■ recognize the importance of culture in psy-
chological research and clinical work.
The developers designed these guidelines to
provide psychologists with a framework for provid-
ing services (educational, clinical, etc.) to an
increasingly diverse population.
Along these lines, S. Sue (1998) has advo-
cated that clinical psychologists and other mental
health professionals must demonstrate cultural
competence—a knowledge and appreciation of
other cultural groups and the skills to be effective
with members of these groups. Sue (1998) has
identified three major characteristics of cultural
competence:
■ Scientific-mindedness. Clinicians must formulate
and test hypotheses regarding the status of their
culturally different clients; clinicians must not
adhere to the“myth of sameness.”
■ Dynamic sizing. Clinicians must be skilled in
knowing“when to generalize and be inclusive
and when to individualize and be exclusive”
(p. 446). This allows the clinician to avoid
stereotypes but still appreciate the importance
and influence of the culture in question.
■ Culture-specific expertise. Clinicians must under-
stand their own culture and perspectives, have
knowledge of the cultural groups with whom
they work, and if indicated, be able to use
culturally informed interventions.
According to Sue (1998), these characteristics
will be present to varying degrees in individual
clinicians. Clinical psychologists must actively
develop these skills to achieve cultural competence
in their work with various groups of clients or
patients.
Likewise, issues of gender have become prom-
inent in recent years. There are a number of unique
influences that must be considered when providing
mental health services to girls and women, for
example. First, there is evidence that some diagnos-
tic criteria may be applied in a biased way, depend-
ing on the biological sex of the client. For example,
a very impulsive woman is more likely to be diag-
nosed with borderline or histrionic personality
disorder, whereas a man exhibiting the same symp-
toms might be given a diagnosis of antisocial per-
sonality disorder. This likely reflects biases and
expectations on the part of the clinician concerning
gender. Worldwide, women and girls are more
likely to experience a traumatic event (e.g., sexual
abuse, partner abuse) and oppression, are more vul-
nerable to sexually transmitted diseases, and are
more likely to be victims of violence than their
male counterparts (APA, 2007). These and other
unique biological, psychological, and environmen-
tal influences suggest the need for sensitivity to the
experience of girls and women when providing
psychological services.
As for how to integrate these considerations
and apply them to the practice of clinical psychol-
ogy, the American Psychological Association
(2007) provides a number of recommendations,
including:
■ Use treatment interventions that have
been shown to be effective with girls and
women.
■ When providing treatment, promote empow-
erment and a range of choices.
■ Be sensitive to the issue of sex bias when
conducting assessment and formulating a
diagnosis.
■ Become familiar with and utilize community
resources for girls and women during
treatment.Guidelines like these remind us that we
must be sensitive to the unique experience of
each of our clients and to not fall into a one-
treatment-fits-all mentality. In the future, we must
continue to train clinical psychologists to recognize
and understand both gender differences and cultural
diversity and how these relate to the provision
of mental health services. Web sites 3-8 and 3-9
at the end of this chapter provide a link to the
American Psychological Association’s GuidelinesCURRENT ISSUES IN CLINICAL PSYCHOLOGY 85