating effectively to develop new theories, practices, policies, and organizational structures that are more responsive to all groups.

More specifically, cultural competence can be seen as residing in three major domains: (a) attitudes/beliefs component—an understanding of one’s own cultural conditioning and how this conditioning affects the personal beliefs, values, and attitudes of a culturally diverse population; (b) knowledge component—understanding and knowledge of the worldviews of culturally diverse individuals and groups; and (c) skills component—an ability to determine and use culturally appropriate intervention strategies when working with different groups in our society.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 10 Question Type: Essay Type Question: How would you respond to the statement ―There is only one race, the human race‖?

Solution: Sue 8th edition describes that on the one side are beliefs that people are unique and that the psychosocial unit of operation is the individual. On the other side are beliefs that clients are the same and that the goals and techniques of counseling and therapy are equally applicable across all groups. The authors contend that taken to its extreme this latter approach nearly assumes that persons of color, for example, are White, and that race and culture are insignificant variables in counseling and psychotherapy (D. W. Sue, 2010, as cited in Sue 8th edition).

Statements such as ―There is only one race, the human race‖ and ―Apart from your racial/cultural background, you are no different from me‖ are indicative of the tendency to avoid acknowledging how race, culture, and other group dimensions may influence identity, along with values, beliefs, behaviors, and the perception of reality (Lum, 2011; D. W. Sue, 2015, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 11

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Question Type: True/False Question: The Latin expression ―ataque de nervios,‖ or attack of the nerves, is basically the same as the American expression of a panic attack and should be treated similarly.

Answer: False Solution: The transcript between Dr. D and Gabriella highlights the dangers of assuming the symptom presentation is consistent with Westernized nomenclature. For example, as Sue 8th edition points out when Gabriella uses the term ataques to describe her emotional outbursts, episodes of crying, feeling faint, somatic symptoms (―heat rising in her chest‖), feeling of depersonalization (unreal), and loss of control, a Western-trained counseling/mental health professional may very likely diagnose a panic attack.

Sue 8th edition asks, however, if a panic attack diagnosis the same as ataques? Or is the ataque simply a Latin American translation of an anxiety disorder? The authors state that it is now recognized that ataque de nervios (―attack of the nerves‖) is a cultural syndrome, occurs often in Latin American countries (in individuals of Latina/o descent) and is distinguishable from panic attacks (American Psychiatric Association, 2013, as cited in Sue 8th edition). Furthermore cultural syndromes that do not share a one-to-one correspondence with psychiatric disorders in DSM-5 have been found in South Asia, Zimbabwe, Haiti, China, Mexico, Japan and other places. The authors warn that failure to consider the cultural context and manifestation of disorders often result in inaccurate diagnosis and inappropriate treatment (D. Sue, Sue, Sue, & Sue, 2016).

Bloom’s Level: Application Difficulty Level: EASY

Question 12 Question Type: Multiple Selection Question: Identify some of the competencies needed in competent multicultural counseling. a. therapist awareness of one’s own assumptions, values, and biases b. understanding the worldviews of culturally diverse clients c. developing culturally appropriate intervention strategies and techniques d. being ―color blind‖ and diminishing the effect of culture Answer: a, b, c Solution: Culturally competent healers are working toward several primary goals (American Psychological Association, 2003; D. W. Sue et al., 1992; D. W. Sue et al., 1998, as cited in Sue 8th edition). Culturally competent helping professionals are ones who are actively in the process of becoming aware of their own values, biases, assumptions about human behavior, preconceived notions, personal limitations, and so forth. Furthermore, culturally competent helping professionals are ones who actively attempt to understand the worldview of their culturally diverse clients. They investigate what the client’s values and assumptions about human behavior biases are. Additionally, culturally competent helping professionals are ones who are in the process of actively developing and practicing appropriate, relevant and sensitive intervention

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strategies and skills in working with their culturally diverse clients.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 13 Question Type: Multiple Choice Question: Cultural humility is described as which of the following? a. a way of doing b. a way of cultural awareness c. a way of assessing d. a way of being Answer: d Solution: Another attribute, cultural humility, seems central to effective multicultural counseling.

In fact, cultural humility appears more like a ―way of being‖ rather than a ―way of doing,‖ which has characterized cultural competence (Owen, Tao, Leach, & Rodolfa, 2011 as cited in Sue 8th edition).This may manifest in an attitudinal component of respect for others, an egalitarian stance and diminished superiority over clients means an ―other-orientation‖ rather than one that is selffocused.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 14 Question Type: Text Entry Question: Multicultural counseling can be defined as both a _____________ and a _____________.

Answer: helping role; process Solution: Multicultural counseling and therapy can be defined as both a helping role and a process that uses modalities and defines goals consistent with the life experiences and cultural values of clients. It recognizes client identities to include individual, group, and universal dimensions and advocates the use of universal and culture-specific strategies and roles in the healing process. It also balances the importance of individualism and collectivism in the assessment, diagnosis, and treatment of client and client systems. (D. W. Sue & Torino, 2005, as cited in Sue 8th edition).

Bloom’s Level: Analysis Difficulty Level: HARD

Question 15 Question Type: Essay Type

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Question: Identify the three levels of the Tripartite Framework for Understanding Multiple Levels of Identity. Provide a definition and example of each level.

Solution: The three levels are: Individual Level, Group Level, and Universal Level.

Individual Level: All people have individual uniqueness. An example is a personal experience with bullying in school. At the individual level, those who have a bullying experience will all experience it somewhat differently.

Group Level: Group membership results in shared experiences and characteristics. For example, the belief that family needs supersede individual needs can be a Group Level belief of some Latino groups.

Universal Level: We are all human beings. An example is that we all experience birth.

Bloom’s Level: Application Difficulty level: MEDIUM

Question 16 Question Type: True/False Question: ―Be your own person‖ will be welcome counsel for individuals from collectivistic cultures allowing them to finally meet their goals to gain independence.

Answer: False Solution: The authors emphasize that many therapists operate from an individualistic approach and values individualism, autonomy, and independence. As in the case of Dr. D and Gabriella, Dr. D communicates to Gabriella that it is more important for her to decide what she wants for herself than being concerned about her parents’ desires. Sue 8th edition states that Western European concepts of mental health stress the importance of independence and ―being your own person‖ because it leads to healthy development and maturity, rather than dependency (in Gabriella’s case ―pathological family enmeshment‖). The authors point out that Dr. D fails to consider that in many collectivistic cultures such as Latino or Asian American, independence may be considered undesirable and interdependence is valued (Ivey, Ivey, & Zalaquett, 2014; Kail & Cavanaugh, 2013, as cited in Sue 8th edition).

Bloom’s Level: Analysis Difficulty Level: HARD

Question 17 Question Type: Multiple Selection Question: In the arena of cultural knowledge, which areas of competencies are important to have to be a culturally competent counselor? a. knowledgeable and informed on a number of culturally diverse groups b. knowledgeable about diverse groups one might work with c. specific knowledge and understanding of generic characteristics of counseling and therapy e. knowledge about sociopolitical background of clients

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f.

knowledge about institutional barriers that prevent some diverse clients from utilizing services

Answer: a, b, c, d, e Solution: In the section on cultural knowledge, the authors list the above competencies that a multiculturally competent therapist must possess. The list is as follows: II. Cultural Competence: Knowledge 1.

Knowledgeable and informed on a number of culturally diverse groups, especially groups with whom therapists work.

2.

Knowledgeable about the sociopolitical system’s operation in the United States with respect to its treatment of marginalized groups in society.

3.

Possess specific knowledge and understanding of the generic characteristics of counseling and therapy.

4.

Knowledgeable of institutional barriers that prevent some diverse clients from using mental health services (Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 18 Question Type: Multiple Choice Question: As a counselor, what stereotypes, perceptions, and beliefs about culturally diverse groups do you personally and professionally hold that may hinder your ability to form a helpful and effective relationship? This is a question you may ask if you are attempting to develop which component of cultural competence? a. cognitive empathy b. skills c. knowledge d. awareness Answer: d Solution: Awareness is the aspect of cultural competence development that involves an understanding of stereotypes, perceptions, and beliefs about culturally diverse groups. As the authors have pointed out the therapy session between Dr. D and Gabriella illustrates the importance of cultural awareness and sensitivity in mental health practice.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 19 Question Type: Text Entry Question: The three levels of ___________, ___________ and ___________ are the most important levels of identity to consider when working with a client.

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Answer: individual; group; universal Solution: A holistic approach to understanding personal identity demands that we recognize all three levels of identity: individual (uniqueness), group (shared cultural values and beliefs), and universal (common features of being human). Psychology has historically ignored the group level and prized the individual level, which represents a culture-bound and potentially oppressive practice.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 20 Question Type: Essay Question: Describe some of the implications for clinical practice you have learned from this chapter.

Solution: Sue 8th edition lists several implications; the list includes the following: 1. Know that the definition of multiculturalism is inclusive and encompasses race, culture, gender, religious affiliation, sexual orientation, age, disability, and so on.

2. When working with diverse populations, attempt to identify culture-specific and cultureuniversal domains of helping.

3. Be aware that persons of color, gays/lesbians, women, and other groups may perceive mental illness/health and the healing process differently than do Euro-American men.

4. Do not disregard differences and impose the conventional helping role and process on culturally diverse groups, as such actions may constitute cultural oppression.

5. Be aware that Euro-American healing standards originate from a cultural context and may be culture-bound. As long as counselors and therapists continue to view Euro-American standards as normative, they may judge others as abnormal.

6. Realize that the concept of cultural competence is more inclusive and superordinate than is the traditional definition of clinical competence. Do not fall into the trap of thinking ―good counseling is good counseling.‖ 7. If you are planning to work with the diversity of clients in our world, you must play roles other than that of the conventional counselor.

8. Use modalities that are consistent with the lifestyles and cultural systems of clients.

9. Understand that one’s multicultural orientation, cultural humility, is very important to successful multicultural counseling. (Sue 8th edition) Bloom’s Level: Synthesis and Evaluation Difficulty Level: HARD

Question 21 Question Type: True/False Question: Most of the psychological research has been conducted on 5% of the world’s population.

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Answer: True Solution: In what Sue 8th edition describes as hard-hitting article, Arnett (2009) as cited in Sue 8th edition) indicates that psychological research, which forms the knowledge base of our profession, focuses on Americans who constitute only 5% of the world’s population. Arnett concludes that the knowledge of human behavior neglects 95% of the world’s population and is an inadequate representation of humanity (Arnett, 2009, as cited in Sue 8th edition).

Additionally, the concepts of counseling and psychotherapy are uniquely Euro-American in origin, as they are based on certain philosophical assumptions and values that are strongly endorsed by Western civilizations. On one side are beliefs that people are unique and that the psychosocial unit of operation is the individual.

On the other side are beliefs that clients are the same and that the goals and techniques of counseling and therapy are equally applicable across all groups. This latter approach, taken to the extreme, nearly assumes that persons of color, for example, are White, and that race and culture are insignificant variables in counseling and psychotherapy (D. W. Sue, 2010, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 22 Question Type: Multiple Selection Question: Identify some of the ways a culturally competent counselor may supplement the conventional role of therapy. a. having a more active helping style b. being focused on changing environmental conditions rather than focus on changing the client c. serving as a consultant d. serving as a change agent e. serving as a teacher or advocate Answer: a, b, c, d, e Solution: The authors state that if you are planning to work with the diversity of clients in our world, you must play roles other than that of the conventional counselor. They add that part of cultural competence involves systemic intervention, such roles as consultant, change agent, teacher, and advocate supplement the conventional role of therapy.

Bloom’s Level: Knowledge Difficulty level: EASY

Question 23 Question Type: Multiple Choice Question: The inclusive definition of multiculturalism believes that: a.

Race is the only reference group included in the definition.

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b. c. d.

Culture is the only reference group included in the definition.

Reference groups related to race, ethnicity, sexual orientation, gender, age, and socioeconomic status are included in the definition.

None of the above.

Answer: c Solution: Sue 8th edition postulates that multiculturalism should not just focus on race. They say that a number of psychologists have indicated that an inclusive definition of multiculturalism (one that includes gender, ability/disability, sexual orientation, and so forth) can obscure the understanding and study of race as a powerful dimension of human existence (Carter, 2005; Helms & Richardson, 1997, as cited in Sue 8th edition).

They add, however, that this stance is not intended to minimize the importance of the many cultural dimensions of human identity but rather emphasizes the greater discomfort that many psychologists experience in dealing with issues of race rather than with other sociodemographic differences (D. W. Sue, Lin, Torino, Capodilupo, & Rivera, 2009, as cited in Sue 8th edition).

Bloom’s Level: Application Difficulty level: MEDIUM

Question 24 Question Type: Text Entry Question: The term ___________ ___________is the ability to engage in actions or create conditions that maximize the optimal development of client and client systems.

Answer: cultural competence Solution: The explanation provided by Sue 8th edition encompasses multicultural counseling and therapy as both a helping role and a process that uses modalities and defines goals consistent with the life experiences and cultural values of clients. It recognizes client identities to include individual, group, and universal dimensions and advocates the use of universal and culturespecific strategies and roles in the healing process. This balances the importance of individualism and collectivism in the assessment, diagnosis, and treatment of client and client systems. Thus, Sue 8th edition summarizes that cultural competence is the ability to engage in actions or create conditions that maximize the optimal development of client and client systems.

Bloom’s Level: Analysis Difficulty Level: HARD

Question 25 Question Type: Essay Type Question: Define the difference between cultural competence and cultural humility.

Solution: The authors report that cultural humility appears more like a ―way of being‖ rather than a ―way of doing,‖ which has characterized cultural competence (Owen, Tao, Leach, &

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Rodolfa, 2011 as cited in Sue 8th edition). To clarify the difference, with ―cultural competence‖ the authors are referring to the virtues and dispositions inherent in the attitudes that counselors hold toward their clients. Whereas ―cultural humility‖ refers more to the acquisition of knowledge and skills used in working with clients. This includes the attitudinal components of respect for others, an egalitarian stance, and diminished superiority over clients means an ―otherorientation‖ rather than one that is self-focused (concern with one’s expertise, training, credentials, and authority).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 26 Question Type: True/False Question: Effectiveness is most likely enhanced when the therapist uses therapeutic modalities and defines goals that are consistent with the life experiences and cultural values familiar to the counselor.

Answer: False Solution: Effectiveness is most likely enhanced when the therapist uses therapeutic modalities and defines goals that are consistent with the life experiences and cultural values of the client.

Bloom’s level: Application Difficulty level: MEDIUM

Question 27 Question Type: Multiple Selection Question: A culturally competent counselor should be able to a. generate a wide variety of verbal and nonverbal helping responses b. communicate (send and receive both verbal and nonverbal messages) accurately and appropriately. c. exercise institutional intervention skills on behalf of clients when appropriate d. anticipate the impact of their helping styles and of their limitations on culturally diverse clients e. play helping roles characterized by an active systemic focus, which leads to environmental interventions Answer: a, b, c, d, e Solution: Each of these cultural competence skills are provided in the textbook.

1. Able to generate a wide variety of verbal and nonverbal helping responses.

2. Able to communicate (send and receive both verbal and nonverbal messages) accurately and appropriately.

3. Able to exercise institutional intervention skills on behalf of clients when appropriate.

4. Able to anticipate the impact of their helping styles and of their limitations on culturally diverse clients.

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5. Able to play helping roles characterized by an active systemic focus, which leads to environmental interventions. Not restricted by the conventional counselor/therapist mode of operation.

Sources: D. W. Sue et al. (1992; 1998). Readers are encouraged to review the original 34 multicultural competencies, which are fully elaborated in both publications. D. W. Sue et al.

(1992; 1998, as cited in Sue 8th edition). The authors note that readers are encouraged to review the original 34 multicultural competencies, which are fully elaborated in both publications.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 28 Question Type: Multiple Choice Question: A holistic approach to personal identity demands that we recognize levels of identity to include a. familial, societal, and group b. individual, group, and universal c. cultural, group, and universal d. individual, group, and vocational Answer: b Solution: It is possible to conclude that all people possess individual, group, and universal levels of identity. A holistic approach to understanding personal identity demands that we recognize all three levels: individual (uniqueness), group (shared cultural values and beliefs), and universal (common features of being human). Because of the historical scientific neglect of the group level of identity, the Sue and Sue (2016) text focuses primarily on the group category.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 29 Question Type: Text Entry Question: According to the Multicultural and Social Justice Counseling Competencies (MSJCC), multiculturalism leads to _________ ___________ initiatives and actions.

Answer: social justice Solution: Sue 8th edition reports that recently, the Multicultural Counseling Competencies Revision Committee of the American Counseling Association (Ratts, Singh, Nassar-McMillan, Butler, & McCullough, 2015, as cited in Sue 8th edition) has presented an important draft document. The Multicultural and Social Justice Counseling Competencies (MSJCC) proposes to revise the multicultural counseling competencies devised by D. W. Sue et al. (1992). As will be indicated in Chapter 4, the heart of the revision is integration of social justice competencies with multicultural competencies. Acknowledging that multiculturalism leads to social justice initiatives and actions, it is proposed that a conceptual framework that includes quadrants

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(privilege and oppressed statuses), domains (counselor self-awareness, client worldview, counseling relationships, and counseling and advocacy interventions), and competencies (attitudes and beliefs, knowledge, skills, and action).

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 30 Question Type: Essay Type Question: Name and define the three components of cultural competence.

Solution: The three components of cultural competence are: (a) attitudes/beliefs component—an understanding of one’s own cultural conditioning that affects the personal beliefs, values, and attitudes of a culturally diverse population; (b) knowledge component—understanding and knowledge of the worldviews of culturally diverse individuals and groups; and (c) skills component—an ability to determine and use culturally appropriate intervention strategies when working with different groups in our society.

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 31 Question Type: True/False Question: The individual and group levels have traditionally been the focus of psychology, and mental health professionals in particular.

Answer: False Solution: Psychology—and mental health professionals in particular—have generally focused on either the individual or the universal levels of identity, placing less importance on the group level. There are several reasons for this orientation. First, our society arose from the concept of rugged individualism, and we have traditionally valued autonomy, independence, and uniqueness. Second, the universal level is consistent with the tradition and history of psychology, which has historically sought universal facts, principles, and laws in explaining human behavior.

Bloom’s Level: Comprehension Difficulty Level: EASY Question 32 Question Type: Multiple Selection Question: What are some of the attitudinal components of respect for others? a. egalitarian stance b. diminished superiority c. ethnocentricism d. other orientation

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e. self focus Answer: a, b, d Solution: The authors refer to the attitudinal components of respect for others, an egalitarian stance, and diminished superiority over clients means an ―other-orientation‖ rather than one that is self-focused (concern with one’s expertise, training, credentials and authority).

Bloom’s Level: Application Difficulty level: MEDIUM

Question 33 Question Type: Multiple Choice Question: The authors define cultural competence as the ability to engage in actions or create conditions that a. maximize independence form dominant society and inherent racism b. maximize the optimal development of client and client systems c. maximize acculturation into dominant society for optimum functioning d. all of the choices are correct Answer: b Solution: The authors postulate that to be an effective multicultural helper requires cultural competence. They define cultural competence as the ability to engage in actions or create conditions that maximize the optimal development of client and client systems.

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 34 Question Type: Multiple Choice Question: From what point of view do culturally responsive psychologists operate? a. etic b. emic c. cultural distress d. collectivistic awareness Answer: b Solution: Many culturally responsive psychologists operate from an emic position. They argue that lifestyles, cultural values, and worldviews affect the expression and determination of behavior disorders (Ponterotto, Utsey, & Pedersen, 2006). They stress that all theories of human development arise within a cultural context and that using the EuroAmerican values of normality and abnormality may be culture-bound and biased (Locke & Bailey, 2014).

Bloom’s Level: Comprehension Difficulty Level: EASY

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Question 35 Question Type: Essay Question: Differentiate between cultural universality and cultural relativism.

Solution: Proponents of cultural universality focus on disorders and their consequent treatments and minimize cultural factors, whereas proponents of cultural rela- tivism focus on the culture and on how the disorder is manifested and treated within it. Both views have validity. It would be naive to believe that no disorders cut across different cultures or share universal characteristics. Likewise, it is naive to believe that the relative frequencies and manners of symptom formation for various disorders do not reflect the dominant cultural values and lifestyles of a society.

Bloom’s Level: Application Difficulty Level: MEDIUM

Chapter 3: Multicultural Counseling Competence for Counselors and Therapists of Marginalized Groups Test Questions Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 3 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will also find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Question 1 Question Type: True/False Question: According to the authors, minority therapists working with White clients should avoid acknowledging their racial differences because it can cause tension and division.

Answer: False Solution: Self-disclosure, or the acknowledgment of differences, may increase feelings of similarity between therapist and client and reduce concerns about differences.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 2 Question Type: Multiple Choice

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Question: The client becomes a symbol of the inherent mistrust that exists in majority-minority relationships is a characteristic of which challenge associated with counseling White clients? e. dealing with expressions of racist attitudes/beliefs/behaviors f. transferring racial animosity to White clients g. having the competency of the counselor of color challenged h. unrealistically viewing the therapist of color as a Super Minority therapist Answer: b Solution: Because counselors of color can have a countertransference reaction whereby their feelings of animosity and anger toward White supremacy are directed at White clients.

Therefore, viewing the client with mistrust is a characteristic of transferring animosity to White clients.

A is incorrect because this challenge involves conscious or unconscious actions or statements on the part of the client.

C is incorrect because this challenges involves the conscious or unconscious beliefs of the client that the therapist is not competent enough.

D is incorrect because this challenge takes place when the client places unrealistic expectations and beliefs upon the minority therapist.

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 3 Question Type: Essay Type Question: Discuss one reason why some scholars and researchers have avoided discussing the types of discrimination that may occur between different groups of color.

Solution: (1) Historically, there were smaller numbers of people of color, and because of their small numbers, recognizing and/or publicizing interracial conflict could be a barrier to progress against racism and civil rights. (2) People of color may have difficulty admitting to their biases or stereotypes about other groups because of their unwillingness to admit to their own prejudices.

Some people of color believe they are incapable of discrimination because they themselves have been racially victimized. Additional acceptable answers include: people of color become wary about discussing interethnic conflict out of fear that such problems will be used by those in power to (a) assuage their own guilt feelings and excuse their own racism, (b) divide and conquer ―as long as people of color fight among themselves, they can’t form alliances to confront the establishment,‖ and (c) divert attention away from the injustices of society by defining problems as residing between minority groups.

Bloom’s Level: Comprehension Difficulty Level: HARD

Question 4 Question Type: True/False

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Question: Only White individuals need to learn cultural competence.

Answer: False Solution: Cultural competence is not just majority group members. All individuals are capable of biases, assumptions and beliefs that can prevent their development toward cultural competence.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 5 Question Type: Multiple Choice Question: Familismo refers to a. a high value placed on the role of the paternal caregiver b. focus on the individualism of each family member c. a high value placed on the family and individual roles d. a high value placed on family loyalty and unity Answer: d Solution: D is the correct response. As defined in collectivist Latino families familismo is a strong value that places emphasis on family loyalty and unity. A is incorrect as it is not one person but the whole family that is valued. B is incorrect as it is a White Eurocentric value. C is incorrect as this is more of a White Majority view.

Bloom’s Level: Comprehension Difficulty level: EASY

Question 6 Question Type: Essay Type Question: Provide one challenge situation that can arise when counselors of color work with White clients.

Solution: There are five possible situations that represent challenges associated with counseling White clients: (1) having the competency of the therapist of color challenged, (2) needing to prove competence, (3) transferring racial animosity to White clients, (4) unrealistically viewing the therapist of color as a Super Minority therapist, and (5) dealing with expressions of racist attitudes/beliefs/behaviors.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 7 Question Type: True/False

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Question: The myth of the ―model minority‖ has often played into major misunderstandings between Black and Asian communities.

Answer: True Solution: The myth of the ―model minority‖ has perpetuated the success myth and belief that Asians are somehow immune to prejudice and racism. These false stereotypes of Asian Americans have often played into major misunderstandings between the Black and Asian American communities.

Bloom’s Level: Knowledge Difficulty Level: HARD

Question 8 Question Type: Multiple Choice Question: With regard to cultural competence, greater emphasis has been placed on the education of White trainees because a.

There are more mental health professionals of color than White. b.

Most theories and practices in psychology arise from a White, Western perspective. c.

Increasing numbers of minority members are controlling the gateways to the delivery of mental health services to socially devalued client populations. d.

None of the choices is correct.

Answer: b Solution: B is the correct response because the theories and practices of counseling/therapy arise from a predominantly White, western perspective and form the educational foundations of our graduate programs.

A is incorrect because the majority of mental health providers are White or members of the majority group.

C is incorrect because White, male, and straight Euro-Americans continue to control and hold power in being able to determine normality‒abnormality and to define mental health reality for marginalized groups.

Bloom’s Level: Synthesis Difficulty Level: MEDIUM

Question 9 Question Type: Essay Type Question: Name one cultural value that can cause a potential conflict between therapist and client.

Solution: The section on encountering clashes in cultural values provides the following examples: (a) Asian Americans prizing more subtle and indirect communication than White Americans, and (b) Asian Americans valuing restraint of strong emotions versus Latino/as and African Americans, who often prize strong affect, passion, and emotional closeness.

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Bloom’s Level: Synthesis Difficulty Level; HARD

Question 10 Question Type: True/False Question: While a Black American therapist may value sitting close to an Asian American client in therapy, this client may feel the close conversing distance to be an intrusion of personal space.

Answer: True Solution: Black Americans tend to have a much closer conversing distance with one another than Asian Americans.

Bloom’s Level: Comprehension Difficulty Level: EASY Question 11 Question Type: Multiple Choice Question: Most of the articles in the field of psychology that focus on interracial interactions between Asian, Black, Native, and Latino/a Americans concentrate mainly on a. interracial romantic relationships b. historical interracial conflict c. interracial therapeutic relationships d. a and b Answer: b Solution: Most articles in the field of psychology that focus on interracial interactions between counselors and clients of different racial/ethnic minority groups with a focus on historical interracial conflict. This may falsely convey that there is limited tension between groups of color and that discrimination and stereotyping does not occur between these groups.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 12 Question Type: True/False Question: Whites think they are treated far worse than Blacks and worse than other minority groups when it comes to getting equal treatment in applying for mortgages, in the media, and in job promotions.

Answer: FALSE Solution: Blacks think they are treated far worse than Whites and worse than other minority groups when it comes to getting equal treatment in applying for mortgages, in the media, and in job promotions.

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Bloom’s Level: Comprehension Difficulty Level: EASY

Question 13 Question Type: Multiple Choice Question: Which culture(s)’ communication styles change depending on the varying levels of authority between two people: a.

African American b.

Native American c.

Latino American d.

White American e. b and c Answer: e Solution: E is the correct answer as both Native American and Latino American cultures vary their communication based on the authority between two people.

A is incorrect because African American communication style tends to be direct, passionate, and forthright.

D is incorrect as White Americans value egalitarianism, where children are encouraged to freely express their thoughts and feelings.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 14 Question Type: Text Entry Question: In a dyad where the counselor and client are both from marginalized groups, overidentification is manifested through ____________.

Answer: countertransference Solution: Overidentification with clients of color, whether with in-group or outgroup dyadic counseling racial relationships, is often manifested through countertransference. Although it is accepted that the transference of symbolic feelings, thoughts, and experiences of the client of color can occur in relation to the counselor, an equally powerful countertransference can occur from therapist to client, especially in interracial and interethnic dyadic combinations.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 15 Question Type: Multiple Choice Question: When working with White clients, a counselor of color is likely to operate in a

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situation of a. power reversal b. a power relationship that is congruent c. oppressor–oppressed d. overidentification with the client Answer: a Solution: A is the correct answer because a counselor of color is likely to operate in a situation of power reversal.

B is incorrect because when the counselor is White and the client is a person of color, the power relationship is congruent with historical and sociopolitical racial roles and structures in our society.

C is incorrect as it is a Majority to Minority viewpoint.

D is incorrect as it is a position that a counselor of color would take with a client of color.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 16 Question Type: Multiple Choice Question: A traditional Native American client may a. prefer talk therapy b. be more comfortable with a therapist that emphasizes Western practices c. value spiritual healing or indigenous practices d.

None of the choices is correct.

Answer: c Solution: C is the correct response because traditional Native Americans may view Westernized practices as ineffective in comparison to spiritual healing or indigenous practices.

A is incorrect because traditional Native Americans may view talk therapy, a traditional Western practice, as ineffective.

B is incorrect because Native Americans who value nontraditional counseling practices may not seek or continue therapy if the counselor does not recognize alternatives to Western practices.

Bloom’s Level: Comprehension Difficulty Level: HARD

Question 17 Question Type: Multiple Choice Question: An African American therapist is working with an Asian American therapist who seems reluctant to discuss her feelings about a recent death in her family. The therapist determines that the client is unfeeling and resistant. This is an example of a. encountering clashes in cultural values. b. receiving and expressing racial animosity.

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c. d.

dealing with the stage of the racial identity of counselors and clients.

None of the choices is correct.

Answer: a Solution: A is the correct response because there is a clash between the Asian American’s cultural value of restraint of strong feelings and the African American’s cultural valuing of expression of affect and passion.

B is incorrect because receiving racial animosity refers to clients of color viewing therapists of color as ―sell outs‖ or untrustworthy.

C is incorrect because the given scenario is unrelated to racial identity issues.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 18 Question Type: Multiple Choice Question: Which of the following is characteristic of transferring racial animosity toward White clients? a. being unable to form a working alliance b. having difficulty in being empathic c. falling into the ―omnipotent‖ trap d. a and b Answer: d Solution: D is the correct response because when counselors of color transfer racial animosity to White clients, they have difficulty establishing rapport and feeling empathy.

C is incorrect because counselors of color need to avoid falling into the omnipotent trap when White clients view them as a super minority therapist.

Bloom’s Level: Synthesis Difficulty Level: MEDIUM

Question 19 Question Type: Multiple Choice Question: Therapists of color who operate from their own worldview without awareness of different worldviews held by other clients of color may be guilty of a. culture clash scenarios b. cultural empowerment c. cultural oppression d. cultural hostility Answer: c Solution: C is the correct answer because the counselor may be imposing their values and standards upon culturally diverse clients.

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A is incorrect because it refers different communication styles demonstrated within and between cultures.

B is incorrect because it in no way empowers the client due to the counselor imposing their worldview upon them.

D is incorrect because cultural hostility refers to demonstrations of oppression.

Bloom’s Level: Synthesis Difficulty Level: MEDIUM

Question 20 Question Type: Multiple Choice Question: The author warns readers contextualize the views when an ethnic minority experiences strong feelings related to racial issues because a.

The person is most likely misdirecting feelings toward White supremacy onto White people. b.

These reactions are likely the result of cumulative years of prejudice and discrimination. c. a and b d.

People of color are not capable of discrimination and bias.

Answer: c Solution: C is the correct response because the author states both A and B as reasons not to ―blame the victim‖ when an ethnic minority has strong and emotive feelings about racial issues.

A is incorrect as a singular answer because B is also correct.

B is incorrect as a singular answer because A is also correct.

D is incorrect because people of color are capable of bias and discrimination.

Bloom’s Level: Knowledge Difficulty Level: EASY Chapter 4: The Political and Social Justice Implications of Counseling and Psychotherapy Test Questions Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 4 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Question 1 Question Type: True/False Question: Minority clients most likely terminate prematurely from therapy sessions because they realize they actually do not need the help.

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Answer: False Solution: Researchers hypothesize that minority-group individuals underutilize and prematurely terminate counseling/therapy because of the biased nature of services.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 2 Question Type: Multiple Choice Question: Which of the following is NOT a relevant question for counselors to ask? a.

When counseling culturally diverse clients, how does one reconcile such major differences in worldviews? b.

As a helping professional, what emotional reactions around ―race‖ do you possess that may act as a barrier to effective multicultural counseling? c.

What explains the perseverance of the belief among members of certain sociodemographic categories that they are undergoing oppression in the United States? d.

How might the unconscious biases of helping professionals affect their ability to deliver culturally appropriate mental health services to marginalize groups? e.

All of the choices are correct. f.

None of the choices is correct.

Answer: c Solution: C is the correct response because it places blame on people for their own oppression.

A is incorrect because it is important to grapple with reconciliation of worldviews.

B is incorrect because it is important to understand personal reactions around the topic of race.

D is incorrect because it is important to understand unconscious biases.

Bloom’s Level: Analysis Difficulty Level: HARD

Question 3 Question Type: Text Entry Question: To be culturally competent means to understand the _______ of ___________ experienced by marginalized groups in our society.

Answer: history of oppression Solution: In the section covering the mental health impact of sociopolitical oppression, the authors write that multicultural counseling/therapy means understanding the worldviews and life experience of diverse groups in our nation. To be culturally competent means to understand the history of oppression experienced by marginalized groups in our society. These stories of discrimination and pain of the oppressed are often minimized and neglected. Many contend that the reality of racism, sexism, and homophobia is relatively unknown or ignored by those in power because of the discomfort that pervades such topics.

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Bloom’s Level: Knowledge Difficulty Level: EASY

Question 4 Question Type: Essay Type Question: Name four of the seven basic principles related to social change and social justice counseling.

Solution: Principle 1: A failure to develop a balanced perspective between person and system focus can result in false attribution of the problem.

Principle 2: A failure to develop a balanced perspective between person and system focus can result in an ineffective and inaccurate treatment plan potentially harmful toward the client.

Principle 3: When the client is the ―organization‖ or a larger system and not an ―individual,‖ it requires a major paradigm shift to attain a true understanding of problem and solution identification.

Principle 4: Organizations are microcosms of the wider society from which they originate. As a result, they are likely to be reflections of the monocultural values and practices of the larger culture.

Principle 5: Organizations are powerful entities that inevitably resist change and possess many ways to force compliance among workers. Going against the policies, practices, and procedures of the institution, for example, can bring about major punitive actions.

Principle 6: When multicultural organizational development is required, alternative helping roles that emphasize systems intervention and advocacy skills must be part of the role repertoire of the mental health professional.

Principle 7: Although remediation will always be needed, prevention is better. Conventional practice at the micro level continues to be oriented toward remediation rather than prevention.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 5 Question Type: True/False Question: Graduate programs tend to shy away from teaching about antiracism because there is a limited amount of literature on the topic.

Answer: False Solution: A major criticism is that training programs leave out antiracism curricula for fear that they require students to confront their harmful and detrimental attitudes toward race.

Bloom’s Level: Application Difficulty Level: EASY

Question 6

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Question Type: Multiple Choice Question: Preparing counselors with multicultural expertise means a. revamping our training programs to include accurate and realistic multicultural content and experiences b. developing multicultural competencies as core standards for our profession c. providing continuing education for our current service providers d.

All of the choices are correct. e.

None of the choices is correct.

Answer: d Solution: All of the choices are correct because preparing counselors with multicultural expertise means revamping our training programs to include accurate and realistic multicultural content and experiences, developing multicultural competencies as core standards for our profession, and providing continuing education for current service providers.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 7 Question Type: Essay Type Question: What does the term cultural deprivation mean?

Solution: The term is used to indicate that many groups perform badly on tests or exhibit deviant characteristics because they lack many of the advantages of middle-class culture.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 8 Question Type: True/False Question: An effective curriculum should allow students to understand feelings of helplessness and powerlessness.

Answer: True Solution: The authors posit that an effective curriculum must enable students to understand feelings of helplessness and powerlessness, low self-esteem, and poor self-concept and how they contribute to low motivation, frustration, hate, ambivalence, and apathy.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 9 Question Type: Multiple Selection

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What components of content should multicultural curriculum include? a. a consciousness-raising component b. an experiential component c. a knowledgeable component d. a skills component Answer: a, b, c, d Solution: Each course in the curriculum should contain (a) a consciousness-raising component, (b) an affective/experiential component, (c) a knowledge component, and (d) a skills component.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 10 Question Type: Multiple Choice Question: Multicultural counseling and psychotherapy assumes a.

Western therapy does not oppress people of color. b.

What happens in the therapist’s office may represent a microcosm of race relations in the larger society. c.

So-called psychological problems of minority groups may reside not within but outside of our clients. d. b and c e.

None of the above Answer: d Solution: D is the correct response because what happens in the therapist’s office may in fact represent a microcosm of race relations in larger society, and the so-called psychological problems of minority groups may reside not within but outside of clients.

A is incorrect because Western therapy does oppress people of color.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 11 Question Type: Text Entry Question: The foci of counseling interventions include the ____________, _____________, _____________, and ____________________.

Answer: individual; professional; organizational; societal Bloom’s Level: Knowledge Difficulty Level: EASY

Question 12 Question Type: Essay Type

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Question: Define the Genetically Deficient model and provide one example of its use in the social science literature.

Solution: The Genetically Deficient model refers to the belief that race and gender dictate intelligence. The belief that Whites have bigger brains than Blacks is one such example.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 13 Question Type: Multiple Choice Question: Some researchers have argued that minority-group individuals underutilize and prematurely terminate counseling/therapy because a. of the biased nature of the services themselves b. they do not know where to locate services c. services are too accommodating d. mental health professionals are too culturally competent Answer: a Solution: A is the correct response because research indicates that minority-group individuals underutilize and prematurely terminate counseling because of the biased nature of the services themselves.

B is incorrect because while some people may not know where to locate services, it is not the primary reason.

C is incorrect because research does not indicate that services are too accommodating.

D is incorrect because research does not indicate that mental health professionals are too culturally competent.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 14 Question Type: Essay Type Question: Discuss the mental health impact of sociopolitical oppression and how the minimization of discrimination and pain of marginalized groups has manifested through political policies.

Solution: Responses will vary, but the authors discuss how many contend that the reality of racism, sexism, and homophobia is relatively unknown or ignored by those in power because of the discomfort that pervades such topics among people of every political persuasion. Examples are Jordan’s analogy of the September 11 terrorist attacks and racism directed toward African Americans, the Tuskegee experiment, and the Black Lives Matter movement.

Bloom’s Level: Synthesis

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Difficulty Level: HARD

Question 15 Question Type: Essay Type Question: The authors posit that higher scores among African Americans on paranoia inventories do not necessarily indicate abnormality. Instead, what do they suggest?

Solution: The personality test that reveals Blacks as being suspicious, mistrustful, and paranoid needs to be understood from a larger sociopolitical perspective. Minority groups who have consistently been victims of discrimination and oppression in a culture that is full of racism have good reason to be suspicious and mistrustful of White society. In their classic book Black Rage, Grier and Cobbs (1968) point out how Blacks, in order to survive in a White racist society, have developed a highly functional survival mechanism to protect them against possible physical and psychological harm.

Bloom’s Level: Analysis Difficulty Level: HARD

Question 16 Question Type: Essay Type Question: Reflect on your reaction to ―An Open Letter to Brothers and Sisters of Color‖ found on the second page of Chapter 4. Consider the following: What emotions did this letter provoke in you? Do you agree with the author on his position?

Solution: Responses will vary and reflect individual reactions along a spectrum of anger, remorse, guilt and depression to ones of jubilation, relief, justification and validation.

Bloom’s Level: Analysis Difficulty Level: HARD

Question 17 Question Type: Multiple Selection Question: Social justice counseling/therapy has which of the following goals? a. aims to produce conditions that allow for equal access and opportunity b. reduces or eliminates disparities in education, health care, employment, and other areas that lower the quality of life for affected populations c. encourages mental health professionals to consider micro, meso, and macro levels in the assessment, diagnosis, and treatment of clients and client systems d. broadens the role of the helping professional to include not only counselor/therapist but advocate, consultant, psychoeducator, change agent, community worker, and so on.

Answer: a, b, c, d

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Solution: Bell (1997, as cited in Sue 8th edition) proposes that social justice counseling/therapy is an active philosophy and approach aimed at producing conditions that allow for equal access and opportunity; reducing or eliminating disparities in education, health care, employment, and other areas that lower the quality of life for affected populations; encouraging mental health professionals to consider micro, meso, and macro levels in the assessment, diagnosis, and treatment of client and client systems; and broadening the role of the helping professional to include not only counselor/therapist but advocate, consultant, psychoeducator, change agent, and community worker.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 18 Question Type: Essay Type Question: Describe what the authors describe as ―culture bound and biased training system (Mio, 2005; Utsey, Grange, & Allyne, 2006, as cited in Sue 8th edition). What have been some of the results of this tendency?

Solution: Sue 8th edition describes that most graduate programs continue to give inadequate treatment to the mental health issues of persons of color (Ponterotto & Austin, 2005; Utsey et al., 2006, as cited in Sue 8th edition). The cultural influences affecting personality formation, career choice, educational development, and the manifestation of behavior disorders are infrequently part of mental health training or are treated in a tangential manner (Parham, Ajamu, & White, 2011; Vazquez & Garcia-Vazquez, 2003, as cited in Sue 8th edition). Furthermore, when the experiences of socially devalued groups are discussed, they are generally seen and analyzed from the White, Euro-American, middle-class perspective. Additionally, in programs where these experiences have been discussed, the focus tends to be on pathological lifestyles and/or maintenance of false stereotypes.

The result is that professionals who deal with mental health problems of people of color lack understanding and knowledge about ethnic values and their consequent interaction with a racist society. Second, the mental health practitioners are graduated from our programs believing that persons of color are inherently pathological and that therapy involves a simple modification of traditional White models.

Bloom’s Level: Analysis Difficulty Level: HARD

Question 19 Question Type: True/False Question: The main thesis of this book is that counseling and psychotherapy take place in a vacuum and the larger sociopolitical influences of our societal climate should not be a factor.

Answer: False

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Solution: The main thesis of this book is that counseling and psychotherapy do not take place in a vacuum, isolated from the larger sociopolitical influences of our societal climate. Multicultural counseling often mirrors the nature of race relations in the wider society as well as the dominantsubordinate relationships of other marginalized groups.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 20 Question Type: Text Entry Question: Those behaviors that occur less frequently is the definition of

.

Answer: abnormality Solution: Abnormality is defined in terms of those behaviors that occur least frequently.

Bloom’s Level: Comprehension Difficulty Level: EASY Chapter 5: The Impact of Systemic Oppression within the Counseling Process Test Questions Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 5 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Question 1 Question Type: True/False Question: Being White may serve as a barrier to an effective therapeutic process.

Answer: True Solution: While the therapist may be possessed of the most admirable motives, the client may reject the helping professional simply because he or she is White.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 2 Question Type: Multiple Choice

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Question: What is the key element that can destroy trustworthiness within a helping relationship? a. agreeableness b. defensiveness c. insight d. expertness Answer: b Solution: B is the correct response because defensiveness on the counselor’s part can signal to the client that he she is not culturally competent.

A is incorrect because agreeableness has nothing to do with building trust.

C is incorrect because insight has nothing to do with building trust.

D is incorrect because expertness can build trust.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 3 Question Type: Essay Type Question: Define ethnocentric monoculturalism.

Solution: The authors describe that ethnocentric monoculturalism refers to a belief in the superiority of one group’s cultural heritage over another and the imposition of those standards upon the less powerful group.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 4 Question Type: True/False Question: Theories of counseling and psychotherapy and standards to judge normality and abnormality have been largely adapted to reflect the changing microcosm of society.

Answer: False Solution: According to Sue 8th edition, the theories of counseling and psychotherapy, the standards used to judge normality–abnormality and the actual process of mental health practice are culture bound and reflect a monocultural perspective of the helping professions (Highlen, 1994; J. M. Jones, 2010, as cited in Sue 8th edition). They are often culturally inappropriate and antagonistic to the lifestyles and values of diverse groups in our society. Some mental health professionals assert that counseling and psychotherapy may be ―handmaidens of the status quo,‖ instruments of oppression and transmitters of society’s values (Halleck, 1971; Thomas & Sillen, 1972, as cited in Sue 8th edition).

Bloom’s Level: Application Difficulty Level: MEDIUM

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Question 5 Question Type: Multiple Choice Question: Which is an example of the historical manifestation of ethnocentric monoculturalism? a.

The signers of the Declaration of Independence were all White men. b.

European immigrants escaping persecution did not recognize their role in the oppression of American Indians. c.

Textbooks on history often put too much emphasis on the importance of other countries. d.

European immigrants considered American Indians to be different culturally but equal in rights.

Answer: b Solution: B is the correct response because ethnocentric monoculturalism refers to the values, assumptions, beliefs and practices of our society that are structured in such a manner as to serve only one narrow segment of the population, and as such, this perspective would dictate that those Europeans who escaped persecution did not understand their role in the oppression of American Indians.

A is incorrect because while the fact that the signers of the Declaration of Independence were all White men came about through a Eurocentric society, that fact is not explicitly fit into the definition of ethnocentric monoculturalism.

C is incorrect because U.S. textbooks often do not place emphasis on other countries.

D is incorrect because Europeans did not view American Indians as equal.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 6 Question Type: Multiple Choice Question: To survive slavery, African Americans often adopted a pattern of a. ignoring the thoughts of others b. expressing aggression directly c. revealing their true self only to fellow Blacks d.

All of the choices are correct.

Answer: c Solution: C is the correct response because to survive slavery, Blacks could only trust other Blacks, as revealing true feelings to people outside of their race could have had devastating consequences.

A is incorrect because Blacks could not afford to ignore the thoughts of others and had to respond accordingly.

B is incorrect because Blacks could have been severely punished or killed if they expressed any aggression.

Bloom’s Level: Synthesis Difficulty Level: HARD

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Question 8 Question Type: Essay Type Question: Describe how worldview may or may not affect the client’s view of the counselor’s attractiveness and credibility. Why is this important for building rapport?

Solution: The authors report that counselors who are perceived by their clients as credible (expert and trustworthy) and attractive (similar) are better able to establish rapport with them than those therapists lacking such attributes (Heesacker & Carroll, 1997 as cited by Sue 8th edition).

Regardless of the respective counseling orientation (psychodynamic, humanistic, behavioral, etc.), therapists’ effectiveness depends on client perceptions of their expertness, trustworthiness and attractiveness. However, most studies on social influence and counseling, have dealt exclusively with a White population (Heesacker, Conner, & Pritchard, 1995; Strong, 1969, as cited in Sue 8th edition). Therefore, counselor attributes traditionally associated with credibility and attractiveness may not be so perceived by culturally diverse clients. The authors add that it is entirely possible that credibility, as defined by professional credentials or advanced degrees, might only indicate to a Latino/a client that the White therapist has no knowledge or expertise in working with Latinos. It seems important, therefore, for helping professionals to understand what factors/conditions may enhance or negate counselor credibility and attractiveness when working with diverse clients.

Bloom’s Level: Synthesis Difficulty: HARD

Question 9 Question Type: True/False Question: A culturally effective counselor is open to viewing problems as stemming from survival mechanisms.

Answer: True Solution: A culturally effective counselor is open to viewing problems stemming from survival mechanisms.

Bloom’s Level: Application Difficulty: MEDIUM

Question 10 Question Type: Multiple Choice Question: The statement that clients are responsible for their own actions and predicaments represents a.

White male middle-class values b. collectivistic cultural values

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c. d.

an Afro-centric perspective a multicultural perspective

Answer: a Solution: A is the correct response because individual responsibility is thought to be a White male middle-class value.

B is incorrect because collectivistic cultural values do not view the individual as having sole responsibility for his/her actions—the group is a strong component.

C is incorrect because an Afro-centric value system would take into account the family, community and spirituality in its worldview.

D is incorrect because a multicultural perspective would also consider the environment.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 11 Question Type: True/False Question: Worldview can be defined broadly as how an individual understands his or her race.

Answer: False Solution: The authors define worldviews as being composed of people’s attitudes, values, and beliefs that affect how people think, define events, make decisions, and behave.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 12 Question Type: Essay Type Question: Describe the terms locus of control and locus of responsibility.

Solution: Locus of control refers to people’s beliefs about the degree of control they have over their life circumstance.

Locus of responsibility refers to the degree of responsibility or blame placed on the individual or system.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 13 Question Type: Multiple Choice Question: What type of orientation has characterized counseling practice? a. situation-centered b. person-centered c. counselor-centered

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d.

system-blame

Answer: b Solution: B is the correct response because the person-centered approach has characterized counseling practice.

A is incorrect because situation-centered approaches have not characterized counseling practice.

C is incorrect because counselor-centered approaches have not characterized counseling practice—in fact, it is not an approach.

D is incorrect because system-blame describes external locus of control.

Bloom’s Level: Application Difficulty Level: EASY

Question 14 Question Type: Multiple Choice Question: Early research indicates that African Americans who scored high external on the locus of control a. more often aspired to nontraditional occupations b. were more in favor of group rather than individual action for dealing with discrimination c. engaged in more civil rights activities d. exhibited less innovative social action behavior.

Answer: d Solution: D is the correct response because African Americans who scored high external on the locus of control exhibited less innovative social action behavior because they feel that situations are out of their control.

A is incorrect because African Americans who scored high external on the locus of control did not aspire to nontraditional occupations.

B is incorrect because African Americans who scored high external on the locus of control did not favor group rather than individual action for dealing with discrimination.

C is incorrect because African Americans who scored high external on the locus of control did not engage in more civil rights activities.

Bloom’s Level: Analysis Difficulty Level: HARD

Question 15 Question Type: Multiple Choice Question: U.S. society is characterized by which philosophy? a. internal control (IC)–internal responsibility (IR) b. internal control (IC)–external responsibility (ER) c. external control (EC)–internal responsibility (IR) d. external control (EC)–external responsibility (ER) Answer: a

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Solution: A is the correct response because the United States is high in IC and IR. Bloom’s Level: Comprehension Difficulty Level: EASY

Question 16 Question Type: Multiple Choice Question: The expectation of hopelessness is characterized in which constellation? a.

IC-IR b.

IC-ER c.

EC-IR d.

EC-ER Answer: d Solution: D is the correct response. EC and ER both put control and responsibility outside of the person, which can lead to hopelessness.

Bloom’s Level: Analysis Difficulty Level: HARD

Question 17 Question Type: Multiple Choice Question: Pride in one’s racial and cultural identity is most likely to be accepted by an a.

IC-IR person b.

IC-ER person c.

EC-IR person d.

EC-ER person Answer: b Solution: B is the correct response. The IC-ER person would have pride in one’s identity because control of fate is internal and responsibility is external.

A is incorrect because the IC-IR person would not have pride in one’s identity because control of fate is internal and responsibility is internal.

C is incorrect because the EC-IR person would not have pride in one’s identity because control of fate is external and responsibility is internal.

D is incorrect because the EC-ER person would not have pride in one’s identity because control of fate is external and responsibility is external.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 18 Question Type: Multiple Choice

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Question: A person of color who shows deference to the White counselor most likely has which worldview? a.

IC-IR b.

IC-ER c.

EC-IR d.

EC-ER Answer: d Solution: D is the correct response because a person of color who shows deference to a White counselor would most likely have an external locus of control and responsibility—feeling that Whites must be better than Blacks because everything is out of their control and responsibility.

A is incorrect because and IC-IR Black person would see responsibility and control within him/herself.

B is incorrect because a Black IC-ER person would feel in control but not responsible.

C is incorrect because a Black EC-ER person would not feel in control but responsible.

Bloom’s Level: Analysis Difficulty Level: MEDIUM

Question 19 Question Type: Multiple Choice Question: The authors assert that more and more people of color are coming to hold which worldview? a.

IC-IR b.

IC-ER c.

EC-IR d.

EC-ER Answer: b Solution: B is the correct response because more people of color are developing an IC-ER worldview that is positive because to realize that you are not responsible for racism is good and that one is control of one’s fate is empowering.

A is incorrect because people of color are not becoming more IC-IR. C is incorrect because people of color are not becoming more EC-IR. D is incorrect because people of color are not becoming more EC-ER. Bloom’s Level: Analysis Difficulty Level: HARD

Question 20 Question Type: Multiple Choice Question: Which quadrant is associated with ―I’m okay and have control over myself‖ and ―Society is okay, and I can make it in this system‖? a.

IC-IR

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b. c. d.

IC-ER EC-IR EC-ER

Answer: a Solution: A is the correct response because an IC person would say, ―I’m okay and have control over myself,‖ and an IR person would say, ―Society is okay, and I can make it in this system.‖ B is incorrect because an IC person would say, ―I’m okay and have control over myself,‖ but an ER person would not say, ―Society is okay, and I can make it in this system.‖ C is incorrect because an EC person would not say, ―I’m okay and have control over myself,‖ but an IR person would say, ―Society is okay, and I can make it in this system.‖ D is incorrect because an EC person would not say, ―I’m okay and have control over myself,‖ and an ER person would not say, ―Society is okay, and I can make it in this system.‖ Bloom’s Level: Application Difficulty Level: MEDIUM Chapter 6 Microaggressions in Counseling and Psychotherapy Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 6 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Question 1 Question Type: True/False Question: A person is more likely to engage in overt discrimination when their anonymity is ensured.

Answer: True Solution: One of the conditions under which people are more likely to engage in overt acts of discrimination is when they can be sure they will remain anonymous.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 2 Question Type: Multiple Choice Question: Microaggressions can a. have a detrimental impact upon marginalized groups

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b. c. d. e.

make clients feel uncomfortable and assail their identity make clients feel they are not accepted unless they conform to others’ standards invalidate the client’s experiential reality All of the choices are correct.

Answer: e Solution: E is the correct response because microaggressions have a detrimental impact on marginalized groups, can make clients feel uncomfortable and assail their identity, can make clients feel they are not accepted unless they conform to others’ standards, and invalidate the client’s experiential reality.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 3 Question Type: Essay Type Question: Define and describe microaggressions.

Solution: Microaggressions are ―brief and commonplace daily verbal or behavioral indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative racial slights and insults that potentially have a harmful or unpleasant psychological impact on the target person or group‖ (Sue, Bucceri, Lin, Nadal, & Torino, 2007, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 4 Question Type: True/False Question: Modern homonegativity refers to an antigay sentiment that is based on religious or moral condemnation.

Answer: False Solution: Old-fashioned homonegativity refers to an antigay sentiment that is based on moral or religious condemnation. Modern homonegativity refers to the belief that prejudice against LGBT people no longer exists and this group contributes to its own marginalization by overemphasizing sexual orientation.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 5 Question Type: Multiple Choice

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Question: Microaggressions are often subtle and can be manifested in the following realms EXCEPT: a. verbal b. nonverbal c. visual d. proprioceptive e. behavioral Answer: d Solution: D is the correct response because microaggressions cannot be proprioceptive— pertaining to physical stimulation.

A is incorrect because microaggressions can be verbal.

B is incorrect because microaggressions can be nonverbal.

C is incorrect because microaggressions can be visual.

E is incorrect because microaggressions can be behavioral.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 6 Question Type: Essay Type Question: What does the author Capodilupo (as cited in Sue 8th edition) mean by ―Assumption of Abnormality‖? Provide some examples of how this might present in a counseling scenario.

Solution: Assumption of Abnormality occurs when it is implied that there is something inherently wrong with being LGBT. This may manifest in counseling when discussing the client’s bisexuality, the therapist continues to imply that there is a ―crisis of identity.‖ The message this conveys is that bisexuality represents confusion about the person’s sexual orientation. Another example might be when a lesbian comes in for career counseling, but the therapist continually insists that she needs to discuss her sexuality or it is only a ―phase.‖ The implicit message is that the sexual orientation represents a type of pathology, ―abnormality‖ or an instability.

Bloom’s Level: Analysis Difficulty Level: HARD

Question 7 Question Type: True/False Question: The largest percentage of religious harassment and civil rights violations in America are committed against Jewish and Muslim individuals.

Answer: True Solution: According to the Anti-Defamation League, Jewish and Muslim individuals are targeted more than any other religious group in the United States.

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Bloom’s Level: Knowledge Difficulty Level: EASY

Question 8 Question Type: Multiple Selection Question: What psychological dilemmas have been identified when microaggressions occurs? a. clash of sociodemographic realities b. the invisibility of unintentional expression of bias c. perceived minimal harm of microaggressions d. the Catch-22 of responding to microaggressions Answer: a, b, c, d Solution: All of these four are dilemmas that may occur with microaggressions.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 9 Question Type: Essay Type Question: Describe the ―Catch 22 of responding to microagressions.‖ Solution: As described by the author, the ―dilemma‖ occurs when the recipient is often placed in an unenviable position of deciding what to do. This may be compounded with numerous questions likely to go through the mind of the recipient. For example, they may ask themselves, ―Did what I think happened really happen? If it did really happen, how can I possibly prove it?‖ Or they may ask such questions as: ―How should I respond?‖ or ―Will it do any good if I bring it to the attention of the perpetrator? If I do respond, will it affect my relationship with coworkers, friends, or acquaintances?‖ Moreover, many well-intentioned perpetrators are unaware of the exhausting nature of these internal questions as they sap the spiritual and psychological energy of victims.

Bloom’s Level: Analysis Difficulty Level: HARD

Question 10 Question Type: True/False Question: People are more likely to deny racism or sexism than transphobia.

Answer: True Solution: It is generally considered politically incorrect to be racist or sexist in the United States, but people adhere to gender roles and expectations rather strictly and tend to feel more justified in their transphobic views.

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Bloom’s Level: Knowledge Difficulty Level: EASY

Question 11 Question Type: Essay Type Question: Differentiate between microinsult and microassault. Provide a specific example of each.

Solution: Microassaults refer to a blatant verbal, nonverbal, or environmental attack intended to convey discriminatory and biased sentiments. This is related to overt racism, sexism, heterosexism, ableism, and religious discrimination in which individuals deliberately convey derogatory messages to target groups. Some examples might be referring to people by derogatory terms like spic, faggot, or kyke, or only hiring men for managerial positions.

Microinsults are largely unintentional behaviors or verbal comments that convey rudeness or insensitivity or demean a person’s racial heritage/identity, gender identity, religion, ability, or sexual orientation identity. Despite being outside the level of conscious awareness, these subtle snubs are characterized by an insulting hidden message. One example of this might be when a person frantically rushes to help a person with a disability onto public transportation. The underlying message is that disabled people are in constant need of help and dependent on others.

Bloom’s Level: Analysis Difficulty Level: HARD

Question 12 Question Type: True/False Question: The term racial microaggression was first coined by Derald Wing Sue to refer to daily put-downs that Asian Americans face.

Answer: False Solution: The term racial microaggression was first coined by Chester Pierce to describe daily experiences of African Americans.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 13 Question Type: Multiple Choice Question: Which of the following is NOT a question that would help in understanding the effects of microaggressions? a.

How can people who commit microaggressions be so unaware of their actions? b.

What types of psychological impact do they have on marginalized groups? c.

Why do oppressed groups overreact to unintentional insults that denigrate their way of being?

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d.

What lessons can we learn from a better understanding of the psychological dynamics of microaggressions?

Answer: c Solution: C is the correct response because it is not relevant to ask why oppressed groups would overreact to microaggressions; it assumes that microaggressions are not harmful.

A is incorrect because asking how people who commit microaggressions can be unaware is legitimate.

B is incorrect because microaggressions do psychologically impact marginalized groups.

D is incorrect because lessons can be learned from understanding the psychological dynamics of microaggressions.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 14 Question Type: Multiple Choice Question: Which of the following statements is NOT true about racism? a.

White supremacy and hate crimes are associated with blatant and overt acts of discrimination. b.

Old-fashioned racism has seemingly declined. c.

The nature and expression of racism has evolved into a more subtle and ambiguous form. d.

Racism was eliminated with the social acceptance and legal codification of the goals and values of the civil rights movement.

Answer: d Solution: D is the correct response because racism was not eliminated with the social acceptance and legal codification of the goals and values of the civil rights movement.

A is incorrect because White supremacy and hate crimes are associated with blatant and overt acts of discrimination.

B is incorrect because old-fashioned racism has seemingly declined.

C is incorrect because the nature and expression of racism has evolved into a more subtle and ambiguous form.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 15 Question Type: True/False Question: Ableism has received limited attention in the literature on modern forms of oppression.

Answer: True Solution: Despite the belief that discrimination against people with disabilities is increasing, there is a limited amount of literature about ableism.

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Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 16 Question Type: Multiple Choice Question: Covert sexism is a. unequal yet favorable treatment of women that is conducted in a hidden manner b. acceptable treatment of women that women nonetheless consider to represent ―hidden‖ sexism c. unequal and harmful treatment of women that is conducted in a hidden manner d. inequitable and injurious treatment of women by men that is conducted in an openly hostile manner.

Answer: c Solution: C is the correct response because covert sexism is unequal and harmful treatment of women that is conducted in a hidden manner.

A is incorrect because covert sexism is not favorable.

B is incorrect because covert sexism is unacceptable.

D is incorrect because covert sexism is not done in an openly hostile manner.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 17 Question Type: Multiple Choice Question: Inheriting negative feelings and beliefs about members of marginalized groups is a. avoidable due to the socialization process in the United States b. unavoidable due to biased attitudes and stereotypes that challenge group hierarchy c. unavoidable and inevitable due to the socialization process in the United States d. avoidable due to the lack of critical thinking on the part of the average U.S. citizen Answer: c Solution: C is the correct response because it is unavoidable and inevitable to inherit negative feelings and beliefs about members of marginalized groups due to the socialization process in the United States.

A is incorrect because one cannot avoid inheriting negative feelings and beliefs through socialization.

B is incorrect because inheriting negative feelings in not unavoidable due to biased attitudes and stereotypes that challenge group hierarchy—they do not challenge anything.

D is incorrect because inheriting negative feelings in not avoidable as a result of lack of critical thinking on the part of the average U.S. citizen—that is a stereotype.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

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Question 18 Question Type: Multiple Choice Question: Which of the following is an example of an environmental microaggression? a.

A male coworker has pinups of nude women in his cubicle. b.

All the deans of a university are White males. c.

There is no Braille next to the numbers in an elevator. d.

All of the choices are correct.

Answer: d Solution: D is the correct answer because all of the provided examples are microaggressions that are environmental in nature. Therefore, a, b, and c are incorrect as singular answers.

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 19 Question Type: Multiple Choice Question: Rushing to help a disabled person onto public transportation could potentially signal to them that a.

You believe they cannot help themselves. b.

You see them as chronically dependent. c.

They are unimportant to society. d. a and b Answer: d Solution: D is the correct answer because both a and b are correct: When a person frantically rushes to help a person with a disability, the underlying message is that disabled people are in constant need of help and are dependent on others.

C is incorrect because helping a person with a disability does not convey any message about societal worth or importance.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 20 Question Type: Multiple Choice Question: The statement ―There is only one race: the human race‖ is an example of a.

Ascription of Intelligence b.

Colorblindness c.

Alien in Own Land d.

Assumption of Criminality

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Answer: b Solution: B is the correct answer because statements such as this one indicate that a person does not want to acknowledge race as having important and valid sociocultural implications.

A is incorrect because it refers to assigning intelligence to a person of color or woman based on their race/gender.

C is incorrect because it refers to when Asian Americans and Latino Americans are assumed to be foreign-born.

D is incorrect because it refers to the belief that a person of color is dangerous, criminal, or deviant.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM Chapter 7: Multicultural Barriers and the Helping Professional: The Individual Interplay of Cultural Perspectives Test Questions Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 7 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Question 1 Question Type: True/False Question: Shame is an emotion felt at the group level, whereas guilt is an individual emotion.

Answer: True Solution: According to Sue 8th edition, guilt is an individual affect, whereas shame appears to be a group one (it reflects on the family or group).

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 2 Question Type: Multiple Choice Question: Which of the following has been described as a challenge faced by counselors in treating culturally diverse populations? a. linguistic barriers, because the United States is largely a monolingual society b. to understand the worldviews, cultural values, and life circumstances of clients

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c. d.

to play roles other than that of ―psychotherapist‖ based on the needs of the client All of the choices are correct.

Answer: d Solution: D is the correct response. Challenges faced by counselors in treating culturally diverse populations consist of linguistic barriers because the United States is largely a monolingual society; understanding the worldviews, cultural values and life circumstances of clients; and playing roles other than that of ―psychotherapist‖ based on the needs of the client.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 3 Question Type: Text Entry Question: One definition of ___________ is that it consists of all those things that people have learned to do, believe, value, and enjoy.

Answer: culture Solution: Culture consists of all those things that people have learned to do, believe, value, and enjoy. It is the totality of the ideals, beliefs, skills, tools, customs and institutions into which members of society are born (Ratts & Pedersen, 2014, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 4 Question Type: Multiple Selection Question: Which of the following are components of White culture? a. rugged individualism b. individual has primary responsibility for self c. independence and autonomy highly valued d. individual can control the environments e. all of the above Answer: e Solution: All of the responses are correct and reflect components of the White culture.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 5 Question Type: Essay Type Question: Describe what the YAVIS syndrome is and what effect may it have in working with

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diverse populations?

Solution: Schofield (1964, as cited in Sue 8th edition) has noted that therapists tend to prefer clients who exhibit the YAVIS syndrome: young, attractive, verbal, intelligent, and successful.

The authors state that this preference tends to discriminate against people from different minority groups or those from lower socioeconomic classes.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 6 Question Type: True/False Question: Cognitive behavioral therapy, but not psychodynamic therapy, includes many components of White culture.

Answer: False Solution: Whether the particular theory is psychodynamic, existential, or cognitive behavioral in orientation, a number of multicultural specialists agree that they share common components of White culture in their values and beliefs.

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 7 Question Type: True/False Question: ―Minority standard time‖ refers to the poor people’s tendency to disregard punctuality due to a conflict with their past-focused time orientation.

Answer: False Solution: Minority standard time (Schindler-Rainman, 1967, as cited in Sue 8th edition) is the tendency of poor people to have a low regard for punctuality due to their experiences with endless waits at medical clinics, police stations, and governmental agencies.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 8 Question Type: Multiple Choice Question: Which of the following has been described as the three major categories of cultural barriers that can lead to an ineffective helping relationship with culturally diverse clients? a. racial identity, health variables, and worldview orientation b. culture-bound values, language variables, and class-bound values

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c. d.

culture-bound values, location, and language variables None of the choices is correct.

Answer: b Solution: B is the correct response because cultural-bound (e.g., traditions, nature of people), language, and class-bound values are cultural barriers that can lead to ineffective helping relationships.

A is incorrect because racial identity, health variables, and worldview orientation collectively are not cultural barriers that can lead to ineffective helping relationships.

C is incorrect because culture-bound values, location, and language variables are not cultural barriers that can lead to ineffective helping relationships.

D is incorrect because answer is b.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 9 Question Type: True/False Question: Assertiveness training represents the White cultural value of emotional and behavioral expressiveness.

Answer: True Solution: Assertiveness training reflects a valuing of verbal, emotional, and behavioral expressiveness; these characteristics of counseling are antagonistic to lower-class values and to different cultural values as well. The authors cite Wood and Mallinckrodt (1990), who recommend that in teaching assertiveness skills, gaining these skills is a value shared by the client of color and not being imposed by the therapist.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 10 Question Type: Multiple Choice Question: Which of the following has been described as the most dominant affective expression emphasized by collectivism? a. guilt b. passivity c. shame d. sadness Answer: c Solution: C is the correct response because shame has been identified as the most dominant affective expression emphasized by collectivism.

A is incorrect because guilt is more of an individualistic emotion.

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B is incorrect because passivity is a behavioral characteristic and not an emotion.

D is incorrect because sadness has not been identified as the most dominant affective expression emphasized by collectivism.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 11 Question Type: Essay Type Question: How should a lack of self-disclosure be understood when working with diverse populations?

Solution: Throughout the textbook thus far, the authors have highlighted some of the main differences in self-disclosure among people groups. This chapter elaborates on this, and the authors point out that most forms of counseling and psychotherapy tend to value one’s ability to self-disclose and to talk about the most intimate aspects of one’s life. Self-disclosure has often been discussed as a primary characteristic of a healthy personality. Therefore, clients who do not self-disclose readily in counseling and psychotherapy are seen to possess negative features; that is, being guarded, mistrustful, or paranoid. However, multicultural therapists must recognize that personal self-disclosure in some collectivistic societies is not acceptable because it may reflect poorly on the entire family and bring a collective sense of shame. Previous experiences in some groups may prohibit self-disclosure due to past history of racism.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 12 Question Type: Multiple Choice Question: Nonlinear, holistic, harmonious, and intuitive thinking have been described as characterizing: a. scientific methods b. left-brain activities c. right-brain activities d.

Western philosophies Answer: c Solution: C is the correct response because the right side of the brain is primarily responsible for nonlinear, holistic, harmonious, and intuitive thinking.

A is incorrect because the aforementioned characteristics are incompatible with Western scientific methods.

B is incorrect because the left brain is more responsible for rational and linear thinking.

D is incorrect because Western philosophies are generally rationalist and linear.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

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Question 13 Question Type: Multiple Choice Question: How should a counselor enter a situation with a client who is culturally different? a. free from any preconceived notions or generalizations b. with a mental list of generalizations from which to view the client c. with guidelines to be tentatively applied, changed, and challenged d. a and c Answer: c Solution: C is the correct response because a counselor should enter each counseling interaction with guidelines to be tentatively applied, changed, and challenged.

A is incorrect because it is not realistic to expect a counselor to enter a counseling situation with any preconceived notions.

B is incorrect because having a list of generalizations prior to entering a counseling interaction will cause harm to your client.

D is incorrect because A is not appropriate (see above).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 14 Question Type: Multiple Choice Question: What are considered two of the most overlooked topics in psychology and mental health practice? a. openness and intimacy b. social class and classism c. individualism and collectivism d.

None of the choices is correct.

Answer: b Solution: B is correct because social class and classism have been identified by American Psychological Association, Task Force on Socioeconomic Status (2007) as two of the most overlooked topics in psychology and mental health practice.

A is incorrect because openness and intimacy (self-disclosure) have been well-studied in psychology and mental health practices.

C is incorrect because individualism and collectivism have been well-studied in psychology and mental health practices.

D is incorrect because the answer is b.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM Question 15

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Question Type: Text Entry and Essay Type Question: Insight is considered a _______ -___________ value. Elaborate on why this is important in working with culturally diverse clients.

Answer: class-bound Solution: Insight is a class-bound value because it assumes that people have time to sit back and contemplate motivations. The authors share that we need to realize that insight is not highly valued by many culturally diverse clients. There are major class differences as well (APA Task Force on Socioeconomic Status, 2007, as cited in Sue 8th edition). Furthermore, people from lower socioeconomic classes frequently do not perceive insight as appropriate to their life situations and circumstances. Their particular concerns may revolve around such questions as, ―Where do I find a job?‖, ―How do I feed my family?‖, and ―How can I afford to take my sick daughter to a doctor?‖ Indeed, when survival on a day-to-day basis is important, it seems inappropriate for the therapist to use insightful processes. After all, insight assumes that someone has time to sit back, reflect and contemplate motivations and behavior. For the person who is concerned about making it through each day, this orientation proves counterproductive (Reed & Smith, 2014, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 16 Question Type: Text Entry Question: Because of cultural misunderstandings, a counselor that works with a person from a minority background might conclude that the client is ___________ if he/she avoids eye contact. a. repressed, inhibited, shy, or passive b. angry and guilty c. low in his/her racial identity d. trying to manipulate the counselor Answer: a Solution: A is the best answer because in Western culture, lack of eye contact is interpreted as being repressed, inhibited, shy, or passive.

B is incorrect because lack of eye contact is generally not seen as angry by Western standards.

C is incorrect because lack of eye contact is unrelated to racial identity.

D is incorrect because lack of eye contact has not been linked to manipulation of the counselor.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 17 Question Type: Text Entry Question: Western society tends to value ___________, which involves linear thinking.

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a. b. c. d.

constructivism intuition collaboration scientific empiricism

Answer: d Solution: D is the correct response because Western society does value scientific empiricism, which involves linear thinking.

A is incorrect because constructivism can be nonlinear and intuitive.

B is incorrect because intuition is incompatible with Western notions.

C is incorrect because Western philosophies value rugged individualism and not collaboration.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 18 Question Type: Multiple Choice Question: Culturally diverse clients who do not conceive of mental and physical health as separate entities may expect a. empathic listening b. immediate solutions and tangible forms of treatment c. psychoanalysis with a psychiatrist d.

None of the choices is correct.

Answer: b Solution: B is the correct response because culturally diverse clients who do not conceive of mental and physical health as being separate (but one) may expect immediate solutions and tangible forms of treatment.

A is incorrect because empathic listening would not be compatible with dualistic thinking.

C is incorrect because dualistic understanding of the mind and body is not necessarily compatible with psychoanalysis with a psychiatrist.

D is incorrect because the answer is b.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 19 Question Type: Essay Question: Describe therapeutic class bias.

Solution: Considerable bias against people who are poor has been well documented (American Psychological Association, Task Force on Socioeconomic Status, 2007; Smith, 2013). In the area of diagnosis, it has been found that an attribution of mental illness is more likely when the person’s history suggested a lower rather than higher socioeconomic class origin (Liu et al., 2006). The

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class-bound nature of mental health practice emphasizes the importance of assisting the client in selfdirection through the results of assessment instruments and through self-exploration via verbal interactions between client and therapist. However, the assumptions underlying these activities are permeated by middle-class values that do not always apply to life in poverty. In an extensive historic research of services delivered to minorities and low socioeconomic clients, Lorion (1973) found that psychiatrists refer to therapy those persons who are most like themselves—White rather than nonWhite and from upper socioeconomic status.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 20 Question Type: True/False Question: Almost all racial/ethnic minority groups are collateral compared with White Americans in their relationships with people.

Answer: True Solution: Table 7.2 shows that true is the correct response because often racial/ethnic minority groups are more collateral than White Americans with respect to their relationships with people.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 21 Question Type: Multiple Choice Question: The view that a ―bad‖ child was destined to be that way is most likely to be found among a.

Asian Americans b.

Hispanic Americans c.

African Americans d.

American Indians Answer: b Solution: B is the correct response because Hispanic Americans tend to believe in destiny.

A is incorrect because there is no evidence to suggest that Asian Americans believe in destiny.

C is incorrect because there is no evidence to suggest that African Americans believe in destiny.

D is incorrect because there is no evidence to suggest that American Indians believe in destiny.

Bloom’s Level: Knowledge Difficulty Level: EASY Chapter 8: Communication Styles and Its Impact on Counseling and Psychotherapy Test Questions

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Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 8 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Question 1 Question Type: True/False Question: The study of kinesics refers to perception and use of personal and interpersonal space.

Answer: False Solution: Kinesics is the term used to refer to bodily movements.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 2 Question Type: True/False Question: Most therapists are concerned with whether communication appropriate rather than accurate.

Answer: False Solution: Most counselors seem more concerned with the accuracy of communication (getting to the heart of the matter) than with whether their communication is appropriate.

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 3 Question Type: Text Entry Question: _____________ refers to vocal cues that individuals use to communicate, such as loudness of voice, pauses, silences, hesitations, rate of speech, and inflections.

Answer: Paralanguage Solution: Paralanguage refers to vocal cues that individuals use to communicate, such as loudness of voice, pauses, silences, hesitations, rate of speech, and inflections.

Bloom’s Level: Knowledge Difficulty Level: EASY

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Question 4 Question Type: Essay Type Question: Part A: Describe the concept of proxemics as it relates to different cultures.

Part B: Elaborate on how this may be interpreted in a counseling context.

Solution: Different cultures dictate different distances in personal space. For example, for Latin Americans, Africans, Black Americans, Indonesians, Arabs, South Americans, and French, conversing with a person dictates a much closer stance than is normally comfortable for EuroAmericans (Jensen, 1985; Nydell, 1996, as cited in Sue 8th edition). A Latin American client’s closeness may cause the therapist to back away. In the counseling context a client may interpret the therapist’s behavior as aloofness, coldness, or a desire not to communicate. In some crosscultural situations, it may even be perceived as a sign of haughtiness and superiority. On the other hand, the therapist may misinterpret a client’s behavior as an attempt to become inappropriately intimate or as a sign of pushiness or aggressiveness. Both therapists and culturally diverse clients could benefit from understanding that their reactions and behaviors are attempts to create the spatial dimension to which they are culturally conditioned.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 5 Question Type: True/False Question: Low-context cultures tend to be more opportunistic and individual oriented.

Answer: True Solution: Low-context cultures place a greater emphasis on the verbal part of the message. They are associated with being more opportunistic and individual oriented.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 6 Question Type: Text Entry Question: The cultural group that best characterizes these communication styles are the ____________ ________________.  speak softly/slower  indirect gaze when listening or speaking  interject less; seldom offer encouraging communication  delayed auditory (silence)  manner of expression low keyed, indirect Answer: American Indians Solution: Table 8.1 categorizes general types of communication styles of various people groups.

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Bloom’s Level: Knowledge Difficulty Level: EASY

Question 7 Question Type: True/False Question: Differences in communication style are most strongly manifested in verbal communication.

Answer: False Solution: The authors highlight that differences in communication style are most strongly manifested in nonverbal communication, or those aspects of communication that transcend the written or spoken word.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 8 Question Type: Multiple Choice Question: Communication styles are a. strongly correlated with race, culture, and ethnicity b. strongly influenced by gender c. often more dependent on nonverbal than verbal communication d.

All of the choices are correct.

Answer: d Solution: D is the correct response because communication styles are strongly correlated with race, culture, and ethnicity; are influenced by gender; and are often more dependent on nonverbal than verbal communication.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 9 Question Type: Multiple Selection Question: Which of the following may be affected by race or culture a. proxemics b. kinesics c. paralanguage d. high- and low-context communication Solution: a, b, c, d Race and culture may influence several areas of nonverbal behavior: (a) proxemics, (b) kinesics,

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(c) paralanguage and (d) high- and low-context communication.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 10 Question Type: True/False Question: Some African Americans tend to feel it is more important to listen to what a White person has to say than to pay attention to nonverbal behavior.

Answer: False Solution: There is a common saying among African Americans: ―If you really want to know what White folks are thinking and feeling, don’t listen to what they say, but how they say it.‖ Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 11 Question Type: True/False Question: Nonverbal cues are important because they often reflect our conscious biases.

Answer: False Solution: The opposite is true: nonverbal cues often reflect our unconscious biases.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 12 Question Type: True/False Question: When counselors remain unaware of their own biases, their nonverbal behaviors are likely to reveal their true feelings.

Answer: True Solution: A therapist who has not adequately dealt with his or her own biases and racist attitudes may unwittingly communicate them to a culturally different client.

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 13 Question Type: Multiple Choice Question: Which gesture or body movement type in the culture indicated is INCORRECT?

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a. b. c. d.

A French person who lifts her chin when speaking is seen as poised and polite.

Mayan tribe members say no by jerking the head to the right.

Asians may consider being shown the bottom of the feet as a sign of rudeness and arrogance.

Muslim consider it an obscenity to touch anyone with the left hand.

Answer: a Solution: A is the correct answer because it is an educated Englishman who may consider the lifting of the chin when conversing as a poised and polite gesture, but to EuroAmericans it may connote snobbery and arrogance (―turning up one’s nose‖).

B is incorrect because it is accurate that Mayans say no by jerking their head to the right.

C is incorrect because Asians may consider being shown the bottom of the feet as a sign of rudeness and arrogance.

D is incorrect because in some Muslim countries, touching anyone with the left hand may be considered an obscenity (the left hand aids in the process of elimination and is ―unclean,‖ whereas the right one is used for the intake of food and is ―clean‖). Offering something with the left hand to a Muslim may be an insult of the most serious type.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 14 Question Type: Text Entry Question: ________________ ___________ refers to those factors that go beyond the content of what is said.

Answer: Communication style Solution: Communication style refers to those factors that go beyond the content of what is said.

Communication specialists have historically found that only 30 to 40 percent of what is communicated conversationally is verbal (Ramsey & Birk, 1983; Singelis, 1994, as cited in Sue 8th edition). What people say and do is usually qualified by other things that they say and do such as gestures, or the tone, inflection, posture, or degree of eye contact. Many of these may enhance or negate the content of a message. Communication styles have a tremendous impact on our face-to-face encounters with others (Geva & Wiener, 2015, as cited in Sue 8th edition).

Other aspects of communication style might be whether our conversation proceeds in fits and starts, whether we interrupt one another continually or proceed smoothly, the topics we prefer to discuss or avoid, the depth of our involvement, the forms of interaction (e.g., ritual, repartee, argumentative, persuasive), and the channel we use to communicate (verbal–nonverbal versus nonverbal–verbal).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 15 Question Type: Multiple Choice

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Question: What has been found regarding nonverbal communication? a.

The lack of facial expression in many Asians has contributed to their ―model minority‖ status. b.

Avoidance of eye contact is often interpreted negatively. c.

Many Black Americans make infrequent eye contact when speaking. d.

All of the choices are correct.

Answer: b Solution: B is the correct response because Western norms and standards prefer direct eye contact in communication.

A is incorrect because there is no evidence to suggest that lack of facial expression has contributed to Asians model minority status.

C is incorrect because oftentimes Black Americans do make eye contact while speaking but not when listening.

D is incorrect because answer is b.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 16 Question Type: Essay Type Question: Explain the culturally complex rules of when to speak or allowing someone else to speak.

Solution: Americans frequently feel uncomfortable with a pause or silent stretch in the conversation, feeling obligated to fill it in with more talk. Silence is not always a sign for the listener to take up the conversation. While it may be viewed negatively by many, other cultures interpret the use of silence differently. The British and Arabs use silence for privacy, while the Russians, French, and Spanish read it as agreement among the parties (Hall, 1976). In Asian culture, silence is traditionally a sign of respect for elders. Furthermore, silence by many Chinese and Japanese is not a floor-yielding signal inviting others to pick up the conversation. Rather, it may indicate a desire to continue speaking after making a particular point. Often silence is a sign of politeness and respect rather than a lack of desire to continue speaking.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 17 Question Type: Text Entry Question: Effective helping depends on the counselor and the client being able to ______ and ________ both ________ and _________ messages accurately and appropriately.

Answer: send and receive, verbal and nonverbal

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Solution: The authors share that effective helping depends on the counselor and the client being able to send and receive both verbal and nonverbal messages accurately and appropriately. This requires that the counselors not only send messages (make themselves understood) but also receive messages (attend to clients). The definition for effective counseling also includes the elements of verbal content of what is said and nonverbal—how something is said. Most counselors seem more concerned with the accuracy of communication in getting to the heart of the matter than with whether the communication is appropriate across all culture groups.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 18 Question Type: Multiple Choice Question: Which of the following statements is INACCURATE regarding proxemics? a.

In general, greater space is accorded to those of greater prestige and status. b.

In U.S. society, people seem more uncomfortable when others stand too close rather than too far away. c.

Latin Americans may feel more uncomfortable having a desk between them and the person they are speaking to. d.

The factor of personal space has minor implications for how furniture is arranged or where the seats are located. e.

Some Eskimos may prefer to sit side by side rather than across from one another when talking about intimate aspects of their lives.

Answer: d Solution: D is the correct answer because the factor of personal space has major implications for how furniture is arranged, where the seats are located, where you seat the client and how far you sit from him or her.

A is incorrect because oftentimes people with greater status are afforded greater space (e.g., firstclass cabin).

B is incorrect because it is true that people from the United States prefer to be further away from others.

C is incorrect because it is likely that Latin Americans would feel uncomfortable with the distance that a desk would create.

E is incorrect because in fact it is true that some Eskimo clients prefer sitting side by side when discussing intimate information about their lives.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 19 Question Type: Multiple Choice Question: In regard to the meaning of facial expressions: a. among Asians, smiling may represent embarrassment, apprehension, or anxiety.

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b. c. d.

some Asians believe that smiling may suggest weakness. it appears to be culturally conditioned.

All of the choices are correct.

Answer: d Solution: D is the correct response because regarding facial expressions, smiling may represent embarrassment, apprehension, anxiety, or weakness and has been found to be culturally conditioned among Asians.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 20 Question Type: Multiple Choice Question: Which statement about the differences between Black and White styles of communication is INACCURATE? a.

White middle-class individuals tend to be advocates rather than mere spokespersons of ideas. b.

African Americans are often high-keyed, emotional, and confrontational in presenting their ideas. c.

White middle-class individuals believe that emotion and reason work against one another. d.

African Americans tend to believe that ideas are to be tested in the crucible of argument.

Answer: a Solution: A is the correct response because oftentimes White middle-class individuals are not advocates of their ideas.

B is incorrect because oftentimes African Americans are high-keyed, emotional, and confrontational in presenting their ideas.

C is incorrect because White middle-class individuals believe that emotions and reason work against one another.

D is incorrect because African Americans tend to believe that ideas are to be tested in the crucible of argument.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 21 Question Type: Multiple Choice Question: Which of the following is true regarding counseling and therapy as a communication style? a.

Although theories of counseling differ, they represent similar communication patterns. b.

Different cultural groups may be more receptive to certain counseling styles because of cultural and sociocultural factors. c.

As opposed to African Americans, Asian American clients prefer an insight approach to a

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d.

directive approach.

Black males and females tend to use more reflection and self-exploration than their White counterparts.

Answer: b Solution: B is the correct response. Evidence shows that different cultural groups may be more receptive to certain counseling styles because of cultural and sociocultural factors.

A is incorrect because although theories of counseling differ, they do not represent similar communication patterns.

C is incorrect because it is untrue that, as opposed to African Americans, Asian American clients prefer an insight approach to a directive approach.

D is incorrect because Black males and females tend not to use reflection and self-exploration in contrast to their White counterparts.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 22 Question Type: True/False Question: High-context cues and situations are common in traditional Asian societal communication styles.

Answer: True Solution: In traditional Asian society, many interactions are understandable only in light of highcontext cues and situations. For example, to extend an invitation only once for dinner would be considered an affront because it implies that you are not sincere. One must extend an invitation several times, encouraging the invitee to accept.

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 23 Question Type: Multiple Choice Question: A Latin American, Black American, or Arab American may perceive the counselor that backs away from a client to be a. acting appropriately b. respectful of personal space c. haughty or aloof d.

None of the choices is correct.

Answer: c Solution: C is the correct response because backing away from a client may be seen as haughty or aloof by Latinos, Blacks, and Arabs.

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A is incorrect because backing away would not be seen as acting appropriately in a culture that values close proximity.

B is incorrect because backing away would not be seen as giving personal space in a culture that values close proximity.

D is incorrect because the answer is c.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 24 Question Type: Multiple Choice Question: Counselors who believe that direct eye contact is a positive indicator of mental health may a. perceive African American clients negatively. b. believe that Asian American clients are pathological. c. perceive Whites as healthier than people of color. d.

All of the choices are correct.

Answer: d Solution: D is the correct response because counselors who believe that direct eye contact is a positive indicator of mental health may perceive African American clients negatively, believe that Asian American clients are pathological, and perceive Whites as healthier than people of color.

Bloom’s Level: Synthesis Difficulty Level: HARD Chapter 9 Multicultural Evidence-Based Practice Test Questions Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 9 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Question 1 Question Type: True/False Question: Beliefs such as ―we are all part of the human race‖ and ―I do not see color‖ are most helpful in establishing empathy between the therapist and clients of color.

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Answer: False Solution: For example, among counselors working with African American clients, those with color-blind attitudes showed lower levels of empathy than those who were aware of the significance of racial factors.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 2 Question Type: Multiple Choice Question: Empirically supported treatments must demonstrate a. superiority to placebo in two or more controlled studies b. superiority in the treatment of ethnic minorities c. superiority in the treatment of symptoms d.

All of the choices are correct.

Answer: a Solution: A is the correct response because according to the guidelines of the task force charged with defining and identifying ESTs, they must demonstrate superiority to placebo in two or more methodologically rigorous, controlled studies.

B is incorrect because the task force makes no mention of ethnic minorities.

C is incorrect because the task force makes no mention of being superior to other treatments.

D is incorrect because A is correct and the other answers are incorrect.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 3 Question Type: Text Entry Question: ________________ interventions are increasingly promoted in social work, school psychology, clinical psychology, counseling, and psychiatry.

Answer: Evidence-based Solution: The broader and more recent focus on evidence-based practice (EBP) has more formally introduced cultural sensitivity as an essential consideration in assessment, case conceptualization, and selection of interventions. Specifically, EBP refers to ―the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences‖ (American Psychological Association, Presidential Task Force on EvidenceBased Practice, 2006, p. 273, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 4

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Question Type: Essay Type Question: When treating clients with specific disorders, multicultural therapists have had the choice of ignoring ESTs or adapting them. Describe what ―cultural adaptations‖ of certain ESTs might entail. Give three examples of this with a particular people group.

Solution: Organista (2000, as cited in Sue 8th edition) made the following modifications to empirically supported cognitive-behavioral strategies when working with low-income Latinos suffering from depression: Engagement strategies is one adaptation. This would entail recognizing the importance of personalismo, the value of personal relationships, initial sessions are devoted to relationship building. Time is allotted for presentaciones (introductions), during which personal information is exchanged between counselor and client. Issues that may affect ethnic minorities, such as acculturation difficulties, culture shock, and discrimination, are discussed.

Another example might be activity schedules. In the treatment of depression, for example, a common recommendation is for clients to take some time off for themselves. This idea may run counter to the Latino/a value of connectedness and putting the needs of the family ahead of oneself. Therefore, in cultural adaptation, instead of solitary activities, clients can choose social activities they find enjoyable, such as visiting neighbors, family outings, or taking children to the park. In recognizing the income status of clients, activities discussed are generally free or affordable.

A third example might be in assertiveness training. Assertiveness is discussed within the context of Latino values and culturally acceptable ways of expressing assertiveness, such as prefacing statements with con todo respeto (with all due respect) and ¿me permite expresar mis sentimientos? (Is it okay if I express my feelings?) are discussed, as well as strategies for using assertion with spouses or higher status individuals.

Another example is with cognitive restructuring techniques. Rather than labeling thoughts that can reduce or increase depression as rational or irrational, the terms helpful thoughts and unhelpful thoughts are used. This adaptation recognizes the religious nature of many Latinos, the saying Ayudate, que Dios te ayudara (i.e., ―God helps those who help themselves‖) is used to encourage follow-through with behavioral assignments.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 5 Question Type: Essay Type Question: Explain what some of the outcomes of cultural adaptations might be.

Solution: Types of cultural adaptations that maintain fidelity to both empirically supported techniques and cultural influences have resulted in a lower dropout rate and better outcome for low-income Latino/a clients compared to nonmodified therapy.

Bloom’s Level: Analysis Difficulty Level: HARD

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Question 6 Question Type: Multiple Selection Question: Cultural adaptations can include factors such as a. matching language, racial, or ethnic backgrounds of client and therapist b. incorporating cultural values in the specific treatment strategies c. utilizing cultural sayings or metaphors in treatment d. considering the impact of environmental variables, such as acculturation conflicts, discrimination, and income status Answer: a, b, c, d Solution: A, b, c and d are all factors utilized in cultural adaptations.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 7 Question Type: Essay Type Question: Describe the limitations of solution-focused brief therapy (SFBT).

Solution: One possible limitation of SFBT [with Muslim American clients] is related to the discrimination and violence that Muslim Americans face as in the United States in the post-9/11 era. When these individuals enter therapy, their problem is far more complicated than simply an individual concern. They also need change and advocacy at a system or institutional level as well as strategies to cope with adverse social conditions. However, a SFBT therapist may not have the tools to expand their work beyond the one-on-one sessions recommended. Another limitation that may arise is related to the interconnectedness and closeness of Muslim families. There is a tendency to keep important and personal information within the immediate family, extended family and religious community. If a therapist is hoping to get his client to open up either alone or in the context of a family session, it is important to be trusted by the family and community network.

Bloom’s Level: Analysis Difficulty Level: MEDIUM

Question 8 Question Type: Multiple Choice Question: Which of the following is an empirically supported relationship variable? a. strong interpersonal bond b. effective management of countertransference c. strong therapeutic alliance d.

All of the choices are correct.

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Answer: d Solution: D is the correct response because all of the answers are empirically supported relationship variables.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 9 Question Type: Text Entry Question: Although there is optimism about the convergence of multicultural psychology and evidence-based practices, there is still resistance to _____________ ______________________________among some individuals in the field.

Answer: Evidence-based practices Solution: The authors elaborate that although optimism about the convergence of these forces is increasing, there is still resistance to EBP among some individuals within the field of multicultural counseling. They report that the applicability of EBP for many diverse groups has been insufficiently researched, and the concept of ―evidence‖ has historically been very narrow.

Additionally, the therapist–client relationship is not adequately acknowledged in the evidencebased treatment and empirically supported treatment formulations.

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 10 Question Type: Essay Type Question: What are empirically supported relationships (ESRs)? How is an evidence-based practice (EBP) different than an empirically supported treatment (EST), and how do they relate to evidence-based practice?

Solution: Empirically supported relationships are the therapeutic interventions that possess empirical support for the efficacy of the therapeutic relationship, client values and beliefs, and the working alliance between client and therapist.

Empirically supported treatments are the treatments that have empirical evidence regarding their effectiveness. Evidence-based practices use counseling interventions based on research evidence from qualitative studies, clinical observations, systematic case studies, and interventions delivered in naturalistic settings.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 11 Question Type: True/False

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Question: Culturally adapted ESTs have been successfully used with Asian Americans experiencing phobias.

Answer: True Solution: Huey and Pan (2006) have demonstrated effectiveness of ESTs with Asian Americans experiencing phobias.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 12 Question Type: Multiple Choice Question: Which of the following is considered a shortcoming of empirically supported treatments? a.

They generally take a long time to conduct. b.

The manuals can be very difficult to follow. c.

Very few minority groups are included in clinical trials. d.

It is very difficult to recruit participants for clinical trials.

Answer: c Solution: C is the correct response because very few clinical trials include minority groups, and these inform empirically supported treatments.

A is incorrect because there is no mention in the chapter that ESTs are time consuming.

B is incorrect because there is no mention in the chapter that the manuals are difficult to follow.

D is incorrect because there is no mention of participant recruitment in the chapter.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 13 Question Type: Text Entry Question: Western approaches to psychological treatment are often based on ____________ value systems instead of the interdependent values found in many ethnic minority communities.

Answer: individualistic Solution: However, many of these can be adapted for other orientations. For example, cognitivebehavioral approaches can be modified to incorporate a collectivistic rather than an individualistic perspective.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 14 Question Type: Multiple Selection

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Question: Which of the following are well-established empirically supported treatments? a.

Cognitive therapy for depression b.

Emotionally focused couples therapy c.

Exposure/guided mastery for specific phobias d.

Exposure treatment for posttraumatic stress disorder (PTSD) Answer: a, c Solution: A and C are correct because they are well-established empirically supported treatments (ESTs).

B and D are incorrect because they are probably efficacious empirically supported treatments.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 15 Question Type: Text Entry Question: Difficulties in the ___________ _____________ may be a factor in the underutilization of mental health services and early termination of therapy seen with minority clients.

Answer: therapeutic alliance Solution: It is now widely agreed on that the quality of the working relationship between the therapist and the client is consistently related to treatment outcome and has led to the formulation of empirically supported relationships. A number of relationship variables are considered effective based on research findings. These ESR variables include the development of a strong therapeutic alliance, a solid interpersonal bond (i.e., a collaborative, empathetic relationship based on positive regard, respect, warmth, and genuineness), the effective management of countertransference and goal consensus—all factors known to be critical for effective multicultural counseling.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 16 Question Type: Essay Type Question: How does cognitive empathy differ from empathy? Provide an example of a cultural adaptation that would employ cognitive empathy.

Solution: Cognitive empathy is defined as cognitively understanding the client’s predicament associated with others or his or her life circumstance. Empathy is defined as the ability to place oneself in the client’s world, to feel or think from the client’s perspective, or to be attuned to the client. An example of a cultural adaptation that demonstrates cognitive empathy would be considering a client’s economic state when discussing social activities to improve mood.

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Bloom’s Level: Synthesis Difficulty Level: HARD

Question 17 Question Type: True/False Question: Findings from qualitative research can inform an empirically supported treatment.

Answer: False Solution: Evidence-based practice allows for the inclusion of findings from qualitative research.

ESTs are informed by controlled clinical trials.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 18 Question Type: Text Entry Question: When differences exist between a client’s view of a problem and the therapist’s theoretical conceptualization, __________ dynamics are likely to occur.

Answer: negative Solution: The authors proffer that when differences exist between a client’s view of a problem and the therapist’s theoretical conceptualization, negative dynamics are likely to occur.

Collaboration regarding the definition of the problem reduces this possibility and is most effective when employed consistently throughout therapy.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 19 Question Type: Multiple Choice Question: Which of the following is NOT an important aspect of the therapeutic alliance? a. mutual agreement on goals for treatment b. an emotional bond between therapist and client c. interventions that are viewed as relevant by the therapist d. potential changes are viewed as positive by the client Answer: c Solution: C is the correct response because intervention strategies need to be viewed as relevant

by BOTH therapist and client for a strong therapeutic alliance.

A, b and d are incorrect because they all represent important aspects of the therapeutic alliance.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

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Question 20 Question Type: Text Entry Question: ___________ is known to significantly enhance the therapeutic bond.

Answer: Empathy Solution: It is well understood that empathy is known to significantly enhance the therapeutic bond. Empathy is defined as the ability to place oneself in the client’s world and to feel or think from the client’s perspective or to be attuned to the client. This allows therapists to form an emotional bond with clients, helping the clients to feel understood.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 21 Question Type: Text Entry Question: Behaviors such as asking clients how they would like to be addressed, showing that their comments and insights are valuable, and tailoring your interaction according to their needs are ways of communicating ___________.

Answer: respect Solution: The formation of a bond between the therapist and the client is a very important component of the therapeutic relationship. This is defined as a collaborative partnership based on empathy, positive regard, genuineness, respect, warmth, and self-disclosure. For optimal outcomes, the client must feel connected with, respected by, and understood by the therapist.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 22 Question Type: True/False Question: It is easier to integrate multicultural sensitivity with evidence-based practice than with empirically supported treatments.

Answer: True Solution: Evidence-based practice (EBP) considers the client’s background and problem first before considering which therapeutic approach to employ. EBP also accepts research evidence from qualitative studies, clinical observations, case studies etc., whereas ESTs rely primarily on randomized control studies. Finally, EBP considers clinical expertise to include factors such as knowledge about cultural differences.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

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Question 23 Question Type: Text Entry Question: ______________ involves the therapist’s emotional reaction to the client based on the therapist’s own set of attitudes, beliefs, values, or experiences.

Answer: Countertransference Solution: The therapist must identify issues that may detract from the relationship, such as countertransference, the reactions to the client based on the therapist’s own personal issues.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 24 Question Type: Text Entry Question: An agreement on ______________ between the therapist and client is an important relationship variable.

Answer: goals Solution: The potential for positive therapeutic outcomes is increased when the client is ―on board‖ regarding the definition of the problem, identification of goals, and choice of interventions.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 25 Question: Multiple Choice Question: Incorporating tribal practices and rituals into an aspect of a cognitive-behavior therapy (CBT) treatment for an American Indian represents a. an empirically supported treatment b. a cultural adaptation c. an example of merging evidence-based practice and multicultural counseling d. b and c e.

None of the choices is correct.

Answer: d Solution: D is the correct response because including cultural elements into the treatment is both a cultural adaptation (b) and an example of merging evidence-based practice and multicultural counseling (c).

A is incorrect because no empirically supported treatment is named.

Bloom’s Level: Comprehension

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Difficulty Level: MEDIUM

Question 26 Question Type: True/False Question: An egalitarian stance and encouragement of sharing and self-disclosure facilitates the development of empathy.

Answer: True Solution: The development of an emotional bond is enhanced by collaboration, which may include a shared process in which a client’s views are respected and his or her participation is encouraged in all phases of the therapy. An egalitarian stance and encouragement of sharing and self-disclosure facilitate the development of empathy (Dyche & Zayas, 2001, as cited in Sue 8th edition) and reduce the power differential between therapist and client. Furthermore, the potential for a positive therapeutic outcome is increased when the client is ―on board‖ regarding the definition of the problem, identification of goals, and choice of interventions.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 27 Question Type: Essay Type Question: What is trauma-focused cognitive-behavioral therapy (TF-CBT)? Name some of the cultural groups this type of treatment has been evaluated on. Describe some of the components of this type of therapy and who might be included in the treatment.

Solution: TF-CBT is described as a conjoint child and family psychotherapy that has been comprehensively evaluated and designated by the National Crime Victims Research and Treatment Center as having the highest level of research support as an ―efficacious treatment‖ for childhood abuse and trauma.

This type of treatment has been evaluated with Caucasian and African American children and adapted for American Indian/Alaska Native populations, Latinos, hearing-impaired individuals, immigrant Cambodians, and children of countries including Zambia, Uganda, South Africa, Pakistan, the Netherlands, Norway, Sweden, Germany, and Cambodia (National Child Traumatic Stress Network, 2008).

Components of TF-CBT include a focus on reducing negative emotional and behavioral responses resulting from trauma and correcting trauma-related beliefs through gradual exposure to memories and emotional associations with the traumatic event. Relaxation training is also used to reduce negative emotions. Parents are included in the treatment process as an emotional support for the child. Parents are also provided with strategies for helping to manage their child’s emotional reaction to the trauma.

Bloom’s Level: Synthesis Difficulty Level: HARD

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Chapter 10: Non-Western Indigenous Methods of Healing: Implications for Multicultural Counseling and Therapy Test Questions Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 10 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Question 1 Question Type: True/False Question: A shaman is a male healer who is able to communicate with the spirit world.

Answer: False Solution: A shaman can be a man or a woman. For example, in the case study of Vang, the shaman in the vignette is a woman.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 2 Question Type: Multiple Choice Question: The author asserts that it is important to understand indigenous healing practices in order to e. anticipate potential conflicts in belief systems that might hinder the ability to be therapeutically effective f. begin to use them to replace current methods that deal with racial minorities g. fully understand the worldview of culturally different clients h.

All of the choices are correct.

Answer: d Solution: D is the correct response because it is important to understand indigenous healing practices in order to anticipate potential conflicts in belief systems that might hinder the ability to be therapeutically effective, begin to use them to replace current methods that deal with racial minorities, and fully understand the worldview of culturally different clients.

Bloom’s Level: Synthesis Difficulty Level: HARD

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Question 3 Question Type: Text Entry Question: The encompasses the centuries of recognition of healers within communities and refers to people known as witches, witch doctors, wizards, sorcerers, magic men or women, and medicine men or women.

Answer: Universal shamanic tradition.

Solution: What is called the universal shamanic tradition, which encompasses the cen- turies-old recognition of healers (shamans) within a community, refers to people often called witches, witch doctors, wizards, medicine men or women, sorcerers, and magic men or women (E. Lee, 1996 as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 4 Question Type: Essay Type Question: What was your first impression when reading about Vang’s experience with the spirit world and the shaman practice employed.

Solution: Responses will vary depending on the worldview of the student. Some Western-trained or -oriented students may express doubt and confusion. Other worldview-oriented students may resonate with both the belief in the spirit world and the shaman practices. The authors postulate that these worldview differences pose problems for Western-trained mental health professionals, who may quickly dismiss these belief systems and impose their own explanations and treatments on culturally diverse clients. However, most researchers now acknowledge that attitudes, beliefs, and emotional states are intertwined and can have a powerful effect on physiological responses and physical well-being.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 5 Question Type: True/False Question: The indigenous African approach teaches that human beings should be oriented toward individual survival.

Answer: False Solution: The indigenous African approach teaches that humans should be orientated toward collective rather than individual survival.

Bloom’s Level: Knowledge Difficulty Level: EASY

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Question 6 Question Type: Multiple Choice Question: What is true regarding the case of Vang? e.

His distressing symptoms involved severe headaches and hearing voices. f.

The shaman attributed the symptoms to spirits. g.

Treatment was only temporarily successful. h.

Before coming to the United States, his past life was relatively peaceful.

Answer: b Solution: B is the correct response because in the case of Vang, the shaman attributed his symptoms to spirits.

A is incorrect because severe headaches and hearing voices were not his symptoms.

C is incorrect because his treatment was fully successful.

D is incorrect because his life prior to arriving in the United States was very difficult.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 7 Question Type: Multiple Selection Question: Which of the following are examples of cultural syndromes? a. amok b. ataque de nervios c. brain fag d. koro e. ghost sickness Answer: a, b, c, d, e Solution: All of the choices are examples of cultural syndromes, which the authors describe as disorders specific to a cultural group or society but not easily given a DSM diagnosis. These illnesses or afflictions all have local names, with distinct culturally sanctioned beliefs surrounding causation and treatment.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 8 Question Type: True/False Question: Asian psychologies focus on enlightenment and ideal mental health rather than psychopathology.

Answer: True

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Solution: Asian perspectives concentrate less on psychopathology and more on enlightenment and ideal mental health.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 9 Question Type: Essay Type Question: Why is it important for mental health professionals to become familiar with the cultural background of their clients?

Solution: It is very important for mental health professionals not only to become familiar with the cultural background of their clients but also to be knowledgeable about specific cultural syndromes. One of the primary dangers from lack of cultural understanding is the tendency to overpathologize (overestimate the degree of pathology). For example, the mental health professional would have been wrong in diagnosing Vang as a paranoid schizophrenic suffering from delusions and hallucinations. Furthermore, most might have prescribed powerful antipsychotic medication or even institutionalization. The fact that he was cured so quickly by the shaman indicates that such a diagnosis would have been erroneous. It is equally dangerous to underestimate the severity or complexity of a refugee’s emotional condition.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 10 Question Type: Multiple Choice Question: Which of the following culture-bound syndromes are attributed to ―an excess loss of semen‖? a. amok b. koro c. susto d. shenkui Solution: D is the correct response because shenkui is a culture-bound syndrome, which has been linked to an excess loss of semen.

A is incorrect because amok is a dissociative episode preceded by introspective brooding and then an outburst of violent, aggressive, or homicidal behavior toward people and objects.

B is incorrect because koro is a Malaysian term refers to an intense fear of the shrinkage or retraction of one’s genitals—typically the penis for males or breasts for females. Sometimes referred to as the genital retraction syndrome.

C is incorrect because susto is a disorder associated with fright or soul loss and is a prevalent folk illness among some Latino/as.

Bloom’s Level: Knowledge Difficulty Level: EASY

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Question 11 Question Type; True/False Question: In Asian psychology, the shamanic drumming circle is the most widely used form of therapy to reach enlightenment and liberation.

Answer: False Solution: Research findings indicate that yoga and meditation are the most widely used of all therapies.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 12 Question Type: Text Entry Question: ______________ ________________ is used by some American Indians as a religious renewal or rite of passage.

Answer: Vision quest Solution: The vision quest, in conjunction with the sweat lodge experience, is used by some American Indians as a religious renewal or rite of passage.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 13 Question Type: Multiple Choice Question: The term Thùôc Nam spoken by Mrs. Nguyen to the counselor signified e. traditional medicine f. child abuse g. discipline h. medicine man Answer: a Solution: A is the correct response. Thùôc Nam refers to traditional medicine.

B is incorrect because Thùôc Nam does not refer to child abuse.

C is incorrect because Thùôc Nam does not refer to discipline.

D is incorrect because Thùôc Nam does not refer to the medicine man.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 14

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Question Type: Text Entry Question: _______________________ is described by the authors as the life force that resides within individuals that makes them inherently worthy and connects them to other living creatures.

Answer: Spirituality Solution: The authors define spirituality as the life force that resides within individuals that makes them inherently worthy and connects them to other living creatures. Throughout the text various forms of spirituality are described and may be culturally specific as well as understood.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 15 Question Type: Multiple Choice Question: Which of the following refers to the Native Hawaiian termination ritual in which food is offered to the gods and the participants? f.

Pule weke g.

Oia’i’o h.

Mahiki i.

Pani Answer: d Solution: D is the correct response. Pani refers to the ritual of offering food to the gods and participants.

A is incorrect because Pule weke is an opening prayer.

B is incorrect because Oia’i’o refers to truth telling.

C is incorrect because Mahiki is a process of getting to the problems.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 16 Question Type: Essay Type Question: Why does Western science remain skeptical of using supernatural explanations to explain phenomena experienced by non-Westerners?

Solution: One of the main reasons is that these phenomena cannot be verified empirically. The authors posit that Western science remains skeptical of using supernatural explanations to explain phenomena and certainly does not consider the existence of spirits to be a scientifically sound belief.

Bloom’s Level: Analysis Difficulty Level: HARD

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Question 17 Question Type: Multiple Choice Question: Espiritismo refers to a. an Indian belief b. the enlightenment of personal spirit c. the destruction of the physical world d. a world where spirits reside and impact people in the physical world Answer: d Solution: D is the correct response because espiritismo refers to a world where spirits reside and impact people in the physical world.

A is incorrect because espiritismo does not refer to an Indian belief.

B is incorrect because espiritismo is not enlightenment of a personal spirit.

C is incorrect because espiritismo is not destruction of the physical world.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 18 Question Type: Multiple Choice Question: Counselors’ acceptance of potential benefits of spirituality as a means of coping with hopelessness, powerlessness, and identity issues is a. increasing b. decreasing c. staying the same d. not known Answer: a Solution: A is the correct response. Counselors’ acceptance of the potential benefits of spirituality as a means of coping with hopelessness, powerlessness, and identity issues is increasing.

B is incorrect because it is not decreasing.

C is incorrect because it is not staying the same.

D is incorrect because it is known to be increasing.

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 19 Question Type: Multiple Choice Question: Vang Xiong suffered from which of the following illnesses/disorders?

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a. b. c. d. e.

Dissociative disorder Sleep terror disorder Hmong sudden death syndrome Catatonic disorder None of the choices is correct.

Answer: c Solution: C is the correct response because Vang Xiong suffered from the Hmong sudden death syndrome.

A is incorrect because Vang did not suffer from dissociative disorder.

B is incorrect because Vang did not suffer from sleep terror disorder.

D is incorrect because Vang did not suffer from catatonic disorder.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 20 Question Type: Multiple Choice Question: Which of the following is an approach often used in indigenous healing methods in Korea? a. b. c. d. e.

reliance on communal, group, and family networks to shelter the disturbed individual reliance on communal, group, and family networks to problem solve in a group context reliance on communal, group, and family networks to improve the life of only one family member reliance on communal, group, and family networks to reconnect an individual with family or significant others None of the choices is correct.

Answer: d Solution: D is the correct response because Koreans rely on communal, group, and family networks to reconnect an individual with family or significant others.

A is incorrect because Koreans do not rely on communal, group, and family networks to shelter disturbed individuals.

B is incorrect because Koreans do not rely on communal, group, and family networks to problems solve in a group context.

C is incorrect because Koreans do not rely on communal, group, and family networks to improve the life of one family member.

E is incorrect because the answer is d.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 21 Question Type: Multiple Choice

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Question: Studies suggest that which two pathologies are most frequently found with refugees from Southeast Asia? a.

Schizophrenia and dependent personality disorder b.

PTSD and borderline personality disorder c.

PTSD and major affective disorders d.

Schizophrenia and PTSD Answer: c Solution: C is the correct response because studies suggest that the two pathologies most frequently found with refugees from Southeast Asia are PTSD and major affective disorders.

A is incorrect because schizophrenia and dependent personality disorder are not most frequently found with refugees.

B is incorrect because PTSD and borderline personality disorder are not most frequently found with refugees.

D is incorrect because schizophrenia and PTSD are not most frequently found with refugees.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 22 Question Type: Multiple Choice Question: Which of the following is true regarding Western forms of healing? a.

Reality consists of distinct and separate units or objects. b.

Reality consists of what can be observed and measured via the five senses. c.

Space and time are fixed and are absolute constructs of reality. d.

All of the choices are correct.

Answer: d Solution: D is the correct response because Western forms of healing reality consists of distinct and separate units or objects, reality consists of what can be observed and measured via the five senses, and space and time are fixed and are absolute constructs of reality.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 23 Question Type: Essay Type Question: Describe indigenous healing.

Solution: According to Edwards (2011, as cited in Sue 8th edition), indigenous healing can be defined as helping beliefs and practices that originate within the culture or society. It is not simply transported from other regions, and it is designed for treating the inhabitants of the given group.

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Bloom’s Level: Knowledge Difficulty Level: EASY

Question 24 Question Type: True/False Question: Most non-Western indigenous forms of healing take a holistic outlook on well-being.

Answer: True Solution: The answer is true because most non-Western indigenous forms of healing take a holistic outlook on well-being, in that they make minimal distinctions between physical and mental functioning and believe strongly in the unity of spirit, mind, and matter. Additionally, the interrelatedness of life forms, the environment, and the cosmos is a given. As a result, the indigenous peoples of the world tend to conceptualize reality differently (Mpofu, 2011, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty: MEDIUM

Question 25 Question Type: True/False Question: Because of the importance of spirituality in many cultures, religious beliefs systems are considered harmless.

Answer: False Solution: The authors share that although they have discussed the important role that indigenous healing plays in many societies and cultures, there are downsides reflected in our historical past where an uncritical acceptance of religious belief systems may actually harm rather than heal or enlighten. For example, this was the case during the Middle Ages, when supernatural explanations of human behavior led to a total eclipse of science and resulted in the deaths of many innocent people, primarily those accused of being witches (women, the mentally ill, those with disfigurements, gypsies, and scientists who voiced beliefs that differed from the Church’s doctrines). Early forms of Christianity did little to promote science and in many ways actively discouraged it.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 26 Question Type: Essay Type Question: In the case study presented in this chapter, do you consider the practice of Thùôc Nam a form of child abuse? How would you have handled this case if this child presented to you in a counseling session with fresh bruises?

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Solution: Thùôc Nam, or traditional medicine, involves using natural fruits, herbs, plants, animals, and massages to heal the body. Massage treatment is the most common cause of misdiagnosis of child abuse because it leaves bruises on the body. The authors state that if the social worker could have understood Mrs. Nguyen, he would have known that Phuoc’s four-day absence from school was due to illness and that he was treated by his parents via traditional folk medicine. The massage treatments are a widespread custom practiced not only by Vietnamese but also by Cambodians, Laotians, and Chinese. These treatments aim at curing a host of physical ailments, such as colds, headaches, backaches, and fevers. In the mind of the practitioner of this treatment, such treatments have nothing to do with child abuse. However, the question still remains. Is it considered child abuse when traditional healing practices result in bruises? The authors proffer that this is a very difficult question to answer because it raises larger questions. Some questions might arise such as Can culture justify a practice, especially when it is harmful? The authors point out that many medical practitioners in California do not consider it child abuse because (a) medical literature reveals no physical complications as a result of Thùôc Nam, (b) the intent is not to hurt the child but to help him or her, and (c) it is frequently used in conjunction with Western medicine. However, that being said, the authors add that health professionals and educators have a responsibility to educate parents concerning the potential pitfalls of many folk remedies and indigenous forms of treatment.

Bloom’s Level: Synthesis Difficulty Level: HARD Chapter 11: Racial, Ethnic, Cultural (REC) Identity Attitudes in People of Color: Counseling Implications Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 11 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Test Questions Question 1 Question Type: Multiple Choice Question: Feelings of being brainwashed by the forces of White society would most likely be found in what stage of the REC identity developmental model? a.

Conformity Stage b.

Resistance and Immersion Stage c.

Introspection Stage d.

Integrative Awareness Stage Answer: b

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Solution: B is the correct response, because realizing that one has been brainwashed is a disorienting dilemma, which may propel someone into the Resistance and Immersion Stage.

A is incorrect because in the Conformity Stage, one is conforming to White society.

C is incorrect because the Introspection Stage is marked by self-definition.

D is incorrect because the Integrative Awareness Stage is marked by integration of the self as a racial cultural being.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 2 Question Type: Text Entry Question: Cross (1991, as cited in Sue 8th edition) introduces the concept of _________ _________, the degree to which race is an important and integral part of a person’s approach to life.

Answer: race salience Solution: Race Salience is defined as the degree to which race is an important and integral part of a person’s approach to life.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 3 Question Type: True/False Question: During the resistance and immersion stage, the three most active types of affective feelings are guilt, shame, and anger.

Answer: True Solution: During this stage there are considerable feelings of guilt and shame that in the past the individual has sold out his or her own racial and cultural group. These feelings of guilt and shame extend to the perception that during this past ―sellout,‖ one has been a contributor to and participant in the oppression of one’s own group and other marginalized groups. Moreover, this is coupled with a strong sense of anger at the oppression, and feelings of having been brainwashed by forces in White society. This anger is directed outwardly in a very strong way toward oppression and racism.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 4 Question Type: Essay Type Question: Name the stages of the Racial/Cultural Identity Development model (R/CID).

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Solution: The stages of the Racial/Cultural Identity Development model are: Conformity, Dissonance, Resistance and Immersion, Introspection, and Integrative Awareness. The R/CID model proposed is a conceptual framework that can aid therapists in understanding their culturally diverse clients’ attitudes and behaviors. The five levels of development that oppressed people experience as they struggle to understand themselves in terms of their own culture, the dominant culture, and the oppressive relationship between the two cultures are described. These are conformity, dissonance, resistance and immersion, introspection, and integrative awareness.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 5 Question Type: Multiple Selection Question: At each level of racial identity, which are the four corresponding beliefs and attitudes? a.

How a person views the self b.

How the person views others of the same minority c.

How the person views society d.

How the person views others of another minority e.

How the person views majority individuals f.

How the person views majority society Answer: a, b, d, e Solution: At each level of racial identity, there are four corresponding beliefs and attitudes, the understanding of which may help therapists better understand their clients, are discussed. These attitudes/beliefs are an integral part of identity, and are manifest in how a person views (1) the self, (2) others of the same minority, (3) others of another minority, and (4) majority individuals.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 6 Question Type: Multiple Choice Question: Which stage has the most profound negative impact on nearly all people of color? a.

Resistance and Immersion Stage b.

Dissonance Stage c.

Introspection Stage d.

Conformity Stage Answer: d Solution: D is the correct response because in the Conformity Stage, people of color value Whiteness and devalue being non-White, which evokes self-loathing.

A is incorrect because conflict leads to change in the Resistance and Immersion Stage.

B is incorrect because in the Dissonance Stage, change begins to occur.

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C is incorrect because people of color begin for form a more solid identity in the Introspection Stage.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 7 Question Type: Text Entry Question: In the Cross model (1971 as cited in Sue 8th edition), the last stage, ________________ speaks to the commitment that individuals have toward social change, social justice, and civil rights.

Answer: Internalization–Commitment Solution: Internalization–Commitment is the last stage of this model and speaks to the commitment that such individuals have toward social change, social justice, and civil rights. It is expressed not only in words but also in actions that reflect the essence of their lives.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 8 Question Type: True/False Question: The R/CID model can be considered a global personality theory, which provides fixed and identifiable phases that serve to identify where clients fit on a spectrum.

Answer: False Solution: Just the opposite is true, and the authors state to be aware that the R/CID model should not be viewed as a global personality theory with specific identifiable phases that serve as fixed categories. The process of cultural identity development is dynamic, not static.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 9 Question Type: Essay Type Question: Describe characteristics of people in the Conformity Stage of the R/CID with regard to attitudes and beliefs toward (a) self, (b) members of the same group, (c) members of other minority groups, and (d) the dominant group.

Solution: People in the conformity stage are (a) self-deprecating, (b) group-deprecating, (c) discriminatory or neutral and (d) group appreciating.

Attitudes and beliefs toward the self—self-depreciating attitudes and beliefs:

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The physical and cultural characteristics (i.e., skin color, eye shape) identified with one’s own racial/cultural group are perceived negatively, as something to be avoided, denied, or changed.

Attitudes and beliefs toward members of the same group—group-depreciating attitudes and beliefs: The majority cultural beliefs and attitudes about the minority group are also held by the person in this stage. These individuals may have internalized many of the majority of White stereotypes about their group.

Attitudes and beliefs toward members of different marginalized groups— discriminatory/neutral: Because the Conformity Stage person most likely strives for identification with the White society, the individual shares similar dominant attitudes and beliefs not only toward his or her own group but toward other marginalized groups as well.

Attitudes and beliefs toward members of the dominant group—group appreciating attitude and beliefs: This stage is largely characterized by a belief that White cultural, social, and institutional standards are superior.

Bloom’s Level; Knowledge Difficulty level: MEDIUM

Question 10 Question Type: Text Entry Question: One experiences a when their previous belief systems concerning White Americans and their own ethnic/cultural group are challenged by social reality and the experiences of being a ―visible racial/ethnic minority.‖ Answer: racial awakening Solution: A racial awakening has strong implications for racial, ethnic, cultural (REC) identity.

Previous belief systems concerning White Americans and one’s own ethnic/cultural group are challenged by social reality and along with the experiences of being a ―visible racial/ethnic minority.‖ Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 11 Question Type: Multiple Choice Question: In which stage does the person of color realize racism exists? a.

Integrative Awareness Stage b.

Conformity Stage c.

Dissonance Stage d.

Introspection Stage Answer: c Solution: C is the correct response because an incident or experience propels the person of color to realize that racism does exist in the Dissonance Stage.

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A is incorrect because in the Integrative Awareness Stage, he/she knows that racism exists but has come to a more integrative space.

B is incorrect because the Conformity Stage, the person of color does not realize that racism exists.

D is incorrect because the Introspection Stage is not where the person realizes that racism exists.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 12 Question Type: Essay Type Question: What changes did Cross make to the preencounter stage of his model, and why?

Solution: Instead of using the term ―pro-White‖ in the earlier pre-encounter stage, Cross now uses the term race salience. Originally, Cross believed that the rejection of Blackness and the acceptance of an American perspective were indicative of only one identity, characterized by self-hate and low self-esteem. His current model now describes three identities: (1) preencounter assimilation, (2) preencounter miseducation, and (3) preencounter anti-Black. The first has low salience for race and a neutral valence toward Blackness, the second reflects internalization of negative messages in society about Blacks but an ability to separate their personal identity from their racial group membership, while the third describes individuals who hate Blacks and hate being Black (high negative salience). In other words, it is possible for a Black person at the preencounter stage who experiences the salience of race as very minor and whose identity is oriented toward an ―American‖ perspective not to be filled with self-hate or low self-esteem.

Bloom’s Level: Analysis Difficulty Level: HARD

Question 13 Question Type: Text Entry Question: In the Racial/Cultural Identity model, the authors believe that the ____________ Stage continues to be most characterized by individuals who have bought into societal definitions about their minority status.

Answer: Conformity Solution: The authors believe that the Conformity Stage continues to be most characterized by individuals who have bought into majority societal definitions about their marginalized status in society. Because this Conformity Stage represents, perhaps, the most damning indictment of White racism and because it has such a profound negative impact on persons of color, understanding its sociopolitical dynamics is of utmost importance for the helping professional.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

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Question 14 Question Type: Multiple Choice Question: Which stage is characterized by a disdain for the dominant culture and development of pride in one’s own culture: a.

Integrative Awareness Stage b.

Resistance and Immersion Stage c.

Dissonance Stage d.

Introspection Stage Answer: b Solution: B is the correct response because in the Resistance and Immersion Stage, the person has disdain for the dominant culture and begins to develop pride in one’s own culture.

A is incorrect because in the Integrative Awareness Stage is marked by integration of the self as a racial, cultural being.

C is incorrect because in the Dissonance Stage, change begins to occur.

D is incorrect because the Introspection Stage is marked by self-definition.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 15 Question Type: True/False Question: The inferior status of minorities is constantly reinforced and perpetuated by the media (or mass media).

Answer: True Solution: The authors write that it is unfortunate that the inferior status of people of color is constantly reinforced and perpetuated by the mass media through television, movies, newspapers, radio, books, and magazines. This actually contributes to widespread stereotypes that tend to trap them. For example, the stereotypes that Blacks are superstitious, childlike, ignorant, fun-loving, dangerous, and criminal; Hispanics are dirty, sneaky, and criminal; Asian Americans are sneaky, sly, cunning, and passive; Indians are primitive savages. These types of portrayals can cause widespread harm to the self-esteem of minorities who may incorporate them.

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 16 Question Type: Text Entry Question: In the Resistance and Immersion Stage, the minority person tends to ____________ minority-held views completely and to _________ the dominant values of society and culture.

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Answer: endorse; reject Solution: The primary orientation of individuals in this phase is the tendency to endorse minority-held views completely and to then reject values of the dominant society and culture.

The desire to eliminate oppression becomes an important motivation of the individual’s behavior.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 17 Question Type: Essay Type Question: From the vignette that opens the chapters, explain Jenny’s internal struggle for identity.

Solution: Jenny’s internal struggle to cast off the cultural conditioning of her past and the attempts to define her REC identity are both painful and conflicting. We have clear evidence of the internal turmoil she is undergoing when she (a) refers to her ―Yellow-White‖ identity; (b) writes about the negative images of Asian American men but winds up dating one; (c) uses the terms ―Oriental‖ and ―boy‖ (in reference to her Asian male friend) but acknowledges their derogatory racist nature; (d) describes Asian men as ―sexually emasculated‖ but sees her Filipino date as ―athletic,‖ ―outgoing,‖ and ―sexy‖; (e) expresses embarrassment at confronting the waiter about discrimination but feels proud of her friend for doing so; and (f ) states that she finds him attractive but could never consider marrying anyone but a White man.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 18 Question Type: Multiple Choice Question: In which stage does an individual experience conflict in terms of responsibility and allegiance to one’s own group versus notions of personal independence and autonomy? a.

Introspection Stage b.

Conformity Stage c.

Integrative Awareness Stage d.

Resistance and Immersion Stage Answer: a Solution: A is the correct response because in the Introspection Stage, one experiences conflict with respect to responsibility to one’s group and personal independence.

B is incorrect because one does not experience this in the Conformity Stage.

C is incorrect because one does not experience this in the Dissonance Stage.

D is incorrect because one does not experience this in the Resistance and Immersion Stage.

Bloom’s Level: Knowledge Difficulty Level: EASY

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Question 19 Question Type: True/False Question: Due to the increased awareness and progress in race relations, racism, prejudice, and discriminatory practices are largely a thing of the past.

Answer: False Solution: The authors point out several current events that point to the fact that race relations, prejudice, stereotyping, and discriminatory practices are still a present part of today’s society.

For example, the authors point out a few high-profile cases such as Eric Garner and Ferguson Police and Michael Brown throughout the text.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 20 Question Type: Multiple Choice Question: The stage of Integrative Awareness is exemplified by which of the following? a. a full understanding of how racism operates in society and a hatred toward Whites b. group-deprecating attitudes c. selective trust and distrust according to the dominant group’s demonstrated attitudes d. a strong sense of self-worth Answer: d Solution: D is the correct response because the Integrative Awareness Stage is exemplified by a strong sense of self-worth.

B is incorrect because in the Integrative Awareness Stage one would not have hatred toward Whites.

B is incorrect because in the Integrative Awareness Stage one would not have self-deprecating attitudes.

C is incorrect because in the Integrative Awareness Stage one would not have selective trust and distrust according to the dominant group’s demonstrated attitudes.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 21 Question Type: Essay Type Question: Contrast early models of REC identity with more recent REC identity conceptualizations.

Solution: An important contribution of REC identity models is their acknowledgment of

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sociopolitical influences in shaping identity. Early models of REC identity all incorporated the effects of racism and prejudice (oppression) upon the identity transformation of their victims.

More recent REC identity conceptualizations also provide insights about how to consider the ways in which multiple identity attitudes influence the counseling/therapy process; that is, the consideration of REC identity attitudes along with other social identity attitudes such as gender, sexual orientation, and religion (Robinson-Wood, 2016).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 22 Question Type: Essay Type Question: What purpose do racial identity models serve?

Solution: Racial identity development models have proven helpful in many respects. (1) they reveal major within-group differences that occur depending on one’s level of identity; (2) research suggests that reactions to counseling, the counseling process, and counselors are influenced by cultural/racial identity and are not simply linked to minority group membership; (3) they clarify the impact of sociopolitical forces in shaping racial identity; and (4) identity development models that discuss the oppressor–oppressed relationship seem equally applicable to other marginalized groups, such as women, lesbians/gays and individuals with disabilities.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 23 Question Type: Multiple Choice Question: The sociopolitical identity transformations experienced by Asian Americans, Latina/os, and American Indians in the last few decades with the awareness of cultural oppression as the common unifying force is known as what? a.

Integrative awareness b.

Ethnocentric monoculturalism c.

Internalized racism d.

Third World consciousness Answer: D Solution: D is correct because in the past several decades, Asian Americans, Latina/os, and American Indians have experienced sociopolitical identity transformations so that a Third World con- sciousness has emerged, with the awareness of cultural oppression as the common unifying force.

A is incorrect because integrative awareness is a phase where people have developed an inner sense of security and now can own and appreciate unique aspects of their culture as well as those of U.S. culture.

B is incorrect because ethnocentric monoculturalism is (a) belief in the superiority of one group’s

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cultural heritage—its language, traditions, arts-crafts, and ways of behaving (White) over all others; (b) belief in the inferiority of all other lifestyles (non-White); and (c) the power to impose such standards onto the less powerful group.

C is incorrect because internalized racism is the term used to describe the process by which persons of color absorb the racist messages that are omnipresent in our society and internalize them.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Chapter 12 White Racial Identity Development: Counseling Implications Test Questions Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 12 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Question 1 Question Type: True/False Question: The authors contend that there is a denial associated with being White, and it is related to the denial of White privilege.

Answer: True Solution: The authors contend that much of the denial associated with being White is related to the denial of White privilege.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 2 Question Type: Multiple Choice Question: Which ego status would be best represented by the following statement, ―My grandfather is really prejudiced, but I try not to be‖? a.

Reintegration b.

Contact c.

Disintegration d.

Autonomy

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Answer: c Solution: C is correct because in Disintegration, Whites come to understand that racism exists and experience dissonance. Oftentimes, this dissonance results in denial in the role of racism and/or oppression.

A is incorrect because in Reintegration, Whites fall back into a comfort zone and embrace Whiteness.

B is incorrect because during the Contact ego status, Whites don’t see color.

D is incorrect because during the Autonomy ego status, Whites have a more integrated identity and can acknowledge their role in racism.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 3 Question Type: Text Entry Question: One of the earliest integrative attempts at formulating a White racial identity development model is that of ______________ (1982).

Answer: Hardiman Solution: One of the earliest integrative attempts at formulating a White racial identity was the development model created by Rita Hardiman (1982, as cited in Sue 8th edition). She was intrigued with why certain White Americans exhibit a much more nonracist identity than do other White Americans. This led her to study the autobiographies of individuals who had attained a high level of racial consciousness and led her to identify five White developmental stages: (a) naiveté—lack of social consciousness, (b) acceptance, (c) resistance, (d) redefinition and (e) internalization.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 4 Question Type: Essay Type Question: Name and provide a brief description of the five developmental stages of the Hardiman White Racial Identity Development model.

Solution: The five stages are (1) naïveté—lack of social consciousness, (2) acceptance, (3) resistance, (4) redefinition and (5) internalization.

The naiveté stage or lack of social consciousness is characteristic of early childhood, when we are born into this world innocent, open, and unaware of racism and the importance of race.

The acceptance stage is marked by a conscious belief in the democratic ideal in that everyone has an equal opportunity to succeed in a free society and that those who fail must bear the responsibility for their failure.

The third stage is the resistance stage, the individual begins to challenge assumptions of White superiority and the denial of racism and discrimination.

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In the fourth stage, called the redefinition stage, one asks the painful question of who one is in relation to one’s racial heritage, honestly confronting one’s biases and prejudices, and accepting responsibility for one’s Whiteness are the culminating characteristics.

The last stage is the internalization stage, and it is the result of forming a new social and personal identity. There is a greater comfort in understanding oneself and the development of a nonracist White identity come a commitment to social action as well. The individual now accepts responsibility for effecting personal and social change without always relying on persons of color to lead the way.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 5 Question Type: True/False Question: The effectiveness of White therapists is related to their ability to overcome sociocultural conditioning and to make their Whiteness invisible.

Answer: False Solution: Just the opposite is true. The authors offer as an implication for clinical practice that the effectiveness of White therapists is related to their ability to overcome sociocultural conditioning and to make their Whiteness visible.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 6 Question Type: Multiple Choice Question: According to the Hardiman (1982, as cited in Sue 8th edition) White Racial Identity Development model, which stage is characterized by a conscious belief in the democratic ideal that everyone has an opportunity to succeed? a. naiveté b. acceptance c. resistance d. redefinition Answer: b Solution: B is the correct response. Acceptance refers to the belief in the democratic ideal that everyone has an opportunity to succeed.

B is incorrect because naïveté refers to unawareness of racial issues.

C is incorrect because resistance is where Whites come to understand the suffering of people of color and often experience painful emotions.

D is incorrect because in redefinition, Whites begin to search for a new identity.

Bloom’s Level: Knowledge Difficulty Level: EASY

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Question 7 Question Type: Text Entry Question: The ____________ model is by the far the most widely cited, researched, and applied of all the White racial identity formulations.

Answer: Helms Solution: The authors write that Helms’s model is by far the most widely cited, researched, and applied of all the White racial identity formulations.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 8 Question Type: Essay Type Question: Name two critiques of the Helms White Racial Identity model.

Solution: In an article critical of the Helms model (and of most ―stage‖ models of White racial identity development), Rowe, Bennett, and Atkinson (1994, and cited in Sue 8th edition) raised objections including the model’s basis on racial/ethnic minority identity development models, which may not apply to White identity and the unsupported conceptual accuracy of putting forth the model as linear developmental via stages Finally, Rowe (2006, and cited in Sue 8th edition) attacks the Helms model because it is based upon the White Racial Identity Attitude Scale (Helms & Carter, 1990), which he labels as ―pseudoscience‖ because he asserts that the psychometric properties are not supported by the empirical literature.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 9 Question Type: True/False Question: Research suggests that it is possible for people to avoid inheriting the racial biases, prejudices, misinformation, deficit portrayals, and stereotypes of their forebears if they are exposed to various and diverse cultures before entering formal schooling.

Answer: False Solution: The authors point out that research suggests that it is nearly impossible for anyone to avoid inheriting the racial biases, prejudices, misinformation, deficit portrayals, and stereotypes of their forebears.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

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Question 10 Question Type: Multiple Selection Question: Which are stages of the Sue 8th edition) descriptive model of White racial identity development? a. naiveté phase b. conformity phase c. dissonance phase d. resistance and immersion phase e. denial phase f. introspective phase g. integrative awareness phase h. acceptance phase i. commitment to antiracist action phase Answer: a, b, c, d, f, g and i Solution: A, b, c, d, f, g and i are phases of Sue’s 8th edition descriptive model. The seven-step model includes naiveté, conformity, dissonance, resistance and immersion, introspective, integrative awareness, and commitment to antiracist action.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 11 Question Type: Essay Type Question: According to the authors, what are the two underlying factors that account for the denial and mystification of Whiteness for White EuroAmericans?

Solution: The authors share that it appears that the denial and mystification of Whiteness for White EuroAmericans are related to two underlying factors. First, Whiteness is transparent precisely because of its everyday occurrence—its institutionalized normative features in our culture—and because Whites are taught to think of their lives as morally neutral, average, and ideal (Sue, 2004, as cited in Sue 8th edition). Second, EuroAmericans often deny that they are White, seem angered by being labeled as such, and often become very defensive. It is our contention that much of the denial associated with being White is related to the denial of White privilege.

Bloom’s Level: Analysis Difficulty Level: HARD

Question 12 Question Type: True/False Question: There is a difference between being nonracist and antiracist.

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Answer: True Solution: Becoming nonracist means soul searching, individual change, and working on the self; becoming antiracist, however, means taking personal action to end external racism that exists systemically and in the actions of others.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 13 Question Type: Multiple Choice Question: According to Helms, the Contact ego status is supported by what characterization? a. suppression b. obliviousness c. selective perception d. reaction formation Answer: b Solution: B is the correct response because the Contact ego status is characterized by lack of awareness.

B is incorrect because the person who typifies the Contact ego status has no material to suppress.

C is incorrect because the person has no material to perceive.

D is incorrect because reaction formation is an ego defense mechanism in which unacceptable emotions are replaced by the direct opposites.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 14 Question Type: Multiple Choice Question: During which ego status is an individual likely to state, ―I don’t even know if my ancestors owned slaves, but I know that because I am White, I continue to benefit from a racist system that stems from the slavery era‖? a.

Immersion/emersion b.

Contact c.

Disintegration d.

Pseudo-independence Answer: a Solution: A is the correct response because during the immersion/emersion status, the White person understands the system of oppression and can admit his/her role.

B is incorrect because at during Contact, the person is unaware.

C is incorrect because during Disintegration the person would not be able to underscore his/her role in racism.

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D is incorrect because during Pseudo-independence the person has not fully taken on responsibility for racism.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 15 Question Type: Essay Type Question: The Helms White Racial Identity model asserts that developing a healthy White identity requires movement through two phases. Name the two phases and their accompanying racial identity statuses.

Solution: To Helms, developing a healthy White identity requires movement through two phases: (1) abandonment of racism and (2) defining a nonracist White identity. Six specific racial identity statuses are distributed equally in the two phases: contact, disintegration, reintegration, pseudoindependence, immersion/emersion, and autonomy.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 16 Question Type: Multiple Choice Question: According to Sue and Sue (1990, as cited in Sue 8th edition), in which of the following stages is a White person forced to deal with the inconsistencies that are at odds with his or her denial? a.

Resistance and Immersion b.

Conformity c.

Dissonance d.

Introspective Answer: c Solution: C is the correct response because the Dissonance Stage is marked with inconsistencies.

A is incorrect because during the Resistance and Immersion Stage, the person is not dealing with inconsistent information.

B is incorrect because during the Conformity Stage, the person is conforming to dominant standards.

D is incorrect because during the Introspective Stage, the person is forming a solid identity.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 17 Question Type: True/False

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Question: There are typically higher levels of racism among those least aware of their White identity.

Answer: True Solution: The authors state that the less aware subjects studied were of their White identity, the more likely they were to exhibit higher levels of racism. Conversely, the greater their White identity development, the greater their levels of multicultural counseling competence, the higher their positive opinions toward diverse groups, and the better their ability to form therapeutic alliances with clients of color.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 18 Question Type: Multiple Choice Question: The Autonomy ego status is represented by which of the following? a.

A person is knowledgeable about racial differences, values diversity, and no longer fearful of the experiential reality of race. b.

A person sees people as people and autonomously decides if he/she sees race or not. c.

A person has the belief that the White way is the right way. d.

A person intellectually understands race but sees Whites as being superior to people of color.

Answer: a Solution: A is the correct response because during the Autonomy ego status, the person is knowledgeable about racial differences, values diversity, and no longer fears the experiential reality of race.

B is incorrect because the person does see race.

C is incorrect because the person does not believe the White way is the right way.

D is incorrect because the person no longer believes in the superiority of Whites.

Bloom’s Level: Comprhension Difficulty Level: MEDIUM

Question 19 Question Type: Multiple Choice Question: A person who believes that racial blending is inevitable is most likely to operate from which ego status? a.

Contact b.

Disintegration c.

Immersion/Emersion d.

Pseudo-independence Answer: d

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Solution: D is the correct response because the person wants to make everyone equal in the Pseudo-independence status.

A is incorrect because during Contact, the person does not see color.

B is incorrect because during Disintegration the person is just starting to see difference.

C is incorrect because during the Immersion/Emersion status, the person respects difference.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 20 Question Type: Multiple Choice Question: The belief that racial and cultural differences are unimportant is best exemplified by which ego status? a.

Autonomy b.

Disintegration c.

Reintegration d.

Contact Answer: D Solution: D is the correct response because the Contact ego status is marked by obliviousness to racial groups.

A is incorrect because during Autonomy, the person believes in the importance of valuing group differences.

B is incorrect because during Disintegration the person is just starting to see difference.

C is incorrect because during Reintegration the person is into their Whiteness.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 21 Question Type: Multiple Choice Question: What happens to a White person who is in Sue and Sue’s (1990, as cited in Sue 8th edition) Dissonance Stage? a.

Realizations occur that one is biased and that EuroAmerican society does play a part in oppressing people of color. b.

One is comfortable with the concept of race and works towards a nonracist identity. c.

A person does not recognize race and believes that people are people. d.

None of the choices is correct.

Answer: a Solution: A is the correct response because during the Dissonance Stage, the person realizes that he/she is biased and that EuroAmerican society does play a role in oppressing people of color.

B is incorrect because one is not quite comfortable with race during the Dissonance Stage.

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C is incorrect because ―people are people‖ is a naïve stance that would not be found in the Dissonance Stage.

D is incorrect because the answer is a.

Bloom’s level: Knowledge Difficulty: MEDIUM Chapter 13: Culturally Competent Assessment Test Questions Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 13 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Question 1 Question Type: True/False Question: Accurate assessment, diagnosis, and case conceptualization is dependent on the characteristics, values, and worldviews of the therapist.

Answer: False Solution: Accurate assessment, diagnosis, and case conceptualization, key prerequisites to the provision of appropriate treatment, are dependent upon the characteristics, values, and worldviews of both the therapist and the client (American Psychological Association, 2006 and 2017, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 2 Question Type: Multiple Choice Question: In addition to working collaboratively with your client to construct an accurate definition of the problem, you also include the __________________, which acknowledges that both the client and therapist are embedded in systems such as family, work, and culture. a. contextual viewpoint b. multicultural perspective c. multicultural worldview d. contextual limit Answer: a

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Solution: A is the correct response because the contextual viewpoint acknowledges that the client and therapist are embedded in systems such as family, work and culture.

B is incorrect because the multicultural perspective does not accurately capture the sentiment expressed in the question.

C is incorrect because the answer is a.

D is incorrect because the answer is a.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 3 Question Type: Text Entry Question: To reduce error, a clinician must be aware of potential biases that can affect clinical judgment, including the influence of ___________.

Answer: stereotypes Solution: Errors in assessment can occur because of biases, mistakes in thinking, and stereotypes held by the clinician.

Bloom’s Level: Knowledge Difficulty Level EASY

Question 4 Question Type: Essay Type Question: Describe some of the common diagnostic errors that may occur during assessment and diagnosing. Explain why and when these may occur.

Solution: Some of the commonly occurring diagnostic errors the authors point out include: Confirmatory strategy—searching for evidence or information that supports one’s hypothesis and ignoring data that are inconsistent with this perspective.

Attribution error—the therapist places an undue emphasis on internal causes regarding a client’s problem.

Judgmental heuristics: commonly used quick-decision rules, which can be problematic because they short-circuit our ability to engage in self-correction.

Diagnostic overshadowing-the client’s problem receives inadequate treatment because attention is diverted to a more salient characteristic.

These types of errors can happen and are most likely to occur when clinicians fail to use selfcorrecting strategies or fail to consider the individuality of each client. The authors believe that effective culturally competent assessment can, in fact, minimize the dangers of stereotyping or placing inordinate weight on race or other diversity issues.

Bloom’s Level: Analysis Difficulty Level: HARD

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Question 5 Question Type: True/False Question: ―Professionally sanctioned stereotyping‖ happens when cultural attributes are given primary consideration rather than a focus on the understanding of the uniqueness and life circumstances of each client.

Answer: True Solution: This is true according to current research. The authors describe that some mental health professionals have argued that the emphasis on culture and the development of culture-specific approaches have led to fragmentation, confusion, and controversy in the field of counseling and psychotherapy. Furthermore, diversity training has been accused of producing ―professionally sanctioned stereotyping,‖ in which the therapist gives primary consideration to cultural attributes rather than focusing on understanding the uniqueness and life circumstances of the individual client (Freitag, Ottens, & Gross, 1999; D. W. Sue & Sue, 2013, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 6 Question Type: Text Entry Question: Cultural competence includes ____________- _________________ knowledge of _________________ _______________ ______________, and ______________________ ___________________ _______________.

Answer: self-awareness; culturally diverse groups; specific clinical skills.

Solution: The authors highlight that cultural competence is defined in different ways. They, however, use the definition focusing on the following three components: (a) self-awareness (i.e., self-reflection and awareness of one’s values and biases); (b) knowledge of culturally diverse groups (e.g., marginalized status, characteristics, strengths, norms, and values); and (c) specific clinical skills, including the ability to generate a wide variety of verbal and nonverbal helping responses, form a therapeutic alliance, and intervene at the individual, group, institutional, and societal levels. They believe that appropriate use of these aspects of cultural competence can prevent diagnostic and treatment errors due to inaccurate assumptions and stereotypes.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 7 Question Type: Multiple Selection Question: Specific clinical skills working with diverse clients may include which of the following: a. ability to generate a wide variety of verbal and nonverbal helping responses

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b. c. d.

form a therapeutic alliance intervene at the individual or group level intervene at institutional and/or societal levels

Answer: a, b, c, d Solution: The authors believe that appropriate use of these aspects of cultural competence can prevent diagnostic and treatment errors due to inaccurate assumptions and stereotypes.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 8 Question Type: True/False Question: Knowledge of cultural values associated with specific groups can help therapists generate hypotheses about the manner in which a client might view a disorder.

Answer: True Solution: Knowledge of cultural values associated with specific groups can help therapists generate hypotheses about the manner in which a client might view a disorder. However, cultural knowledge alone is insufficient and the client must be given opportunities to share their beliefs, perspectives, and expectations, as well as their explanation of the problem.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 9 Question Type: Multiple Choice Question: The authors believe that what occurs through a combination of evidence-based guidelines for assessment and a cultural competency framework? a. contextual and collaborative assessment b. culturally responsive assessment c. confirmatory strategy d. diagnostic overshadowing Answer: b Solution: B is correct because the authors believe culturally responsive assessment occurs through a combination of evidence-based guidelines for assessment and a cultural competency framework.

A is incorrect because contextual and collaborative assessment infuses cultural factors into standard intake and assessment procedures and takes into consideration the client’s unique personal and cultural background.

C is incorrect because confirmatory strategy searches for evidence or information that supports one’s hypothesis and ignoring data that are inconsistent with this perspective.

D is incorrect because with diagnostic overshadowing, the client’s problem receives inadequate

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treatment because attention is diverted to a more salient characteristic.

Bloom’s Level: Difficulty Level:

Question 10 Question Type: Multiple Choice Question: Cultural differences between specific groups of people can affect individuals in a unique way. Which one of the following differences can affect individuals? a. degree of assimilation b. socioeconomic background c. family experiences d. educational level e.

All of the choices are correct.

Answer: e Solution: Among many, some cultural differences, such as the degree of assimilation, socioeconomic background, family experiences, and educational level, affect each individual in a unique manner.

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 11 Question Type: Text Entry Question: ___________ ___________ describes the search for evidence or information supporting one’s hypothesis and ignoring data that is inconsistent with this perspective.

Answer: Confirmatory strategy Solution: Confirmatory strategy is defined as searching for evidence or information that supports one’s hypothesis and ignoring data that are inconsistent with this perspective.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 12 Question Type: Multiple Choice Question: Which term BEST describes the situation where both the client and the therapist are embedded in systems such as family, work, and culture? a. worldview b. collaborative approach c. contextual viewpoint d. ethnocentric inquiry

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Answer: c Solution: Contextual viewpoint is important, recognizing that both therapist and client operate from their own experiences and worldviews. Consider that just as clients may have socialization experiences or experiences with prejudice or discrimination that play a role in their presenting concerns, therapists may also hold worldviews or have had experiences that influence their perceptions of the client or the client’s issues.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 13 Question Type: Essay Type Question: What are the seven components of collaborative conceptualization (modified from Spengler, Strohmer, Dixon, & Shivy, 1995, as cited in Sue 8th edition)? Why is this approach needed?

Solution: 1. Use both clinician skill and client perspective to understand the presenting problem.

2. Collaborate and jointly define the presenting problem.

3. Jointly formulate a possible hypothesis regarding the cause of the problem.

4. Jointly develop ways to confirm or disconfirm the hypothesis on the problem, and continuing to consider alternative hypotheses.

5. Test out the hypothesis using both the client and the therapist as the evaluators.

6. If the conceptualization appears to be valid, develop a treatment plan.

7. If the hypothesis is not borne out, therapist and client collect additional data and formulate a new, testable hypotheses.

The authors believe that it is of critical importance to go through a collaborative process such as this. The therapist and client can adopt a scientific framework as they work to conceptualize the problem and then have an equal voice in evaluating the problem definition. Moreover, unless there is substantial agreement on the definition of a problem, therapeutic progress is likely to be less than optimal.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 14 Question Type: Essay Type Question: Elaborate on why a collaborative approach is necessary in working with diverse populations.

Solution: It is only through close collaboration with the client can we accurately identify the specific issues involved in the presenting problem and eliminate the blind application of cultural knowledge. This is best accomplished within a collaborative approach in which clients are given

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opportunities to share their beliefs, perspectives, and expectations, as well as their explanations of problems. Consider, for example, if a client’s belief about the presenting problem differs from that of the therapist, treatment based only on the therapist’s views is likely to be ineffective.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 15 Question Type: Text Entry Question: Multicultural awareness can lead to ___________ __________ if clinical attention to race or other diversity issues results in neglect of other important aspects of the client.

Answer: diagnostic overshadowing Solution: This may occur when the client’s problem receives inadequate treatment because attention is diverted to a more salient characteristic.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 16 Question Type: Text Entry Question: It is important that clinicians avoid a ―________‖ approach in which the characteristics of different groups are memorized and applied to all clients who belong to a specific group.

Answer: cookbook Solution: It is important to understand group-specific differences, it is equally critical that we avoid a ―cookbook‖ approach, in which the characteristics of different groups are memorized and applied to all clients who belong to that specific group (Lee, 2006, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 17 Question Type: True/False Question: When conducting a culturally sensitive intake interview, it can be helpful to assess the primary language used in the home in the identifying information section.

Answer: True Solution: When relevant, it is important to ask about the primary language used in the home or the degree of language proficiency of the client or family members. Also, one should determine whether an interpreter is needed. As previously discussed, it is important not to rely on family members to interpret when assessing clinical matters.

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Bloom’s Level: Knowledge Difficulty Level: EASY

Question 18 Question Type: Essay Type Question: Explain why some mental health professionals have argued that the emphasis on culture and the development of culture-specific approaches have led to fragmentation, confusion, and controversy in the field of counseling and psychotherapy.

Solution: Some mental health professionals have argued that the emphasis on culture and the development of culture-specific approaches have led to fragmentation, confusion, and controversy in the field of counseling and psychotherapy. Diversity training has been accused of producing ―professionally sanctioned stereotyping,‖ in which the therapist gives primary consideration to cultural attributes rather than focusing on understanding the uniqueness and life circumstances of the individual client (Freitag, Ottens, & Gross, 1999; D. W. Sue & D. Sue, 2013, as cited in Sue 8th edition). Although it is important to understand group-specific differences, it is equally critical that we avoid a ―cookbook‖ approach, in which the characteristics of different groups are memorized and applied to all clients who belong to a specific group (Lee, 2006, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 19 Question Type: Multiple Selection Question: Which of the following items should be considered during a culturally sensitive intake interview? a. identifying information and presenting information b. history of presenting problem c. psychosocial history d. abuse history e. strengths f. medical history g. substance abuse history h. risk of harm of self or others Answer: a, b, c, d, e, f, g, h Solution: All of the choices should be included in a culturally sensitive intake interview.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 20

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Question Type: True/False Question: The opening question, ―How can I help you?‖ may feel like a top-down hierarchal approach that may offend some cultural groups.

Answer: False Solution: ―How can I help you?‖ This question addresses the reason for the visit and client expectations regarding therapy. Clients may have different ideas of what they want to achieve and unclear or divergent expectations between client and therapist can hamper therapy.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 21 Question Type: True/False Question: Standard clinical intake forms are sufficient for assessing cultural differences therefore there is no need to modify them.

Answer: False Solution: A standard clinical assessment forms need to account for the cultural identity of the individual, cultural conceptualizations of distress, and appropriate treatment, psychosocial stressors, and any cultural differences between the individual and the clinician. These diversity considerations can easily be incorporated into the intake process.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM Chapter 14: Counseling African Americans Test Questions Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 14 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Question 1 Question Type: Multiple Choice Question: Which of the following is TRUE regarding the health of African Americans? a.

African Americans are underrepresented among AIDS cases. b.

African Americans are more likely to undergo corrective surgeries than White Americans are.

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c. d.

There is little evidence that the blood pressure of African Americans can be influenced by psychological factors.

The average lifespan of African Americans is up to five to six years shorter than that of White Americans.

Answer: d Solution: D is the correct response because the average lifespan of African Americans is up to five to six years shorter than that of White Americans.

A is incorrect because African Americans are not underrepresented among AIDS cases.

B is incorrect because African Americans are not more likely to undergo corrective surgeries than White Americans are.

C is incorrect because there is evidence that the blood pressure of African Americans can be influenced by psychological factors.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 2 Question Type: Text Entry Question: ___________ and __________ protective factors have been hypothesized to account for the finding that African Americans have lower levels of heavy binge drinking among any ethnic group except for Asians.

Answer: Family; religious Solution: Family and religious protective factors have been hypothesized to account for the findings that African Americans have lower levels of heavy and binge drinking than any other ethnic group, with the exception of Asian Americans (Substance Abuse and Mental Health Services Administration, 2013, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 3 Question Type: True/False Question: Although African Americans represent only 13 percent of the U.S. population, 40 percent of those incarcerated are Black.

Answer: True Solution: Although African Americans represent 13 percent of the U.S. population, 40 percent of those incarcerated are Black. Whites who make up 64 percent of the population account for only 39 percent of those in prison (Hagler, 2015, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

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Question 4 Question Type: Essay Type Question: Based on the chapter and some of the family characteristics that are noted, what are some of the ways a therapist might work with African American families?

Solution: The authors suggest that therapists should work to strengthen and increase functionality of the existing family structure rather than attempt to change it. One of the strengths of the African American family is that men, women, and children are allowed to adopt multiple roles within the family structure. For example, older children might adopt a caretaking role, and friends or grandparents might help raise children. In such cases, therapy might focus on enhancing the working alliance among caregivers (Muroff, 2007, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 5 Question Type: Multiple Choice Question: Demographics on the African American population show a. within 20 years, they will be the largest minority group in the United States. b. the number of African American men in their 20s who are in prison, in jail, or on parole has decreased in recent years. c. the poverty rate of African Americans remains nearly two times as high as that of White Americans. d. their unemployment rate is now only slightly higher than that of White Americans.

Answer: c Solution: C is the correct response because demographics indicate that the poverty rate of African Americans remains nearly two times as high as that of White Americans.

A is incorrect because within 20 years, African Americans will not be the largest minority group in the United States—Latinos will be.

B is incorrect because the number of African American men in their 20s who are in prison, in jail or on parole has increased in recent years.

D is incorrect because the unemployment rate for African Americans is not only slightly higher than that of White Americans.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 6 Question Type: Text Entry Question: One of the most important counselor characteristic for African Americans is the _______ _______ of the counselor.

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Answer: cultural sensitivity Solution: The most important counselor characteristic for African Americans is the cultural sensitivity of the counselor. Culturally sensitive counselors are those who acknowledge the possibility that race or culture might play a role in a client’s problem. These counselors are seen as more competent than culture- or color-blind counselors, those who do not assess for environmental issues such as prejudice (Want, Parham, Baker, & Sherman, 2004, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 7 Question Type: Essay Type Question: Why should a therapist working with African Americans examine their own beliefs about family structure and roles within families?

Solution: The counselor’s reaction to a client’s family structure may be affected by a Eurocentric, nuclear-family orientation. Many assessment forms and evaluation processes are based on a middle-class EuroAmerican perspective of what constitutes a family. For family therapy to be successful, counselors must first identify their own set of beliefs and values regarding appropriate roles and communication patterns within a family. They should take care not to impose these beliefs on other families. It is helpful to move away from a deficit model to an asset or strengths perspective when evaluating families (Rockymore, 2008, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 8 Question Type: Multiple Choice Question: What is accurate regarding the educational experience of African Americans? a.

The educational attainment gap between Black and White children has widened considerably in the last 10 years. b.

Approximately 25 percent of African American adults do not graduate from high school. c.

The percentage of African Americans in higher education has increased dramatically in the last few years, even with the dismantling of affirmative action programs. d.

In general, African American college students report few instances of discrimination and prejudice on college campuses.

Answer: b Solution: B is the correct response because although gains have been made, the gap in high school graduation between African American and White children persists. In the 2014-2015 school year, the adjusted cohort graduation rate for African Americans was 75 percent compared

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to White Americans at 88 percent (NCES, 2017 as cited in Sue 8th edition).

A is incorrect because the educational attainment gap between Black and White children has not widened considerably in the last 10 years.

C is incorrect because the percentage of African Americans in higher education has decreased dramatically in the last few years, even with the dismantling of affirmative action programs.

D is incorrect because in general, African American college students report several instances of discrimination and prejudice on college campuses.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 9 Question Type: True/False Question: African Americans in the immersion stage are less likely to report instances of racial discrimination.

Answer: False Solution: African Americans who have attitudes and behaviors consistent with the preencounter level are less likely to report racial discrimination, whereas those in the immersion stage tend to be least satisfied with societal conditions.

Bloom’s Type: Comprehension Difficulty Level: MEDIUM

Question 10 Question Type: True/False Question: The poverty rate for African Americans remains nearly two times higher than that of all households.

Answer: True Solution: This is a true statistic as reported in the text that the poverty rate for African Americans remains nearly twice as high as that of all households (25.4% versus 14.7%) (U.S. Census Bureau, 2017, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 11 Question Type: Multiple Choice Question: What has been found regarding African American adolescents/young adults (ages 16 to 24)? a.

Unemployment rates among this population are low. b.

African American youth have the lowest rate of substance abuse.

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c. d.

Most do not feel that race is a factor in terms of how people are judged.

Their suicide rate is lower than that of White youth.

Answer: B Solution: B is the correct response because African American adolescents have low rates of substance use compared to Whites and other ethnic groups (Johnston, O’Malley, Miech, Bachman, & Schulenberg, 2014, as cited in Sue 8th edition).

A is incorrect because unemployment rates among this population are high.

C is incorrect because most do feel that race is a factor in terms of how people are judged.

D is incorrect because their suicide rate is higher than that of White youth.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 12 Question Type: Multiple Selection Question: Counselors working with economically disadvantaged African American families may need to assume which of the following roles? a. problem solver b. babysitter c. help do chores d. facilitating mentor e. advocate f. case manager g. navigate community resources Answer: a, d, e, f, g Solution: In working with economically disadvantaged African American families, the counselor may need to assume various roles, including advocate, case manager, problem solver, and facilitating mentor and to help the family navigate community systems, including the educational or judicial system.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 13 Question Type: True/False Question: The unemployment rate for African Americans is nearly twice as high as that of all households.

Answer: True Solution: The unemployment rate is over twice that of White Americans (9.5% versus 4.6%) (U.S. Department of Labor, 2015, as cited in Sue 8th edition).

Bloom’s Level: Knowledge

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Difficulty Level: EASY

Question 14 Question Type: Essay Type Question: What are three specific challenges the African American male faces?

Solution: Responses will vary but should cover several of the challenges the chapter describes such as poverty rate, unemployment rate, health issues, racism, crime, school failure, family issues.

Bloom’s Level: Synthesis Difficulty level: HARD

Question 15 Question Type: Essay Type Question: Describe why the educational environment is often a negative one for African American youth.

Solution: The educational environment is often negative for African American youth. They are two to five times more likely to be suspended from school and often receive harsher consequences than their White peers (Rudd, 2014, as cited in Sue 8th edition). School personnel often hold stereotypes of African American parents as being neglectful or incompetent and blame children’s problems on a lack of parental support for schooling. As one teacher stated, ―The parents are the problem! They [the African American children] have absolutely no social skills, such as not knowing how to walk, sit in a chair, . . .it’s cultural‖ (Harry et al., 2005, p.

105, as cited in Sue 8th edition); but when these researchers visited the homes of parents who were criticized, they often observed parental love, effective parenting skills, and family support for education.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 16 Question Type: True/False Question: According to research, African Americans have the highest birth rates among unmarried women.

Answer: False Solution: Although there has been a significant decline in nonmarital births in the U.S. across racial and ethnic groups, African Americans have the second highest birth rates among nonmarried women (63 per 1000 compared to Hispanic women’s 73 per 1000) (CDC, 2014, as cited in Sue 8th edition).

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Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 17 Question Type: Text Entry Question: Over ____percent of African American households are middle income and _____ percent upper income versus ______percent and _______percent of White households.

Answer: 38; 12; 44; 26 The text reports that 38 percent of African American households are middle income and 12 percent are upper income, compared with 44 percent and 26 percent of White households respectively (Parlapiano, Gebeloff, & Carter, 2015, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 18 Question Type: Essay Type Question: Explore why the first therapy session is crucial in determining if an African American client will return for subsequent sessions.

Solution: The authors describe that the first therapy sessions are crucial in determining whether a client will return. African Americans have a high rate of therapy termination (Fortuna, Alegria, & Gao, 2010, as cited in Sue 8th edition). Termination often reflects the counselor’s inability to establish an effective therapeutic alliance. Prior experiences may render issues of trust very important. The counselor can deal with these issues by discussing them directly and by being open, authentic, and empathetic. Clients often make a decision regarding continuation of therapy based on their personal evaluation of the counselor. Counselors may need to have a broader role and more flexible style, including being more direct, serving in an educative function, and helping the client deal with agencies or with issues involving health and employment.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 19 Question Type: True/False Question: Assessing spiritual strengths and beliefs is recommended when working with African American clients.

Answer: True Solution: Spiritual beliefs are important to many African Americans and may serve as a protective factor in response to stressors. For example, if a client is heavily involved in church

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activities or has strong religious beliefs, the counselor might consider enlisting church leaders to help the client (or family) deal with social and economic stressors or conflicts involving the family, school, or community. Church personnel are also often aware of the family dynamics and living conditions of parishioners. Moreover, churches often sponsor parenting programs or activities that enrich family life.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 20 Question Type: True/False Question: With respect to crime, it has been found that darker-skinned women experience shorter sentences than women with lighter skin.

Answer: False Solution: With respect to crime, it has been found that lighter-skinned women experience shorter sentences than women with darker skin.

The textbook reports that in a study involving African American defendants who were convicted of killing White victims, Eberhardt and colleagues (2006 as cited in Sue 8th edition) found that defendants with darker skin and broader noses were twice as likely to receive the death penalty compared to African Americans who looked less stereotypically black. Similarly, Viglione, Hannon, and DeFina (2011, as cited in Sue 8th edition) found that African American women with lighter skin received shorter sentences than women with darker skin who committed similar crimes.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 21 Question Type: True/False Question: African American clients who sense that the counselor is willing to ―go the extra mile‖ with the client are more likely to continue with counseling.

Answer: True Solution: The authors share one particular example of this when one African American client stated, ―I am assessing to see if that person [counselor] is willing to go that extra mile and speak my language and talk about my Blackness‖ (Ward, 2005, p. 475, as cited in Sue 8th edition).

Counselors may need to have a broader role and more flexible style, including being more direct, serving in an educative function, and helping the client deal with agencies or with issues involving health and employment.

Bloom’s Level: Knowledge Difficulty Level: EASY

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Question 22 Question Type: True/False Question: Clients who are at the pre-encounter stage of racial identity may believe that race is an important factor in their lives.

Answer: False Solution: Clients who are at the pre-encounter stage of racial identity generally do not believe that race is an important factor in their lives. Furthermore, African Americans who are at the preencounter level are less likely to report racial discrimination, whereas those in the immersion stage tend to be least satisfied with societal conditions.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM Chapter 15: Counseling American Indians/Native Americans and Alaska Natives Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 15 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Test Questions Question 1 Question Type: Multiple Choice Question: Approximately what percentage of American Indian children were being placed by state courts and child welfare workers into non-Indian homes prior to the enactment of the Indian Child Welfare Act? a. under 30 percent b. over 50 percent c. over 90 percent d. under 50 percent Answer: c Solution: C is the correct response because over 90 percent of American Indian children were being placed by state courts and child welfare workers into non-Indian homes prior to the enactment of the Indian Child Welfare Act. A is incorrect because it is 90 percent.

B is incorrect because it is 90 percent.

D is incorrect because it is 90 percent.

Bloom’s Level: Knowledge Difficulty Level: EASY

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Question 2 Question Type: True/False Question: According to the Bureau of Indian Affairs, since American Indian/Alaska Natives comprise such a small percentage of the U.S. population, they are relatively ―invisible‖ and thus susceptible to stereotypes. This is a reason that people are opposed to the use of Indian-themed mascots and logos.

Answer: True Solution: The text reads that because American Indian/Native American and Alaska Natives (AI/AN) comprise such a small percentage of the U.S. population, they are relatively ―invisible,‖ which makes information about them susceptible to stereotypes. This is one of the reasons that many oppose the use of Indian-themed mascots and logos.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 3 Question Type: Text Entry Question: The high incidence of suicide among American Indians is thought to be the result of ______ ________, _________, __________, and __________ ___________.

Answer: alcohol abuse; poverty; boredom; family stress Solution: The high incidence of suicide is associated with alcohol abuse, poverty, boredom, family breakdown and disconnection from their culture and community according to Gray and McCullagh (2014, as cited in Sue 8th edition).

Bloom’s Level: Difficulty Level:

Question 4 Question Type: Essay Type Question: Describe some of the cultural and spiritual values among American Indians/Native Americans. Why might some of these issues be important in the counseling relationship?

Solution: Various parts of the chapter refer to spirituality issues among American and Native Indians. The spirit, mind and body are all interconnected; therefore, they believe that illness involves disharmony between these elements. Spiritual and traditional practices act as a protective factor (Garroutte et al., 2003, as cited in Sue 8th edition).

Many Indians believe that mental health issues are due to unbalanced spiritual relationships (Limb & Hodge, 2010, as cited in Sue 8th edition). In work with AI/NA/AN, counselors need to understand how the values of sharing, cooperation, noninterference, time orientation, spirituality, and nonverbal communication are all relevant to mental health practice.

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Bloom’s Level: Synthesis Difficulty Level: HARD

Question 5 Question Type: Multiple Choice Question: In terms of time orientation, American Indians and Alaskan Natives are much more oriented toward a. the future b. the present c. the past d. time does not exist Answer: b Solution: B is the correct response because in terms of time orientation, American Indians and Native Alaskans are much more oriented toward the present.

A is incorrect because American Indians and Native Alaskans are not future oriented; however, European Americans are.

C is incorrect because American Indians and Native Alaskans are not oriented to the past.

D is incorrect because time does exist for American Indians and Native Alaskans.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 6 Question Type: True/False Question: Statistics indicate that American Indian women suffer a higher rate of domestic violence as compared to other ethnicities.

Answer: True Solution: The authors state that the rate of domestic violence, along with physical and sexual assault, is quite high in many native communities. Statistics indicate that American Indian/Native American and Alaska Native women experience domestic violence and physical assault at much higher rates than women of other ethnicities (Peters, Straits, & Gauthier, 2015, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 7 Question Type: True/False Question: American Indians/Alaska Natives are a heterogeneous group composed of approximately 159 distinct tribes, some consisting of only four to five members.

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Answer: False Solution: At the time of the 8th edition, American Indians/Alaska Natives form a highly heterogeneous group composed of 566 distinct tribes, some consisting of only four or five members (Bureau of Indian Affairs, 2014, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 8 Question Type: Essay Question: Describe a typical ―Indian family.‖ Solution: According to the authors it is difficult to describe ―the Indian family.‖ They vary from the matriarchal structures seen in the Navajo, where women govern the family, to patriarchal structures, in which men are the primary authority figures. However, some generalizations can be made. A high fertility rate and strong roles for women are commonly seen. For most tribes, the extended family is the basic unit. Children are often partially raised by relatives such as aunts, uncles, and grandparents, who live in separate households (Garrett, 2006, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 9 Question Type: Multiple Choice Question: Which is NOT an acculturation orientation? a. marginal b. pantraditional c. pannational d. bicultural Answer: c Solution: C is the correct response because pannational is not an acculturation orientation.

A is incorrect because marginal is an acculturation value where the individual may speak both languages but has lost touch with his or her cultural heritage and is not fully accepted in mainstream society.

B is incorrect because pantraditional is an acculturation value focusing on going back to the old ways.

D is incorrect because bicultural is an acculturation value focusing on being knowledgeable and flexible in two cultures.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

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Question 10 Question Type: Text Entry Question: The __________ person is conversant with both sets of values and communicates in a variety of contexts.

Answer: bicultural Solution: Bicultural is defined as a person who is conversant with both sets of values and can communicate in a variety of contexts.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 11 Question Type: True/False Question: More American Indians are high school graduates that the general U.S. population (96% versus 72%).

Answer: False Solution: According to the text, fewer Indians are high school graduates that the general U.S. population (83.4% versus 86.9%).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 12 Question Type: Essay Type Question: Describe why it is important when working with Indians and Native Americans to consider the historical sociopolitical relationships. Give an example of a past practice that may still be a factor in working with this population.

Solution: The authors state that when working with children and families, it is important to consider the historical sociopolitical relationship between American Indians/Native Americans and the local, state and federal government. The counselor should understand not only the national history of oppression but also local issues and specific tribal history that affects them.

The historic disruption of families resulting in the Indian Child Welfare Act has important implications for how AI/ANs might view child protective services or respond to runaway youth.

Currently, decisions regarding the placement of their children are held in tribal courts. Testimony from expert witnesses familiar with the specific tribal or cultural group must be obtained before children can be removed from their homes. Additionally, if children are removed from their parents, residence with extended family members, other tribal members, or other AI/AN families is given primary consideration.

Bloom’s Level: Synthesis

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Difficulty Level: HARD

Question 13 Question Type: Multiple Choice Question: In general, how is honor and respect gained among American Indians? a. sharing b. educational achievement c. material wealth d.

None of the choices is correct.

Answer: a Solution: A is the correct response honor and respect gained among American Indians through sharing.

B is incorrect because honor and respect are not gained among American Indians through educational achievement.

C is incorrect because honor and respect are not gained among American Indians through material wealth.

D is incorrect because the answer is b.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 14 Question Type: Text Entry Question: ___________ ____ ________________ is likely to guide selection of therapeutic interventions.

Answer: Level of acculturation Solution: The client’s level of acculturation should be a factor that guides the therapist’s selection of therapeutic interventions. For instance, acculturated and bicultural American Indians/Native Americans have found success with all components of cognitive behavior therapy (CBT). Whereas those who are traditionally oriented are responsive to the short-term focus, activity schedule, and homework assignments in CBT but have difficulty with the underlying theoretical assumptions regarding the association between thoughts and emotional symptoms (Jackson, Schmutzer, Wenzel, & Tyler, 2006, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 15 Question Type: True/False

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Question: You are a counselor in private practice and are working with a 42-year-old Native American woman going through a life transition. In your initial intake, she reports living with her White, American husband and 8-year-old daughter in your city. As such, you do not assess the importance of tribal affiliation. This is the correct action to take because she does not live on a reservation.

Answer: False Solution: Even though she does not live on a reservation, it does not mean that tribal affiliation is not important to her. The authors report that counselors need to discuss the client’s tribal affiliation (if any), languages spoken, self-identity, and residential background, and find out whether there is a current relationship to a tribe or tribal culture (Garrett & Pichette, 2000, as cited in Sue 8th edition).

In reference to this particular question, however, the types of problems and the therapeutic process and goals appropriate for someone living on a rural reservation may be very different from those appropriate for an urbanized Indian who retains few traditional beliefs.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 16 Question Type: Multiple Choice Question: In American Indian culture, children having direct eye contact with an elder would probably be seen as a sign of a. anger b. disrespect c. agreement d. resentment Answer: b Solution: B is the correct response because in American Indian culture, children having direct eye contact with an elder would probably be seen as a sign of disrespect.

A is incorrect because in American Indian culture, children having direct eye contact with an elder would not be seen as a sign of anger.

C is incorrect because in American Indian culture, children having direct eye contact with an elder would not be seen as a sign of agreement.

D is incorrect because in American Indian culture, children having direct eye contact with an elder would not be seen as a sign of resentment.

Bloom’s Level: Knowledge Difficulty Level: EASY Question 17 Question Type: Text Entry Question: _______________ _____________ is one of the greatest problems faced by American Indian/Alaska Native populations.

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Answer: Substance abuse Solution: The authors report that substance abuse is one of the greatest problems faced by American Indian/Native American and Alaska Native populations. Many youth begin substance use at an early age and use multiple substances, and maintain high levels of use during adolescence (Boyd-Ball, Véronneau, Dishion, & Kavanagh, 2014, as cited in Sue 8th edition).

Although rates of alcohol use vary across tribes and regions, American Indians/Native American and Alaska Natives have the highest weekly alcohol consumption of any ethnic group according to Chartier & Caetano (2010, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 18 Question Type: Multiple Choice Question: The American Indian and Alaska Native population was ____ in 2015 representing ____ of the total U.S. population. a.

10 million; 15 percent b.

5.4 million; 2 percent c.

3.8 million; 5 percent d.

28 million; 22 percent Answer: b Solution: B is the correct response because according to the 2015 U.S Census, there were 5.4 million American Indian and Alaskan Native individuals totaling nearly 2 percent of total U.S. population.

A is incorrect because the 2014 U.S. Census data did not reflect these statistics.

C is incorrect because the 2014 U.S. Census data did not reflect these statistics.

D is incorrect because the 2014 U.S. Census data did not reflect these statistics.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 19 Question Type: True/False Question: Factors such as conflict over exposure to two different cultures may result in failure to develop a positive self-image or strong ethnic identity for Native American adolescents.

Answer: True Solution: Garrett and Portman (2011, as cited in Sue 8th edition) state that not only do Indian children and adolescents face the same developmental issues as other youth, but they also may experience conflict over exposure to two very different cultures, a factor that may result in failure to develop a positive self-image or strong ethnic identity.

Bloom’s Level: Knowledge Difficulty Level: EASY

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Question 20 Question Type: Multiple Choice Question: The reason so many American Indian/Alaska Native populations endured extermination and assimilation efforts was a. spirituality and respect for the land b. respect for traditional values and extended family networks c. allegiance to the family, community, and tribe and respect for elders d.

All of the choices are correct.

Answer: d Solution: D is the correct response because according to APA (2014) and Gilgun (2002, as cited in Sue 8th edition), all of the stated factors in this response contributed to American Indian/Alaskan Native resilience to extermination and assimilation efforts.

A is incorrect because all factors contributed to resilience.

B is incorrect because all factors contributed to resilience.

C is incorrect because all factors contributed to resilience.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 21 Question Type: Multiple Choice Question: When do American Indian children appear to do well in their formal education? a. the first few years b. high school years c. middle school years d. never Answer: a Solution: A is the correct response because American Indian children appear to do well in their formal education during the first few years.

B is incorrect because American Indian children appear not to do well in their formal education during high school.

C is incorrect because American Indian children appear not to do well in their formal education during middle school.

D is incorrect because American Indian children appear to do well in the first few years of school.

Note: The authors report that the children appear to do well during the first few years of school. However, by the fourth grade, there is a pattern of academic decline and truancy develop and there is a significant drop in achievement motivation often occurs in middle school.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

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Question 22 Question Type: Essay Type Question: What constitutes an Indian?

Solution: What constitutes an Indian is often an area of controversy. The U.S. Census depends on self-report of racial identity. Congress has formulated a legal definition: An individual must have an Indian blood quantum of at least 25 percent to be considered an Indian. This definition has caused problems both within and outside the Indian community. Some tribes have developed their own criteria and specify either tribal enrollment or blood quantum levels. Tribal definitions typically allow inclusion of the 60 percent of American Indians who have mixed heritage, including Black, White, and Latino/a backgrounds (Trimble, Fleming, Beauvais, & JumperThurman, 1996, as cited in Sue 8th edition).

Blooms Level: Synthesis Difficulty Level: HARD

Question 23 Question Type: Essay Type Question: How do the educational practices of many Indian and Native American youth contribute to current trends seen in the population?

Solution: Educational gaps between AI/AN youth and White youth persist (Education Trust, 2013, as cited in Sue 8th edition). Native children appear to do well during the first few years of school. However, by the fourth grade, a pattern of academic decline, disengagement, and truancy develops; a significant drop in achievement motivation often occurs in middle school. Although some have argued that traditional cultural values and beliefs are incompatible with those of the educational system, there is increasing support for the view that perceived barriers to mobility are the culprit for reduced academic performance. In other words, academic success is not perceived as leading to rewards or success. Others argue that structural issues within the school including limited resources, lack of teacher preparation or cultural sensitivity, and racial discrimination are in fact pushing AI/AN youth out of traditional school settings (JohnstonGoodstar & VeLure, 2017, as cited in Sue 8th edition). In addition, some of the youth from low income communities see that jobs are available in casinos or on the reservation; jobs in turn provide the youth with opportunities to contribute financially to their families, making it difficult to see the value in pursuing a ―White man’s education.‖ Bloom’s Level: Synthesis Difficulty Level: HARD Chapter 16: Counseling Asian Americans and Pacific Islanders

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Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 16 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Test Questions Question 1 Question Type: Multiple Choice Question: The Asian American population is growing rapidly, and, as of 2013, was almost at a.

6 million b.

18 million c.

38 million d.

52 million Answer: b Solution: B is the correct response because as of 2013 there were almost 18 million Asian Americans.

A is incorrect because the number is 18 million.

C is incorrect because the number is 18 million.

D is incorrect because the number is 18 million.

Bloom’s Level Knowledge Difficulty Level: EASY

Question 2 Question Type: True/False Question: Traditional Asian American families tend to be egalitarian and matriarchal in structure.

Answer: False Solution: The traditional Asian American families tend to be hierarchical and patriarchal in structure, with males and older individuals occupying a higher status (Kim, 2011, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 3 Question Type: Text Entry

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Question: __________ and other _______________ strategies are useful in working with Asian American clients.

Answer: Cognitive-behavioral; solution-focused Solution: According to S.W.-H. Chen & Davenport (2005, as cited in Sue 8th edition), cognitivebehavioral and other solution-focused strategies are useful in working with Asian Americans.

However, these may need to be modified to address a collectivistic focus.

Bloom’s Level: Knowledge Difficulty Level: EASY Question 4 Question Type: Essay Type Question: Based on the readings, why do the Asian population appear to underutilize mental health services?

Solution: Responses will vary but should encompass the fact that there is a lot of stigma with mental health issues. The authors point out that although Asian Americans underutilize mental health services, it is unclear if this is due to low rates of socioemotional difficulties or cultural values inhibiting self-referral (Zane & Ku, 2014, as cited in Sue 8th edition). It is very possible that a large portion of the mental illness, adjustment problems, and juvenile delinquency among Asians is hidden. There is a discrepancy between official and real rates of adjustment difficulties.

This may be due to cultural factors, such as the shame and disgrace associated with admitting to emotional problems, the handling of problems within the family rather than relying on outside resources, and the manner of symptom formation, such as a low prevalence of acting-out disorders.

Bloom’s Level: Synthesis Difficulty Level: HARD Question 5 Question Type: Multiple Selection Question: What are some things counselors should consider during assessment and problem definition? a.

Consider the family context. b.

Consider community context. c.

Define the problem as related to family enmeshment. d.

Begin to develop client autonomy.

Answer: a, b Solution: Because of a possible collectivistic orientation, it is important for counselors to consider the family and community context during assessment and problem definition. A therapist should also be open to different family orientations and to avoid automatically considering interdependence as a sign of enmeshment.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

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Question 6 Question Type: True/False Question: In an Asian American family, it is not atypical for a parent to induce guilt or shame and love withdrawal when a child misbehaves.

Answer: True Solution: In an Asian American family, it is not atypical for a parent to induce guilt or shame and love withdrawal when a child misbehaves. In fact, shame, the induction of guilt, and love withdrawal are often used to control and train the children (J. S. Lau, Fung, Wang, & Kang, 2009, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 7 Question Type: Text Entry Question: When working with an Asian American client, assess not just from an individual perspective but include _________, ________ and ________ ________ on the problem.

Answer: family; community; societal influences Solution: Clinical implications teach counselors to assess not just from an individual perspective but include family, community and societal influences on the problem. In addition, obtain the worldview, degree of acculturation, and ethnic identity of the Asian American client.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 8 Question Type: Essay Type Question: Why is the contemporary image of Asian Americans that of a very successful minority that has made it in society?

Solution: The contemporary image of Asian Americans is that of a highly successful minority that has ―made it‖ in society. Indeed, a close analysis of census data (U.S. Census Bureau, 2016, as cited in Sue 8th edition) seems to support this contention. Of those over the age of 25, over half of AAPIs have a bachelor’s degree, versus a little over 30 percent of their White counterparts; 21.4 percent have an advanced degree, compared with 12.1 percent of Whites (U.S. Census Bureau, 2016, as cited in Sue 8th edition). Words such as intelligent, hardworking, enterprising, and disciplined are frequently applied to this population (Lim, 2014, as cited in Sue 8th edition). The median income of Asian American families was $77,166 as compared with

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$56,516 for the U.S. population as a whole (U.S. Census Bureau, 2013, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 9 Question Type: True/False Question: A father takes his adolescent son to the store to buy a skateboard. The salesperson overcharges the son for the skateboard, so the son proceeds to raise his voice and demands to see the manager. When they return home, the father would likely compliment his son for standing up to the manager.

Answer: False Solution: Emotional restraint is often valued. Strong displays of emotion, especially in public, are signs of immaturity and lack of self-control.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 10 Question Type: Text Entry Question: Between-group differences within the Asian American population are quite large, since the population is composed of at least _______ distinct subgroups.

Answer: 40 Solution: Asian Americans/Pacific Islanders are nearly 6 percent of the population, but are composed of 40 distinct subgroups, each with its own language, religion and customs.

Counselors should not assume that they are all the same.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 11 Question Type: Essay Type Question: Define what acculturation is and what conflicts may occur in the process of acculturation.

Solution: Children of Asian descent who are exposed to different cultural standards often attribute their psychological distress to their parents’ backgrounds and different values. The issue of not quite fitting in with their peers yet being considered ―too Americanized‖ by their parents is common. Parent–child conflicts are among the most common presenting problems for Asian American college students seeking counseling (R. M. Lee, Su, & Yoshida, 2005, as cited in Sue

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8th edition) and are often related to dating and marriage issues (Ahn et al., 2009, as cited in Sue 8th edition). Chinese immigrant mothers report a larger acculturation gap with sons than with daughters (Buki, Ma, Strom, & Strom, 2003, as cited in Sue 8th edition). The larger the acculturation gap between parents and children, the greater the number of family problems.

Parents may complain, ―My children have lost their cultural heritage‖ (Hwang et al., 2010, as cited in Sue 8th edition). The inability to resolve differ- ences in acculturation results in misunderstandings, miscommunication, and conflict (R. M. Lee, Choe, Kim, & Ngo, 2000, as cited in Sue 8th edition). Parents may feel at a loss in terms of how to deal with their children.

Some respond by becoming more rigid.

Bloom’s Level: Analysis Difficulty Level: HARD

Question 12 Question Type: Multiple Choice Question: What has been found regarding value differences and their impact on counseling practice? e.

Most Asian immigrants and refugees believe in the value of talking about problems to a counselor. f.

Physical complaints are expressed in terms of emotional or psychological problems. g.

Among many Asian groups restraint of emotions is equated with maturity. h.

Asian immigrants and refugees tend to view mental illness as similar to any other problem.

Answer: c Solution: C is the correct response because many Asian groups restraint of emotions is equated with maturity.

A is incorrect because most Asian immigrants and refugees do not believe in the value of talking about problems to a counselor.

B is incorrect because physical complaints are not expressed in terms of emotional or psychological problems.

D is incorrect because Asian immigrants and refugees do not view mental illness as similar to any other problem.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 13 Question Type: True/False Question: According to current research, enculturation or identification with racial/ethnic background can result in pride and serve as a buffer against prejudice and discrimination.

Answer: True Solution: This is because the achievements and success of an individual are considered a source

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of pride for the family rather than the individual; group harmony is primary. Enculturation or identification with one’s racial and ethnic background may serve as a buffer against prejudice, discrimination, and family conflicts (Hwang, Woods, & Fujimoto, 2010; Kim, 2011, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty: MEDIUM

Question 14 Question Type: Text Entry Question: In regards to discrimination and racism, even fourth- and fifth-generation Asian Americans are sometimes identified as ―_______.‖ Answer: foreign Solution: Asian Americans have been exposed to discrimination and racism throughout history and continue to face anti-Asian sentiments. Even fourth- and fifth-generation Asian Americans are sometimes identified as being ―foreign‖ (Tsuda, 2014, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 15 Question Type: Text Entry Question: Perceived racial and discrimination are associated with higher psychological distress, anxiety, depression and somatic symptoms.

Answer: microagressions Solution: Perceived racial microaggressions and discrimination are associated with higher psychological distress, anxiety, depression and somatic symptoms (Lee, 2011; Ong et al., 2013, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 16 Question Type: Multiple Choice Question: References to the higher median income of Asian Americans do not take into account: a. the higher percentage of Asian American families having more than one wage earner b. a higher prevalence of poverty despite the higher median income c. the discrepancy between education and income d. a and c only e.

All of the choices are correct.

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Answer: e Solution: E is the correct response because references to the higher median income for Asian Americans do not take into account the higher percentage of Asian American families having more than one wage earner, a higher prevalence of poverty despite the higher median income, and the discrepancy between education and income.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 17 Question Type: True/False Question: Asian American college students report higher self-esteem and more satisfaction with their racially defined characteristics than their White counterparts.

Answer: False Solution: Research suggests that the opposite is true that Asian American college students have lower self-esteem due to their racially defined characteristics. More specifically, Asian American college women report lower self-esteem and less satisfaction with their racially defined features than do their Caucasian counterparts (Mintz & Kashubeck, 1999, as cited in Sue 8th edition). C.R. Lee (1995, as cited in Sue 8th edition) described his experiences as ―straddling two worlds and at home in neither‖ and tells how he also felt alienated from both American and Korean cultures.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 18 Question Type: Text Entry Question: Counseling techniques that focus directly on emotions may be uncomfortable and produce _________ for traditional Asian Americans. a. guilt b. shame c. aggressiveness d. depression Answer: b Solution: B is the correct response because counseling techniques that focus directly on emotions may be uncomfortable and produce shame for traditional Asian Americans; shame is a grouporiented emotion.

A is incorrect because counseling techniques that focus directly on emotions would not produce guilt because that is a more individualistic emotion.

C is incorrect because counseling techniques that focus directly on emotions may be uncomfortable but not produced aggressiveness for traditional Asian Americans.

D is incorrect because counseling techniques that focus directly on emotions may be uncomfortable would not produce depression for traditional Asian Americans.

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Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 19 Question Type: True/False Question: Feelings of shame or embarrassment may interfere with self-disclosure in Asian American clients.

Answer: True Solution: As counseling techniques that focus directly on emotions may be uncomfortable and produce shame for traditional Asian Americans, emotional behavior can be recognized in a more indirect manner. The authors have found that many Asian Americans are more responsive to a more indirect acknowledgment of emotions. Feelings of shame or embarrassment may interfere with self-disclosure and need to be addressed in counseling, and the process may be facilitated by affirming that the sharing of personal information, although it may be uncomfortable, is a natural process in therapy (Zane & Ku, 2014, as cited in Sue 8th edition). It is also helpful to focus on behaviors more than emotions.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 20 Question Type: Essay Type Question: What are the collectivistic orientation implications for a therapist with Asian American clients?

Solution: Because of a possible collectivistic orientation, it is important to consider the family and community context during assessment and problem definition. A therapist should be open to different family orientations and to avoid automatically considering interdependence as a sign of enmeshment. After doing a client-centered analysis of the problem, counselors can ask, ―How does your family see the problem?‖ For traditionally oriented Asian Americans, a focus on individual client needs and wishes may run counter to the values of collectivism. Goals and treatment approaches may need to include a family focus.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 21 Question Type: Essay Type Question: What might be some acceptable practices in working with Asian American clients?

Solution: The authors share that there is a range of acceptable practices in working with Asian

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American clients. The highlight qualities such as attitudinal similarity between the counselor and the Asian American client and agreement on the cause and treatment of a disorder are more important than racial match in promoting counselor credibility and a strong therapeutic alliance (Meyer, Zane, & Cho, 2011, as cited in Sue 8th edition). Asian Americans view counselors who can demonstrate multicultural competence by addressing the cultural beliefs of clients as more competent (Wang & Kim, 2010, as cited in Sue 8th edition). Also helping Asian American clients formulate culturally acceptable strategies can improve their problem-solving abilities and facilitate the development of skills for successful interactions within the larger society, including balancing conflicting values. In addition, many of the counseling skills learned in current mental health programs, such as cognitive behavioral therapies, can be effective, especially if modifications are made for less acculturated clients (W.-Y. Lau, Chan, Li, & Au, 2010, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD Chapter 17 Counseling Latinx Individuals Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 17 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Test Questions Question 1 Question Type: Multiple Choice Question: According to the U.S. Census Bureau (2017, as cited in Sue 8th edition), Latinx Americans are percent of U.S. population. a.

25.2 b.

17.6 c.

14.7 d.

8.9 Answer: b Solution: B is the correct response because there are Latinx Americans in the United States make up 17.6 percent of the population.

A is incorrect because the answer is b.

C is incorrect because the answer is b.

D is incorrect because the answer is b.

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Bloom’s Level: Knowledge Difficulty Level: EASY

Question 2 Question Type: True/False Question: The largest Latinx ethnic group is Puerto Rican.

Answer: False Solution: The largest Latinx group is Mexican, and Mexican Americans are the dominant Latinx group in metropolitan areas throughout the United States.

Bloom’s Level: Knowledge: Difficulty Level: EASY

Question 3 Question Type: True/False Question: Prayers are not generally considered a source of strength for Latinx.

Answer: False Solution: For many Latinx religion and prayer serve as sources of strength. Religion, often but not always, Catholicism, is important to many Latinx, although less so among younger individuals (Pew Research Center, 2014, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 4 Question Type: Essay Type Question: Describe fatalism and how it may impact counseling interventions.

Solution: Fatalism is a term that describe Latinx beliefs that life’s misfortunes are inevitable and feel resigned to their fate. Therefore, they may take a seemingly passive approach to problems and lack experience assertively addressing challenges. Some Latinx groups believe that evil spirits cause mental health problems and rely on indigenous healing practices. It is important to consider religious or spiritual beliefs and to explore the spiritual meanings of presenting problems. For example, if there is a strong belief in fatalism, instead of attempting to change this view, the therapist can acknowledge this attitude and help the individual or family determine the most adaptive response to the situation.

Bloom’s Level: Synthesis Difficulty Level: HARD

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Question 5 Question Type: Multiple Choice Question: Fatalism refers to a. respect and loyalty to the family b. the male is the head of the household c. acculturation conflicts d. resignation to misfortunes Answer: d Solution: D is the correct response because fatalism refers to resignation to misfortunes.

A is incorrect because familismo refers to respect and loyalty to the family.

B is incorrect because patriarchal refers to the male heading the household.

C is incorrect because fatalism does not refer to acculturation conflicts.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 6 Question Type: True/False Question: Approximately 68 percent of Latinx are immigrants.

Answer: False.

Solution: A little over a third of Latinx individuals are immigrants (U.S. Census Bureau, 2017, as cited by 8th edition). However, of that percentage approximately one-fourth of the Latinx adults are undocumented immigrants; about two-thirds of all undocumented immigrants are from Mexico (Marrero, 2011, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 7 Question Type: Text Entry Question: The median income of Latinx families is _____ that of U.S. median family income.

Answer: 80% Solution: The median income of Latinx families ($47,675) is about 80 percent of the U.S. median family income ($59,039), with nearly 1 in 5 Latinx individuals living in poverty; and in 2016 about 16 percent of Latinx individuals did not have health insurance (U.S. Census Bureau, 2017, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

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Question 8 Question Type: Essay Type Question: Describe the Latinx concept of familismo. How may this impact counseling services?

Solution: Familismo refers not only to family cohesiveness and interdependence but also to loyalty and placing the needs of close friends and family members before personal needs (Baumann, Kuhlberg, & Zayas, 2010, as cited in Sue 8th edition). Counselors can inquire about this connectedness with extended and nuclear family members and the value placed on familismo. It is important to note that because of these strong familial and social relationships, Latinx often wait until resources from extended family and close friends are exhausted before seeking help. Even in the cases of severe mental illness, many delay obtaining assistance (Kouyoumdjian, Zamboanga, & Hansen, 2003, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 9 Question Type: Multiple Choice Question: Assessments should be conducted in a.

Spanish b.

English c. the primary language of the client d. the primary language of the therapist Answer: c Solution: C is the correct response because assessments should be conducted in the primary language of the client.

A is incorrect because assessments should not be conducted in Spanish if that is not the client’s primary language.

B is incorrect because assessments should not be conducted in English if that is not the client’s primary language.

D is incorrect because assessments should not be conducted in the primary language of the therapist if that is not the client’s primary language.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM Question 10 Question Type: True/False Question: With respect to gender roles, women’s conflicts may involve lack of confidence in areas of authority; feelings of isolation and depression because of the need to be strong; and conflicts of the need to be consistent in the role.

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Answer: False Solution: These conflicts are more typical for Latino (immigrant) men. The authors report that in Latino men there is lack of confidence in areas of authority, in that Latino men may lack confidence interacting with agencies and individuals outside of the family. This can result in feelings of inadequacy and concern about diminished authority, especially if the wife or children are more fluent in English.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 11 Question Type: Text Entry Question: The development and maintenance of _________ _________ are central to the Latinx culture.

Answer: interpersonal relationships Solution: The authors report that many immigrants hold cultural belief systems that are collectivistic. This may contrast to the individualistic Western worldview, and Latinx may consider interpersonal relationships and social networks to be of paramount importance.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 12 Question Type: Essay Type Question: Explore some of the stressors Latinx families encounter. How may a mental health worker come alongside these families during this process?

Solution: Latinx immigrants and refugees face multiple stressors, including the stress of moving to and living in another country; learning another language; and negotiating new social, economic, political, educational, and social systems. This can often be a confusing and frightening experience. Mental health providers who understand the complexities of this situation can do a lot to reassure clients by demystifying the process.

Bloom’s Level: Analysis Difficulty Level: MEDIUM

Question 13 Question Type: Multiple Choice Question: The term to describe family unity, respect, and tradition is a. personalismo b. fatalism c. familismo

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d.

marianismo

Answer: c Solution: C is the correct response because familismo refers to family unity, respect, and tradition.

A is incorrect because personalismo refers to a personal- ized communication style that is characterized by interactions that are respectful, interdependent, and cooperative.

B is incorrect because fatalism is the belief that life experiences are determined by fate.

D is incorrect because marianismo is where women are expected to maintain harmony and nurture spiritual life within the family and be modest, virtuous, and subordinate to others.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 14 Question Type: Text Entry Question: Because the Latinx family is strongly connected and rely on other member’s cooperation, some of the typical expected roles of family members include Mother __________________ Father __________________ Children _________________ Grandparents _____________ Godparents _________________ Answer: care giver; provider; obedience; wise counsel; resourcefulness Solution: Because of the strong sense of familisimo, cooperation among family members is stressed. The extended family includes not only relatives but also close friends and godparents.

Each member of the family has a specific role: mother (care giver), father (provider), children (obedience), grandparents (wise counsel), and godparents (resourcefulness) (Lopez-Baez, 2006, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 15 Question Type: Essay Type Question: Describe the role religion may play in Latinx families. Why is this important to consider in the counseling relationship?

Solution: The main religion, most often, but not always, is Catholicism. Religion is important to many Latinx, although less so among younger individuals (Pew Research Center, 2014a, as cited in Sue 8th edition). Prayers requesting guidance and specifically from patron saints can be a source of comfort in times of stress. Latinx often believe that life’s misfortunes are inevitable and feel resigned to their fate, which is known as fatalism. Therefore, they may take a seemingly

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passive approach to problems and lack experience assertively addressing challenges. Some Latinx groups believe that evil spirits cause mental health problems and rely on indigenous healing practices.

Therefore, during assessment, it is important to consider religious or spiritual beliefs and to explore the spiritual meanings of presenting problems. If there is a strong belief in fatalism, instead of attempting to change this view, the therapist can acknowledge this attitude and help the individual or family determine the most adaptive responses to the situation.

Bloom’s Level: Synthesis Difficulty Level: HARD Question 16 Question Type: Multiple Choice Question: The degree of deviation from traditional gender roles should ultimately be determined by a. the client in the context of cultural variables b. the counselor c. the place the client is currently living d. the deviation acceptable to the spouse Answer: A Solution: A is the correct response because the degree of deviation from traditional gender roles should ultimately be determined by the client in the context of cultural variables.

B is incorrect because the degree of deviation from traditional gender roles should not ultimately be determined by the counselor.

C is incorrect because the degree of deviation from traditional gender roles should not ultimately be determined by where the client is living.

D is incorrect because the degree of deviation from traditional gender roles should not ultimately be determined by the spouse.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 17 Question Type: Text Entry Question: What terms best describe gender roles in the Latino family? In traditional Latinx culture, men are expected to be strong, dominant, and the provider for the family (_______), whereas women are expected to be subordinate and self-sacrificing (________).

Answer: machismo; marianismo Solution: Latinx often experience conflicts over specific gender roles. In traditional culture, men are expected to be strong, dominant, and the provider for the family—machismo. Women are expected to be modest, virtuous, and subordinate to others—marianismo (Piña-Watson et al., 2013, as cited in Sue 8th edition).

Bloom’s Level: Comprehension

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Difficulty Level: MEDIUM

Question 18 Question Type: Multiple Choice Question: The conflicts in gender roles in both Latinx American men and women are as a result of a. the degree of religiosity b. educational level c. different expectations between ethnic group and mainstream values d. the degree to which the family speaks Spanish in the home Answer: C Solution: C is the correct response because the conflicts in gender roles in both Latinx Americans men and women as a result of different expectations between ethnic group and mainstream values.

A is incorrect because the conflicts in gender roles in both Latinx Americans men and women is not a result of the degree of religiosity.

B is incorrect because the conflicts in gender roles in both Latinx Americans men and women is not a result of education level.

D is incorrect because the conflicts in gender roles in both Latinx Americans men and women is not a result the degree to which the family speaks Spanish at home.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 19 Question Type: Text Entry Question: _________ refers to the relational style displayed by many Latinx—a style emphasizing social harmony and a gracious, hospitable, personable atmosphere.

Answer: Simpatico Solution: Simpatico refers to the relational style displayed by many Latinx which is a style emphasizing social harmony and a gracious, hospitable, and personable atmosphere (Holloway, Waldrip, & Ickes, 2009, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 20 Question Type: True/False Question: Acculturation can increase gender role conflict.

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Answer: True Solution: Therapists should explore the client’s degree of adherence to traditional gender norms, as well as the gender role views among other family members. It is important to consider the potential impact of acculturation on marital relationships. This is particularly important when women function independently in the work setting or when dealing with schools and other agencies. For both males and females, role conflict is likely to occur if the man is unemployed, if the woman is employed, or both.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM Question 21 Question Type: Text Entry Question: What percentage of Latinx students graduate high school? a.

78 percent b.

88 percent c.

60 percent d.

52 percent Answer: A Solution: A is correct because Latinx students have significantly lower public high school graduation rates compared to their White peers, 78 percent compared to 88 percent in 2014-2015 (National Center for Educational Statistics, 2017, as cited in Sue 8th edition). The good news is that although the gap exists in graduation rates, it has narrowed over the past decade.

B is incorrect because the answer is 78 percent.

C is incorrect because the answer is 78 percent.

D is incorrect because the answer is 78 percent.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 22 Question Type: Essay Type Question: Distinguish between the use of Latinx (or Latino/a) and Hispanic.

Solution: The gender inclusive term Latinx in reference to individuals living in the United States with ancestry from Spanish-speaking (e.g., Mexico, Puerto Rico, Cuba, Dominican Republic) and non-Spanish speaking (e.g., Brazil, French Guiana, Suriname) countries. However, people vary in preference for the terms used for pan-ethnic self-identification, some prefer the gendered terms Latina or Latino, some prefer the term Hispanic, and still others prefer more specific ethnic terms such as Chicana, Puerto Rican, and Brazilian. The U.S. Census uses the term Hispanic as an ethnic descriptor rather than the term Latina/o or Latinx Bloom’s Level: Synthesis Difficulty Level: HARD Chapter 18: Counseling Multiracial Individuals

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Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 18 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Test Questions Question 1 Question Type: Multiple Choice Question: The one drop rule is also known as a. monoracial b. miscegenation c. hypodescent d. rules biracial people live by Answer: c Solution: Hypodescent is known as the ―one drop rule,‖ which is a class-based social system that maintains the myth of monoracialism by assigning a person of mixed racial heritage to the least desirable racial status.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 2 Question Type: True/False Question: Saying to someone, ―I know you are Asian but you look White,‖ can lead to major psychological and social stressors in terms of identity formation.

Answer: True Solution: Such statements can be harmful to a multiracial individual. This question is similar to the ―What are you?‖ inquiries that can lead to ambiguity or marginality.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 3 Question Type: Text Entry

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Question: In the case of interracial relationships/marriages, current research now suggests that these marriages are based on the same ingredients as other marriages: _______, _____________, ___________ __________, and ___________.

Answer: love; companionship; compatible interests; values Solution: As is stated in the text, in the case of interracial relationships, current research now suggests that these marriages are based on the same ingredients as other marriages: love, companionship, and compatible interests and values (Rosenblatt et al., 1995, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 4 Question Type: Essay Question: Explore some of the stereotypes surrounding interracial marriages and how may these affect client the client /therapist relationship?

Solution: Sociopsychological research on this topic has often perpetuated and reinforced inaccurate beliefs about race mixing and mixed-race people. Even today, some individuals still view interracial relationships as an oddity. When an interracial couple is asked ―So how did the two of you meet?‖ the inquiry may not be due to pure curiosity but may instead reflect the question: ―How did you two end up together?‖ (Goff, 2014, as cited in Sue 8th edition).

There is considerable evidence that myths and stereotypes associated with multiracial individuals and interracial couples have involved attempts to prevent the mixing of races through stigmatizing such mixture (Wehrly et al., 1999, as cited in Sue 8th edition). African Americans, especially males, are often stereotyped as lazy, violent, and poor fathers and African American women are stereotyped as aggressive, hostile and undesirable. History is replete with incidents reflecting society’s hostility and antagonism toward African Americans.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 5 Question Type: Multiple Choice Question: Models of multiracial identity development are distinct from monoracial identity development models in that a. multiracial identities are static across contexts. b. resolution of marginality occurs between dominant and subordinate groups. c. identities are fluid and shift in different environments. d. integration of a bicultural identity is considered the most adaptive and most desired resolution.

Answer: c

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Solution: C is the correct response because models of multiracial identity development are distinct from monoracial identity development models in that identities are fluid and shift in different environments.

A is incorrect because models of multiracial identity development are distinct from monoracial identity development models, not because multiracial identities are static across contexts.

B is incorrect because models of multiracial identity development are distinct from monoracial identity development models, not because resolution of marginality occurs between dominant and subordinate groups.

D is incorrect because models of multiracial identity development are distinct from monoracial identity development models, not because integration of a bicultural identity is considered the most adaptive and most desired resolution.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 6 Question Type: True/False Question: The 2000 U.S. Census allowed multiracial individuals to check more than one box to describe their racial identities. This served to create clarity and is considered by most to be the best way to categorize people.

Answer: False Solution: This action set in motion a complex psychological and political debate.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 7 Question Type: Text Entry Question: ___________ occurs when people are not easily able to distinguish the monoracial category of the multiracial individual from phenotypic characteristics Answer: Racial/ethnic ambiguity Solution: Racial/ethnic ambiguity occurs when people are not easily able to distinguish the monoracial category of the multiracial individual from the phenotypic characteristics.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 8 Question Type: Essay Question: What are some of the challenges multiracial people may experience due to their ethnicity?

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Solution: Responses will vary but should include topics such as stereotypes, discrimination, stares, identity issues. Some of the stressors are unique to multiracial people. For example, most monoracial minorities find their own groups receptive and supportive of them. Multiracial individuals may be placed in the awkward situation of not being fully accepted by either group.

Likewise, monoracial minority group children can expect psychological and emotional support from their parents; that is, the parents share common experiences with their children, can act as mentors, and relate to the experiences their children encounter with respect to minority status.

However, multiracial children are likely to have monoracial parents who do not understand the challenges facing their children (Townsend, Markus, & Bergsieker, 2009, as cited in Sue 8th edition). Some common problems for multiracial youth and adults include communication difficulties with their parents about racial identity issues, reactions of peers and society to their identity, and pressure to assume a monoracial identity (Jolivette & Gutierrez-Mock, 2008, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 9 Question Type: Multiple Choice Question: Counselors need to understand the negative stereotypes of multiracial individuals (i.e., confused, unhealthy) and the research that reveals that multiracial individuals a. have improved abilities to relate to diverse groups b. greater tolerance for people c. increased ability to build alliances d.

All of the choices are correct.

Answer: D Solution: D is the correct response because counselors need to understand the negative stereotypes of multiracial individuals (i.e. confused, unhealthy) and the research that reveals that multiracial individuals have improved abilities to relate to diverse groups, greater tolerance for people, and increased ability to build alliances.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 10 Question Type: True/False Question: It is estimated that multiracial people make up 10.3 percent of the national population.

Answer: False Solution: The authors report that it is estimated that multiracial people make up about 2.4 percent of the national population.

Bloom’s Level: Knowledge

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Difficulty: MEDIUM

Question 11 Question Type: Text Entry Question: In 1996, Maria Root wrote the ______________ of ________________ for ___________________ ____________________ _______________ that asserts rights of multiracial individuals.

Answer: Bill of Rights for Racially Mixed People Solution: Maria Root, a leading psychologist in the field of multiracial identity and development expressed concerns about the way in which society has historically relegated multiracial persons to deviant status or ignored their existence because they do not fit into a monoracial classification. In her personal and professional journey, Root (1996, as cited in Sue 8th edition) developed a Bill of Rights for Racially Mixed People that asserts the right of multiracial individuals not to justify their existence or ethnic legitimacy, the right to self-identity rather than assume the identity expected by others, and the right to identify with more than one group of people.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 12 Question Type: Essay Type Question: Define racial/ethnic ambiguity and what implications might it have in the counseling paradigm?

Solution: Racial or ethnic ambiguity occurs when people are not easily able to distinguish the monoracial category of the multiracial individual from phenotypic characteristics. These phenotypic traits play a major role in how people perceive others. For example African American traits are apparent. But for multiracial individuals with ambiguous features, the ―What are you?‖ question becomes a constant dilemma. The ―What are you?‖ question requires the individual to have to justify his or her existence in a world rigidly built on the concepts of racial purity and monoracialism.

Multiracial children often feel quite isolated and may find little support, even from their parents. This is especially true for monoracial parents, who themselves are not multiracial. How, for example, does a White mother married to a Black husband raise her child? White? Black?

Mixed? Parents of interracial marriages may fail to understand the challenges encountered by their children, gloss over differences, or raise the child as if he or she were monoracial. The child may, therefore, lack role models and feel even greater loneliness. Even being a multiracial parent may not result in greater empathy for or understanding of the unique challenges faced by multiracial children, especially if the parents (themselves victims of a monoracial system) have not adequately resolved their own identity conflicts. Therapists can help interracial couples prepare their children for questions about their racial heritage. Children are more likely to

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develop positive multiracial identities if the parents have modeled strong ethnic identities (Stepney, Sanchez, & Handy, 2015, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 13 Question Type: True/False Question: Inquiries such as ―Who are your parents?‖ ―Which one is Black?‖ and ―Why did they marry?‖ are good for multiracial children to hear as they can help them clarify issues.

Answer: False Solution: The aforementioned inquiries can communicate to the individual that ―there is something different about you,‖ which can result in invalidation and conflicting feelings.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 14 Question Type: Multiple Choice Question: Compared to their male counterparts, Latinas and Asian American women are _______ to marry interracially. a. as likely. b. less likely. c. more likely. d. expected.

Answer: C Solution: C is the correct response because compared to their male counterparts, Latinas and Asian American women are more likely to marry interracially.

A is incorrect because the compared to their male counterparts, Latinas and Asian American women are not as likely to marry interracially.

B is incorrect because compared to their male counterparts, Latinas and Asian American women are not more likely to marry interracially.

D is incorrect because the compared to their male counterparts, Latinas and Asian American women are not expected to marry interracially.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 15 Question Type: True/False Question: Hypodescent thinking and laws maintained racial purity and generated additional property for slave owners.

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Answer: True Solution: Since hypodescent (one drop rule) laws created a class based system of monoracialism, slave owners benefited from this because Black people could not own property. Also, Africans were purchased as slave laborers; the more slaves an owner possessed, the greater his wealth and access to free labor. Thus, economically it was beneficial to classify offspring of a Black–White union as ―Negro‖ because it increased owners’ wealth.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 16 Question Type: Text Entry Question: Counselors may have conscious and unconscious attitudes, biases, and stereotypes similar to the layperson regarding race mixing, or __________.

Answer: miscegenation Solution: The term miscegenation describes the ―mixing‖ of two or more different races.

Blooms’ Level: Knowledge Difficulty Level: MEDIUM

Question 17 Question Type: Essay Type Question: Name some of strengths seen in multiracial individuals.

Solution: Responses will vary but may include the greater acceptance of multiracial individuals in society. Other responses may cover that although a multicultural identity can result in challenges, many cite advantages, such as having access to and support from several cultural communities (Sanchez et al., 2009, as cited in Sue 8th edition). Multiracial individuals who have multiple racial identity integration appear to have higher levels of psychological adjustment (K. F. Jackson, Yoo, Guevarra, & Harrington, 2012, as cited in Sue 8th edition). Other advantages include the ability to see issues from a variety of perspectives (Cheng & Lee, 2009, as cited in Sue 8th edition). Those who have an integrated multiple racial identity have lower stress levels and feelings of alienation than individuals who are in conflict about their racial identity (Binning, Unzueta, Huo, & Molina, 2009, as cited in Sue 8th edition).

Blooms Level: Synthesis Difficulty Level: HARD

Question 18 Question Type: Multiple Selection Question: Being a multiracial person often means coping with marginality and isolation resulting

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from external factors related to prejudice. Which of the following is a possible healthy resolution of marginality? a.

The multiracial individual accepts the identity assigned by society. b.

The person may choose to resolve marginality through identification with both groups. c.

The person may decide to choose a single racial identity in an active manner. d.

Identification with a mixed-race heritage or multiracial identity is another option.

Answer: a, b, c, d Solution: According to Root (1998, as cited in Sue 8th edition), all four choices describe possible healthy resolutions of marginality.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 19 Question Type: True/False Question: Research suggests that multiracial individuals are as well-adjusted as their monoracial peers.

Answer: True Solution: Multiracial individuals who have multiple racial identity integration appear to have higher levels of psychological adjustment (K. F. Jackson, Yoo, Guevarra, & Harrington, 2012, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 20 Question Type: Text Entry Question: __________, or the _______ _______ __________, is a class-based system that maintains the myth of monoracialism by assigning the person of mixed race heritage to the least desirable racial status.

Answer: Hypodescent; one drop rule Solution: The ―One Drop of Blood‖ Rule refers to the event where Alvin Poussaint, an African American Harvard psychiatrist, stood before a packed audience and posed a pointed question to them. He asked, ―Do you know how powerful Black blood is?‖ After an awkward silence, Mr Poussaint answered, ―It is so powerful that one tiny drop will contaminate the entire bloodstream of a White person!‖ The authors describe that what Mr. Poussaint was referring to is called hypodescent, or the ―One Drop Rule,‖ which is a class based social system that maintains the myth of monoracialism by assigning the person of mixed racial heritage to the least desirable racial status.

Bloom’s Level: Comprehension

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Difficulty Level: MEDIUM

Question 21 Question Type: True/False Question: The NAACP believes that the multiracial categorization will strengthen the strength of their constituencies.

Answer: False Solution: The NAACP believes that the multiracial categorization will dilute the strength of their constituencies.

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 22 Question Type: Multiple Selection Question: Identify which reason(s) individuals may have if they do not identify as multiracial. a.

They never knew the family member or ancestor who was a different race. b.

They were raised as one race. c.

They look like one race. d.

They closely identified with a single race.

Answer: a, b, c, d Solution: All of the choices are reasons individuals may have for not identifying as multiracial.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 23 Question Type: True/False Question: Biracial couples such as an Asian man and a White woman are seen more favorably by people than an Asian woman and White man.

Answer: False Solution: Asian women are exoticized and are seen as petite, exotic and sexually pleasing to men. Thus, these stereotypes contribute to the perception that a union between Asian women and White men is more favorable.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM Chapter 19: Counseling Arab Americans and Muslim Americans

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Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 19 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Test Questions Question 1 Question Type: Multiple Choice Question: Arabs are individuals who a. originate from countries in the Middle East b. originate from countries in North Africa c. have primary the language of Arabic d.

None of the choices is correct. e.

All of the choices are correct.

Answer: E Solution. E is the correct response because Arabs are individuals who originate from countries in the Middle East and North Africa and have the primary language of Arabic.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 2 Question Type: True/False

Question: Over one-third of Muslim Americans were born in the United States, and over 80 percent of Muslim immigrants are citizens of the United States.

Answer: True Solution: The authors report that over a third of Muslim Americans were born in the United States, and although there is a large percentage of Muslims who are immigrants, about 81 percent are citizens of the United States, including 70 percent of those born outside the United States, which is a higher citizenship rate than in other immigrant groups.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 3 Question Type: Text Entry Question: In traditionally oriented Arab families, the _______ _____ is trained to become the head of the extended family.

Answer: oldest son Solution: The authors state that in traditionally oriented Muslim families, the oldest son is

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prepared to become the head of the extended family.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 4 Question Type: Essay Type Question: What is Ramadan, and what typically happens during this season?

Solution: The lives of Muslims are governed by Islamic laws derived from the Qur’an, which deals with social issues, family life, economics and business, sexuality, and other aspects of Muslim life. The name of their religion means ―submission to God‖ and adherence to Islam is demonstrated by individual accountability and a declaration of faith. Muslims engage in the ritual of prayer five times a day and annually fast during daylight hours throughout the holy month of Ramadan. This is a time for inner reflection, devotion to God and spiritual renewal.

Almsgiving and a pilgrimage to Mecca are additional signs of devotion (Nobles & Sciarra, 2000, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: MEDIUM Question 5 Question Type: Multiple Choice Question: Arabs include individuals who come from approximately how many countries? a.

5 b.

10 c.

20 d.

40 Answer: C

Solution: C is the correct response because Arabs include individuals who come from approximately 20 countries. The authors state that Arabs are individuals who originate from countries located in the Middle East and North Africa and whose primary language is Arabic.

Arabs began immigrating to the United States in the late 1800s and descend from about 20 different countries. They are heterogeneous in terms of race, religion, and political ideology.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 6 Question Type: Text Entry Question: For Arab Americans, treatment for personal problems may be considered ___________ and disclosed to only close family or friends.

Answer: shameful Solution: Seeking treatment for emotional problems may be considered shameful, so outside help is likely to be sought only as a last resort.

Bloom’s Level: Knowledge Difficulty Level: EASY

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Question 7 Question Type: Multiple Selection Question: To which of the following countries or regions of the world can Arab Americans trace their ancestry? a.

Lebanon b.

Jordan c.

Palestine d.

Iraq e.

Syria f.

Egypt g.

Asia h.

Europe i.

Africa Answer: a, b, c, d, e, f, g, h, i Solution: According to the text, Arab Americans can have African, Asian, or European ancestry. Approximately 56 percent of Arab Americans trace their ancestry to Lebanon, while 14 percent are from Syria, 11 percent from Egypt, 9 percent from Palestine, 4 percent from Jordan, 2 percent from Iraq, and 4 percent from other countries (El-Badry, 2006, as cited in Sue 8th edition).

Question 8 Question Type: Multiple Choice Question: Which of the following is true of Islam? a.

Islam is one of the fastest growing religions in the United States. b.

All Arabs are by definition Muslim (majority but not all). c.

Shiites make up about 90 percent of Muslims d.

Almsgiving is considered a sign of unspiritual concern with worldly problems (sign of devotion).

Answer: A

Solution: A is the correct response because Islam is one of the fastest growing religions in the United States.

B is incorrect because not all Arabs are by definition Muslim (majority but not all).

C is incorrect because Shiites make up about 10 percent of Muslims (90 percent are Sunni).

D is incorrect because Almsgiving is considered a sign of spiritual concern with worldly problems (sign of devotion).

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 9 Question Type: True/False Question: Approximately one-quarter of Arab Americans are Muslim.

Answer: True Solution: Although the populations of Arabic-speaking countries include large numbers of Muslims, it is estimated that only about one-quarter of Arab Americans are Muslims (Jackson & Nassar-McMillan, 2006, as cited in Sue 8th edition).

Bloom’s Level: Knowledge

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Difficulty Level: EASY

Question 10 Question Type: Text Entry Question: __________ and __________ supports can be protective factors in dealing with prejudice and discrimination from the larger society.

Answer: Family; community Solution: The authors contend that family and community supports can be protective factors in dealing with prejudice and discrimination from the larger society.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 11 Question Type: Multiple Choice Question: Which of the following may be problematic for traditionally oriented Arab Americans? a. girls being advised by older females b. emphasis on hospitality to guests c. opposite-sex discussions with people other than family members d. father’s aloofness Answer: C

Solution: C is the correct response it may be problematic for Arabs to have opposite-sex discussions with people other than family members considering the hierarchal and patriarchal nature of family relations.

A is incorrect because it would not be problematic for girls to be advised by older females.

B is incorrect because it would not be a problem to emphasize hospitality to guests.

D is incorrect because it would not be problematic for the father of the family to be aloof.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 12 Question Type: Multiple Choice Question: All of the following are recommended practices for working with Arab American clients EXCEPT a.

Be aware of your own attitudes about Arab Americans and Muslims. b.

Always disclose things about yourself that show you are vulnerable. c.

Be ready to help those who have been discriminated against in seeking legal recourse. d.

With traditional families, try addressing the husband or male first.

Answer: B

Solution: B is the correct response because counselors need to be cautious about self-disclosure because it may be interpreted as a weakness.

A is incorrect because counselor’s should be self-aware about attitudes toward Arab Americans and Muslims.

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C is incorrect because counselors should be ready to help those who have been discriminated against in seeking legal recourse.

D is incorrect because counselors should try addressing the husband or male first with traditional families.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 13 Question Type: True/False Question: In comparison with the U.S. population as a whole, Arab Americans are more likely to be single, female, older, and less educated.

Answer: False Solution: In comparison with the U.S. population as a whole, Arab Americans are more likely to be married, male, younger and more educated.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 14 Question Type: Text Entry Question: In most Arab and Muslim families, women are treated with ___________ and _____________.

Answer: honor; respect Solution: The authors report that counselors should be aware that traditional Arab American and Muslim families tend to be hierarchical, with men considered to be the head of the family. And although Western media often portray women as powerless victims of emotional and physical abuse, in most Arab and Muslim families, women are treated with honor and respect (Ibrahim & Dykeman, 2011, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 15 Question Type: Essay Type Question: Describe how Arabs are often portrayed in the media. What do you think perpetuates this stereotype?

Solution: The authors highlight that Arabs, Arab Americans, and Muslims are often stereotyped in movies as sheiks, barbarians, or terrorists (Nassar-McMillan, Lambert, & Hakim-Larson, 2011, as cited in Sue 8th edition).

Arabs are also commonly stereotyped as being violent or terrorists. In one study, individuals

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who played a terrorist-themed video game showed an increase in negative attitudes toward Arabs—even though the game involved Russian characters. The findings clearly demonstrate a ―strong associative link‖ between Arabs and terrorism (Saleem & Craig, 2013, as cited in Sue 8th edition).

Some of the reasons these stereotypes persist may be due to terrorist attacks. The authors point out that in recent years, Muslims and ―Arab-appearing‖ individuals have been subjected to increased discrimination and attacks. Although Arab Americans and Muslims have always encountered prejudice and discrimination, negative behavior directed toward these groups accelerated following attacks on September 11, 2001, the attacks during the Boston marathon bombings in 2013, as well as the recent murders of political cartoonists at the offices of the Charlie Hebdo magazine in France in 2015. Hate crimes against Muslims are now second only to those perpetrated against Jewish Americans (Federal Bureau of Investigation, 2010, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 16 Question Type: Text Entry Question: Between September 11, 2001, and October 11, 2002, more than ______ cases of employment discrimination occurred against Arab Americans.

Answer: 800 Solution: This is one of many cases of discrimination pointed out in the text.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 17 Question Type: Text Entry Question: Results from a recent poll indicated that _______ percent of Americans believe that Muslims are too extreme in their beliefs and _____ percent believe they are sympathetic to the Al Qaeda terrorist group.

Answer: 36; 28 Solution: Results from a recent poll indicated that 36 percent of Americans believe that Muslims are too extreme in their religious beliefs and 28 percent believe that Muslims are sympathetic to Al Qaeda terrorists (Newport, 2011, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 18 Question Type: Text Entry

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Question: ________-________ counselor pairing may be problematic with Arab or Muslim clients.

Answer: Cross-gender Solution: Cross-gender counselor pairing may be problematic with Arab or Muslim clients. One should inquire if gender of the therapist is a factor to be considered.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 19 Question Type: Essay Type Question: What spiritual interventions might be explored with Arab Muslim clients to reduce stress?

Solution: Counselors should be open to exploring spiritual beliefs and the use of prayer or fasting to reduce distress. Furthermore, alternative explanations and expressions of psychological distress should be accepted without the imposition of a Western worldview. Counselors should be open to talking about religion and drawing on religious coping strategies the clients religion offers. Since Islam encourages self-responsibility in actions and encourages alternatives to negative thoughts, identifying the client’s views regarding Islam may be useful in adapting therapy (Ebrahimi, Neshatdoost, Mousavi, Asadollahi, & Nasiri, 2013; Meer & Mir, 2014, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 20 Question Type: Text Entry Question: The two main branches of Islam are ______________ and ______________, with 90 percent from the former sect and 10 percent from the latter sect.

Answer: Sunni; Shiite Solution: Within Islam, there are two major sects, Sunni and Shiite. The Sunnis are the larger group, accounting for approximately 90 percent of Muslims worldwide; the remaining 10 percent are Shiites. Most Muslims in America are Sunni, whereas those in Iraq, Bahrain, Lebanon and Iran are mainly Shiite.

Bloom’s Level: Knowledge Difficulty Level: EASY Chapter 20: Counseling Immigrants and Refugees

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Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 20 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Test Questions Question 1 Question Type: True/False Question: Many immigrants are from collectivistic orientation.

Answer: True Solution: The authors describe that many immigrants are from countries with a collectivistic orientation. They often serve as role models of interdependence and cooperation with multiple extended family and community supports. The role of the family and the strength of their spiritual beliefs serve as core resources to make meaning of and cope with the stress associated with adopting to a completely new environment (Kira & Tummala-Narra, 2015, as cited in Sue 8th edition). These immigrants are often supportive of each other and promote group identification and acceptance of differences. This kind of support can help ameliorate stressors involved in living in a new culture, especially a society that stresses the individual.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 2 Question Type: Multiple Choice Question: The approximate number of the foreign-born population including undocumented immigrants living in the United States is a. approximately 1 million b.

10 to 12 million c. over 35 million d. over 41 million e. no one really knows Answer: D Solution: In mid-2013, the approximate number of foreign-born population including undocumented immigrants is approximately 41.3 million.

Bloom’s Level: Knowledge Difficulty Level: EASY

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Question 3 Question Type: Multiple Choice Question: Of the approximately 41.3 million of the foreign-born population currently living in the United States, how many are considered unauthorized immigrants? a. approximately 5 million b. approximately 11 million c. approximately 15 million d. approximately 22 million e.

Census efforts have failed due to fears of deportation therefore no one can agree on the population estimates Answer: B Solution: In 2013, approximately 11.4 million immigrants are unauthorized, having entered the United States without inspection or overstayed their temporary stay.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 4 Question Type: Multiple Choice Question: Which of the following is NOT true of immigrants to the United States? a.

About one-third of all immigrants have a college degree. b.

Asians in general are the least educated of all the immigrants. c.

Immigrants, particularly those from Latin America, tend to earn lower wages and have higher incidents of poverty. d.

About 39 percent of the current immigrants have arrived since 2000.

Answer: B Solution: B is the correct response just the opposite is true and Asians are the most highly educated immigrants in U.S. history, with more than 60 percent with a bachelor’s degree (Pew Research, 2014, as cited in Sue 8th edition) A is incorrect because about one-third of all immigrants do have a college degree.

C is incorrect because immigrants tend to earn lower wages had have high incidents of poverty.

D is incorrect because about 39 percent of the current immigrants have arrived since 2000.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 5 Question Type: Essay Type Question: Name some of the main reasons refugees flee their countries.

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Solution: Answers will vary but should include that refugees are individuals who flee their country in order to escape persecution due to race, religion, nationality, political opinion, or membership in a particular social group.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 6 Question Type: Multiple Choice Question: Since September 11, 2001, the admission of refugees to the United States has: a. dramatically increased b. slightly increased c. stayed about the same d. declined Answer: d Solution: D is the correct response because since September 11, 2001, the admission of refugees to the United States has declined. The authors report that September 11, 2001, terrorist attacks had a dramatic impact on attitudes toward immigrants and refugees. The result was an emphasis on preventing the entry of terrorists into the United States resulted in not only Arab or Muslim Americans being viewed with suspicion, but also anyone who ―appears foreign.‖ Furthermore, immigrants became regarded as possible terrorists. Following the trauma of September 11, the movement toward legalization of undocumented immigrants slowed, and there was a dramatic decline in admission of refugees (Patrick, 2004, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 7 Question Type: Text Entry Question: ________________ _______________ may lead counselors to misdiagnose refugee children’s ________________ behavior.

Answer: Pre-migration trauma; aggressive Solution: Pre-migration trauma may lead counselors to misdiagnose refugee children’s aggressive behavior—they may be traumatized by the experience.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 8 Question Type: Essay Type Question: Describe some of the concerns refugee children may experience related to pre-

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migration events.

Solution: The characteristics of life experiences of many refugees is their pre-migration trauma, which is often life-threatening in nature. The impact of this trauma is likely to be exacerbated by the challenges of adjustment to a new world. After being displaced from their country of origin, refugees often express concern about adapting to a new culture and country. They worry about losing their cultural identity. They may lack a support or community group. Refugees often feel estranged and isolated. Many report feelings of homesickness and concerns over the breakup of their family and the loss of community. In addition, there are often worries about the future, difficulties communicating in English and unemployment.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 9 Question Type: True/False Question: Any alien present in the United States or arriving at a port of entry may seek asylum.

Answer: True Solution: Asylees are individuals who meet the criteria for refugee status, are physically present in the United States or at a point of entry when granted permission to reside in the United States.

Therefore, any alien present in the United States or arriving at a port of entry may seek asylum.

In addition, individuals granted asylum are authorized to work in the United States and is eligible for certain public benefits including employment assistance, a social security card, and social services.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 10 Question Type: Multiple Choice Question: Some of the traumas that refugees may have been exposed to include a. witnessing war-related beatings and killings b. being personally injured c. being a victim of sexual assault d. living in fear for their lives or those of their family e.

All of the choices are correct. f.

None of the choices is correct.

Answer: E Solution: E is the correct response because refugees may have likely witnessed war-related beatings and killings, been personally injured, been a victim of sexual assault, and live in fear for their lives or those of their family.

F is incorrect because all of the choices are correct.

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Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 11 Question Type: Essay Type Question: Are immigrants more or less likely to be dangerous or a drain on society?

Solution: Despite the belief that immigrants are dangerous or a drain on society, they are no more likely to use social services and are less likely to commit crimes than native-born Americans. Although incidents such as the shooting of a young woman in San Francisco in 2015 by an undocumented Mexican raise fears about crime regarding this population, studies have found that immigrants have a much lower rate of crime and are less likely to be behind bars than native-born individuals. The findings apply ―for both legal immigrants and the unauthorized regardless of their country of origin or level of education‖ (Ewing, Martínez, & Rumbaut, 2015, as cited in Sue 8th edition). Fear regarding immigrants, especially those who are undocumented, may be a product of negative stereotyping or inordinate attention to the criminal acts of a few.

Also, the belief that unauthorized immigrants are a financial burden on society ignores the fact that they pay billions of dollars in taxes each year, and nearly half of the adults who have been in the United States for more than 10 years are homeowners (CAP Immigration Team, 2014, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 12 Question Type: Multiple Selection Question: Which of the following may be a concern for refugees adapting to a new culture and country? a. losing cultural identity b. academic and social adjustment of their children c. inflexible, low-wage jobs that prevent them from monitoring their children d. negotiating new social, economic, and political systems Answer: a, b, c, d Solution: All of the choices are correct because losing their cultural identity, academic and social adjustment of their children, inflexible and low-wage jobs and monitoring their children, and negotiating new systems may be concerns for newly arriving refugees.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 13 Question Type: Multiple Choice

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Question: Which of the following statements is TRUE? a.

The vast majority of refugees are able to make a healthy transition to life in the United States. b.

Refugees and their family members often have low rates of PTSD and depression. c.

It is good practice to urge clients to disclose their traumatic experiences as early as possible in therapy. d.

As of 1990, it was publicly denounced in all countries that when a sexually assaulted women is considered unfit to marry, her family should go to jail.

Answer: A Solution: A is the correct response because the vast majority of refugees are able to make a healthy transition to life in the United States.

B is incorrect because refugees often have high rates of PTSD and depression.

C is incorrect because it is not good practice to urge clients to disclose their traumatic experiences as early as possible in therapy.

D is incorrect because no denouncement has been made.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 14 Question Type: Multiple Choice Question: The somatic view of psychological disorders is that a. mental disorders are the result of physical problems. b. mental disorders are the result of spiritual problems. c. mental disorders are the result of emotional problems. d.

All of the choices are correct. e.

None of the choices is correct.

Answer: A Solution: A is the correct response because the somatic view of psychological disorders are the result of physical problems.

B is incorrect because the somatic view doesn’t take into account spiritual problems.

C is incorrect because the somatic view doesn’t regard mental disorders as a result of emotional problems.

D is incorrect because the answer is A. E is incorrect because the answer is A. Further information: It is important to consider the cultural perspective of refugees concerning mental and physical disorders to determine how their views might be different from those of the dominant culture. In some countries, women victimized by sexual assault are shunned and considered unfit for marriage. Many immigrants take a somatic view of psychological disorders and see mental disorders as resulting from physical problems. If a client brings up somatic symptoms, the therapist can first work with these complaints.

Bloom’s Level: Comprehension

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Difficulty Level: MEDIUM

Question 15 Question Type: Multiple Selection Question: Which are the barriers to accessing health care services for immigrants? a. communication difficulties due to language differences b. lack of knowledge of mainstream delivery services c. cultural factors d. lack of resources Answer: a, b, c, d Solution: All of the choices are barriers to accessing health care services for immigrants.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 16 Question Type: Essay Type Question: Discuss the four best practices for utilizing interpreters with immigrants and refugees.

Solution: Responses should include that interpreters should receive training regarding specific mental disorders and the interventions employed in therapy, particularly regarding treatment of trauma, grief, and loss.

Because interpreters can be affected emotionally by traumatic experiences discussed in therapy, therapists should discuss self-care strategies for the interpreters, as well as ways of dealing with exposure to traumatic reports.

Clients clearly do not regard interpreters as translation machines. Therefore, interpreters should be trained in the relationship skills that are needed in therapy. In the triadic relationship, interpersonal skills such as empathy and congruence are necessary. Therapists should also receive training on how to work effectively with interpreters and become conversant with different models of interpreting. Some prefer simultaneous translation, whereas others prefer delayed translation.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 17 Question Type: True/False Question: Due to the importance of extended families, immigrant children and adolescents who attend school take longer to acculturate due to the absence of significant family members they left in their countries of origin.

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Answer: False Solution: Just the opposite is true in that in immigrant families, children and adolescents attend school and more quickly acculturate and adapt to U.S. culture, whereas the parents and older family members tend to adhere to traditional cultural values.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 18 Question Type: Text Entry Question: ___________________ is the emotion associated with surviving atrocities in their country of origin and the necessity of leaving other family members behind.

Answer: Guilt Solution: The loss of friends, family, and status is very troubling to refugees. They often feel guilty about leaving other family members behind and may go through a bereavement process.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 19 Question Type: Essay Type Question: Describe what may occur when utilizing interpreters who have had similar experiences as the clients they are interpreting for.

Solution: The use of interpreters may be necessary. However, many therapists and interpreters are unaware of the dynamics involved when another individual is involved in the therapy relationship. Most interpreters receive minimal or no training in working with distressed or traumatized individuals, and they may experience uncontrollable feelings of emotional distress when hearing traumatic stories, especially when their backgrounds are similar to those of the clients (Miller, Zoe, Pazdirek, Caruth, & Lopez, 2005, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 20 Question Type: Text Entry Question: Polls in 2018 show that percent of Americans believe DACA, or dreamers, should be able to stay in the United States legally.

Answer: 70

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Solution: About 70 percent of Americans believe DACA or dreamers should be able to stay in the country legally (Samuels, 2018, as cited in Sue 8th edition) and a little over half believe immigration strengthens the United States.

Bloom’s Level: Knowledge Difficulty Level: EASY

Chapter 21: Counseling Jewish Americans Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 21 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Test Questions Question 1 Question Type: Multiple Choice Question: Between 1880 and 1942, more than 2 million Jews emigrated to the United States from a.

Russia, Italy, Austria, and Portugal b.

Germany, France, England, and Austria c.

Germany, Hungary, Italy, and Japan d.

Russia, Austria, Hungary, and Romania Answer: D Solution: D is the correct response because between 1880 and 1942, more than 2 million Jews emigrated to the United States from Russia, Austria, Hungary and Romania.

A is incorrect because the answer is D. B is incorrect because the answer is D. C is incorrect because the answer is D. Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 2 Question Type: True/False Question: Recent statistics conclude that more than 59 percent of the 1,163 hate crimes were anti-Semitic.

Answer: True Solution: The authors report that Jewish Americans have long been targets of discrimination and prejudice. This prejudice continues to this day and is revealed in the astonishing statistics that of

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the 1,163 hate crimes motivated by religious bias, the vast majority (more than 59%) have been anti-Semitic. The second highest were anti-Islamic (as reported by the Federal Bureau of Investigation, 2013, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 3 Question Type: Text Entry Question: ___________ _________ are individuals who do not acknowledge or who question the existence of the genocide that occurred during the Holocaust.

Answer: Holocaust deniers Solution: Holocaust deniers are described as individuals who do not acknowledge or who question the existence of the genocide that occurred during the Holocaust.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 4 Question Type: Essay Type Question: What might be some guiding principles in working with Jewish clients?

Solution: The authors offer some guiding principles of importance for mental health providers based on the work of Langman (1999, as cited in Sue 8th edition). First, they contend it is very important to be respectful of and knowledgable about Jewish culture. As most clinicians are from a Christian background, the traditions, values, and religious rituals that are important to Jewish Americans are often overlooked or dismissed. As was discussed in Chapter 6, therapists might inadvertently commit microaggressions due to their lack of understanding. In an example Langman describes is of a Jewish client who requested that an appointment not be scheduled during Yom Kippur. The therapist responded: ―What? Do you need to pray or something?‖ The outcome was that the client felt humiliated, devalued, ashamed, and unsupported.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 5 Question Type: Multiple Choice Question: The largest Jewish community in the world is in which country? a.

Spain b.

United States c.

Canada d.

Argentina

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e.

Israel

Answer: E Solution: E is the correct response because the largest Jewish community in the world is in Israel.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 6 Question Type: True/False Question: The United States has the highest Jewish population next to Israel.

Answer: True.

Solution: There are approximately 5.3 million Jewish people in the United States, second in the world outside of Israel (7.8 million).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 7 Question Type: Text Entry According to research, only _____ percent of multicultural courses in APA doctoral programs in counseling covered Jews as a distinct cultural group.

Answer: 8 Solution: Texts on multicultural counseling often do not address Jewish Americans as a diverse group. It was found that only 8 percent of multicultural courses in APA doctoral programs in counseling covered Jews as a distinct cultural group (Priester et al., 2008, as cited in Sue 8th edition) Bloom’s Level: Knowledge Difficulty Level: EASY

Question 8 Question Type: Essay Type Question: What characteristics may make Jewish people reluctant to seek therapy?

Solution: Because of their strong faith in Judaism, some Jewish individuals may be reluctant to seek treatment. Seeking help that might imply that their religion has failed them or that they are defective in some way. Orthodox Jewish communities tend to be closely knit, thus the stigma associated with seeking therapy might reduce a person’s opportunities to establish social relationships or marry within the community (Schnall, 2006, as cited in Sue 8th edition).

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Bloom’s Level: Analysis Difficulty Level: MEDIUM

Question 9 Question Type: Multiple Choice Question: According to the text, there are approximately 4.2 million who claim to be Jewish, and another 1.1 million profess to be secular or cultural Jews, which means that they are a. people who identify as Jewish but have no religion and do not engage in Jewish practices b. people who identify as Jewish and believe in a specific sect of the Jewish faith c. people who identify as Jewish but are guilt ridden about their faith d. people who do not identify as Jewish but believe in faith rather than science Answer: A Solution: In the United States, approximately, 4.2 million individuals are Jewish by religion, while another 1.1 million are secular or cultural Jews, who say that they have no religion but consider themselves to be Jewish (Pew Research Center, 2013, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 10 Question Type: True/False Question: People who have converted to Judaism but who do not have Jewish parents are not considered Jewish.

Answer: False Solution: According to Schlosser (2006, as cited in Sue 8th edition), people who have converted to Judaism but who do not have Jewish parents are considered Jewish.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 11 Question Type: Multiple Selection Question: Which of the following describe Jewish Americans? a. people who practice Judaism and have a Jewish ethnic background b. people who have converted to Judaism but do not have Jewish parents c. individuals with a Jewish ethnic background who do not practice Judaism but still maintain their cultural identity and connection to their Jewish descent d. only those born in Israel are authentic Jewish Americans Answer: a, b, c

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Solution: A, B, and C are all descriptions of Jewish Americans per Schlosser (2006, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty: MEDIUM

Question 12 Question Type: Text Entry Question: In the text, a therapist responded to a client who requested to not be scheduled during Yom Kippur, to which the therapist responded, ―What? Do you need to pray or something?‖ This could be considered a __________________.

Answer: microaggression Solution: Based on the story related by Langman (1999, as cited in Sue 8th edition), this may be inadvertent but could cause harm to a client.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM Question 13 Question Type: Essay Type Question: What are some of the main tenets of the Jewish faith?

Solution: Judaism bases its belief in an omnipotent God who created humankind, and was one of the earliest monotheistic religions. According to Judaism, God established a covenant with the Jewish people. He subsequently revealed His commandments to them in the Torah, the holy book. The most important commandments are the Ten Commandments found in several sections of the holy book. Individuals who desire to convert to Judaism go through the process of (a) studying Judaism and the observance of the commandments, (b) immersion in a ritual bath and, for males (c) circumcision (although symbolic circumcision may be allowed by some sects).

Bloom’s Level: Analysis Difficulty Level: MEDIUM

Question 14 Question Type: Multiple Choice Question: According to Judaism, the holy book that reveals God’s commandments is called the a.

Synagogue b.

Yom Kippur c.

Torah d.

Talmud e.

Kosher Answer: C

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Solution: C is the correct response according to Judaism, the holy book that reveals God’s commandments is called the Torah.

A is incorrect because a synagogue is a place of worship.

B is incorrect because Yom Kippur is a day of atonement for sins.

D is incorrect because the Talmud is a series of rabbinic discussions of Jewish law.

E is incorrect because kosher refers to Jewish dietary laws.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 15 Question Type: True/False Question: Religious behavior and traditions such as lighting the Shabbat candles are not considered to be useful to Jewish people because it brings up negative feelings associated with the Holocaust.

Answer: False Solution: Lighting the Shabbat candles has been found to be calming since they remind individuals of their history and community.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 16 Question Type: Text Entry Question: According to a national Jewish survey, the Jewish population is on the decline due to __________, ________, __________ and ___________.

Answer: aging; falling birth rate; intermarriage; assimilation Solution: Since 1990, it is noted that the Jewish population in the United States has decreased from 5.5 million to 4.2 million. According to the Pew Research Center (2013, as cited in Sue 8th edition), this population decline is due to aging (many are older than age 65, and younger individuals are more likely to identify themselves as having no religion), falling birth rate, intermarriage (over one-third of Jewish individuals who intermarry do not raise their children to be Jewish), and assimilation.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 17 Question Type: Essay Type Question: Name some of the more important Jewish holidays. Why are these important to remember in working with Jewish clients?

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Solution: One of the most important Jewish holidays is Yom Kippur, the Day of Atonement. It is the one day a year set aside to atone for sins during the past year. Another important holiday is Rosh Hashanah, which is the start of the Jewish New Year, and is another High Holiday in Judaism. This holiday, is celebrated 10 days before Yom Kippur, and represents the creation of the world or universe. Even Jews who are not religious often attend synagogue services and spend time with family during these celebrations. Other important religious holidays are Passover and Hanukkah both with significant ties to Jewish history.

As with all culturally diverse clients the authors recommend counselors know the history, spiritual, sociopolitical backdrop, and context of clients’ lives that can aid in becoming more culturally aware and competent.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 18 Question Type: Multiple Choice Question: Most sects of Judaism require the following processes to be successfully achieved EXCEPT: a.

Studies on Judaism and the observance of the commandments. b.

Immersion in a ritual bath. c.

Communion for children transitioning into adolescence. d.

Circumcision (or symbolic circumcision) for males.

Answer: C Solution: C is the correct response because communion is a Catholic sacrament.

A is incorrect because studies on Judaism and the observance of the commandments are required for Jews.

B is incorrect because immersion in a ritual bath is a requirement to convert to Judaism.

D is incorrect because circumcision (or symbolic circumcision) for males is required.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 19 Question Type: True/False Question: Among Orthodox Jews, higher levels of religious beliefs are associated with negative mental health outcomes.

Answer: False Solution: Among Orthodox Jews, higher levels of religious beliefs are associated with positive mental health outcomes. This may be due to the emotional and spiritual support from having a personal relationship with God (Rosmarin, Pirutinsky, Pargament, & Krumrei, 2009, as cited in Sue 8th edition).

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Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 20 Question Type: Text Entry Question: Some Jewish people speak _________, _________, or the language of their country of origin.

Answer: Hebrew; Yiddish Solution: The authors report that approximately 85 percent of Jewish Americans were born in the United States, and almost all are native English speakers, some speak Hebrew, Yiddish, or the language of their country of origin.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 21 Question Type: Essay Type Question: What are some rituals that may help Jewish clients achieve a state of calmness?

Solution: Religious behavior and traditions, such as lighting Shabbat candles, may be calming, since they remind individuals of their history and their community (Altman et al., 2010, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 22 Question Type: Multiple Choice Question: According to Pew Research Center (2013, as cited in Sue 8th edition) the Jewish population in the United States is estimated to be a.

320,000 b.

1.2 million c.

5.3 million d.

12.8 million e.

26.8 million Answer: C Solution: In the United States, approximately, 4.2 million individuals are Jewish by religion, while another 1.1 million are secular or cultural Jews, who say that they have no religion but consider themselves to be Jewish (Pew Research Center, 2013, as cited in Sue 8th edition).

Bloom’s Level: Knowledge

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Difficulty Level: EASY

Question 23 Question Type: Multiple Choice Question: When counseling an orthodox Jew, it may be desirable to a. focus on the emotional aspect of the client’s concern rather than on their particular religious beliefs and practices b. try the ―blaming the victim‖ approach c. consult with a rabbi d. raise the issue of the client’s obstructiveness and hostility in a nonconfrontational way Answer: C Solution: C is the correct response. When counseling an orthodox Jew, it may be desirable to consult with a rabbi.

A is incorrect because it may not be a good idea to focus on the emotional aspect of the client’s concern rather than on their particular religious beliefs and practices since orthodox Judaism is very strict.

B is incorrect because it would be inappropriate to ―blame the victim‖ with any client.

D is incorrect because it would be inappropriate to raise the issue of the client’s obstructiveness and hostility in a nonconfrontational way.

Note: The authors note that consulting with a rabbi on how to deal with issues such as confidentiality or how Judaism might affect counseling could be useful. Therapists can also work jointly with the client and the rabbi in defining the problem and developing appropriate and culturally and religiously sensitive interventions (Schnall, 2006, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 24 Question Type: True/False Question: Anti-Semitic views toward American Jews often decrease in conjunction with negative reaction to Israeli actions in the Middle East.

Answer: False Solution: Anti-Semitic views toward American Jews often arise in conjunction with negative reaction to Israeli actions in the Middle East.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 25 Question Type: Essay Type

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Question: What are the stages of identity development for Jews?

Solution: Schlosser (2009b, as cited in Sue 8th edition) believes that Jews go through the following stages of ethnic identity development: • Lack of awareness of one’s Jewish identity • Gradual awareness of Jewish identity • Comparison of Jewish identity with other religions, such as Christianity • Development of a sense of Jewishness Bloom’s Level: Synthesis Difficulty Level: HARD Chapter 22 Counseling Individuals with Disabilities Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 22 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Test Questions Question 1 Question Type: Multiple Choice Question: Approximately how many individuals in the United States have some level of a disability? a.

7 million b.

12 million c.

21 million d.

57 million Answer: D Solution: At the time of the 8th edition of the text, there are about 56.7 million individuals with some level of disability (physical or mental), of whom over half have a disability that severely affects daily functioning (Brault, 2012, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 2 Question Type: True /False Question: In the United States, the rates of disability are higher among African Americans as compared to non-Hispanic Whites or American Indian and Alaska Native groups.

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Answer: True Solution: At the time of the 8th edition, of the 72.3 million families in the United States, about 21 million have at least one member with a disability. Rates of disability are higher among African Americans (22.2%) and American Indian/Alaska Native groups (27%) compared with non-Hispanic Whites (16.2%) (Cornish, Gorgens, Olkin, Palomibi, & Abels, 2008, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 3 Question Type: Text Entry Question: The greatest impediment to people with disabilities are _____________ ________________ and ____________________.

Answer: negative attitudes; stereotypes Solution: One of the myths that perpetuates is that the greatest barriers are physical ones, when in actuality the greatest barriers to people with disabilities are physical ones. In actuality, negative attitudes and stereotypes are the greatest impediments and the most difficult to change.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 4 Question Type: Essay Type Question: Explore why many struggle with knowing how to respond or address someone with a disability. As a professional, how can you serve to improve this phenomenon?

Solution: One of the many reasons people do not know how to respond to someone with a disability is because they often lack understanding. Attitudes toward individuals with disabilities may go along a spectrum and be disdainful and dismissive, or overly protective or sympathetic.

Counselors can work toward improving understanding of disabilities by serving as an advocate and by increasing awareness of discriminatory practices. Counselors can make sure their offices are compliant for those with physical disabilities and provide additional services such as Braille materials, sign language interpreters, ramps, parking spaces, and other practical services. The authors point out that it is important for therapists to make sure that they do not provide unequal service or deny treatment to clients with disabilities. If the individual requires treatment outside your area of specialization, you can help facilitate a referral to a more qualified provider.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 5 Question Type: Multiple Selection

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Question: Which of the following are myths about the disabled? a.

The majority of the disabled are wheelchair bound. b.

Those who are disabilities are a drain on the economy. c.

Employees with disabilities have a higher absentee rate than employees without disabilities. d.

The greatest barriers to people with disabilities are physical ones. e.

Persons who have disabilities are brave and courageous.

Answer: a, b, c, d, e Solution: All of the choices are myths associated with persons with disabilities.

Bloom’s level: Comprehension Difficulty Level: MEDIUM

Question 6 Question Type: True/False Question: Individuals with physical disabilities have the highest rates of unemployment of all disability groups.

Answer: False Solution: Individuals with psychiatric disabilities have the highest rates of unemployment (90%) of all disability groups (Larson et al., 2011, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 7 Question Type: Text Entry Question: Children with disabilities are more likely to suffer from maltreatment such as __________ and __________ abuse and ____________.

Answer: physical; sexual; neglect Solution: The text reports that children with disabilities are more likely to be subjected to maltreatment, including neglect; physical, sexual, or emotional abuse; or bullying (Jones et al., 2012; Zablotsky, Bradshaw, Anderson, & Law, 2014, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 8 Question Type: Essay Type Question: How does the American with Disabilities Act (ADA) define disability? What are some

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of the similarities and differences of these types of disabilities?

Solution: The ADA defines disability as ―a physical or mental impairment that substantially limits one or more of the major life activities of such individual.‖ It protects individuals with intellectual impairment, hearing or vision impairment, orthopedic conditions, learning disabilities, speech impairment, HIV/AIDS and other health or physical conditions. Psychiatric disorders covered under this act include major depression, bipolar disorder, panic and obsessivecompulsive disorders, some personality disorders, schizophrenia and rehabilitation from drug addiction.

Responses will vary but may include that some of the disabilities listed are physical, others are emotional. Some disabilities are obvious, while others are not and are invisible to the uninformed. Many of these disabilities present across a spectrum of severity and/or impairment.

Bloom’s Level: Synthesis Difficulty Level: HARD Question 9 Question Type: Multiple Choice Question: Counselors can address their discomfort with disabilities in clients by a. emphasizing the individual rather than the limitation b. getting specific information about disabilities through many resources c. avoiding the use of phrases such as ―afflicted with‖ or ―a victim of‖ d.

All of the choices are correct.

Answer: D Solution: D is the correct response because counselors can address their discomfort with disabilities in clients by emphasizing the individual rather than the limitation, getting specific information about disabilities through many resources, and avoiding the use of phrases such as ―afflicted with‖ or ―a victim of.‖ Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 10 Question Type: True/False Question: Terms such as retarded, lame, or crazy are not prejudicial.

Answer: False Solution: These terms are prejudicial and can be harmful to persons with disabilities.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 11 Question Type: Text Entry

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Question: Mental health professionals may need to serve as ____________ or ______________ to initiate changes in academic and work settings.

Answer: advocate; consultant Solution: The authors state that from the medical model perspective, the client (or family) may want to focus on improving the client’s condition, using technology or other interventions to help ―normalize‖ functioning. Therefore, mental health professionals not only can help clients and family members obtain technological resources but can also enhance independent living skills and advocate for appropriate accommodations in school or work environments.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 12 Question Type: Essay Type Question: Why would a counselor explore spiritual factors with a person who has a disability?

Solution: The authors point out that spirituality and religious beliefs can be a source of inner strength and support. Religion and spirituality or a connection to a higher power are associated with increased life satisfaction and functional ability for individuals with traumatic brain injuries (Waldron-Perrine et al., 2011, as cited in Sue 8th edition). The mental health professional should determine the role, if any, that religious beliefs or spirituality play in the life of clients with a disability. Spirituality may factor in the person’s sense of self. Such beliefs may be a source of support for clients and their caregivers. Furthermore, therapists can ask clients about their religious or spiritual beliefs and how their beliefs help them confront challenges. Counselors can then incorporate these beliefs into treatment (Waldron-Perrine et al., 2011, as cited in Sue 8th edition). On the other end of the spectrum, individuals may believe that their disability is a punishment from God or may blame God for not preventing the injury. These types of issues should also be addressed and resolved. Therapists may consult with or refer to religious leaders when working with clients who are attempting to come to terms with a disability.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 13 Question Type: Multiple Choice Question: Approximately _____ of students enrolled in postsecondary educational institutions have some form of disability: a.

25 percent b.

9 percent c.

37 percent d.

68 percent

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Answer: B Solution: B is the correct response because approximately 9 percent of students enrolled in postsecondary educational institutions have some form of disability (Haller, 2006, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 14 Question Type: True/False Question: Errors of omission may occur if counselors fail to address sexual concerns of persons with disabilities.

Answer: True Solution: This is a true statement from the text, errors of omission may be made. For example, the counselor may fail to ask questions about critical aspects of the client’s life because the assumption is made that the issue is unimportant owing to the presence of the disability.

Sexuality and relationship issues may be ignored because of the belief that the individual lacks the ability or interest to pursue these intimacies.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 15 Question Type: Text Entry Question: The __________ ___________ of disability assumes that disability results from societal failure to accommodate individual differences.

Answer: minority model Solution: This model views disability as an external problem involving an environment that is filled with negative societal attitudes and that fails to accommodate the needs of individuals with special needs.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 16 Question Type: Essay Type Question: What are some coping strategies counselors can help foster in clients with disabilities?

Solution: Responses will vary but may include connection with a higher power or other spiritual practices, tapping into resilience skills, cognitive thought processing, self-control, creativity, changing perceptions, empowering, encouraging active decision making and improving self-

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esteem.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 17 Question Type: Multiple Choice Question: The moral model of disability a. focuses on the disability as a ―defect‖ representing a moral lapse b. states that it is moral for those with disabilities to help others with disabilities c. provides moral guidelines for caretakers of those with disabilities to follow d. is paramount for those who have a disability Answer: A Solution: A is the correct response because the moral model of disability focuses on the disability as a ―defect‖ representing a moral lapse as if the person did something bad to deserve the disability.

B is incorrect because the moral model has nothing to do with people with disabilities helping others with disabilities.

C is incorrect because the moral model does not provide moral guidelines for caretakers of those with disabilities to follow.

D is incorrect because the moral model does not suggest that morality is paramount for those who have a disability.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 18 Question Type: Multiple Choice Question: ―The disability represents a defect that resides in the individual and action is taken to rehabilitate that condition‖ is a description of which type of model of disability? a. minority model b. medical model c. morality model d.

Mitchell model Answer: B Solution: B is the correct response because the medical model suggests that the disability represents a defect that resides in the individual and action is taken to rehabilitate that condition.

A is incorrect because the minority model suggest that the problem resides externally to the person who has the disability because society has not adequately accommodated or responded to the individual in a satisfactory way.

C is incorrect because the morality model does not exist—the moral one does.

D is incorrect because the Mitchell model does not exist.

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Bloom’s Level: Knowledge Difficulty Level: EASY

Question 19 Question Type: Text Entry Question: A ____________-____________ approach has been found to increase self-efficacy among family members and improved their ability to cope with stress.

Answer: problem-solving Solution: The authors share that among family caregivers, attributes such as positive problemsolving skills, positive problem orientation, and coping strategies are associated with greater satisfaction for themselves and the individual with the disability (Elliot, Shewchuk, & Richards, 1999, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 20 Question Type: True/False Question: Religion and spirituality are generally not connected with increased life satisfaction and functional ability for individuals with traumatic brain injuries because oftentimes these individuals are angry with God. Answer: False Solution: Religion and spirituality are generally connected with increased life satisfaction and functional ability for individuals with traumatic brain injuries.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 21 Question Type: Multiple Choice Question: Which of the following are things to remember when interacting with an individual who has a speech impediment? a.

Allow the individual to finish speaking before you speak. b.

Face the individual and give full eye contact. c.

Pretend you understand even if you do not. d. a and b Answer: D Solution: D is the correct response because both are things to remember when working with individuals who have speech impediments.

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C is incorrect. It is not recommended to pretend to understand if you do not.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 22 Question Type: True/False Question: Under the Americans with Disabilities Act, employers are not allowed to inquire about a candidates’ ability to perform the job as well as their disability.

Answer: False Solution: Under the Americans with Disabilities Act, employers are allowed to inquire about the ability a candidates’ possesses to perform the job but not their disability.

Bloom’s Level: Knowledge Level: EASY Chapter 23 Counseling LGBT Individuals Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 23 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Test Questions Question 1 Question Type: Multiple Choice Question: It has been reported that LGBT youth are ______ ______than their heterosexual counterparts to attempt suicide. a. less likely b. more likely c. equally likely d.

This information is unknown.

Answer: B Solution: B is the correct response because it has been reported that LGBT youth are more likely than their heterosexual counterparts to attempt suicide. This is especially true for LBGT youth who live in an unsupportive environment (Hatzenbuehler, 2011, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

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Question 2 Question Type: True/False Question: Although not all are actively involved in same-sex practices, approximately one-fourth of the adult population report acknowledging some same-sex attraction.

Answer: True Solution: About 19 million Americans have engaged in same-sex behaviors and around onefourth of the adult population acknowledges some same-sex attraction (Gates, 2011, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 3 Question Type: Text Entry Question: Individuals who have an affectional and/or sexual attraction to the same sex are referred to as __________ and/or _____________.

Answer: gay; lesbian Solution: Chapter 23 describes individuals who have an affectional and/or sexual attraction to a person of the same sex as gay men and lesbians.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 4 Question Type: Essay Type Question: What are the current trends of LGBT in today’s youth? Explore why it appears there is a higher percentage of LGBT in the millennial population.

Solution: Responses will vary but may include demographics that report higher percentages for LGBT are being reported among millennials between the ages of 18 and 35. Of this group, approximately 4 percent identified themselves as bisexual, 3 percent as gay or lesbian, and 1 percent as transgender (Public Relations Research Institute, 2014, as cited in Sue 8th edition).

Current trends include a more open acceptance of a same-sex lifestyle, more media coverage of issues, more high-profile cases such as that of Caitlyn Jenner, new television programs with openly same-sex couples, more laws protecting LGBT and same-sex couples, and other societal factors Bloom’s Level: Synthesis Difficulty Level: HARD

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Question 5 Question Type: Multiple Choice Question: Awareness of the sexual orientation of gay males and lesbian females tends to occur in a. adulthood b. early childhood c. late adulthood d. early teens Answer: D Solution: D is the correct response because awareness of the sexual orientation of gay males and lesbian females tends to occur in early teens.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 6 Question Type: True/False Question: There has been an increase in the acceptance of same-sex marriage among the elderly.

Answer: False Solution: Although society in general has become more accepting, strong negative attitudes and feelings toward gay people continue among older adults and White Evangelicals (Pew Research Center, 2015, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 7 Question Type: Text Entry Question: The term _____________ ______________ is used when a person who is LGBT decides to reveal their gender or sexual orientation to others.

Answer: coming out Solution: Coming out is the process of a gay, lesbian, bisexual, or transgendered person revealing his or her gender or sexual orientation to others.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 8 Question Type: Essay Type Question: Describe some of the struggles a gay Latino man may encounter in relation to his

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sexual orientation.

Solution: Gay Mexican American men have a greater degree of internalized homophobia. This is partly because of the cultural value of machismo. In Latino communities and culture, there is strong negative reaction to gay men and frequent use of slurs such as maricon (sissy) and joto (fag) (Estrada, Rigali-Oiler, Arciniega, & Tracey, 2011 as cited in Sue 8th edition). Latino men who are gay report racism, discomfort, and rejection from the gay community and Latino men with darker skin or more Indian features are more likely to face such rejection (Ibanez, VanOss Marin, Flores, Millett, & Diaz, 2009, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 9 Question Type: Multiple Choice Question: Which of the following is included under the term transgender? a. only people who cross-dress. b. only individuals who identify as transsexual. c. both transsexuals and individuals who cross-dress. d. both transsexuals and those who identify themselves as being attracted to both male and female genders. e. individuals whose gender identification is inconsistent with their assigned gender Answer: E Solution: E is the correct response because the term transgender describes individuals whose gender identification is inconsistent with their assigned gender.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 10 Question Type: True/False Question: According to the APA (2013), gender dysphoria is considered a mental disorder.

Answer: True Solution: Gender dysphoria is a mental health condition defined in DSM-5 as significant distress and impairment resulting from an incongruence between a person’s gender identity and assigned gender. Although gender dysphoria is still considered a mental disorder (American Psychiatric Association, 2013, as cited in Sue 8th edition), transgender persons are hoping that they can follow the path taken by the gay and lesbian movement and eventually eliminate this classification.

Bloom’s Level: Knowledge Difficulty Level: EASY

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Question 11 Question Type: Text Entry Question: Many LGBT youth describe feeling ―__________‖ from early childhood.

Answer: different Solution: However, adolescence and early adulthood is the time of exploration and experimentation. The authors point out that heterosexual activity does not mean one is a heterosexual, nor does same-sex activity indicate homosexuality. They report that many LGBT individuals describe feeling ―different‖ from early childhood. When they begin to acknowledge their sexual or transgender identity, they begin to confront the stigma associated with being gay, lesbian, bisexual, or transgender.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 12 Question Type: Multiple Selection Question: Which are some of the results of coming out for a LGBT youth? a. rejection, anger, grief b. decrease in life satisfaction c. decrease in self-esteem d. negative reactions from others e. decrease in happiness Answer: a, b, c, d, e Solution: All of the choices are correct responses. The authors report that coming out to parents and friends can lead to rejection, anger, and grief. During the initial stages of this process, selfesteem, life satisfaction, and happiness may decrease as they face negative reactions from others (Chaney et al., 2011, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 13 Question Type: Essay Type Question: From a counseling perspective, what might a therapist focus on in working with LGBT individuals?

Solution: Responses will vary and may include focus on acceptance, affirmation, self-esteem issues, watching their own prejudices and/or stereotypes and assumptions, being knowledgeable about population, being aware of substance abuse issues, suicidality, depression and anxiety, and interpersonal relationships with others.

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Bloom’s Level: Synthesis Difficulty Level: HARD

Question 14 Question Type: Multiple Choice Question: Your client is in the process of coming out as gay. In your sessions, you find that he has an embedded belief that same-sex attraction is abnormal/wrong and that it is better to be heterosexual. As a result, he displays masochistic attitudes and behaviors. It is likely your client is experiencing internalized a. homophobia b. homophobia and heterosexism c. heterosexism d. transsexualism Answer: B Solution: B is the correct response because the client in the scenario is expressing an internalized hatred for himself for being gay (homophobia) and a preference for heterosexualism, not just one or the other.

Bloom’s Level: Analysis Difficulty Level: MEDIUM

Question 15 Question Type: True/False Question: Approximately one out of five same-sex couples are raising children.

Answer: True Solution: According to Yen (2011, as cited in Sue 8th edition), this is true.

Bloom’s Level: Difficulty Level:

Question 16 Question Type: Text Entry Question: The term to describe attraction to members of both sexes is ______________.

Answer: bisexual Solution: Bisexual is a term that describes individuals who have an affectional and/or sexual attraction to members of both sexes Bloom’s Level: Knowledge Difficulty Level: EASY

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Question 17 Question Type: Essay Type Question: Explore stressors, discrimination, and bullying LGBT youth may experience. What can be done to address this issue?

Solution: LGBT youth who are questioning their sexual orientation face a variety of stressors such as discrimination and harassment in the school environment. This may include harassment, physical assaults, and cyberbullying through text messages, emails, and Internet postings on social networking sites.

Programs can be implemented that promote gay–straight alliances and antibullying policies, not only reducing harassment but also reducing the risk of suicide (Hatzenbuehler, 2011, as cited in Sue 8th edition). Other ideas would be support groups, safe places, community-based outreaches, hotlines, youth clubs, and so on.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 18 Question Type: Multiple Choice Question: PFLAG is an organization that represents which of the following? a.

People Fighting to Liberate All Gays b.

Partners Focusing on Loving All Gays c.

Parents, Family, and Friends of Gays and Lesbians d.

None of the choices is correct.

Answer: C Solution: C is the correct response because PFLAG stands for Parents, Family, and Friends of Gays and Lesbians.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 19 Question Type: True/False Question: Bisexual individuals are more likely to say that their sexual orientation is a big part of who they are than gay and lesbian individuals.

Answer: False Solution: Bisexual individuals are much less likely to say that sexual orientation is a big part of who they are or to have come out to important people.

Bloom’s Level: Comprehension Difficulty Level: MEDIUMy

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Question 20 Question Type: True/False Question: Research findings indicate that children raised by LGBT couples are as mentally healthy as children with heterosexual parents.

Answer: True Solution: The authors report that findings indicate that children raised by gay or lesbian parents are as mentally healthy as children with heterosexual parents and that there is no reason to believe that a heterosexual family structure is necessary for healthy child development.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 21 Question Type: True/False Question: Gay Mexican American men may have a greater degree of internalized homophobia, partly because of the cultural value of machismo.

Answer: True Solution: Research indicates that this is true of gay Mexican men. The authors cite that coming out is often more difficult for ethnic minorities who face the stigma of being ―multiple minorities.‖ Gay Mexican American men have a greater degree of internalized homophobia, due partly because of the cultural value of machismo. Furthermore, in Latino communities, there is strong negative reaction to gay men and frequent use of slurs such as maricon (sissy) and joto (fag) (Estrada, Rigali-Oiler, Arciniega, & Tracey, 2011, as cited in Sue 8th edition). Moreover, Latino men who are gay report racism, discomfort, and rejection from the gay community and Latino men with darker skin or more Indian features are more likely to face such rejection (Ibanez, VanOss Marin, Flores, Millett, & Diaz, 2009, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: EASY

Question 22 Question Type: True/False Question: Assuming that a client is heterosexual is considered acceptable by professional standards due to the fact that most people identify as heterosexual in the United States.

Answer: False Solution: Assuming that a client is heterosexual is a bias, and it may make it more difficult to bring up issues regarding sexual orientation.

Bloom’s Level: Comprehension

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Difficulty Level: MEDIUM Chapter 24: Counseling Older Adults Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 24 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Test Questions Question 1 Question Type: Multiple Choice Question: Approximately one in _____ adults age 71 or older have dementia. a. seven b. ten c. three d. four Answer: A Solution: The authors report that approximately one in seven adults aged 71 or older have dementia—memory impairment and declining cognitive functioning.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 2 Question Type: True/False Question: White males aged 85 or older have the second highest suicide rate of any group.

Answer: True Solution: The statement is true as suicide rates are exceptionally high among older men, with the risk increasing with advancing age. White males aged 85 or older have the second highest suicide rate of any group.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 3 Question Type: Text Entry

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Question: Although ____________ has a gradual progression, the effects of this disorder can quickly impact both the affected individual and family members.

Answer: dementia Solution: The authors report that although dementia has a gradual progression, the effects of this condition can quickly affect both the client and family members. In the early stages, it is the memory problems that are often the primary concern.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 4 Question Type: Essay Question: What may contribute to the high rate of suicide among older White men?

Solution: Suicide rates are exceptionally high among older men, with the risk increasing with advancing age; White males aged 85 or older have the second highest suicide rate of any group.

However, it is unclear whether this group has less resilience and fewer coping strategies or whether the high suicide rate is because life changes associated with advanced age such as loss of employment, physical changes, and loss of control are a greater stressor for men. Some of the factors associated with suicide include being separated, divorced, or alone; suffering from depression; having an anxiety disorder; having physical or medical problems; and dealing with family conflict or loss of a relationship (American Foundation for Suicide Prevention, 2015, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 5 Question Type: Multiple Selection Question: When working with older adults, therapists should a. give full attention to the individual. b. talk to, rather than about, the person. c. verify what they tell you with a family member as they may have dementia. d. repeat each question slowly and with a louder than normal voice. e. use respectful language (not elderspeak). f. treat the person as an adult. g. take the individual’s concerns seriously.

Answer: a, b, e, f, g Solution: A, B, E, F, and G are all recommendations provided by the authors.

C and D are incorrect and reflect stereotypical behaviors.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

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Question 6 Question Type: True/False Question: Individuals aged 65 and older currently constitute 24 percent of the U.S. population.

Answer: False Solution: The correct answer is 16.2 percent, according to the text.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 7 Question Type: Text Entry Question: One popular instrument for screening for depression in older adults is the ___________________ ______________ ________________.

Answer: Geriatric Depression Scale Solution: A popular instrument for screening for depression is called the Geriatric Depression Scale, which was developed for older adults. It represents age-related norms and omits somatic symptoms that may be associated with physical problems rather than depression.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 8 Question Type: Essay Type Question: Why is there a high degree of depression in older adults?

Solution: Responses will vary and may include factors such as isolation; health concerns such as cardiovascular disease, cancer, and diabetes; and other concerns such as loss of mobility, loss of function or independence, loss of status, loss of employment, reduction in coping strategies, financial problems, losing a spouse or friends to death, and so on.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 9 Question Type: Multiple Selection Question: Which of the following are family circumstances associated with abuse and neglect of the elderly? a. overcrowded quarters

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b. c. d. e. f.

negative affect in the elderly person financial burdens previous patterns of violence a and c a, c and d

Answer: f Solution: The correct response is f as circumstances most commonly associated with abuse and neglect include (a) previous traumatic experiences and a pattern of violence in the family, (b) stress (including marital stress) resulting from accommodating an older parent or relative in the family home, (c) financial burdens, (d) overcrowded quarters and (e) low levels of social support (Acierno et al., 2010, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 10 Question Type: True/False Question: Unsafe driving and failure to take medication are examples of client self-neglect.

Answer: True Solution: The statement is true as it is important to be alert for client self-neglect, which may manifest in unsafe driving or failure to eat or take medications, which can have serious consequences (Mosqueda & Dong, 2011, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 11 Question Type: Text Entry Question: Among older women, suicide is most prevalent among those who are ____________ or ___________________.

Answer: separated; widowed Solution: According to the text, the prevalence of depression among older women is highest among those who are separated or divorced (23.1%) or widowed (15.4%).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 12 Question Type: Essay Type Question: How can therapists help elders prepare for end-of-life issues?

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Solution: Counselors can significantly improve the quality of life for adults nearing the end of life, or help them resolve late-life issues. The American Counseling Association contains end-oflife care provisions such as quality of care, counselor competence, and confidentiality in its ethics code and should be consulted when working with terminally ill clients and their loved ones (Werth & Crow, 2009, as cited in Sue 8th edition). Therapists can also provide opportunities for clients to reflect on their life. This may help older adults develop a sense of fulfillment in life by discussing the positive aspects of their experiences. These successes can be defined as having done one’s best or having met and survived challenges. A life review is often helpful for older clients.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 13 Question Type: Multiple Selection Question: What is the better treatment model for substance abuse for older adults? a. more structured programs b. more flexible rules concerning discharge c. individual psychotherapy d. medication e. no treatment because of age and quality-of-life issues f. more comprehensive assessment g. more outpatient mental health aftercare Answer: a, b, f, g Solution: As compared to younger substance abusers, older patients respond better to more structured programs, more flexible rules concerning discharge, more comprehensive assessment, and more outpatient mental health aftercare (Moos, Mertens, & Brennan, 1995, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 14 Question Type: True/False Question: Sexual activity is not an area of great interest to older adults, as most men suffer from erectile dysfunction and women suffer from low libido.

Answer: False Solution: Research indicates that older adults derive great satisfaction from sexual experiences even in the later years of life. Sexual interest and activity continue well into the 80s and 90s for many individuals. Among people 70 and older, 80 percent of men and 39 percent of women indicated that a satisfying sexual relationship is an important part of the quality of life (Fisher, 2010, as cited in Sue 8th edition).

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Bloom’s Level: Knowledge Difficulty Level: EASY

Question 15 Question Type: Text Entry Question: _________, defined as negative attitudes toward the process of aging or toward older individuals, is very common in our society.

Answer: Ageism Solution: The definition of ageism is the negative attitudes and behaviors toward the process of aging or toward older individuals.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 16 Question Type: Text Entry Question: It is estimated that approximately _________ percent of older adults abuse alcohol or prescription drugs.

Answer: 11 Solution: The authors report that it is estimated that 11 percent of older adults abuse alcohol or prescription drugs; some of the misuse of prescription drugs may involve misunderstanding of dosing instructions. It is noted that drugs that have abuse potential include benzodiazepines, opiates, and muscle relaxants.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 17 Question Type: Text Entry Question: _____________, such as ―Are we ready for our bath?‖ and ―You want to take your medicine now, don’t you?‖ is often used with exaggerated intonation and elevated pitch when speaking to older adults.

Answer: Elderspeak Solution: Elderspeak is considered to be disrespectful. Many older adults consider elderspeak to be demeaning. Even those with severe dementia may react negatively to its use by showing behavioral resistance (Williams, Herman, Gajewski, & Wilson, 2009, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

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Question 18 Question Type: Essay Type Question: What are some ways to promote positive cognitive functioning among older adults?

Solution: Research has found that cognitive decline in older adults can be delayed or reduced through lifestyle changes such as the use of cognitive activities to stimulate the mind such as chess, crossword puzzles, computer games, reading, or engaging in physical activity and better nutrition.

Bloom’s Level: Analysis Difficulty Level: MEDIUM

Question 19 Question Type: True/False Question: Financial burdens and overcrowded quarters are associated with elder abuse and neglect.

Answer: True Solution: The statement is true as the circumstances most commonly associated with abuse and neglect include (a) previous traumatic experiences and a pattern of violence in the family, (b) stress (including marital stress) resulting from accommodating an older parent or relative in the family home, (c) financial burdens, (d) overcrowded quarters and (e) low levels of social support (Acierno et al., 2010, as cited in Sue 8th edition).

Question 20 Question Type: Multiple Choice Question: One way to reduce the prevalence of elder abuse and neglect in families is to a. place elders in nursing homes. b. increase awareness through public education. c. arrest abusers. d.

None of the choices is correct.

Answer: B Solution: B is the correct response because one way to reduce the prevalence of elder abuse and neglect in families is to educate the public.

A is incorrect because placing elders into nursing homes does not necessarily reduce abuse or neglect—this could happen by staff members.

C is incorrect because while arresting abusers may send a message, it is not an effective systemic strategy.

D is incorrect because the answer is b.

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Bloom’s Level: Knowledge Difficulty Level: EASY

Question 21 Question Type: Multiple Choice Question: By the year 2030, what percentage of the U.S. population is expected to be over the age of 65? a.

10 percent b.

20 percent c.

30 percent d.

40 percent Answer: B Solution: B is the correct response because by the year 2030, 20 percent of the population will be over the age of 65.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 22 Question Type: Essay Question: What are some practical ways counselors can advocate to help reduce elder abuse?

Solution: Several steps can be taken to reduce the prevalence of elder abuse and neglect (APA, 2001). Continued public education can bring the problem out in the open and increase awareness of the risk factors for abuse. Respite care for family members, friends, or hired workers to help with care giving can help reduce caregiver burnout. Increasing social contact and support for caregivers helps keep stress more manageable. Assistance may also be possible from religious or community organizations, as well as organizations focused on particular medical conditions.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 23 Question Type: Essay Type Question: Describe the Mini-Mental State Examination (MMSE) and explain its value.

Solution: For older adults demonstrating significant cognitive decline and for those suspected of having a neurodegenerative condition such as Alzheimer’s disease, the traditional mental status exam can provide some indication of problem areas. However, a more frequently used assessment is the Mini-Mental State Examination (MMSE). This test takes about 5 to 10 minutes to administer and has normative and validity data. The MMSE comprises eleven items that

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assess orientation, attention and calculation, recall, language, and visual motor integrity. Early detection of cognitive decline allows for treatment and advanced planning involving legal matters or dealing with potential problems such as driving.

Bloom’s Level: Synthesis Difficulty Level: HARD Chapter 25: Counseling Individuals Living in Poverty Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 25, of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Test Questions Question 1 Question Type: Multiple Choice Question: According to social-class stratification theory, poverty is understood e. to be at the bottom-most rung in a hierarchical system of sociocultural power relations that goes beyond differences of income f. to be stratified and sees those in poverty equal to those in the middle class g. to be unproblematic and, in fact, desirable as individuals in poverty benefit from social welfare programs h.

None of the choices is correct.

Answer: A Solution: A is the correct response because social-class stratification theory contends that individuals in poverty are at the bottom-most rung in a hierarchical system of sociocultural power relations that goes beyond differences of income.

B is incorrect because social-class stratification theory does not purport that individuals are stratified and sees those in poverty equal to those in the middle class.

C is incorrect because social-class stratification theory does not state that poverty is unproblematic and in fact desirable as individuals in poverty benefit from social welfare programs.

D is incorrect because the answer is a.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 2 Question Type: True/False

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Question: Cognitive and behavioral distancing are techniques that those living in poverty subconsciously live by to try and forget they are poor. It is a form of denial and happens at the preconscious level.

Answer: False Solution: Cognitive and behavioral distancing is understood to be the social exclusion of the poor that is captured by society’s cognitive and behavioral distancing from them.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 3 Question Type: Text Entry Question: The hierarchical system that not only positions poverty and economic characteristics of groups in our society but involves sociopolitical relationships as well is known as _______________ _______________ _____________.

Answer: social class stratification theory Solution: Social class stratification theory is a description of a hierarchical system that not only positions poverty and economic characteristics of groups in our society, but involves sociopolitical relationships as well.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 4 Question Type: Essay Type Question: What might inhibit those living in poverty from accessing counseling services? What could counselors do to help alleviate this problem?

Solution: Many individuals living in poverty do not seek treatment because of practical problems such as limited transportation, inflexible work schedules, lack of health insurance, or other factors that affect their access to any mental health services.

Therefore, counselors working with low-income clients should develop a flexible schedule and style to meet the needs of individuals who may not be able to attend weekly or 50-minute sessions, and address barriers that may affect attendance, along with increasing the outreach component in providing therapy (Santiago, Kaltman, & Miranda, 2013; as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 5

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Question Type: Multiple Choice Question: Your client, a 5-year-old White male, does not have access to a reputable public school in his neighborhood. Your client is likely experiencing a. racism b. sexism c. classism d. homophobia Answer: C Solution: C is the correct response because classism operates to many kinds of socially valued assets such as education.

A is incorrect because racism does not apply to this client because he is White.

B is incorrect because sexism does not apply to this client because he is a male.

D is incorrect because the client is a child and homophobia does not apply to this case.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 6 Question Type: True/False Question: Women are more likely to live in poverty than men.

Answer: True Solution: Women are more likely to live in poverty than men. In 2016, 11.3 percent of males and 14 percent of females were impoverished.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 7 Question Type: Text Entry Question: The trend of practices such as restricting the sharing of food and making it illegal to sit or sleep in public spaces or drive homeless people away from public areas has been called the ― ____________ ___ ___________‖ by Ehrenreich (2009, as cited in Sue 8th edition).

Answer: criminalization of poverty Solution: The text makes note that, increasingly, the poor are being physically as well as metaphorically excluded from mainstream cultural life.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 8

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Question Type: Essay Type Question: What are some strengths that those living in poverty demonstrate?

Solution: Responses will vary but may include strengths such as persistence, patience, determination, creativity, survival skills, problem-solving skills, optimism or maintaining hope.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 9 Question Type: Multiple Choice Question: According to the Department of Health and Human Services, 2015, guidelines that an adult with a child earning $16,544 per year would a. be counted among the poor b. not be counted among the poor c. not be eligible for food stamps d. be considered upper-middle class Answer: B Solution: B is the correct response because an adult with a child attempting to live on $16,544 per year would not be counted among the poor because the cut off is $16,543.

A is incorrect because the cut off is $16,543.

B is incorrect because even though $16,544 is not considered to be poverty level, it does not mean that the family would not be eligible for food stamps.

D is incorrect because an adult with a child earning $16,544 would not be considered to be upper middle class.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 10 Question Type: True/False Question: According to the U.S. Census Bureau, in 2016 the poverty rates continue to decrease.

Answer: True Solution: The U.S. Census Bureau estimated that the American poverty rate was 12.7 percent in 2016, down from 13.5 percent in 2018 (Semega Fontenot, & Kollar, 2017, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

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Question 11 Question Type: Text Entry Question: In 2016 the poverty rate for Whites was ______. For African Americans, the 2016 poverty rate was _______, while the rate for Latinxs was _____. For Asians, the 2016 poverty rate was ______.

Answer: 11 percent; 22 percent; 19.4 percent; 10.1 percent Solution: Additionally, the highest American poverty rates are found among American Indians, at 26.2%.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 12 Question Type: Multiple Selection Question: Which age group most likely to live in poverty with a rate of 18 percent is one of the highest in the developed world? a. elderly b. children c. adolescent homeless d. a and b Answer: B Solution: The authors point out that children, at a poverty rate of 18 percent, continue to be the age group most likely to live in poverty. The U.S. child poverty rate is one of the highest in the developed world (UNICEF, 2012, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 13 Question Type: Essay Type Question: List some of the challenges the poor face in the United States.

Solution: Responses will vary but may include issues such as classism, social class disparities, stereotypes, discriminating names such as lazy or welfare queen, an underappreciation of the difficulty to survive on minimum wage, health care disparities, judicial system issues, educational inequality, lack of opportunities to lift themselves out of poverty, the culture of invisibility, social exclusion, economic worries, stress, poor nutrition, lack of employment opportunities, discrimination, family conflict, inadequate housing and frequent moves, increase exposure to crime and violence, increase exposure to toxins, safety issues, lack of health insurance, transportation problems, media presentations, and so on.

Bloom’s Level: Synthesis

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Difficulty Level: HARD

Question 14 Question Type: Multiple Selection Question: Which are some possible psychological reactions that might result from living in poverty. a.

PTSD b. delinquency c. substance abuse d. academic difficulties e. aggression Answer: a, b, c, d, e Solution: The living environment associated with poverty can increase the risk of exposure to violence and trauma, resulting in high rates of stress disorders such as PTSD, and other problems such as aggression, delinquency, substance abuse, and academic difficulties (Kearney, Wechsler, Kaur, & Lemos-Miller, 2010; as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 15 Question Type: True/False Question: The current 2015 minimum wage of $7.25 is sufficient to lift an average family of four out of poverty.

Answer: False Solution: The federal minimum wage of $7.25 per hour does not allow a full-time worker to lift his or her family of four out of poverty, a conclusion that emerges from examining the cost of living around the country via Penn State’s Living Wage Calculator.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 16 Question Type: Text Entry Question: Social class oppression is called ___________; it operates to limit access to many kinds of socially valued assets.

Answer: classism Solution: The definition provided is that classism is social class oppression, and it operates to limit access to many kinds of socially valued assets.

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Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 17 Question Type: Essay Type Question: How does being poor affect someone’s health?

Solution: Health disparities research is resoundingly clear that poor people face elevated rates of nearly every sort of threat to survival, including heart disease, diabetes, exposure to toxins, cognitive and physical functional decline and homicide, among many other threats (e.g., Belle, Doucet, Harris, Miller, & Tan, 2000; Scott, 2005; as cited in Sue 8th edition). Many health issues are related to poor nutrition, inadequate prenatal care and other factors as well.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 18 Question Type: Text Entry Question: One of the more overt forms of classist discrimination is when a poor person remains in prison, while wealthier people accused of the same crimes go home because the poor do not have funds to post __________.

Answer: bail Solution: As mentioned regularly in media descriptions of legal proceedings, bail represents one of the more overt forms of classist discrimination: the poor remain in prison cells while wealthier people accused of the same crimes go home.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 19 Question Type: True/False Question: The number of uninsured in America is on the increase due to rapidly rising health care costs and disparities in the health care delivery system.

Answer: False Solution; Just the opposite is true; due to the newly legislated Affordable Care Act, the number of uninsured is decreasing. In the first quarter of 2014, the number of Americans without health insurance has dropped to 41 million from 50 million in 2009 (Kaiser Foundation, 2010; Smith; Tavernise, 2014, as cited in Sue 8th edition) primarily because of enrollment via provisions of the Affordable Care Act. Bloom’s Level: Knowledge

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Difficulty Level: EASY

Question 20 Question Type: Essay Type Question: How do common street crimes purportedly committed in lower class neighborhoods mask crimes that are committed in social classes considered of higher privilege?

Solution: Reiman (2007, as cited in Sue 8th edition) has argued that the criminal justice system itself is deeply classist in that it portrays crime as the misdeeds of the poor. In other words, he reports that street crimes like burglary, theft, and selling drugs are the contents of the typical police blotter and are detailed in national crime rate statistics. This practice serves to deflect the attention from the crimes that actually cause the most death, destruction, and suffering in our country, in crimes that derive from the actions of people with social class privilege. This may include corporate fraud, the creation of toxic pollutants, profiteering from unhealthy or unsafe products, and risky high-level financial ventures where the American public ends up bearing the consequences of the risk.

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 21 Question Type: True/False Question: The paradox of American poverty is that it takes place in the wealthiest nation in the world.

Answer: True Solution: Globally, one of the distinguishing features of American poverty is that it takes place in the wealthiest nation in the world. The United States continues to have one of the world’s most unequal income distributions.

Bloom’s Level: Comprehension Difficulty Level: EASY Chapter 26: Counseling Women Below are questions that can be used to test the students’ knowledge of the material covered in Chapter 26 of the 8th edition of Counseling the Culturally Diverse: Theory and Practice (CCD, Sue 8th edition). Questions are presented in various formats (True/False, Multiple Selection, Multiple Choice, Text Entry, and Essay Type). After each series of questions, you will find the correct answers along with accompanying explanations. Bloom’s taxonomy is provided to indicate the style of learning needed to answer the respective question. Additionally, you will find a descriptor, EASY, MEDIUM, HARD, indicating the difficulty level of each question.

Test Questions

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Question 1 Question Type: Multiple Choice Question: Which is a barrier to the advancement of women on the corporate ladder? a. the ―good old boys‖ network b. too few employment opportunities c. family commitments d.

None of the choices is correct.

Answer: A Solution: ―The good old boys‖ network is where male coworkers heightened cultural boundaries by emphasizing male camaraderie and differences from women. They often rely on a ―good old boys network‖ and withhold from women information necessary for job performance.

B is incorrect because there are many employment opportunities.

C is incorrect because family commitments have not been found to inhibit advancement.

D is incorrect because the answer is a.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 2 Question Type: True/False Question: The ratio of men to women decreases with age.

Answer: False Solution: The ratio of men to women increases with age. Furthermore, among those aged 85 or older, there are about twice as many women as men (U.S. Census Bureau, 2014, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 3 Question Type: Text Entry Question: Many women experience _______ because of the emphasis placed on beauty and youthfulness.

Answer: ageism Solution: The number of women aged 65 and older is expected to double and reach 40 million by the year 2030 (U.S. Census Bureau, 2011, as cited in Sue 8th edition). Given the emphasis on youth and beauty that exists in our society, women face additional barriers as they age. These include age discrimination at work; preferential treatment of younger females in stores, restaurants, and other public establishments; reduced dating opportunities (e.g., men often prefer

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to date younger women); and a sense of being ―invisible‖ (Committee on Women in Psychology, 1999, as cited in Sue 8th edition).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 4 Question Type: Essay Type Question: Define feminism. Share what a feminist approach to counseling might entail.

Solution: According to the authors, feminism is a frequently misunderstood term. It refers to efforts directed toward gender equality, which includes equal economic, social, and political rights and opportunities for women.

The early feminists focused on voting and property rights, whereas contemporary feminists advocate for reproductive rights; parental leave and quality childcare; psychosocial safety for women such as targeting domestic violence and sexual assault; and ending wage disparity, sexist power structures, and other forms of discrimination.

Feminist therapists believe that the patriarchal nature of U.S. society actually contributes to many of the problems faced by women and that psychological symptoms are often the result of women’s subordinate status in society. Feminist case conceptualizations incorporate the intersection between multicultural influences and other forms of oppression. Interventions based on a feminist perspective would focus on goals such as empowerment, identifying personal strengths and discovering areas for self-growth outside of traditional roles (Diaz-Martinez, Interian, & Waters, 2010, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 5 Question Type: Multiple Selection Question: The career self-efficacy of women is increased by having them a. understand the impact of gender socialization on career choice and development. b. learn about the career paths of successful women. c. observe successful women and interviewing them about their career decision-making processes and insights. d. promote skills to manage anxiety through relaxation and adaptive self-talk. e. identify and challenge self-defeating thoughts.

Answer: a, b, c, d, e Solution: All of the choices are techniques Sullivan and Mahalik (2000, as cited in Sue 8th edition) introduced to increase the career self-efficacy of women.

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

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Question 6 Question Type: Essay Type Question: Expand on the interventions directed at challenging and changing the female image promoted by the media and advertisers.

Solution: Interventions directed at challenging and changing the unrealistically thin female image promoted by advertisers, magazines, and other mass media can help reduce body dissatisfaction in females. Programs aimed at preventing or altering disturbed eating patterns generally involve (a) learning to develop a more positive attitude toward one’s body; (b) becoming aware of unhealthy societal messages of ―what it means to be female‖ (e.g., girls must be thin, pretty, and sexy); (c) understanding the consequences of internalized gender-related societal messages (e.g., distorted expectations and negative self-statements); (d) developing healthier eating and exercise habits; (e) increasing comfort in expressing feelings to peers, family members, and significant others; (f ) choosing appropriate self-care messages (e.g., ―Being healthy is important, so I will eat and exercise appropriately‖); (g) developing plans to implement health-based changes; and (h) identifying healthy strategies to deal with stress and pressure (Richardson & Paxton, 2010, as cited in Sue 8th edition).

Bloom’s Level: Analysis Difficulty Level: HARD

Question 7 Question Type: Text Entry Question: ___________ is a frequently misunderstood term that refers to efforts directed toward gender equality.

Answer: Feminism Solution: A more full definition would also include efforts directed toward equal economic, social, and political rights and opportunities for women.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 8 Question Type: Essay Type Question: Identify areas that may cause stress for women.

Solution: Responses will vary but may include: work problems and expectations, ageism, sexism, unequal pay, household responsibilities, child care, elder care, sexual harassment, interpersonal problems, lack of career advancement due to gender, racism, discrimination, poverty, depression, intimate partner violence, sexual victimization and more, as highlighted in the chapter.

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Bloom’s Level: Synthesis Difficulty Level: HARD

Question 9 Question Type: Multiple Choice Question: Twelve-year-old Jennifer begins to experience intense heart palpitations prior to a math test. She does not believe she is good at math because through messages from her family, teachers, and media, she is not supposed to excel at math because she is a girl. Jennifer is likely experiencing a. serious posttraumatic stress b. stereotype threat c. internalized homophobia d. cognitive dissonance Answer: B Solution: B is the correct response because Jennifer is experiencing stereotype threat, which is anxiety that one’s performance will confirm negative, stereotype-based expectations.

A is incorrect because there is no evidence in the question to suggest that it is posttraumatic stress.

C is incorrect because the question has nothing to do with sexual orientation.

D is incorrect because cognitive dissonance occurs when one experiences information that is at odds with prior knowledge.

Bloom’s Level: Application Difficulty Level: MEDIUM

Question 10 Question Type: True/False Question: Fortunately for women, many of the counseling theories and practices are gender neutral.

Answer: False Solution: The authors state that it is important to recognize that many counseling theories and practices are male-centered and may require modifications when working with women. An example is cognitive-behavioral therapeutic approaches, which can be modified to include a focus on internalized societal messages or unrealistic standards of beauty.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 11 Question Type: Text Entry

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Question: Women often experience ___________ _________________ and exhaustion due to disproportionate responsibility for child care, housework, and care of elders.

Answer: role overload Solution: In addition to the focus on physical attributes, females are socialized to also prioritize the needs of others, taking on the role of nurturer and caregiver. They are influenced by the belief that ―good mothers‖ should stay home with their children or be available if needed by their children during work hours. Women often experience ―role overload‖ and exhaustion due to the disproportionate responsibility for child care, household chores, and care of elders.

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 12 Question Type: Essay Type Question: Explore what may occur when females are exposed to stereotypical societal messages about women.

Solution: When females are exposed to stereotyped societal messages via toys, dolls, television, music videos, song lyrics, magazines, and advertising, they begin to (a) believe that their primary value comes from being attractive, (b) define themselves according to media-influenced body standards, and (c) see themselves as sexualized objects (American Psychological Association, 2010; Moffitt & Szymanski, 2011, as cited in Sue 8th edition).

Bloom’s Level: Synthesis Difficulty Level: HARD

Question 13 Question Type: Multiple Choice Question: Women are how many times more likely than men to do housework? a.

2.5 b.

1.5 c. men and women do an equal amount of housework d.

5.0 Answer: A Solution: Women often experience ―role overload‖ and exhaustion due to the disproportionate responsibility for child care, household chores, and care of elders. For example, women are 2.5 times more likely than men to do housework, and among couples with children, women spend nearly three times as much time on child care than men (Bureau of Labor Statistics, 2015, as cited in Sue 8th edition). These family responsibilities can affect women’s employment status as well as career commitment (Bertrand, Goldin, & Katz, 2010, as cited in Sue 8th edition) Bloom’s Level: Knowledge

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Difficulty Level: EASY Question 14 Question Type: True/False Question: A typical outcome of the unrealistic ―thin ideal‖ results in healthy eating patterns for women.

Answer: False Solution: A typical outcome of the unrealistic ―thin ideal‖ results in healthy disordered eating patterns for women.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 15 Question Type: Text Entry Question: Depression is one of the most prevalent psychiatric disorders and a leading cause of worldwide disability. Women have a _________ percent greater lifetime risk of experiencing a major depressive episode compared with men.

Answer: 70 Solution: Depression is one of the most prevalent psychiatric disorders and a leading cause of worldwide disability (Andrade et al., 2010, as cited in Sue 8th edition). Women have a 70 percent greater lifetime risk of experiencing a major depressive episode compared with men (Kessler, Chiu, Demler, & Walters, 2005, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 16 Question Type: Essay Type Question: What might some results be of societal pressure toward ―thinness‖?

Solution: The societal pressure for females to be thin leads to the internalization of an unrealistic ―thin ideal,‖ with resultant body dissatisfaction, disordered eating patterns, and frequent dieting (Fallon, Harris, & Johnson, 2014; M. S. Hill & Fischer, 2008, as cited in Sue 8th edition).

Bloom’s Level: Knowledge Difficulty Level: MEDIUM

Question 17 Question Type: Multiple Choice

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Question: Microaggressions in sexism can be a. overt, manifesting in blatantly unequal and unfair treatment b. covert in unequal, harmful treatment conducted in a hidden manner, such as genderbiased hiring practices c. subtle in unequal treatment that is so normative that it is unquestionably accepted d.

All of the choices are correct.

Answer: D Solution: All of the above is the correct response. As the authors described in Chapter 6 in the discussion of microaggressions, sexism can be overt (i.e., blatantly unequal and unfair treatment), covert (i.e., unequal, harmful treatment conducted in a hidden manner, such as gender-biased hiring practices), or subtle (i.e., unequal treatment that is so normative that it is unquestionably accepted).

Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 18 Question Type: True/False Question: Displaying sexually suggestive pictures and/or telling sexist jokes would be considered sexual harassment.

Answer: True Solution: Sexual harassment is broadly defined as verbal or physical conduct of a sexual nature, sometimes with explicit or implicit expectations that a woman submit to sexual requests. This continues to be quite prevalent in school and work environments. Intimidating, hostile, or sexually offensive work environments, for example, where sexually suggestive pictures are displayed or sexual jokes are told, are also examples of sexual harassment Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 19 Question Type: Text Entry Question: The more women are treated as sexual objects such as being subjected to sexualized evaluation such as erotic gazes or overt visual inspection and related sexual comments, the more they feel _______________ and _______________.

Answer: devalued; trivialized Solution: The authors report that the more women are treated as sexual objects (e.g., subjected to sexualized evaluation such as erotic gazes or overt visual inspection and related sexual comments), the more they feel devalued and trivialized. Although harassment can be extremely distressing and can influence academic and work performance, many women are hesitant to report such behaviors.

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Bloom’s Level: Comprehension Difficulty Level: MEDIUM

Question 20 Question Type: Essay Type Question: What might be some effects of intimate partner violence and/or sexual victimization?

Solution: Sexual victimization and intimate partner violence disproportionately affect females and account for 27 percent of the violence experienced by women (U.S. Department of Commerce, 2011, as cited in Sue 8th edition). Many of the women affected by intimate partner violence report significant ongoing psychological distress (Zahnd, Aydin, Grant, & Holtby, 2011, as cited in Sue 8th edition). Such abuse or harassment can have long-term effects, and may include chronic headaches, pelvic pain, gastrointestinal distress, and other physical symptoms, as well as emotional symptoms such as anxiety, depression, disordered eating, and posttraumatic stress disorder (Chen et al., 2010; Steiger et al., 2010, as cited in Sue 8th edition).

Bloom’s Level: Analysis Difficulty Level: HARD

Question 21 Question Type: Multiple Choice Question: During the course of their lifetime, what percentage of women will be subject to intimate partner violence? a.

25 percent b.

19 percent c.

31.5 percent d.

10 percent Answer: C Solution: These statistics are provided by the authors: Sexual and physical assault is a significant concern for women. During their lifetime, an estimated 31.5 percent of American women are subjected to intimate partner violence.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 22 Question Type: True/False Question: Teachers are often unaware that they may be promoting sexism by providing differential responses to male and female students.

Answer: True

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Solution: Research studies indicate that teachers are often unaware that they may be promoting sexism by providing differential responses to male and female students.

Bloom’s Level: Knowledge Difficulty Level: EASY

Question 23 Question Type: Essay Type Question: Despite the difficulties presented in this chapter what are some strengths that characterize women?

Solution: Responses will vary but may include highlights from the chapter that state that women tend to:  display affiliative qualities, such as sensitivity, nurturance, kindness  be concerned with relationships (dePillis & dePillis, 2008 as cited in Sue 8th edition)  have effective teamwork and better rapport within family systems and within society  have a strong capacity for developing and maintaining robust social support networks  demonstrate skill at understanding how others are feeling, and responding accordingly  be skilled at anticipating emotional consequences of decisions  show talent in terms of creativity, problem solving, and mental flexibility  be frequently guided by strong values  have characteristics such as emotional self-regulation Women employees and leaders are more likely to:  display an open, consensus-building, and collegial approach to work  encourage participation, teamwork and cooperative efforts among colleagues  share power (Caliper, 2005, as cited in Sue 8th edition) Bloom’s Level: Synthesis Difficulty Level: HARD

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