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Section 3
Kentucky Administrative Regulations: 201 KAR 23:080
Responsibility to Clients

Question 3 | Test | Table of Contents

     Section 3. Responsibility to Clients. (1) A social worker shall promote the well-being of a client and, if required by law, the safety and well-being of an individual whose life might be affected by the client's behavior or circumstance.
     (2) A social worker shall not illegally discriminate against an individual.
     (3) A social worker shall not provide a service outside his scope of practice as established in 201 KAR 23:060.
     (4) A social worker shall notify a client of the regulatory authority of the board by displaying a written notice in public view in the social worker's office or service site. The notice shall contain the:
     (a) Name of the social worker;
     (b) Type of social work license;
     (c) License number of the social worker; and
     (d) Name, address, and telephone number of the board.
     (5) A social worker shall confine his practice to a condition imposed upon his license by a state or federal authority and shall not practice as a social worker as defined in KRS 335.020 if his license has been suspended or revoked.
     (6) A social worker shall provide a service to a client in a manner that is respectful and appreciative of the client's culture.
     (7) A social worker shall not refer a client or delegate a service to a provider whom the social worker has reason to believe is not qualified to perform a professional service.
     (8) A social worker shall provide a service to a client in the least restrictive mode of care.

- Kentucky Legislature. Title 201, Chapter 23: 080 Board of Social Work. 2018 Kentucky Administrative Regulations. Section 3. Responsibility to Clients.

Commentary by Pamela Newsom, Kentucky LSW:
There are many minority cultures, i.e. African and Asian cultures, in which when someone makes too much eye contact, it could be seen as inappropriate, or in some instances, disrespectful. Teachers or Professors who have had students who have been in refugee camps abroad in the students' home country or who have had students who have immigrated to the United States, the lack of eye contact could create difficulty. The students believe that they are showing respect as that is how it is viewed in their home country, but that is not how it is viewed in the U.S. Thus, respecting the students' culture could potentially become an issue; however, it is very important to work with the student's family, staff, and other professionals who work with the student to understand the student's culture and how it is different than the culture in the United States.

Regarding your client's culture, in this section, we will discuss Atkinson’s Minority Culture Identity Development Model and its five stages. The five stages of the Minority Culture Identity Development Model are the Conformity Stage, the Dissonance Stage, the Resistance and Immersion Stage, the Introspection Stage, and the Synergetic Articulation and Awareness Stage.

Sound interesting?

Obviously a question like "Can a white therapist counsel a black client?" is not easily answered with a yes or no response.

In the Minority Culture Identity Development Model, within each of the five stages there are four corresponding attitudes that form the culturally different client’s identity. These four attitudes are how the client views himself, how he views others of the same minority, how he views others of another minority, and how he views majority individuals. As we discuss the five stages in more detail, keep these four attitudes in mind and think of your culturally different client.

Atkinson’s 5-Stage Minority Culture Identity Development Model

♦ Stage #1 - Conformity
The first stage in the Minority Culture Identity Development Model is the Conformity Stage. According to Atkinson, the Conformity Stage is generally characterized by a preference for dominant cultural values over one’s own culture. As you are well aware the reference group is usually white America. This can cause strong feelings of racial self-hatred and negative beliefs of one’s own culture in the culturally different client.

Do you have a client who is receptive to your counseling and prefers the dominant culture? Is he in the Conformity Stage of the Minority Culture Identity Development Model?

♦ Stage #2 - Dissonance
The second stage in the Minority Culture Identity Development Model is the Dissonance Stage. In this second stage of Dissonance, cultural confusion and conflict are common characteristics of clients. At this stage, information and experiences begin to challenge the accepted values and beliefs of the dominant culture that the culturally different client held in the first stage of Conformity. As you probably guessed this challenge can create Dissonance within the client.

Do you have a culturally different client in the Dissonance stage? Have you considered the ethical implications of your counseling style on him or her?

♦ Stage #3 - Resistance and Immersion
After the Conformity Stage and the Dissonance Stage, the third stage in the Minority Culture Identity Development Model is the Resistance and Immersion Stage. Clients of a different culture in this stage will actively reject the dominant society and culture. Simultaneously, these culturally different clients will completely endorse minority-held views. It goes without saying that, the reference group becomes the culturally different client’s own culture, and his or her distrust and hatred of white society becomes strong.

♦ Stage #4 - Introspection
The fourth stage in the Minority Culture Identity Development Model is the Introspection Stage. Similar to the second stage of Dissonance, the fourth stage of Introspection is characterized by conflict and cultural confusion over the rigid constraints of the previous stage. I have found that in this stage notions of loyalty and responsibility to one’s own group and notions of personal autonomy come into conflict.

Do you have a client questioning his or her group-usurped individuality and absolute rejection of cultural values? Is he or she possibly in the fourth stage of Introspection?

♦ Stage #5 - Synergetic Articulation & Awareness
Finally, the fifth stage in the Minority Culture Identity Development Model is the Synergetic Articulation and Awareness Stage. According to Atkinson, minority individuals in this stage experience a sense of self-fulfillment with regard to cultural identity. At this stage, the conflicts experienced in the fourth stage of Introspection have been resolved. Culturally different clients in this stage objectively examine cultural values of other minorities as well as the dominant group.

As you know these clients then accept or reject these values on the basis of prior experience in the earlier stages of Conformity, Dissonance, Resistance and Immersion, and Introspection.

Ethically you may want to take into consideration the stage in which your culturally different client seems to be in counseling him or her. Obviously a client in the Conformity stage will likely have a preference for a majority member therapist. The conforming client will usually easily find a majority therapist to be credible and trustworthy. However, if your client is in the Dissonance stage, he or she may be less receptive to your counseling techniques because you appear unfamiliar with minority cultures.

Clients of a different culture who are in the Resistance and Immersion stage may be entirely unreceptive to your counseling techniques as they view the dominant culture with distrust and hostility. I have found that clients in the fourth stage of Introspection may prefer therapists of their own race but are more receptive to therapists who share their world view.

For clients in the Introspection stage, the belief similarity component may be given more importance than racial similarity. Culturally different clients who have progressed to the last stage of Synergetic Articulation and Awareness tend to display security in their own ethnic and cultural identity. Like clients in the introspection stage, clients in the synergetic articulation and awareness stage may place more importance on belief similarity than on racial similarity.

Think of your culturally different client. Which stage is your culturally different client in?

In this section, we have discussed Atkinson’s Minority Culture Identity Development Model and its five stages. The five stages of the Minority Culture Identity Development Model were the Conformity Stage, the Dissonance Stage, the Resistance and Immersion Stage, the Introspection Stage, and the Synergetic Articulation and Awareness Stage.
- Atkinson, D.R., Morten, G., & Sue, D. W. Counseling American Minorities: A Cross-Cultural Perspective. Dubuque, Iowa: W.C. Brown, 1979.

Peer-Reviewed Journal Article References:
Allen, L. R., & Dodd, C. G. (2018). Psychologists’ responsibility to society: Public policy and the ethics of political action. Journal of Theoretical and Philosophical Psychology, 38(1), 42–53.

Conrad, M. (2019). Moving upstream in the post-Hoffman era: When ethical responsibilities conflict with the law. Professional Psychology: Research and Practice, 50(6), 407–418.

Cox, J. R., Martinez, R. G., & Southam-Gerow, M. A. (2019). Treatment integrity in psychotherapy research and implications for the delivery of quality mental health services. Journal of Consulting and Clinical Psychology, 87(3), 221–233. 

Younggren, J. N., Fisher, M. A., Foote, W. E., & Hjelt, S. E. (2011). A legal and ethical review of patient responsibilities and psychotherapist duties. Professional Psychology: Research and Practice, 42(2), 160–168.

QUESTION 3
What are the five stages of Atkinson’s Minority Culture Identity Development Model? To select and enter your answer go to Test.

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