Between the individual and the clinician

Included here are (a) ethnic and racial differences between the client and the clinician, and (b) the negative impact of these differences on the diagnosis and treatment of the client. For example, the fact that the client and the clinician are Hispanics does not necessarily mean that they share the same ethnicity (i.e., values, norms, and lifestyle). In this context, a Hispanic clinician, for example, who does not believe in the cultural values of "machismo" and "marianismo" would diagnosis a Hispanic female with Dependent Personality Disorder when, in fact, this woman is simply behaving according to norms expected in the Hispanic community. In the same case, a treatment plan with emphasis on "social skills training" (teaching a client what to do and say to develop self-assertive behaviors, for example) would be a bad tactic in the treatment of that Hispanic female because the clinician would be recommending an intervention which competes with the value that Hispanic places on respeto, machismo, and marianismo (Paniagua, 1998).

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