Diversity, Equity, Inclusion (DEI) Column

Diversity can include race, ethnicity, nationality, gender identity, sexual orientation, age, religion, disabilities, and socioeconomic. It can also include livelihood such as the military culture and first responder culture, education, marital status, non-traditional families, and multigenerational issues. It can be the intersectionality of an individual. We, at SCV-CAMFT, are dedicated to educating and advocating for diversity. We already do this with announcements about holidays, many diverse noted causes and celebrations, and presentations. With these goals in mind, SCV-CAMFT will publish a quarterly diversity column, in which we plan to invite experts in the field to talk about how to address social justice, intersectionality, immigrants, first responders, military members, the LGBTQ community, and many other topics and groups. We are lucky to live in a very diverse area of the country. With that fortune comes the responsibility to understand our clients’ world so that we can better help them with their challenges in a culturally informed manner.

<< First  < Prev   1   2   Next >  Last >> 
  • Saturday, March 18, 2023 5:55 PM | Anonymous

    Interview with Adelina Hills, LMFT by Liliana Ramos, LMFT, Director-at-Large

    Back to Spring 2023 Newsletter
    Liliana:  Hi! Thank you for doing this, Adelina. Can you introduce yourself, who you are, what you do. How long have you been a therapist?

    Adelina: I have been licensed for over 15 years. I started my professional career late. I am an MFT. I have a certification in Somatic Experiencing (SE). After that I studied and got certified in NeuroAffective Relational Model (NARM). Those are the two certifications I have.  

    Liliana:  What made you get certified in both of those?

    Adelina: It’s because of my own childhood trauma: I lost a leg. So, I’ve always been interested in psychology from the body perspective. I graduated from Institute of Transpersonal Psychology (ITP) , the focus is on body, mind, and spirit. Through several courses helped me to realize that I had disconnected myself from my body. This is why I started to look for a somatic approach. I found it helpful as a client, so I decided to become a practitioner.

    Liliana: So you were already a therapist when you received therapy through somatic experiencing. Okay, so how do you help clients with this approach?

    Adelina: The biggest benefit is to pay attention to the body. Our mind might forget what happened but our body remembers. For example, when clients talk about their trauma, they might hold their breath without being aware. I then bring up my observation or ask them to notice their body sensations.   

    Liliana:  Do you work with SE with all of your clients?

    Adelina: I do talk therapy with SE lenses. I tell every new client that I will ask them what they feel in their body so that they’re not surprised when I ask them.

    Liliana: Do you work with clients in person or telehealth?

    Adelina: Since COVID I only work through telehealth.

    Liliana: How does SE differ in-person versus telehealth?

    Adelina: In-person sessions, it’s not a problem because I can see the whole body. In telehealth, sometimes I can observe and sometimes I cannot, so I tell clients that I will rely on them to report to me how they feel. Nonetheless, the questions are not different between in-person and telehealth.

    Liliana: I know you work with couples. Do you use this approach with couples?

    Adelina: I do not use this approach with couples. I mainly use Terry Real “Relational Life Therapy” model for couple therapy.

    Liliana: What else can you tell us that would be good for therapists to know about using SE in therapy?

    Adelina: I think that lots of therapists do not pay attention to the body. SE is a good tool to track body sensations which enhance self awareness from the somatic level.  

    Liliana: Can you do touch therapy as a therapist?

    Adelina: Yes, in the last phase of Somatic Experiencing training, they teach touch. Practitioners have to get consent from clients  to perform touch work. However, I don’t do touch anymore. Personally, it’s very powerful. But if I do touch, I really need a massage table. So when people come for SE, I tell them that I don’t do touch.

    Liliana: I know you decided to learn Somatic Experiencing because of your personal experience with that type of therapy and because of your trauma. What made you become a therapist?

    Adelina: Definitely my trauma because of my accident at a young age. I’ve always been interested in psychology. I never got to study psychology in Taiwan. When I came to the US, I first improved my  English, then I decided to pursue my psychology degree .

    If I may share a story: I was introduced to a psychologist by my English teacher. He is a Native American psychologist. My first psychotherapist, Martin Brokenleg, PhD, a professor at Augustana University, South Dakota, helped me open my eyes to a totally different culture. At that time, I couldn’t drive because of my trauma; fortunately his office was within walking distance, so I could see him by walking to his office. I only saw him for three sessions because I wasn’t ready to process my trauma at that time. However, what made an impression on me is that I asked him why I cannot drive. He told me why. I will never forget his statement: “when you are able to drive, you are going to be a very safe driver”. I remember right after I left his office, I told myself, “I want his job.”  

    Liliana: Why did you want his job at that time?

    Adelina: He saw me. Plus, I was always interested in psychology when I was in Taiwan.

    Liliana: Why were you interested in psychology when you were in Taiwan?

    Adelina: I think it was connected with trauma: I lost my childhood overnight. I think when people go through trauma they have to process so much. I could not play with my classmates and peers. I could only watch them. I think people become therapists, because of something that they went through?

    Liliana: How does your culture being Taiwanese and being able to speak Mandarin help you with your practice?

    Adelina: I have quite a few Chinese clients. They come to me because of my familiarity with the culture. Sessions could be conducted in English or Chinese or mixed. It is handy when I could just  use a couple of Chinese phrases that can catch what clients want to express but it is hard to find words in English.

    Liliana: So most of your clients are Chinese or Asian?

    Adelina: It’s a mix. I have Americans, Asian and Chinese clients.  

    Liliana: If a therapist was working with an Asian client, what are some of the themes that they would bring up or that a therapist who is not Asian needs to be aware of so that they can provide a more meaningful experience for the client?

    Adelina: One thing is that the Westerner is more individualistic. Western culture talks about boundaries. This is a very hard concept for the Chinese community to grasp. Also, when working with Chinese clients, it is important to know that they will want advice from the  therapist. They want the therapist to tell them what to do, and make decisions for them. They will follow the prescriptions and then expect the result. They also want to have quick results or have high expectations. It is important to educate our Chinese clients what therapy is about.

    Liliana: So because that is such an important part of the culture, when a person is suffering from intergenerational trauma or developmental trauma, how do you work with that and still stay true to the culture?

    Adelina: I think self compassion is important for clients to learn and practice. To let my clients know that self care is not the same as being selfish.  

    Liliana:  What would you like therapists to take away from this article?

    Adelina: It’s harder to work with clients from a different culture. I would say to be curious whether you share the same or different culture. If you and the client have the same cultural background, the family culture can still be different. I think that maintaining curiosity is important. Just be humble and say ,“I need you to educate me.”

    Liliana:  When you talk about somatics, the lived experience is in your body, heart, and mind. They can still work with clients from different culture as long as they maintain the curiosity and humility.

    Adelina: Right. It’s impossible for us to have all the experiences that a client brings into therapy. For example, the client who has been severely abused: I don’t have that type of experience. So as therapists we need to maintain curiosity. I think that in therapy it’s really about connection. It’s about the clients feeling that we  care.

    When we say culture, I don’t want to limit it to the color of the people or where you come from, I want to include the LGBTQ and religious culture.

    Liliana:  Yes, so true. It could be the LGBTQ, military, or first responder culture. Maybe even the medical field, inter-sectionalities of the different parts of the person.

    Adelina: Yes, I totally agree.   


    Resources

    Somatic Institute (2023). What is Somatic Experiencing? Retrieved from http://somaticinstitute.com

    NARM Training Institute (2021). What is NARM? Retrieved from https://narmtraining.com

    Adelina Hills is a bilingual (Mandarin Chinese and English) Marriage and Family Therapist licensed in the state of CA. She has been licensed for over 15 years and has a private practice in San Jose. She works with adult individuals and couples using approaches of Somatic Experiencing (SE), Neuro-Affective Relational Model (NARM) and Relational Life Therapy. She is dedicated to helping individuals and couples who are struggling with trauma, depression and anxiety.


    Back to Spring 2023 Newsletter

  • Sunday, October 09, 2022 5:35 PM | Anonymous

    Fall 2022 Newsletter

    I interviewed Dr. Sherry Wang, an associate professor of Counseling Psychology at Santa Clara University and a licensed counseling psychologist, who identifies as an Asian American cisgender woman and a feminist multicultural psychologist. 

    As an anti-racist educator, Dr. Wang’s research is focused on working with and advocating for the voices and experiences of those who have been historically under represented and underserved; for the most part Black, Indigenous, and People of Color (BIPOC) as well as sexual and gender diverse communities. Her research focuses on the need to address systems to improve the quality of life for the mental health and well-being of individuals when dealing with societal oppressions such as racism, sexism, and heterosexism. She trains clinicians in the field and consults with companies regarding anti-Asian racism and issues pertaining to diversity-equity and inclusion. She educates lawyers to be more trauma-informed, and facilitates spaces to talk about difficult topics such as race, power, privilege, and oppression.  She has given talks at corporations regarding race, privilege, quality of life, and burnout and her private practice focuses on people of Color and women. So far, she is primarily working with Asian American women so that her practice can be accessible

    Dr. Wang often gets asked how can clinicians include social justice and advocacy into their clinical work? She said we already do it when our goals are to improve our clients’ lives.  On the topic of privilege and power, which have become "ugly" words for some, she says, “The truth is that power and privilege are not bad words. Everyone has power and privilege of some type. The question is what do we do with power and privilege in terms of sharing it with people whose voices cannot carry. Social justice and advocacy work begins with being able to recognize where we have power and privilege; being grateful for that power and privilege, and being aware of those who don’t have it and our role in that.”  She clarifies how a person can feel conflicted with having privilege and power, but what matters is how we deal with our internal conflict. She gives the example of a therapist who might decline to work with someone who is gay because of concerns surrounding competency. While that may be acceptable once or twice, if the therapist continuously says no without seeking further training, then the clinician needs to ask why they are choosing not to see clients in this demographic and why they are not seeking training to develop the competence to work with them. How are they using their power and privilege affecting their decisions to choose some clients and not others? Where are their blind spots? How are they improving themselves so that they can serve those clients that may need our field the most?

    One power-sharing example from Dr. Wang’s lived experience is using her platform to speak up on anti-blackness and the need to dismantle anti-Black racism. She is aware that when she speaks up about this topic, the issue is taken much more seriously than if a Black person were to talk about anti-blackness. In this case, Dr. Wang has much more privilege and power to have her words be taken seriously.  Similarly, it would be so much more powerful for someone who is a man to speak up on issues of sexism and misogyny so that it is clear that sexism isn’t simply a “women’s problem.”  “It is so crucial for White clinicians to be able to name racism; for male clinicians to recognize the sexism within the therapeutic context, and to convey to clients that they are able to understand what it is like to have power and to use the power for those who do not.”  Dr. Wang conceptualizes this as a way of sharing power and privilege; and is similar to when a therapist writes a letter for a client to get access to hormone therapy or surgery.  As providers, it is not only our knowledge, but also our awareness that contributes to whether people are willing to sit with us to share their vulnerable, intimate information.  

    Moreover, Dr. Wang reminds us how we all carry privilege and marginalization.  For example, a Latinx woman might be marginalized as a woman, but have privilege because of her education and lighter skin color. Or a man might have more privilege than a woman, but be marginalized in his experiences as a Person of Color. By speaking up with each other and for each other, we can advocate for all of us so that those who are marginalized never have to do the lonely work of having to speak for themselves. She goes on to offer that there is beauty in the community using their power to prevent suffering and helping each other with our needs since we are all marginalized in some way.  This is in line with Greene-Moton and Minkler (2019) calling readers to action in their paper on cultural humility by stating that inequitable power, privilege, and injustice affect the well-being of people. Thus, Dr. Wang says, “We can be more effective partners across a wide range of barriers and divides if we work collectively toward racial, social, and health equity. And the more just and habitable society and the planet will be, on which our work and our future depend.”

    As we have all experienced in our field, we take one multicultural course and the message is we can work with anyone. This is not quite true. However, to say that we are not competent to work with a certain group of people is also an excuse. Dr. Wang states, “There are two extremes: one is someone who thinks that they’re competent when they’re not; and the other is when we keep referring clients out because we choose to lack the competence in serving select members of our society.”  Dr. Wang would like to challenge therapists to ask themselves why they keep referring clients of a certain demographic or identity background. We might not have competence, but we need to gain competence.  She goes on to say that “Our personal development is our professional development.”  When working with marginalized groups, “It is a duty for us to learn, as opposed to ‘it’s just something I don’t ever have to deal with’”.  According to Dr. Wang, we grow by challenging our assumptions, ourselves, and worldview. We also need to “challenge ourselves so we are doing more than surviving.” Thus, part of social justice and advocacy is also about having compassion for ourselves so that we can set a bar for ourselves and our clients to thrive, not just survive.

    When asked what topics are close to her heart when it comes to social justice, Dr. Wang talked about how current events are important because they are what our clients need and address current social needs.  She talked about how everything is interrelated. Indeed, if people care about racial justice, then they care about climate change because of its disproportionate impact on People of Color and those who are at the lowest rungs of the socio-economic level.

    A foundational piece to social justice is cultural humility, says Dr. Wang.  “Multicultural competency has the components of knowledge, awareness, and skills.” She describes the three components as follows:  knowledge about other groups; awareness of self; and skills in applying it to the client.  Dr. Wang states, “The piece that is missing is the process piece, which is cultural humility; knowing what you don’t know and how you approach that.”  We approach it from a place of humility because we will never understand the client’s “lived” experience.  To explain further, Dr. Wang gives the example of what happened at her first clinical encounter in graduate school when working in the correctional community. The client was an older, homeless, married, African-American man who identified as being Christian. He took one look at her and questioned her credibility and legitimacy to be able to understand any part of his life experiences. The advice she received from a supervisor, was to give herself the permission not to be defensive.  Instead of, “But I’m not what you think I am…” she was encouraged to think about the root of the pain and to focus instead on: “What can I do to earn your trust?” This is an example of cultural humility, which is part of practicing social justice. It is about validating other people’s worldview. Dr. Wang advises, “Even when your client may have more power and privilege than you, we, as clinicians will always have more power. Which is why it is crucial for us to help someone feel heard and validated in their worldview.” How do we do this? We can start by validating our client's appropriate distrust of us. We can recognize our need to have to earn our client’s trust, and to also share parts of our vulnerability—all of this being a part of our striving for social justice.  This is all the more crucial, according to Dr. Wang, if we look like the people who have harmed them or their ancestors. She mentioned the Tuskegee syphilis study that is still taught in counseling psychology classes as an unethical study conducted on African-Americans. With this in mind, it makes it our responsibility to gain our client's trust since we have the power and the privilege in the room even when we are feeling small.

    When I asked Dr. Wang, how can social justice and cultural humility help the client in the therapy room, she spoke about how, when we listen to the client and understand their “lived” experience, it may be the one time the client feels heard, validated, and accepted.  As a feminist multi-cultural psychologist, she believes in appropriately sharing those aspects of her “lived” experiences to be able to bond with a client and grow in their journey together.

    Finally, Dr. Wang wanted to leave the SCV-CAMFT community with two things. One piece is knowing how much power we hold as experts in the room. “We are experts, so what we say holds a lot.”  She reminds us to be mindful of our defensiveness: “It’s like being a parent. How do we hold our client gently and with compassion and with a sensitivity even when they are trying to rile us up …. We have the power to do harm. So how can we harness that power in ways that we can do a lot of good?”  The second piece is cultural humility: “I feel that it (power and privilege) is connected.” Similar to Dr. Wang’s message, Greene-Moton and Minkler (2019) describes cultural competence as striving to know more about communities and cultural humility as a mental health professional recognizing their own biases, stereotypes, and beliefs (pg. 4). Noting that everyone has some type of bias. So it is up to us clinicians to become culturally competent, notice, and work on our own biases to practice cultural humility with our clients. Cultural humility is a lifelong commitment and a gift of power and privilege that we can offer our clients and our communities.

    References:

    Greene-Moton, E. and Minkler, M. (2019). Cultural Competence or Cultural Humility? Moving Beyond the Debate. Health Promotion Practice. 21(1): 142-145. doi. 10.1177/1524839919884912

    Shaw, S. (2016, Dec). Practicing Cultural Humility. Counseling Today. https://ct.counseling.org/2016/12/practicing-cultural-humility/

    Sherry C. Wang is a licensed counseling psychologist practicing in Santa Clara. She is also an anti-racist educator, mental health media contributor, consultant, and professor at Santa Clara University’s Counseling Psychology Department. Her research is rooted in advocating for the voices of underrepresented groups (e.g., People of Color, immigrants, refugees, LGBTQ populations). At the national level, she co-chairs the Asian American Psychological Association’s (AAPA) Division on Women (DOW). She previously chaired the American Psychological Association (APA) Committee on Ethnic Minority Affairs and was also a member of APA's Committee on Psychology and AIDS, which has since been expanded and renamed as a committee on health disparities. Since the start of COVID-19, she has been featured, cited, and interviewed in the media on the topic of anti-Asian racism, xenophobia, and cross-racial coalition-building. She lives with her husband, her dog, and their twin girls.

    Fall 2022 Newsletter

  • Sunday, October 09, 2022 5:29 PM | Anonymous

    Fall 2022 Newsletter

    I met with Ellie Vargas, a Licensed Clinical Social Worker who has a private practice and runs the Bay Area Center for Immigration Evaluations (BACIE). Ellie identifies as a mother of two children, a 2nd and 5th grader. We decided to interview Ellie to learn more about her work with immigrants.

    Ms. Vargas tells the story that after taking time off to have her second child, she reflected on how to rebuild her practice. A friend connected her with an attorney who needed someone to do some immigration evaluations, a specialized mental health evaluation to serve as a piece of evidence for a legal immigration petition. Lucky for her, this attorney coached her on different types of visas. Within a couple of years, there was so much demand for immigration evaluations that Ms. Vargas could not keep up with the referrals. At that point, she brought in other clinicians to help her and she established BACIE.

    Soon after, Ms. Vargas began to connect with other clinicians around the country who were offering immigration evaluations and she started a Facebook Group to serve as a networking and support system: Network of Immigration Evaluation Clinicians. Ms. Vargas quickly learned that a major challenge for clinicians was marketing their immigration evaluation service to immigration attorneys. In 2019 she launched the Immigration Psych Eval Directory (www.ImmigrationPsychEvalDirectory.com) to fill this need. The online directory helps connect clinicians with attorneys and immigration clients.

    When asked why this work is important, Ellie states “What really drew me to it? It’s a way to engage a population that often doesn’t have a lot of experience getting mental health services because they tend to be more disenfranchised, and provide a service for these visa types, these immigration paths. This piece of evidence according to the attorneys is often the deciding factor; whether they’re granted asylum, granted the U-Visa; granted the hardship exception.” She shared that this work is well within a mental health provider’s scope of practice. “We can share our gift to change someone’s life.”  

    Another reason this is important work is that we are providing “heart space” to these disenfranchised people, especially if they have experienced trauma, to tell their story often for the first time. The mental health professional is also planting the seed of how mental health treatment can be useful for them. “We de-pathologize their experience, normalize their symptoms, and give them hope.” An example she uses is mitigating the immigrant’s sense of shame from thinking they are weak because they are fearful and having nightmares about what has happened to them. Ellie would then validate the immigrant’s experience and normalize the nightmares as a normal psychological reaction as opposed to a weakness. This de-pathologizes their perception of their feelings. Many times immigrants leave their evaluation feeling more optimistic about their future and the possibility of hope with treatment.

    Ellie also shares that, business-wise, immigration evaluations are a way to diversify one’s private practice income stream—something very important to do during uncertain financial climates. She also points out that offering immigration evaluations diversifies one’s tasks and times:  it works a different part of the brain than psychotherapy because the clinician is writing and synthesizing an assessment, like in grad school. Immigration evaluations also improve the clinician’s skills for interviewing, evaluating, diagnosing, case conceptualization, and translating the information into a document that is written for a lay person because the document is written for an adjudicating immigration judge who is not a trained clinician. Ellie describes it as a puzzle, “You have to be thinking about how to structure your assessment to make sure that you’re asking the (right) questions to get the diagnosis.”  

    She adds that clinicians usually ask her if they have to be bilingual. She says that the answer is a resounding no.  Although she and her clinicians are bilingual Spanish, they work with immigrants from all over the world whose languages they do not speak. In these cases they use an interpreter. To prove her point, Ellie shares that one of her colleagues is monolingual. If a clinician is drawn to this type of work, they should not let language be an obstacle to help an immigrant seeking an evaluation.

    Ellie says that when working with undocumented immigrants there is a wariness of authority; a guardedness or suspiciousness, which they verbalize sometimes. Then there are those who want to tell you everything because they know this will help them, but they’ve spent so much time hiding that they have a hard time sharing. These immigrants come from places where people who have power are the oppressors. In all these cases, the clinician has to gain the immigrants’ trust in one session. She gives this example of what a clinician might tell them: “Totally makes sense. It makes sense that you would be wary of me. You don’t know me from anybody. At the same I really want to “get you”, get all the truthful information so that we can create a strong report for you, for your case.”  

    In addition, Ms. Vargas acknowledges that she works with a subgroup of people who have suffered layers of trauma. So when she is evaluating for a U-Visa, she has to realize that although the immigrant was a victim of a crime in the United States, that person probably has multiple traumas from their country of origin. She describes it by saying, “most of the evaluation is spent talking about who-knows-what-trauma that happened to them in their country of origin when they were 7, and then 15, and they’re saying “I’ve never told anybody about this before.” So not only are there layers of trauma but there are also people who have been holding it inside with no outlet and no one to share it with.  She in turn acknowledges what an honor it is to have the privilege of being the first one to hear the person’s testimony and that she holds the information with respect for the individual.

    When asked if the evaluation differs depending on what part of the world the immigrant comes from, Ellie’s perspective is that it’s important to come from a place of curiosity because we cannot be cultural experts for all cultures. It is a time to “check myself, that I am not imposing my cultural norms or my assumptions.” When immigrants describe why it would be difficult to go back to their country, the clinician has to ask questions and not assume. Her advice is to go into the evaluation thinking that you don’t know anything; instead, always ask the immigrant to help you understand.  

    In summary, she wants clinicians to know that it is good work to help people who are “at the crossroads of their life” whether they will be able to stay in this country, which is “life-changing” for them, their children, and their families.  On the business side, she thinks that it is good business practice to diversify where our income is coming from during this uncertain economy. Ellie states that the immigration system is very backed up and attorneys are looking for clinicians who are giving immigration evaluations. “The demand is high.” Clients for immigration evaluations are highly motivated and rarely no show for these appointments.. “I want anyone who has even like the slightest interest in doing this to try it out and explore it. You don’t know until you try.” 

    Ellie Vargas is a Licensed Clinical Social Worker in Berkeley, California. She runs a private psychotherapy practice (www.EllieVargasTherapy.com), the Bay Area Center for Immigration Evaluations (www.bacie.org), a national network of immigration evaluation clinicians, and hosts the premiere national online directory for immigration evaluation clinicians: Immigration Psych Eval Directory (www.ImmigrationPsychEvalDirectory.com).

    Ellie's professional experience has always been in immigrant-heavy communities in the Bay Area and New York City. She is bilingual in English and Spanish. Ellie's clinical specialty is the psychological legacy of trauma. Ellie is available for consultation.

    Fall 2022 Newsletter


  • Thursday, November 18, 2021 11:22 AM | Anonymous

    View our DEI survey results

    You need to log in to view this link.

<< First  < Prev   1   2   Next >  Last >> 

SCV-CAMFT               P.O. Box 60814, Palo Alto, CA 94306               mail@scv-camft.org             408-721-2010

Powered by Wild Apricot Membership Software