Cultural and Contextual Considerations Mental health professional’s appreciation for culture and context extend beyond general understandings of people grouped by factors like ethnicity and sexual orientation. Mental health professionals invest in understanding the deep, underlying components of all the things that come together to make our clients who they are. When culture and context are at odds with societal norms and hegemonic expectations, mental health professionals may need to work with clients to help instill and utilize resources to cope with the possibility of negative messages from society. In addition, mental health professionals work together with clients, for clients, and with other professionals to make changes. Consider how collaborating with others promotes positive changes in client well-being. How might collaboration through advocacy result in alternative approaches for addressing cultural or contextual considerations in treatment recommendations? For this Discussion, view the case study “Multicultural and Contextual Considerations Case Study: Marisol” in the Learning Resources. Consider new and alternative methods that mental health professionals could use to advocate for Marisol. Post · An explanation of how you would advocate for clients like Marisol.  · Explain at least one strategy as a mental health professional you could facilitate culturally and contextually ethical treatment of clients.  · Support your strategy with evidence from the Library. Multicultural and Contextual Considerations Case Study:  Marisol Program Transcript: Professional counselors consider all facets of a client's personal background and history to provide informed ethical care. As such, individuals belonging to special or minority populations require additional consideration on the part of the counselor to ensure appropriate care is given. In the case that you're about to view, Marisol—the client—presents with special ethnographic needs. As the client is introduced, consider possible areas in which the client requires a treatment approach that incorporates culturally sensitive considerations. Think of ways to align specific addiction and mental health concerns with cultural considerations. How should this client be assessed? What alternative approaches should the counselor employ to address multicultural barriers?  Marisol is a 25-year-old Latina living in a traditional home on the south side of San Antonio, Texas. Marisol has lived in the United States for most of her life and has extended family in Mexico and in San Antonio. She is the middle child of six. Her family and friends are pressuring her to get married. Her grandmother, mother, and married friends consistently bring up the subject of marriage. Marisol worries about her ability to be a good wife and mother and sees her siblings struggle to lead a good life as much as she does. Marisol is fluent bilingual. However, English is Marisol's second language. Although she wanted t ...

1. Cultural and Contextual Considerations
Mental health professional’s appreciation for culture and
context extend beyond general understandings of people
grouped by factors like ethnicity and sexual orientation. Mental
health professionals invest in understanding the deep,
underlying components of all the things that come together to
make our clients who they are.
When culture and context are at odds with societal norms and
hegemonic expectations, mental health professionals may need
to work with clients to help instill and utilize resources to cope
with the possibility of negative messages from society. In
addition, mental health professionals work together with clients,
for clients, and with other professionals to make changes.
Consider how collaborating with others promotes positive
changes in client well-being. How might collaboration through
advocacy result in alternative approaches for addressing cultural
or contextual considerations in treatment recommendations?
For this Discussion, view the case study “Multicultural and
Contextual Considerations Case Study: Marisol” in the Learning
Resources. Consider new and alternative methods that mental
health professionals could use to advocate for Marisol.
Post
· An explanation of how you would advocate for clients like
Marisol.
· Explain at least one strategy as a mental health professional
you could facilitate culturally and contextually ethical treatment

2. of clients.
· Support your strategy with evidence from the Library.
Multicultural and Contextual Considerations Case Study:
Marisol Program Transcript: Professional counselors consider
all facets of a client's personal background and history to
provide informed ethical care. As such, individuals belonging to
special or minority populations require additional consideration
on the part of the counselor to ensure appropriate care is given.
In the case that you're about to view, Marisol—the client—
presents with special ethnographic needs. As the client is
introduced, consider possible areas in which the client requires
a treatment approach that incorporates culturally sensitive
considerations. Think of ways to align specific addiction and
mental health concerns with cultural considerations. How
should this client be assessed? What alternative approaches
should the counselor employ to address multicultural barriers?
Marisol is a 25-year-old Latina living in a traditional home on
the south side of San Antonio, Texas. Marisol has lived in the
United States for most of her life and has extended family i n
Mexico and in San Antonio. She is the middle child of six. Her
family and friends are pressuring her to get married. Her
grandmother, mother, and married friends consistently bring up
the subject of marriage. Marisol worries about her ability to be
a good wife and mother and sees her siblings struggle to lead a
good life as much as she does. Marisol is fluent bilingual.
However, English is Marisol's second language. Although she
wanted to succeed in her studies, Marisol struggled as a student
and did not finish high school. She was always nervous in
school. She began working to contribute to the family income
and could never find the time to complete a GED. She worries
that she will never be able to get a good job because of her lack
of education. Marisol is being treated for comorbid cocaine

3. abuse and benzodiazepine dependence and is having difficulty
discussing her mental health issues with her Caucasian male
psychiatrist. Marisol has been seeing her psychiatrist, Dr. Dan,
for treatment of her addictions. Dr. Dan is a Caucasian master's
level counselor who has received specialized training in
addictions counseling. During the past two counseling sessions,
Marisol appeared reluctant to engage in communicating with her
psychiatrist as evidenced by her limited verbalizations. She
responded only to questions that were asked and provided little
additional information beyond yes and no responses. Her
responses have sometimes appeared to be insincere or evasive.
© 2014 Laureate Education, Inc. 1 Multicultural and Contextual
Considerations Case Study: Marisol
MARISOL: I met with my doctor two times. Dr. Dan wants me
to tell him what is going on with me. But when I started to tell
him a little bit, he seemed impatient. These are the things that I
don't like to talk about, especially with someone who's not a
member of my family. If I share too much, he may think I'm a
bad woman. He is a doctor, so what he says goes. He knows
what he needs to know from me, and I don't want to trouble
him. I like Dr. Dan. He seems nice and all that, but I really
don't feel like he can understand my problems. First, I don't
think he's ever had addiction himself. If he hasn't had an
addiction, how can he possibly understand what I'm going
through? He's also a white man. The issues I face as a Latina
woman are very different than those that he experiences. I just
don't understand how he will be able to help me. Let me tell you
a little bit about myself. I'm 25 years old, and I've been using
drugs for the past 10 years. I only really started using drugs to
help with my anxiety. [SPEAKING SPANISH]. Sometimes,
when I get nervous, I forget to talk in English. Anyway, I've
been nervous for as long as I can remember. I've just—I've had
some bad stuff happen, stuff that I don't want to talk about right
now. How am I supposed to talk to a man about these things? I

4. know that in order to get better, I have to talk about things. But
I can't bring myself to talk about them with an educated man
like this. I mean, I tried to start telling him, but he was like in a
hurry or something. He started writing a prescription for me.
You must know what I mean. And—I don't know, maybe I
shouldn't talk so much, you know? Where was I? Oh, yes, my
anxiety. I guess I can tell you a little bit about it. Please don't
tell my mother. I had some bad stuff happen. But even before
that, we just really struggled to make it. I was raised by a single
mother, una santa. She's a saint. She worked 14 hours a day to
make sure that [INAUDIBLE] and the rest of us had food in our
system. We also moved a lot. And sometimes, I was unsure if I
should even unpack, or if we were just going to up and leave.
Like I was saying, my mother worked 14 hours a day. She
worked two jobs. © 2014 Laureate Education, Inc. 2
Multicultural and Contextual Considerations Case Study:
Marisol And she left us kids—there were six of us—with
whoever was willing to watch. Like mi tia, Alejandra. I'm sorry,
my aunt. It was hard on all of us. We fought a lot. All of my
siblings have problems, giving my mother grief. My oldest
brother, Juan, has spent most of his life in and out of prison. He
joined up with MA, so he's all tough and gang banger now. My
sisters are in abusive relationships. I don't think they know how
to keep their men happy. And my youngest brother, my
youngest brother, he's had the hardest because he saw too much
too early. We used to party sometimes together, you know? But
he's worked so much. These days, he parties just as hard as he
works. I think he's stuck on [INAUDIBLE]. Things have been
hard for us all. My poor mother—I try to keep it together
because I know that she needs at least one daughter she can be
proud of. It's too much. I think that's why I started using
alcohol. I used alcohol first. It was a way to help me relax and
forget about my problems. Plus, I mean, Tia Alejandra said she
had been drinking back at age 12 in Chiapas. No big thing. I
never really liked feeling hung over. Then I started taking
Xanax. I really liked the way that made me feel. I didn't feel the

5. anxiety as much. I could get out of the house, go make friends,
and everything. But then I started needing more and more, and
that scared me. I've had friends who overdose, and others get
sick from that stuff. I thought, I'll just cut back. I even had an
attack the day I tried to not take it. It—it felt like if my heart
was going to explode. So I called the counseling center, and
they had me see Dr. Dan. They told me to come see you too. I
sometimes use cocaine. I don't really like the way it makes me
feel, though. It usually just makes me feel more anxious. I know
it sounds stupid, but sometimes I feel like if the cocaine gets me
too up, I'll be too up to even care about being anxious. Yeah,
you know, it's like I can take it. Anyway, I can talk to people
and not feel so stupid all the time, you know? I just want to feel
better. I want a normal life. I want my mother to be proud of
me. I know that using cocaine and Xanax are very wrong for
me. But I just don't want to feel anxious every day. I don't want
to feel anxious every day. I—I haven't been in a relationship in
over three years. And I'm afraid that I can't trust anyone. What
kind of woman am I if I can't keep a husband and have a house
and have my husband happy with the way I make things work?
© 2014 Laureate Education, Inc. 3 Multicultural and Contextual
Considerations Case Study: Marisol It's all too much. So like, I
can't tell Dr. Dan any of this stuff. I'll be so ashamed. I mean,
he is the doctor, right? He'll want to lock me up or tell me that
it's my mother's fault. She's a good woman. She's worked so
much. I wish I could be like that, you know? What if she found
out? It would kill her. I don't—I just think I won't go back. I
can't stand the judgment. Dr. Dan. He can't even pronounce my
name right. "Mare-ah-saul". It's "Mar-ie-sole." I just might not
come back. I can't stand the judgment. Maybe my anxiety isn't
so bad. Maybe I could just cut back on the Xanax and maybe
only do coke like in the weekends or something. I think I'm
wasting his time.
Multicultural and Contextual Considerations Case Study:
Marisol Additional Content Attribution