RESPONSIVE FAMILY THERAPY

CREATING CULTURALLY RESPONSIVE FAMILY THERAPY MODELS AND RESEARCH: INTRODUCING

THE USE OF RESPONSIVE EVALUATION AS A METHOD

Desiree M. Seponski University of Houston-Clear Lake

J. Maria Bermudez and Denise C. Lewis University of Georgia

Models of marriage and family therapy (MFT) typically reflect Western values and norms, and although cultural adaptations are made, many models ⁄ frameworks continue to be inappropriate or inadequate for use with non-Western cultures. Worldwide, therapists are examining ways of using MFT models in a culturally sensitive manner, especially when working with clients who are seen as having minority status or perceived as ‘‘other’’ by the dominant group. This essay suggests the use of responsive evaluation as a theoreti- cally consistent methodology for creating and evaluating culturally responsive therapies. This approach rigorously evaluates each unique client ⁄ therapist context, culture, power, needs, and beliefs. We describe responsive evaluation and discuss how each component addresses the research needs of examining culturally responsive family therapies. A case illustration is offered delineating the process of conducting culturally responsive therapy with a Cambodian sample using solution-focused and narrative therapy.

The field of marriage and family therapy (MFT) has made important strides toward apply- ing cultural sensitivity when working with minority populations. However, serious challenges remain with developing culturally responsive models of therapies. Many interventionists adapt preexisting models rather than develop a model that is designed to be theoretically and techni- cally responsive to the needs unique to a certain population. This is primarily because of a lack of awareness, resources, or adequate methods for creating culturally responsive models. Turner, Wieling, & Allen (2004) note that it is challenging but necessary to test an entire model or to create an emerging model based on the needs of the unique population.

We offer a framework for developing culturally responsive therapy (CRT) and research using responsive evaluation (RE) to assess or create a particular approach. Responsive evaluation is an interpretive methodology that ‘‘builds upon the experiential, personal knowing in real space and real time with real people’’ (Stake, 2004, p. xv). The interpretivist worldview allows the researcher to responsively focus on the issues that are of priority to the stakeholders and practitioners to develop a rich experiential understanding and provide information for improvement (Denzin & Lincoln, 1994). The foci are on the person’s experiences and views of the therapy and on the value of the therapy to that unique group. Coincidently, these foci also are consistent with CRT, as RE privileges the particular needs of a given population, is flexible to the unique needs of partici- pants, and relies on insider knowledge. It also is accountable to the community and works directly to improve the client’s context (Carlson, Erickson, McGeorge, & Bermudez, 2004) as well as assess the lives of participants from a strength-based perspective (Bermúdez, Zak-Hunter, & Silva, 2011). Integration of these two approaches, RE and CRT are compatible (see Table 1) and RE offer scholars and therapists a rigorous method for evaluating and conducting responsive intervention (see Table 2). The following provides an overview of RE and describes how each component addresses the research needs for examining culturally responsive family therapies.

Desiree M. Seponski, PhD, Family Therapy Program, University of Houston-Clear Lake, J. Maria Bermudez,

PhD, and Denise C. Lewis, PhD, Department of Child and Family Development, University of Georgia.

Address correspondence to Desiree M. Seponski, Family Therapy Program, University of Houston-Clear

Lake, 2700 Bay Area Boulevard, Houston, Texas, 77058; E-mails: [email protected], [email protected]

Journal of Marital and Family Therapy doi: 10.1111/j.1752-0606.2011.00282.x January 2013, Vol. 39, No. 1, 28–42

28 JOURNAL OF MARITAL AND FAMILY THERAPY January 2013

Table 1 Consistencies Between Culturally Responsive Therapy and Responsive Evaluation

Culturally responsive therapy Responsive evaluation

Epistemology Social constructionism Social constructionism Theoretical underpinnings

Interpretivism Interpretivism Feminism Naturalistic Just therapy Responsive Critical race theory Particularistic Relies on insider ⁄ local knowledge Qualitative Use of cultural advocated and advisor boards as accountability structures

Attention to context

Focus on socio-political and socio-cultural

Focus on socio-political and socio-cultural

Consideration of neighborhood, communities, and support systems

Recognition of social, cultural, and historical contexts

Recognize social, cultural, and historical contexts

Attention to culture

Consider traditions, values, worldviews, and life experiences

Attention to the culture of the organization, worldviews of each individual, and the experiences of each individual and in relation to one another

Attention to subordinations related to the intersection of race, class, gender, ethnicity, age, sexual orientation, nationality, and ability

Methods Client-centered Client-centered Use of nontraditional measures to address factors that affect recruitment and retention such as poverty, language barriers, structural racism and segregation, social isolation, and distrust toward institutions

Flexible, innovative, adapting, and emerging to fit the needs of the participants

Measures designed to fit population Responsive to concerns, key issues, problems, language, contexts, and standards of an array of stakeholder groups

Measures designed to fit population

Participants Clients and families Stakeholders at multiple levels Community members Various levels of hierarchy Therapists and supervisors Desire to find conflicting or a

wide array of views and experiences

Advisory board Accountable to minority community members and their experiences

Cultural advocates Relies on local knowledge Any stakeholders possible involved

January 2013 JOURNAL OF MARITAL AND FAMILY THERAPY 29

DEFINING CULTURALLY RESPONSIVE THERAPY

At the most basic level, being culturally competent is a necessary component of being a competent family therapist (Bean, Perry, & Bedell, 2001; Waites, Macgowan, Pennell, Carlton- LaNey, & Weil, 2004; Weaver & Wodarksi, 1995). Although multiple researchers describe CRT, there is no uniform definition nor are there concrete parameters for being culturally responsive. To the contrary, the terms culturally competent, culturally sensitive, and culturally responsive often are used interchangeably. This causes problems for researchers in operationaliz- ing, measuring, and cross-comparing CRT studies, as well as for therapists in understanding what is required to be culturally responsive.

A culturally competent service provider can provide services that address problems faced by people in multicultural contexts (Waites et al., 2004). Having a strength-based, nonpatholo- gizing stance is important, and family therapists are aware of the importance of offering inter- ventions that consider families within their socio-political and socio-cultural contexts (even within the same families) while paying special attention to neighborhoods, communities, and support systems (Waites et al., 2004). Attention to traditions, values, worldviews, and life expe- riences of the cultural groups in question is also paramount (Bernal, Bonilla, & Bellido, 1995; Castro, Barrera, & Martinez, 2004; Waites et al., 2004).

Being culturally competent as a researcher is also a necessary component of being a compe- tent researcher. At times, it can seem to be a monumental task to be culturally responsive as a researcher (Domenech-Rodrı́guez & Wieling, 2005). Traditional methods generally do not address factors that affect recruitment and retention such as poverty, language barriers, struc- tural racism and segregation, social isolation, and distrust toward institutions. Consequently, many services remain irrelevant to the needs of ethnic minorities (Parra-Cardona et al., 2009),

Table 1 (Continued)

Culturally responsive therapy Responsive evaluation

Findings Accountable to minority community members

A description of the quality of the process via the experiences of the stakeholders

Use of accountability structures to avoid the replication of dominant power structures

Feedback given throughout the process of evalu