Using Experiential Tasks to Enhance Cultural Sensitivity Among MFT Trainees

Journal of Marital and Family Therapy doi: 10.1111/j.1752-0606.2010.00213.x July 2010, Vol. 36, No. 3, 333–346

USING EXPERIENTIAL TASKS TO ENHANCE CULTURAL SENSITIVITY AMONG MFT TRAINEES Tracey Laszloffy Northcentral University

Julika Habekost Alliant International University

Approximately 60% of accredited MFT master’s programs now offer a single course devoted to diversity and oppression, which is noteworthy given that this is not mandated by accreditation standards. For educators and trainers seeking guidance on how to most effectively teach diversity issues and train therapists who will be culturally competent, the MFT literature does an excellent job of providing support for enhancing cultural awareness, for example, cognizance of, insight into, and knowledge about diversity issues. However, far less attention is focused on assisting educators in how to enhance cultural sensitivity, for example, attunement to, emotional resonance with, and meaningful responsiveness to the needs and feelings of others. This article presents a model for how to teach about issues of diversity in ways that promote both cultural awareness and sensitivity but with emphasis on enhancing sensitivity through the use of a series of experiential tasks. Since 1988 the accreditation standards established by the COAMFTE have required MFT programs to promote cultural competence by considering issues of diversity, multiculturalism, power, and oppression. Specific standards have addressed such factors as increasing the representation of faculty and students from underrepresented groups, infusing diversity issues into all MFT coursework, and utilizing clinical sites that serve diverse populations and clinical issues. Beyond these particular requirements, programs have tremendous latitude to define what constitutes cultural competence and to determine the most effective ways of addressing issues of diversity within the clinical training experience. Although not required by accreditation standards, one method commonly employed to promote cultural competence is offering a single diversity course. Approximately 60% of master’s programs require their students to take at least one course devoted to issues of diversity and oppression.1 The single course approach has been the subject of much debate. Critics have argued that the single course approach reinforces the notion that diversity issues are a separate topic that can be sectioned off and addressed separately from other topics, thereby undermining integration of multicultural issues throughout all coursework (Zimmerman & Haddock, 2001). Proponents, on the other hand, have suggested that the single course approach is critical for providing the kind of in-depth exploration that such a complex topic generates (Murphy, Park, & Lonsdale, 2006). Ideally, it is best when programs find ways both to infuse diversity throughout all aspects of the curriculum and to offer at least a single course that addresses diversity issues in depth (Chao, 2002; Hill, 2003; Marshall & Wieling, 2000). Despite the fact that almost two thirds of accredited master’s programs offer a single diversity course, the MFT literature provides minimal guidance with respect to how to design and teach diversity courses to maximize cultural competence. To address this gap in the literature, this article presents a model for teaching a master’s-level MFT diversity course that enhances cultural competence, with particular emphasis upon going beyond cultural awareness and fostering cultural sensitivity. It is important to note that while this article presents a model for teaching a single diversity course, the authors assume that the most effective way to ensure Tracey Laszloffy, PhD, Marriage and Family Therapy Program, Northcentral University; Julika Habekost, MA, Alliant International University. Address correspondence to Tracey Laszloffy, 12 New London Tnpk #196, Norwich, Connecticut 06360; E-mail: [email protected]

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cultural competence is to simultaneously offer at least one diversity course while also infusing issues of diversity throughout the curriculum. In that spirit, any of the experiential learning tasks that form the basis of the course presented here can be extracted for use in other courses. For example, the first author has used the Task Four tasks in conjunction with a course on couples therapy.

DEFINING TERMS The term culture, as it pertains to the teaching model presented here, is used as an umbrella concept that includes all of the dimensions of diversity, including but not limited to race, ethnicity, nationality, class, gender, sexual orientation, religion, age, and ability. The term cultural competence is defined as the presence of both cultural awareness and sensitivity whereby awareness refers to a state of cognizance of, insight into, and knowledge about diversity issues, and cultural sensitivity refers to a state of attunement to, emotional resonance with, and meaningful responsiveness to the needs and feelings of others (Hardy & Laszloffy, 1995). More specifically, cultural awareness is the ability to recognize how the dimensions of diversity shape reality in inequitable ways. Awareness exists at varying levels of depth and complexity, beginning with the most superficial and cursory levels of insight and advancing to deeper, more nuanced and sophisticated levels of perception. Cultural sensitivity is characterized by empathic resonance. It is the capacity to anticipate another’s perceptions and feelings and to modify and adjust one’s behaviors so as to make another feel comfortable and understood in terms of one or more of the dimensions of diversity (Hardy & Laszloffy, 2008; Holcomb-McCoy & Myers, 1999). While it is possible to have cultural awareness without sensitivity, the reverse is not possible. To the extent that sensitivity is the translation of awareness into meaningful action, all sensitivity requires some awareness. Initially, individuals use their awareness to take empathic action with respect to one or more of the dimensions of diversity; however, they tend to do so awkwardly. As sensitivity deepens, the ability to translate awareness into meaningful, empathic action becomes increasingly fluid and nuanced (Laszloffy & Hardy, 2000). Several MFT scholars (Collins & Pieterse, 2007; Constantine, Juby, & Liang, 2001; McDowell, Storm, & York, 2007) have pointed out that approaches to diversity education and training tend to do an excellent job of promoting awareness. For example, having students read a chapter from Ethnicity and Family Therapy (McGoldrick, Pearce, & Giordano, 2005) that identifies the central tendencies of specific groups is an example of a commonly used teaching strategy that promotes awareness. It engages students’ minds. It presents them with data to memorize as a guide for how to understand and work with clients who have membership in particular racial or ethnic groups. Similarly, PowerPoint-driven lectures, watching films, writing research articles, taking exams, and even role-plays and lectures delivered by guest speakers are teaching strategies that tend to be oriented toward awareness. According to Holcomb-McCoy and Myers (1999), the problem is that while ‘‘current training methods are producing competence in the cognitive domain, the experiential and emotional domains remained unaffected’’ (p. 296). In response to the underutilization of experiential learning opportunities that have the potential to move students outside of their comfort zones to interact with other people across differences, and to negotiate contexts, situations, and circumstances that are unfamiliar or unknown to them, Killian and Hardy (1998) and Marshall and Wieling (2000) have advocated the use of ‘‘cultural plunges.’’ These refer to immersion experiences whereby one enters a setting from a minority position and has to feel and manage the discomfort and tension associated with this status. Diversity education and training that utilize experiential learning, and cultural plunges in particular, are an essential part of enhancing cultural sensitivity.

A SINGLE COURSE DESIGN: DIVERSITY, OPPRESSION AND FAMILY THERAPY This article presents a model for teaching a diversity course to master’s-level MFT trainees in a way that promotes cultural competence (e.g., awareness and sensitivity), but with particular 334

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emphasis upon enhancing sensitivity. This model is conveyed through a course titled Diversity, Oppression and Family Therapy that was developed and refined by the first author over the last 10 years in conjunction with teaching diversity issues to MFT master’s students located at five different university settings. These settings consisted of a midsize private university in upstate New York, a large public university in Connecticut, a small private Catholic university in western Pennsylvania, and two separate campuses of a midsize private professional practice university (one in Southern California and the other in Mexico City). In each of these settings, the first author was assigned to teach a master’s-level MFT diversity course. Based upon a review of syllabi developed by other instructors and a review of the literature, she noted that approaches to teaching diversity relied heavily on fostering awareness with less emphasis on enhancing sensitivity. To adjust for this imbalance, she designed the Diversity, Oppression and Family Therapy course. The course utilizes methods and strategies that promote awareness through the use of lectures, reading assignments, and videos. These strategies are an effective way of delivering specific content that is a vital part of the course. However, the course is primarily focused on enhancing sensitivity through the use of a series of experiential learning tasks. Promoting Sensitivity Through Experiential Learning Tasks Common approaches to fostering sensitivity involve the use of role-plays, class discussions, having students write reflective journals, and inviting guest speakers to engage students directly and stimulate emotional and interpersonal learning. The limitations associated with these methods are that they can be applied in ways that are distant and abstract. They tend not to promote novel and intense real-world experiences that challenge students outside of their comfort zones. Hence, the learning associated with these methods tends to enhance awareness with minimal impact upon sensitivity (Holcomb-McCoy & Myers, 1999). To compensate for this common limitation, the Diversity, Oppression and Family Therapy course is designed to promote sensitivity by engaging students in direct, lived experiences that push them outside of their comfort zones. It is one thing to listen to what it feels like to experience some form of oppression, but it is quite different to feel it for oneself. Moreover, it is one thing to learn about a particular group by hearing a lecture or reading an article or a book, but it is another thing altogether to interact directly with members of that group. The capacity for sensitivity hinges to a large degree on talking with and interacting with others whom one is different from, and struggling to relate across and through differences. Inevitably, during interactions with people from other groups, mistakes are made. We say things that the other perceives as a slight, or we may look foolish for not understanding the meaning of a certain thing. It is these strained and awkward moments that promote sensitivity-based learning and growth. The development of sensitivity also depends upon entering a context that shifts one’s primary location from a dominant position to a subjugated position (McDowell, Fang, Brownlee, Young, & Khanna, 2002). The tasks that students are required to complete as part of the Diversity, Oppression and Family Therapy course are intended to move them beyond mere awareness by placing them in situations that have the power to stimulate insights that will be translated into meaningful, empathic action (e.g., to facilitate sensitivity). The first time this course design was utilized, it was positively received by students who reported heightened levels of both awareness and sensitivity. By applying student feedback about how the course might be further enhanced, the first author continued to modify the design each time the course was taught and over the span of a decade, working with students in five different university settings, the design presented here gradually emerged. In the remainder of this article, the teaching and learning objectives associated with the Diversity, Oppression and Family Therapy course are presented to establish the underlying philosophy and assumptions that shape the design and teaching methods. This is followed by a description of how the course is organized. Finally, the experientially based teaching methods and strategies that constitute the heart of how the course enhances cultural awareness and especially cultural sensitivity are presented. Students’ reactions and data from their journaling experience are included to illustrate their experiences with the course and the experiential tasks they July 2010

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completed. The first author obtained permission from students whose journal comments were included, and identifying data were sanitized to ensure confidentiality. Course Teaching and Learning Objectives There are five core teaching and learning objectives that comprise the Diversity, Oppression and Family Therapy course, which are as follows. First objective. To examine the intersection between six dimensions of diversity (e.g., class, race, gender, sexual orientation, religion, ability) and the dynamics of oppression, with special emphasis upon how these shape family process and the therapeutic process. The dimensions of diversity that are studied in this course are not exhaustive. While there are many others that could be studied, for practical purposes the course is limited to focusing on the chosen six. A key point that is explicitly articulated from the start of the course is that virtually all of these dimensions of diversity apply to all individuals and families. It is commonly assumed that only those who have membership in minority groups have an identity based on these dimensions, but in fact, we all have a class identity, a racial identity, a gender identity, and a sexual identity, and we all fall somewhere on the spectrum of ability ⁄ disability. The possible exception is religion. Although extremely rare, there are some individuals who are born into and raised within families where the parents have no religious affiliation and explicitly socialize their children to think of themselves and to relate to reality devoid of a religious framework. The way we experience the dimensions of diversity is heavily influenced by the unequal distribution of and access to social power that is tied to the dynamics of oppression. Therefore, the course devotes considerable attention to identifying and exploring the dynamics of oppression. Students are introduced to the general characteristics of oppression with the understanding that all oppressions are fundamentally similar at the process level. To concretize this point, the course examines the intersection between the six dimensions of diversity and the dynamics of oppression. Second objective. To understand the experiences of subjugated groups and the impact of marginalization and oppression on family process and the process of therapy. The unequal allocation of access to power and resources in terms of the dimensions of diversity creates a situation whereby some people are privileged in terms of their class, race, gender, sexual orientation, religion, and ⁄ or ability, while others are subjugated. As the experiences of the subjugated are largely marginalized and ⁄ or devalued by mainstream society, the course centers on subjugated groups and devotes considerable attention to inviting students to consider the experiences of those who are oppressed in terms of the various dimensions of diversity. Specific attention also is focused on how various forms of oppression shape family dynamics and the process of therapy. Third objective. To recognize how the dimensions of diversity and the dynamics of dominance ⁄ oppression have shaped students’ family and their identity, and the implications for their work as therapists. In other words, students will engage in self-of-the-therapist work with respect to issues of diversity, power, privilege, oppression, and subjugation. A core assumption of this course is that the capacity to learn about others is rooted in how much individuals are able to understand about and struggle with themselves. Guided by this assumption, this course systematically challenges students to look within and to understand themselves as classed, racial, gendered, religious, sexual, and abled ⁄ disabled beings. They are guided to explore how these aspects of themselves shape their values, beliefs, and biases, as well as the things that they see and fail to see. The capacity to manifest sensitivity is strongly influenced by how much persons have looked within themselves to better understand how these dimensions have shaped their identity. In short, before you can understand others, and before you can empathically join with their perspective, you must understand yourself. This requires insight about the aspects of self that influence what you see, feel, and believe about others, as well as recognizing how others are likely to perceive, experience, and be impacted by you. Fourth objective. To identify and explore culturally competent, oppression-sensitive clinical practices. This course is designed for MFT students, and therefore, an important part of the course involves linking everything that students learn about themselves and others to the process of therapy. Students learn how the dimensions of diversity and the dynamics of power shape the 336

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therapy process, and they learn specific concepts and strategies for working in an oppressionsensitive way with members of subjugated groups. Fifth objective. To appreciate the importance of working on behalf of social justice both inside and outside of therapy that includes promoting healing and transformation both within themselves and in the world at large. An assumption of this course is that MFTs can either serve as agents of social control or activists for social change and social justice. Accordingly, this course encourages students to consider how they can apply their developing knowledge and skills of how systems function, how context shapes reality, and how to change dysfunctional interactions in ways that can heal the wounds of oppression and transform unjust social conditions. Course Organization The course is structured into seven units. The first unit establishes the course foundation by discussing key assumptions and identifying the principles and characteristics of oppression. The remaining six units are divided into Class, Race, Religion, Sexual Orientation, Gender, and Ability, with two classes devoted to each unit. The first class of each unit considers the dimension of diversity in a general sense, whereas the second class within each unit looks at the experiences of those who are subjugated on the basis of that dimension. For example, during the first class offered as part of the Race unit, students learn the definition of race and how race structures social reality. Because the focus is on race as a concept or category, students are asked to consider themselves as racial beings and to examine how their racial identity shapes their perceptions and experiences. The second class of the Race unit specifically centers on the experiences of racial minority groups, culminating in an examination of implications for working in therapy with clients from racial minority groups. In the course syllabus, students are told they will be assigned six tasks throughout the course of the semester, and they are told what percentage of their grade each completed task is worth. They also are informed that they will receive the specifics of each task assignment 2 weeks prior to the date each one is due. The intention is to limit students from thinking too much about what they will be asked to do and to create as much of an ‘‘in the moment lived experience’’ as possible. Students also are asked to refrain from discussing the tasks they will be asked to engage in with students outside of the class as way of maintaining novelty for future students. Finally, students are alerted to the fact that the tasks they will be asked to execute are intended to be challenging and at times they may feel extreme awkwardness and discomfort. They are encouraged to remain aware of whatever reactions they have and to use these as information that can help them to grow. There are two primary ways that students receive feedback and also are provided an opportunity for debriefing after completing the tasks. First, on the day a task journal is due, students are engaged in a discussion about their experiences. They are asked to share what happened when they executed the tasks, what thoughts and feelings they had, and the resulting impact upon and implications for their lives and their work as therapists. The discussion provides a vehicle for students to provide each other with feedback and for the instructor to offer feedback as well. Second, a critical component of the learning associated with the tasks is the written feedback students receive from the instructor on their journal entries. It is recommended that instructors use this opportunity to provide as much in-depth and challenging feedback as possible. Task one: Confronting social class and classism ⁄ poverty. The first task students are assigned requires them to participate in two experiences that are presented below. 1. Whatever toilet paper you have left on the roll at home is all you can use for the next week. Use it carefully because if you run out, there are only three options you can exercise. (a) Ask the instructor to donate a roll to you. (b) Borrow money from one of your classmates to buy a roll. (c) Find something else to use other than toilet paper. In your write-up, please (a) describe how you executed the task; (b) explain what happened, how you felt, and what you thought; (c) identify what you learned about yourself and the implications for your work as a therapist. July 2010

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2.

Go to the local county office to apply for welfare. When you get there, find out from someone at the window what you need to fill out to apply, what steps are involved in the application process, and how long it will likely take before you find out if you are approved. From the time you hand in the application, stay for 30 min after that and just observe. In your write-up, please (a) describe what happened and describe what you observed; (b) describe your thoughts and feelings; and (c) tell me what you learned about yourself and the possible impact on your role as a therapist. The first task is designed to put students in a situation where they have limited access to a valuable resource. The fact that the resource that is limited happens to be toilet paper is important because this is something everyone needs. For students who have never been poor, toilet paper is often taken for granted, and they are unprepared for managing the level of stress and energy that comes with having to conserve this simple yet essential resource. The social stigma associated with the process of elimination makes it too shameful for most to ask for toilet paper assistance. Students often are surprised to discover the level of creativity and even larceny they are capable of manifesting to acquire a resource they need but lack. As one student wrote, ‘‘I am ashamed to admit that I actually stole a roll of toilet paper from a public restroom and my desperation made my theft seem justified. I have always been so judgmental of poor people but this experience has helped me to appreciate how when you do not have enough of something you need, you can go to almost any length to survive.’’ For students who have had experiences with poverty, this exercise tends to activate feelings of shame and the pain of struggling with limited resources. According to another student, ‘‘This exercise brought back a lot of painful memories of growing up dirt poor. There were plenty of times we did not have enough toilet paper. Sometimes I just had to use my hand to wipe myself. Doing this made me feel all that shame and anger all over again. I thought that was in my past, but obviously it’s not.’’ The second task requires students to directly and literally experience what it is like to apply for governmental assistance. They find themselves in a position where they are perceived as being poor and in need and have to manage the thoughts and feelings that this arouses. They also find themselves in the company of others who are poor and in need of assistance, and they do so without the protection of an ‘‘official position.’’ In this context, they are required to observe and to reflect upon their inner thoughts and feelings. For students who have never experienced poverty, the experience tends to be a rude awakening to the level of devaluation and disrespect that poor people often endure. Students often are amazed to discover how frustrating and stressful it is to navigate through the social service system. For students who have had experiences with poverty, again this exercise taps into the feelings associated with not having enough, with having to rely on others to survive, and with managing experiences that are defined by devaluation and disrespect. Task two: Confronting race and racism. The second assigned task directs students to participate in the following experience. Attend an event (religious, social, civic, or political) where you find yourself in the position of being a racial minority. Ideally, you should pick an event where the preponderance of people you are surrounded by will be members of the racial minority group that you are most likely to feel uncomfortable around. In your write-up, explain (a) how you picked this particular event and what does this tell you about yourself racially; (b) what happened while you were there and how you were affected (e.g., what thoughts did you have, what feelings did you experience, what did you observe, what did you do, and how did you respond); and (c) what did this experience teach you about yourself racially and what are the implications for your work as a therapist in terms of race? For white students, this task is often one of the few occasions, if not the first occasion, of being a racial minority. Within the United States, few white people have a visceral understanding of what it feels like to be the only one, or one of a few in racial terms. When confronted with this experience, many white people understand for the first time in a real-life way the sense of awkwardness and discomfort that is associated with being in a minority position. This lived experience is essential to the formation of sensitivity (Hardy & Laszloffy, 1992). 338

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At least within the United States, the racial reality is such that the greatest distance often exists between whites and blacks, with white people experiencing the greatest discomfort and tension interacting cross-racially with blacks (vs. members of other racial minority groups). Therefore, without the inclusion of the final directive of this task, white students are especially likely to attend events where the racial minorities they encounter are groups other than blacks ⁄ African Americans. For this reason, it is important to challenge students to attend an event where they will be the racial minority amongst the group they are most likely to feel uncomfortable, which for most white students, and even for some non-black students of color, is most likely to be amongst blacks ⁄ African Americans (Rockquemore & Laszloffy, 2006). For students of color, in most cases, all they have to do to complete this task is come to class, as most MFT programs are predominantly white. For students of color, the learning embedded in this task is different than it is for most white students. Depending on their racial identity, phenotype, and historical experiences, the goal for students of color may be to have an unfamiliar cross-racial experience from a minority position (e.g., a Taiwanese student who attends a black church service), but it also may be to simply live one’s life as it is lived on a daily basis (e.g., a black student who attends a campus social function where most attendees are white) and to reflect on the experience of living from a racial minority standpoint on a regular basis. One of the questions students are asked to answer in the write-up is how they came to identify the event they decided to attend. What often happens, for white students in particular, is that they have to conduct some kind of research to locate an event where they will be a racial minority (e.g., they usually do an Internet search). The question is intended to focus their attention on what it means if they are not able to locate such an event in a more organic manner (e.g., ask a friend or relative, something they just know about based on their personal lifestyle). The fact that for most whites some kind of investigation is needed to locate an experience where they will be a racial minority reveals the racially segregated nature of their life, and this task invites them to recognize and explore this reality in terms of what it means about who they are racially and their capacity to work responsibly with racial minority clients. As noted by scholars such as Hardy (1989), one of the problems with white therapists working with clients of color arises when white therapists approach therapy with clients of color as on-the-job training. If white therapists live their lives in isolation from people of color, then indeed most of what they come to know and understand will be acquired through therapy, which is unfair to clients. As one white student reported: I had no idea where to go to find myself in a position as a racial minority. I realized that I don’t actually have any friends who are minorities. To do this task I had to go to the internet and try to find something that was a place where most people would be minorities. It really hit me that my entire life is white. I like to think of myself as a very open-minded person, but honestly, I am living in a totally white world and I never even noticed that before. This task is intended to help students recognize whether they are living racially segregated lives, and if they are, hopefully to encourage them to make different choices that will widen their frame of experience and learning. Another aspect of the race task that is critical is when students attend an event but fail to directly participate. Instead they assume the role of the silent observer or that of a ‘‘tourist.’’ When this occurs, it is important for instructors to invite students to explore their reasons for doing so, and to probe what they potentially gained and lost as a result of this decision. Task three: Confronting religion and religion as a tool of liberation and oppression. The third task asks students to participate in two of the following experiences. 1. Attend a religious service that is not part of your faith. If your faith is Christian, try to challenge yourself to experience a non-Christian faith. In your write-up, please explain (a) where you went, how you came to pick this particular house of worship, and what does this tell you about yourself in terms of religion; (b) what happened while you were there and how did this affect you (e.g., what

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thoughts did you have, what feelings did you experience, what did you observe, what did you do, and how did you respond); and (c) what did this experience teach you about yourself and what are the implications for your work as a therapist with respect to matters involving religion? 2. Identify a person that you do not know well who is a member of a religion that either you do not know much about and ⁄ or feel some reactivity toward. Ask to have a conversation with that person about her or his religion. As part of the conversation, explore whatever questions you may have about that faith, but be sure to address the following questions in addition to your own. (a) How is this faith liberatory? (b) How is this faith oppressive (to others and possibly to yourself)? (c) How have members of this faith been discriminated against or persecuted? In your write-up, please (a) explain who you spoke with and how you came to select this individual; (b) briefly describe what happened and report the responses you obtained to the above questions; (c) identify and explore your thoughts and feelings in response to this conversation and what was shared; and (d) summarize what you learned from this experience in general and about yourself specifically. The first task associated with religion is designed to create a real-life experience where students encounter a religious perspective different from their own socialization. Having to attend the religious service of another faith creates the immersion experience that provides students with direct knowledge of another faith. At the same time, they are challenged to feel the discomfort of being a religious minority and feeling what it is like to be in the presence of a different faith. As most students are socialized within Christian faith traditions, it is especially useful to attend a non-Christian faith service because this will present the greatest degree of divergence from their own orientation. For students who were raised without a religious tradition and who may continue to live without one, any service they attend will be instructive. I (Tracey) often encourage such students to select a religion that they believe they are the most reactive to, as the opportunity for learning and transformation is greatest under these circumstances. As a point of clarification, sometimes students remark that they are not religious but they are spiritual, and therefore they are unsure if this is the same as having a religious identity. In anticipation of this confusion, it is useful to begin the Religion unit by clarifying the distinction between religion and spirituality. The fundamental distinction is that religion is grounded in an institutional structure that imposes specific rules, principles, customs, and traditions that define appropriate ways of behaving. Spirituality is a strictly personal experience that an individual has with something they personally define as sacred. As this course focuses on the intersection between the dimensions of diversity and the dynamics of oppression (which are tied to structural and institutional conditions), the tasks for this unit are designed to target religion, not spirituality. The second task requires students to have a real and open conversation about a potentially loaded and taboo topic with a person whom they do not know well. It also requires students to specifically introduce and explore aspects of religion that few people have the courage to talk about directly with ‘‘believers.’’ For example, it is taboo to ask someone how their religion is oppressive, and yet virtually all religions have aspects, some more than others, that are oppressive and are tied to practices that are discriminatory, exclusionary, and even punishing. Depending upon one’s religious background and degree of religiosity, it is not uncommon for therapists to be wary of discussing religion openly with clients for fear of exposing what they do not know, or because they worry about being offensive, or because they fear being judged either for their religious conviction or lack thereof. As one student explained, I was so nervous talking with the Rabbi about the parts of Judaism that are oppressive. First of all, as a Mormon it is not appropriate to challenge religious authorities. We don’t question and confront, so to me, the question of how is your religion oppressive is something I would never ask. But also I especially would never ask this of a Jew when the Jewish people have been victims of so much persecution and discrimination. It feels disrespectful to ask how the religion is oppressive when members of the

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religion have been targets of so much suffering. But I did ask because I had to and I was amazed that the Rabbi was so open to answering my question. He had a lot of examples that he offered and he did not seem offended at all by my question. Just as it can be awkward to discuss the liberatory and oppressive aspects of a religion that one is not familiar with, it also can be difficult to discuss these aspects of a religion when one has had a direct, personal, and conflicted relationship with that faith. The second task provides an opportunity to students to confront potential conflicts rooted in their religious background within the context of a direct and open dialogue with someone who is a member of that religious group. As one student reported: I was raised in a solidly Catholic family and I have a lot of anger and disgust toward everything Catholic. As a lesbian growing up I felt totally alienated by the Church. When I was 16 I told my mother I am a lesbian and she brought me to a priest to be exorcised. It was horrible. So I decided for this task to talk to a priest about the Catholic faith because I am afraid that in therapy I will be very reactive to people who are devout Catholics. Of course, he was more than happy to tell me how the religion is liberatory in terms of serving the poor and how our souls are liberated through Jesus. But he had nothing to say about how the faith is oppressive. I was furious and I wanted to leave at that point, but you know, I pushed myself to engage him. I was polite and respectful but I did confront him. I asked him about the Church’s position on homosexuality, women in the priesthood, and the Church sanctioned oppression of the Native Americans during the times of Columbus. It was awkward to say the least, but I guess that is part of the point. I think I need to now have these conversations with my mother and my aunts. As this student’s reflections reveal, this is a conversation she has avoided in the past and wanted to continue to avoid, but through the task she challenged herself to ask the difficult questions, to hear difficult responses, and to stay engaged. She astutely recognized her need to go to the next level by engaging her family members in an honest dialogue about religion and oppression as she also understands that her anger toward Catholicism is a vulnerability she must deal with as part of her work as a therapist. Task four: Confronting sexual orientation and homophobia ⁄ heterosexism. The fourth task specifies two activities for students to execute. 1. Wear a rainbow pin or button (where it will be visible to others) for a week. The rainbow emblem symbolizes support for the human rights of sexual minorities. If you do not really support the human rights of sexual minorities, please consider doing this task for the experience of what it is like to encounter people like yourself who do not support the human rights of sexual minorities. In your write-up, please (a) describe what happened when you executed the above task; (b) identify your thoughts ⁄ feelings ⁄ reactions; and (c) explain what you learned about yourself and the implications for your work as a therapist. 2. Walk around a public place for 15 min holding hands with someone of the same gender. In your write-up, please (a) describe what happened when you executed the above task; (b) identify your thoughts ⁄ feelings ⁄ reactions; and (c) explain what you learned about yourself and the implications for your work as a therapist. The first task is a request, not a mandate, which is critical. When students are mandated to wear a rainbow pin or pink triangle, inevitably some will explain they cannot do so in good conscience by virtue of their religious affiliation. Sometimes as well, students who are gay or bisexual will resent that this task is mandated. This position is encapsulated by the comments offered by the following student: As someone who is bisexual I have chosen to wear rainbow pins and make my statement for gay rights known publically. And I suffered as a result of doing that. I understand why you mandated this task, but I also want to be clear that for me, I am not ready to re-open myself to the wounds that I have suffered. July 2010

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In anticipation of these kinds of reactions it is useful to invite, not mandate, students to wear the pin ⁄ button as a statement of public support for the human rights of those who are sexual minorities. At the same time, for those who do not support the human rights of sexual minorities, it is effective to ask them to wear the button anyway so they will have the opportunity to know what it feels like to encounter people who share their sentiments. In this way, students who do not support the human rights of those who are sexual minorities are able to directly and experientially feel what it is like to encounter people like themselves. The second task has proven to be one of the most provocative. For straight students it exposes their most deep-seated anxiety about homosexuality, their repulsion, and their fear of being perceived by others as gay or lesbian. The overall sentiment expressed by straight students is reflected in the following passage offered by this student. I always thought of myself as liberal about gay issues. I always have supported the rights of gays, but when I had to do this task I was in near panic mode. I could not imagine relating to another woman in a way that anyone might think of as gay. In fact I discovered a sense of disgust about gayness that I never saw in myself before. I sweated profusely for the whole 15 minutes. I prayed I would not pass by anyone I knew. I see now how I have been pretending all this time to be ‘‘pro-gay’’ but in reality, I am not, for which I feel ashamed. I don’t know what to do with this awareness now. As this student’s write-up revealed, this task helped her confront her heterosexism and homophobia in a way that she had never recognized before. For students who are gay but not fully ‘‘out,’’ this task often proves difficult because it punctuates the dilemma associated with living in the closet versus coming out. Each has its risks and rewards, and this task makes these explicit. Task five: Confronting gender and sexism. For the fifth task students are asked to engage in the following experience. For one full day, perform a gender role that does not match your gender identity. This means adopting as many behaviors as you can, including how you walk, talk, dress, mannerisms, where you go to the bathroom, etc. Please draw upon information gleaned from the book You Just Don’t Understand by Deborah Tannen (2001) to modify your communication style to match the gender you are performing. In addition to trying to manifest specific behaviors associated with another gender, also try to feel into that gender. Try to process the world and adopt your thoughts and emotions in ways that you think would be consistent with this gender. To prepare for this task, be sure to interview members of this other gender to gain insights into their gender-based perceptions, thoughts, feelings, and behaviors. In your write-up, please (a) describe what you did and explain what happened; (b) explore the thoughts and feelings that you had during and after this experience; and (c) explain what this taught you about yourself in terms of gender and the implications for your work as a therapist. Unless otherwise instructed, our experience indicates that students will tend to approach this task superficially. They will attempt to perform another gender in a way that signals they are playing at the role rather then making a serious effort to enact another gender. It is important, therefore, to explain to students that their goal should be to convince other people that they really are the gender they are performing. This is critical for two reasons. First, if others truly see them as the gender they are performing, they will then be able to experience what it feels like, socially and relationally, to be that other gender. In performing a male gender I went to great lengths to look male and to act male and I know I convinced people. But what blew me away was that being in this role I have never felt so powerful. I don’t know if it is because people were seeing me as a man and that compelled them to treat me with more respect, or if my sense of ‘‘being male’’ made me feel more entitled and confident so I somehow demanded more from others. But I can see from this experience the profound difference of being in the world as a man versus a woman. Men really do have power that women overall do not. 342

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Second, if students fail at performing another gender, then they have the opportunity to understand what it feels like to be in a gender-ambiguous space and to experience the reactions that this ambiguity arouses from others (e.g., confusion, anxiety, hostility, mockery). I was performing a female gender and I know I was not convincing. I was dressed like a woman but nothing about me looked like a real woman and people were very uncomfortable with me. I was stared at, laughed at, and sometimes just ignored. At one point a group of guys yelled some humiliating things at me. I think they were threatened, which I am guessing because in their place I think I might feel that way. I am a person who is very uneasy around transgender people or gender ambiguous people. I don’t know what to do or how to act around them so in the past I think I just have been hostile toward them. But when those guys yelled at me, I felt ashamed and afraid, and I am even more ashamed knowing I have been one of those guys before. Whether one succeeds or fails at performing a different gender, there is much to learn about how gender shapes our experiences in dramatically different and unequal ways. Task six: Confronting ability and ableism. The sixth and final task assignment specifies two experiences for students to execute. 1. Participate in an entire class or supervision session while blindfolded. Explain this task beforehand to your instructor or supervisor and ask this person to assume that you are a visually impaired student and to treat you accordingly. In your write-up, please (a) describe what happened and what things did you notice during this experience; (b) explore the thoughts and feelings you had during this experience; and (c) explain what you learned about yourself and the implications this has for your work as a therapist. 2. There is a wheelchair that is on reserve for this assignment. You will have to sign it out to use for this task unless you have access to one on your own. For a period of four consecutive hours, you will have to do everything that you need to do from this wheelchair. In your write-up, please (a) describe what happened and what things you noticed during this experience; (b) explore what thoughts and feelings were generated for you during and as a result of this experience; and (c) explain what you learned about yourself and the implications for your work as a therapist. Disability issues are often an overlooked part of diversity training. Given how many people experience some form of disability, it is especially important to provide students with opportunities to experientially explore what it is like to have to negotiate the world in terms of a certain disability. There are several key insights that students have as a result of completing these tasks. First, they come to experience how the world around them is not designed and adapted to meet the needs of those with any kind of disability. For example, a student reported that she appreciated handicap accessibility in the form of elevators and ramps, but nevertheless she struggled to conduct transactions at places like the post office and her bank where counters were not designed in consideration of people in wheelchairs. She said, ‘‘At the end of the day, the whole society is set up for people who are able to walk. I never really noticed before how things I take for granted must be so hard for people in wheelchairs, or even for those who are extremely short.’’ Students also come to realize the discomfort that disabilities evoke within them and others. As another student shared, ‘‘When I had on the blindfold I swear that people were talking to me louder which I found unnerving and then I realized I have done this to people who are visually impaired. I had to admit that I feel uncomfortable around any kind of disability.’’ Finally, students often come to appreciate how within every disability a counterbalancing strength develops. For example, after completing the task with the blindfold, a student described how, much to her surprise, her sense of hearing and smell became more pronounced. In situations involving students with a mobility disability who are in a wheelchair or students who are visually impaired, it is recommended that they complete both tasks as outlined

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and reflect on the differences between what it is like to have the disability that they live with on a daily basis versus another disability that is not known to them. The impact of this experience is nicely summarized by the comment this student made: As someone who has lived in a wheelchair for most of my life the wheelchair task was just life as usual, but somehow I expected it would be the same for me with the blindfold task. I guess I thought my physical disability would give me a ‘‘leg up’’ (no pun intended) on being visually impaired but of course these are totally different things. I was unprepared for how stressed I was by not being able to see. I just assumed that as someone who lives with a disability I would be better able to handle and understand other forms of disability but that was not the case. I think this is a valuable insight for me as a therapist in training, to realize what maybe I don’t know what I assumed I did know. This student’s comment demonstrates how he had assumed he would be better equipped to understand and manage a visual disability because he lives with a mobility disability. Yet his experience with the task clarified that these are two fundamentally different kinds of disability and each creates unique demands and stressors that require a different set of compensatory skills. By coming to see the differences between these two kinds of disability, this student learned an important lesson about the dangers of assuming that one experience with oppression can translate into understanding another experience with oppression. This is an all too common error and it is important to encourage students to resist this assumption of sameness. It is dangerous to assume that one’s experiences with oppression will translate into understanding another person’s. While there always is some commonality between experiences, differences also are inevitable. The extent to which one remains mindful of this reality facilitates remaining open to gaining deeper levels of understanding, which is an important component of manifesting both awareness and sensitivity.

STRENGTHS, LIMITATIONS, AND IMPLICATIONS This model for teaching diversity has been and continues to be a work in progress. Over the years, I (first author) have become more aware of the strengths of this approach, as well as the limitations, and the implications for how to continue refining this course design. Strengths A principle benefit associated with the experiential tasks that form the foundation of this course is that they can be used in a variety of ways. As presented here they are useful as the primary structure of a single course, yet they also can be used as one component of a course (e.g., selectively using some and not all of these). These tasks also are an excellent way of translating abstract ideas into lived experiences. As previously stated, most approaches to diversity education and training tend to overemphasize awareness to the neglect of sensitivity. The experiential tasks presented here provide a means for helping students gain a more comprehensive and well-rounded understanding of the dynamics of oppression. It is one thing to hear a lecture or read a book about how, for example, racism or homophobia structures social relations and impacts racial and sexual minorities. It is another thing altogether to experience directly what it feels like to be in a subjugated position, or to interact in an intensive way with those who are members of a marginalized group. For students who are privileged on the basis of a given dimension of diversity, these tasks enable them to walk in the shoes of those who are marginalized, if only for a moment. For students who are oppressed on the basis of a given dimension of diversity, the tasks create an opportunity to openly confront and explore their experiences with subjugation and to be heard and understood by members of the dominant group in a way that rarely occurs. Limitations An obvious limitation of assigning these tasks is that they provide those who are privileged with only the briefest opportunity to experience what it is to stand in the space of those who

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are oppressed or to interact with members of marginalized groups while having to be aware of their privilege. While these encounters almost always prove to be enlightening, nevertheless, they are not sustained. For a deeper, more transformative learning to occur, students most likely need more protracted and intensive experiential learning opportunities. This idea is reflected in a growing body of literature on immersion education that involves placing students in cultural contexts that are unknown and unfamiliar for a period of several weeks to several months (Alexander, Kruczek, & Ponterotto, 2005; Platt, 2008). Immersion education forces students to adapt and grow because they cannot retreat from the new and unfamiliar cross-cultural experience. They must find ways to acclimate to a new context; to learn it from the inside out; to face their internalized biases, assumptions, and fears; and to develop knowledge and skills that will allow them to negotiate this new space. The experiential tasks presented here simply do not allow for this kind of deeper transformation. Therefore, while tasks such as those presented here are valuable, they merely constitute a starting point. Another limitation of the course model presented here is that there are a limited number of dimensions of diversity that can be examined. This model focuses on six dimensions, but there are many others, such as age (Hays, 2008; Ivey, Weiling, & Harris, 2000) and nationality (McDowell et al., 2006; Platt, 2008), that are often overlooked during MFT diversity training and that warrant attention. While the pragmatics of time requires focusing on some dimensions while overlooking others, this constitutes a limitation of the course.

SUMMARY This article sought to fill a gap in the MFT literature on how to design and teach a single course on diversity within MFT master’s programs. The model of a course was presented that focuses on the intersection between various dimensions of diversity and the dynamics of oppression. A discussion of the assumptions that underpin the course was provided, as were the teaching and learning objectives, and a description of the course organization and structure. Particular attention was devoted to explicating a series of experientially designed tasks that form the center of the course and are designed to promote cultural sensitivity through direct, relationally, and emotionally intensive learning opportunities.

REFERENCES Alexander, C. M., Kruczek, T., & Ponterotto, J. G. (2005). Building multicultural competencies in school counselor trainees: An international immersion experience. Counselor Education and Supervision, 44, 255–266. Chao, R. (2002). Toward an integrative curriculum. American Psychologist, 57, 451–452. Collins, H., & Pieterse, A. (2007). Critical incident analysis based training: An approach for developing active racial ⁄ cultural awareness. Journal of Counseling and Development, 85, 14–23. Constantine, M. G., Juby, H. L., & Liang, J. J. (2001). Examining multicultural counseling competence and racerelated attitudes among white marital and family therapists. Journal of Marital and Family Therapy, 27, 353–362. Hardy, K. V. (1989). The theoretical myth of sameness: Implications for training. In G. Saba, B. H. MackuneKarrer, & K. V. Hardy (Eds.), Minorities and family therapy (pp. 17–33). Binghamton, NY: Haworth Press. Hardy, K., & Laszloffy, T. (1992). Training racially sensitive family therapists: Context, content and contact. Families in Society: Journal of Contemporary Human Services, 73, 364–370. Hardy, K. V., & Laszloffy, T. A. (1995). The cultural genogram: Key to training culturally competent family therapists. Journal of Marital and Family Therapy, 21, 227–237. Hardy, K. V., & Laszloffy, T. A. (2008). The dynamics of a pro-racist ideology: Implications for family therapists. In M. McGoldrick & K. V. Hardy (Eds.), Re-visioning family therapy: Race, culture and gender in clinical practice (pp. 225–237). New York: Guilford. Hays, P. A. (2008). Addressing cultural complexities in practice: Assessment, diagnosis, and therapy (2nd ed.). Washington, DC: American Psychological Association. Hill, N. R. (2003). Promoting and celebrating multicultural competence in counselor trainees. Counselor Education & Supervision, 43, 39–51. Holcomb-McCoy, C., & Myers, C. (1999). Multicultural competence and counselor training: A national survey. Journal of Counseling and Development, 77, 294–302.

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Ivey, D. C., Weiling, E., & Harris, S. M. (2000). Save the young—the elderly have lived their lives: Ageism in marriage and family therapy. Family Process, 39, 163–175. Killian, K. D., & Hardy, K. V. (1998). Commitment to minority inclusion: A study of AAMFT conference program content and members’ perceptions. Journal of Marital and Family Therapy, 24, 207–223. Laszloffy, T. A., & Hardy, K. V. (2000). Uncommon strategies for a common problem: Addressing racism in family therapy. Family Process, 39, 35–50. Marshall, J., & Wieling, E. (2000). Promoting MFT diversity through ‘‘cultural plunges.’’ Family Therapy, 27(2), 89–99. McDowell, T., Fang, S., Brownlee, K., Young, C. G., & Khanna, A. (2002). Transforming an MFT program: A model for enhancing diversity. Journal of Marital and Family Therapy, 28, 179–191. McDowell, T., Fang, S., Griggs, J., Speirs, K., Perumbilly, S., & Kublay, A. (2006). International dialogue: Our experience in a family therapy program. Journal of Systemic Therapies, 25(1), 1–15. McDowell, T., Storm, C. L., & York, C. D. (2007). Multiculturalism in couple and family therapy education: Revisiting familiar struggles and facing new complexities. Journal of Systemic Therapies, 26(4), 75–94. McGoldrick, M., Pearce, J. W., & Giordano, J. (2005). Ethnicity and family therapy (3rd ed.). New York: Guilford. Murphy, M. J., Park, J., & Lonsdale, N. J. (2006). Marriage and family therapy students’ change on multicultural counseling competencies after a diversity course. Contemporary Family Therapy, 28, 303–311. Platt, J. J. (2008). Addressing nationalism through immersion education. La Comunidad: California Latino Psychological Association Newsletter, 8, 5–6. Rockquemore, K. A., & Laszloffy, T. A. (2006). Raising biracial children. Lanham, MD: Altamira Press. Sierra, V. M. (1997). Multicultural training in marriage and family therapy: A survey. Dissertation Abstracts International, 5cS(08A), 3026. (UMI No. AAG9803825) Tannen, D. (2001). You just don’t understand: Men and women in conversation. New York: Harper. Zimmerman, T. S., & Haddock, S. A. (2001). The weave of gender and culture in the tapestry of a family therapy training program: Promoting social justice in the practice of family therapy. Journal of Feminist Family Therapy, 12, 1–31.

NOTE 1

This figure was derived from the authors’ direct polling of the directors of all accredited MFT master’s programs via email, in conjunction with reviewing curricula at program websites. This finding is consistent with what Sierra (1997) found a decade ago.

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