Topic 8 DQ 1 (Obj. 8.2) DQ 1
How should a culturally competent counselor approach the processes of assessment and diagnosis when dealing with clients from minority populations? Support your answer with at least one scholarly reference and review cultural syndromes from the latest version of the DSM.
This discussion question is informed by the following CACREP Standard(s):
2.F.7.h. Reliability and validity in the use of assessments.
TEXTBOOKS
Jones-Smith, E. (2019). Culturally diverse counseling: Theory and practice. Thousand Oaks, CA: Sage Publications Inc. ISBN-13: 9781483388267
URL:
https://www.gcumedia.com/digital-resources/sage/2018/culturally-diverse-counseling_theory-and-practice_1e.php

Saul Arras1 posts
Re: Topic 8 DQ 1 (Obj. 8.2)

The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), is often required to diagnose clients’ problems. It is necessary for counselors to access managed care and insurance reimbursements (Tomlinson-Clare & Georges, 2021). During the intake process, counselors should reflect on what is necessary to work with this particular client. This may require review and research on the clients’ cultural backgrounds or traditions that may impact their current struggles. The goal for any counselor is to have cultural competence and empathy when working through the therapeutic process while maintaining the course of healing in the therapeutic process.
DeSilva et al., share a flow of the Cultural Formulation Interview (CFI) domains (2015). When working through cultural assessments there are 4 domains that have been identified:

The cultural definition of the problem.
The cultural perceptions of cause, context, and support (including identity)
Cultural factors that affect self-coping and past help-seeking
Cultural factors that affect current help-seeking

These domains are meant to help the counselor make person-centered cultural assessments to inform diagnosis and treatment planning (DeSilva et al., 2015). This information will allow the counselor to make informed and decisions on treatment and take into consideration how the client’s race, ethnicity, and culture affect the client. Working collaboratively with the client will help build a strong and trusting relationship.

Christy Johnson1 posts
Re: Topic 8 DQ 1 (Obj. 8.2)

When working with clients from minority populations a counselor should use a person-centered approach during the assessment and diagnosis process. The American Psychiatric Association’s (2013) Diagnostic and Statistical Manual of Mental Health Disorders (5th ed.; DSM-5) suggests using the Cultural Formulation Interview (CFI), which takes into consideration the client’s cultural identity, how they comprehend hardship and communicate their distress to others, what their primary stressors are and who they turn to for support, differences between the counselor and client that may interfere with diagnosis, treatment, and communication, and a summary of the information found in the CFI along with any other information that would be relevant to the clients’ treatment plan (p. 750). DeSilva et al. (2015) denotes that the CFI elicits “the patients own narrative of the illness…inquires about the views of members of the patient’s social network, to better place him or her in the context of a community and help the patient and his or her entourage engage more fully in the treatment process” (para. 8). In a study examining the mental health of Indigenous Australians Haswell-Elkins et al. (2007) describes the importance of clinicians recognizing “the impact of disempowering history” (p. S30) and “ongoing suffering and injustices” (p. S30) and their affect on the client’s mental health during the assessment and diagnostic process.

Rachael Herbison
2 posts
Re: Topic 8 DQ 1 (Obj. 8.2)

First, the counselor must above all be sensitive and non-assuming, not only in the first couple of meetings, but throughout the rest of the sessions as well.
One cultural syndrome that is in the DSM-5 is “gender dysphoria,” which, according to da Silva Paes Henriques & Filipe dos Santos Leite (2019), is a result of the inability of Americans to see past the male/female sexual orientations. The counselor should keep this in mind during assessment and consequential diagnosis, remembering the correct language and appropriate behavior.
One way to help with assessment is to be involved with programs of outreach, like the Comprehensive Statewide Needs Assessment, or the CSNA, which is a program that connects with and supports minorities who are also disabled (Sink & Bua-Iam, 2012).
When assessing and diagnosing any minority, the counselor needs to learn more about how they identify, whether they identify with their culture, and what their particular people group has experienced over the years. With programs like the CSNA (Sink & Bua-Iam, 2012), the counselors can learn more about these individuals and gather better tools in which to engage their new and recurring clients. 

Option #1: Critical Thinking: Quality at A1 Hotels
A1 Hotels operates luxury hotels throughout the world. Recently, motivated by some incidents that appeared in the news, they have been concerned about the quality of service. The company has been giving the following survey to its clients after their stay:
How would you rate the quality of your room? Select one.
Good(G), Poor(P)
How would you rate the quality of your food? Select one.

Good(G), Poor(P)

How would you rate the quality of your service? Select one.
Good (G), Poor(P)
Any customer who answered “Poor” to at least one of the three questions above is considered to be “dissatisfied.” Traditionally, 40% of customers have been dissatisfied.

A1 Hotels would like to see if the recent level of customer satisfaction has changed. Therefore, 200 survey responses were recently chosen at random for analysis. The complete data set is in the file named Hotels.

Managerial Report
Prepare a report (see below) for A1 Hotels that summarizes your assessment of customer satisfaction. Be sure to include the following seven items in your report.
To summarize the data, compute the proportion of all clients that

Answered “Poor” to room quality.

Answered “Poor” to food quality.
Answered “Poor” to service quality.
What do these three proportions tell you about customer satisfaction at A1 hotels? What graphical displays of data would you use to understand or explain the results of the survey?
What is the point estimate of the proportion of all recent clients who were “dissatisfied?” Develop the 92% confidence interval for the proportion of all recent clients who were “dissatisfied.” Interpret what the confidence interval tells you about the proportion of all recent clients who were “dissatisfied.” What is the corresponding margin of error? How can the margin of error be decreased?
Develop the 92% confidence interval for the proportion of all recent clients who answered “Poor” to room quality. Interpret what the confidence interval tells you about the proportion of all recent clients who answered “Poor” to room quality. What is the corresponding margin of error? How can the margin of error be decreased?
Develop the 92% confidence interval for the proportion of all recent clients who answered “Poor” to food quality. Interpret what the confidence interval tells you about the proportion of all recent clients who answered “Poor” to food quality. What is the corresponding margin of error? How can the margin of error be decreased?
Develop the 92% confidence interval for the proportion of all recent clients who answered “Poor” to service quality. Interpret what the confidence interval tells you about the proportion of all recent clients who answered “Poor” to service quality. What is the corresponding margin of error? How can the margin of error be decreased?
Conduct a hypothesis test, using both the p-Value Approach and the Critical Value Approach, to determine if the proportion of all recent clients is more dissatisfied than the traditional level of dissatisfaction. Use ? = 0.08 level of significance. Do not forget to include the correctly worded hypothesis and show all of the steps required to conduct the hypothesis test.
What would be possible effects of a lower and then of a higher level of significance?

What other hypothesis tests would you use to better understand hotel customer satisfaction?

What advice would you give A1 Hotels based upon your analysis of the data?

What is the magnitude of the improvement (if any)?
How can this study be improved?
Write a report that adheres to the formatting and APA expectations outlined on the CSU Global Writing Center (Links to an external site.). As with all written assignments at CSU Global, you should have in-text citations and a reference page.

Submit your Excel file in addition to your report.

Requirements:
Paper must be written in third person.
Your paper should be four to five pages in length (counting the title page and references page) and cite and integrate at least one credible outside source. The CSU Global Library (Links to an external site.) is a great place to find resources.
Include a title page, introduction, body, conclusion, and a reference page.
The introduction should describe or summarize the topic or problem. It might discuss the importance of the topic or how it affects you or society as a whole, or it might discuss or describe the unique terminology associated with the topic.
The body of your paper should answer the questions posed in the problem. Explain how you approached and answered the question or solved the problem, and, for each question, show all steps involved. Be sure this is in paragraph format, not numbered answers like a homework assignment.

The conclusion should summarize your thoughts about what you have determined from the data and your analysis, often with a broader personal or societal perspective in mind. Nothing new should be introduced in the conclusion that was not previously discussed in the body paragraphs.

This is a 2 part assignment. The 1st part is to read the material and then write the initial discussion post. The 2nd part is to write a short reply to 3 classmates posts. Once the initial post is completed I will post here 3 other classmates posts for you to write a short reply to. There is no minimum word count for the post or replies but they must be thorough and complete.
** THE INITIAL POST MUST BE COMPLETED WITHIN 24 HOURS **
Assignment: Forty percent of American kids living below the poverty line are obese or overweight, according to a 2010 study published in Health Affairs. Poorer kids are more likely to be obese or overweight than middle-class kids and consume a bigger proportion of their calories while at school.
With obesity issues rising, one Chicago school has banned homemade lunches. Except for students with food allergies, all students eat a well-balanced nutritious lunch from the school’s cafeteria. This change in Chicago’s school cafeterias feeds into a larger effort to combat the country’s childhood obesity epidemic. What are your thoughts on this effort? Be sure to reference any outside resources you may use in your post.
Source: Bethell, C., Simpson, L. Stumbo, S., Carle, A.C., Gombojav, N. (2010). National, state and local disparities in childhood obesity. Health Affairs, 3, 347-356.

Peer 1:
In my opinion I feel that school lunches should be nutritious but still good to enjoy eating, the thing about lunches in public school possibly private schools is that is not tasty & really not that good to the students. Most of time, maybe all the time the students don’t eat it at all. But schools should definitely push nutrition for students, not the so fatty foods.
In 2010, congress gave the Federal school lunch program a nutrition makeover new regulations call for: Increasing the amount of whole grains served in school cafeterias. Shifting to fat free or low-fat milks. Limiting the amount of calories that can come from saturated fats to 10 percent Offering fruits and vegetables on a daily basis.
Implementing caloric minimums and maximums for each meal The US PTA issue a 2012 rule that mandated big changes, Including replacing refined flour with whole grains increasing the amount of variety of vegetables are reducing sodium and implementing age specific serving size. It also limit the kinds of sugary snacks and beverages school could sell school begin implementing the standers in 2012 2013 school year. Again keeping nutrition in the food is the best thing for student, so I can’t really argue but then again the food has to be somewhat good enough for kids to eat. Having lunch, in their case free lunches! Keeps the mind going your a little more forces! In my opinion Ramon the same I do nutrition is best route because we’re trying stop obesity not increase it..
https://www.google.com/amp/s/www.publicschoolreview.com/amp/blog/why-fast-food-is-healthier-than-school-lunches-the-shocking-usda-truth (Links to an external site.)
https://www.google.com/amp/s/civileats.com/2020/08/10/changes-to-school-meals-have-made-low-income-kids-healthier-will-they-last/amp/

Peer 2:
I love that Chicago is doing this. I remember when I was in elementary, middle and high school the cafeteria food was not good. Pizza, cookies, chicken nuggets, chips, etc so we were better off by brining our own lunches. I think that school should have healthier options but kids tend to flood towards unhealthy food because they are in a time where they don’t worry about the effects of bad eating.
“Nutrition wise, it is better for the children to eat at the school,” she told the Tribune. “It’s about the nutrition and the excellent quality food that they are able to serve (in the lunchroom). It’s milk versus a Coke. But with allergies and any medical issue, of course, we would make an exception.”
Reference: https://www.foxnews.com/us/chicago-elementary-scho…

Peer 3:
Obesity is a rising concern, I don’t like the fact that a Chicago school banned homemade lunches. But I do find it ethical, it does feed a larger effort of child obesity in this country. I do like this effort even though I feel many will disagree. Young people generally become overweight or obese because of poor eating habits and lack of physical activity. Genetics and lifestyle also contribute to a child’s weight status. What the Chicago school did was take it a step further, students are obligated to go to school but not eat the lunch provided. The more you see others eating healthy lunch foods the more you will be able to adapt that habit. Obesity happens when you take in more calories than you burn through normal daily activities and exercise,Your body stores these excess calories as fat. Obesity can cause many health problems and disease in young teenagers and adults. Some health problems include but aren’t limit to heart disease and strokes, type 2 diabetes, and certain cancers.
https://www.hopkinsmedicine.org/health/conditions-…
https://www.mayoclinic.org/diseases-conditions/obe…

Assignment 1:The autopsy reports on celebrity or high profile deaths are a popular online search topic. Since the report is public record, the family cannot block it from public access. The owners of the website “Autopsy Files” collect and facilitate public access to some of these reports.Use the link below to access the following “celebrity autopsy reports” to answer the questions related to each name:*On the website, use the “Celebrity Autopsies” tab in the upper left corner to access the list of nameswww.autopsyfiles.org (Links to an external site.) – Chris BenoitWhat is the cause of death?During the autopsy, the neck structures were examined-were any injuries found?What type of object was found under the rope that was wrapped around his neck? Why did Mr. Benoit use that object?Was there any petechial hemorrhage noted in the eyes? Refer to the textbook chapter on asphyxia for more info-Nancy BenoitWhat is the cause of death?Was there any injury to her scalp?Why can’t her age be accurately assessed?Why can’t the Forensic Pathologist assess for petechia in her conjunctiva?Where any tattoos found on her body?What does the horizontal ligature furrow on her neck indicate?Were any structures in her neck fractured? (Hyoid, Thyroid cartilage, Cricoid cartilage)Based on the investigation of the deaths, how long was Nancy dead before Chris died?NOTE: this situation could be considered a Dyadic Death-see the Phil Hartman case for a link to the description of Dyadic Death- Ronni Chasen What is the cause of death? How many gunshot entry wounds did the Forensic Pathologist describe? Were any healed surgery wounds noted that could help with positive I.D.? What therapeutic interventions started by EMS or hospital staff were described in the autopsy report? What is the pathologists’ opinion about which gunshot wound(s) was/were “rapidly” fatal? Briefly, describe why the Forensic Pathologist stated each “rapidly fatal” gunshot wound would have led to death.- Michael Hastings Why was his death investigated as a “John Doe”? On page 6 of the autopsy report: Was the Forensic Pathologist able to use tattoos or surgical scars used to identify the body during autopsy? What is notable about the position of the Left arm?(refer to your textbook chapter on Burns, specifically pg 460, figures 9.24-9.27 Was I.D. based on a Driver’s License photo possible?(refer to your textbook chapter on Burns, specifically, pg 474, figures 9.78, 9.79) On page 7 of the autopsy report: What does the condition of the Hyoid bone indicate?(Photo of a “normal” Hyoid bone, textbook page 491, figure 10.48; fractured Hyoid, page 493, figure 10.56) On page 10 of the autopsy report: “Opinion” -What is the cause of death (how was the heart affected by deceleration injury)? Was he thought to be alive and conscious after the impact with the tree? On page 10 of the autopsy report: When does the pathologist state that the thermal burns occurred? (before or after death?) On page 11 of the autopsy report: What does the Forensic Pathologist state about the presence of Carbon Monoxide in the blood stream, and what does that indicate about cause/time of death?*In the autopsy report, Mr. Hastings is never positively I.D.ed-page 2 of the website: Steven Paul “Elliott” Smith What weapon was used? What medical appliances were in place at autopsy? How was the decedent positively identified? Which stab wound perforated the heart? Who is suspected of inflicting the stab wounds? What reason(s) did the Forensic Pathologist give for stating that the death could be a homicide?-Phil HartmanUse the link below:http://www.autopsyfiles.org/phartman.htm (Links to an external site.)-Which of the 3 gunshot wounds was not considered to be fatal?-* the 2d page of the Coroners Investigator report has a complaint in the “investigation” description about the delay by the Los Angeles Police Department in officially notifying the Coroner’s office of the deaths. Once the Investigator was on scene, he was not allowed in to examine the bodies for several more hours. # From my experience in the crime lab, this “delay” in reporting did not surprise me, nor the delay in allowing the Investigator on to the scene. The time of death of both individuals was not in question, nor was the likely primary cause of death. Detectives did know that they had a lot of evidence to document at the scene. The Detectives that I worked with used the same approach: when the time of death and likely cause of death was not in question, they waited for a search warrant, then took several hours to examine and document the scene before notifying the Medical Examiner’s office. When the M.E. Investigator arrived, he/she was politely informed of what known evidence was on scene, and where to step to get to the body.The process of examining the body and removing it from the scene can easily destroy trace evidence if that evidence has not already been identified, documented, and collected.-On page 21 of the autopsy, the “GSR” (gunshot residue) report

Topic: Environmental Injustice
Environmental justice ensures that all communities are treated fairly and are meaningfully involved in environmental-based decisions, such as where to build a new sanitary landfill, hazardous waste repository, industrial plant, or any other such site that could create an environmental hazard for those who live in the area.
Describe a time when environmental injustice occurred. This can include any current or past events where the community was not fairly and meaningfully involved in the decision-making process.
Who is or was negatively affected? What negative health effects could or did the community experience? What other social factors compound the negative health outcomes of the community?

Reply:

A few counties over from mine there have been a wide variety of health reports from tap water. It has recently been found that there are in fact toxic chemicals resulting in many different medical reactions. This issue has prompted exposure to lead from aging pipes beneath the ground. Also, with the hurricane season recently coming through, it hasn’t helped concerning contamination. Climate always has such a hard impact on my area, there are a lot of natural disasters that occur along with a lot of structures that need rebuilt such as our bridges, roadways, and even underground utilities. A lot of these projects are underway currently and continue to be throughout the many weatherly seasons of the year.
“Water is deemed unfit for drinking whereas irrigation or recreation the water would have no bad effect,” (Schweitzer, 2018). Therefore, we learn that not all water is harmful in all aspects but when it comes to tap water being contaminated, that is an issue that is deemed unfit for drinking and the community should be made aware because so many can be potentially affected.
The entire town has been affected from personal homes to professional businesses, surgical and other medical centers, grocery stores and even restaurants as well. Water contamination has been such an issue throughout the community that they have a purified water drive to bring in clean water. Having this clean water helps to prevent exposure and intake of unhealthy toxins. Likewise, reducing the risk of the many health issues that can occur from contaminated water.
“Advocates and Researchers of Public Health say inequality is damaging to overall health and wellbeing, it is distasteful,” (Pastor, 2018).
Although the water department is doing heir part to ensure the problems are fixed, it still leaves so many people within this small town without. Without not just drinking water but running water all the way around. Some people have left town, meanwhile, some have traveled to an extreme to find clean water. Then with our current pandemic and need of proper hand washing makes it all that much worse. What a terrible time to not have clean water, to have contaminated air and surfaces and no way of adequately cleaning our hands. Therefore, public events such as fairs will be difficult for the town to host due to the water contamination. This means there is even more price to pay than initiated.
References
Pastor, M., & Morello-Frosch, R. (2018). Gaps Matter: Environment, Health, and Social Equity. Generations, 42(2), 28–33.
Schweitzer, L., & Noblet, J. (2018). Water contamination and pollution. In Green chemistry (pp. 261-290). Elsevier.
Thanks so much, my friends! It is so good to be here! I look forward to working and learning more with you as we progress throughout our course! Keep pushing and finish strong, I know you will all be simply amazing! Stay safe and stay well out there!
Geri

Reply:

In North Richmond, California, there are five oil refineries, three chemical companies, eight superfund sites, toxic waste sites, and rail yards (Kay & Katz). During World War II, black settlers migrated to this part in California to escape the Jim Crow traditions. At the time, there were no rentals or sales on houses available to the blacks, so they were given what was available to them, and that was land near the shipyard. Not much has changed since then as the area is still full of pollution and filled with minorities such as blacks, Asians, Latin Americans, and pacific islanders. The area is filled with air pollution, water pollution, noise pollution from highways, and visual pollution. Compared to their neighboring county, Contra Costa, there is a significant health disparity between it and Richmond. The negative health effects include asthma, heart disease, cancer, headaches, breathing difficulties, fatigue and strokes (Kay & Katz). Overall, the area of Richmond is heavily polluted and not only on the outside, but even through into peoples’ homes. The pollution is so heavy that it has seeped into the walls of the residents’ homes.
Reference
Kay, J. & Katz, C. (2012, June 4). Pollution, Poverty, and People of Color: The Factory on the Hill. Retrieved from https://www.ehn.org/pollution-poverty-richmond-264…