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Services to Spanish-speaking populations Supplemental Appendix A: Sample Topics and Activities for Spanish Instruction Topic Narration in the present Narration in the past Narration in the future Use of the conditional Use of the subjunctive Written accents Activities Students compose a short narration in the present incorporating most of the verbs listed in a handout on verbos con cambio de ortografía. While students take turns narrating, another writes on the board the list of verbs used in the narration. The group provides feedback/correction on written material. One student shares his or her narration with the rest of the class. Another student has to retell the story in the third person singular. Students practice using the first and third person singular of the ‘irregular’ verbs in the present indicative. Have students work in pairs to narrate one of the following: Mi primer caso El caso más interesante que tuve en mi vida profesional Cómo y por qué escogí esta carrera. As students talk to one another, the instructor listens in and takes notes of errors that need to be addressed as a group. Emphasis should be placed on past tense declensions and use. Select two or three students to share their ‘story’ with the rest of the class. Present a list of verbs and have them create a short story. The entire class participates. The instructor writes what is being said on the board. Students take turns adding to the narration. For example: El verano próximo Elvira irá a ... / future Si Elvira pudiera, ella… / conditional. Role play giving advice to a client or the parents/teachers of a ‘problem child’ to practice using the imperfect subjunctive. ¿Qué le aconsejaría a un niño que no quisiera hacer la tarea? Le diría que tratara de concentrarse y que hiciera lo posible para que... Provide students with a case example and ask them to: Summarize in their own words what the problem is Infer what other circumstances might have led to the problem Hypothesize as to what could the client have done to find a solution Recommend what course of action the client should take Introduce the subject by projecting the handout on Los acentos and addressing each category separately. For example, to address ‘palabras agudas’, cover the columns for palabras graves and esdrújulas. Have students read out loud the list of words under palabras agudas. Then, ask them what the words have in common in terms of stress and word endings. Students should be able to come up with the rule themselves. Services to Spanish-speaking populations Use the same method for the other two sets of words. Provide extensive practice. Select a passage pertaining to mental health; retype leaving accents out and have students place the accents. Expressing emotions The Jerarquía de las necesidades básicas exercise: Students are given a list of values based on Maslow’s theory and they are told to work in groups of at least three to eliminate the two least important values on the list. They should then rank order the remaining ones. The group selects a spokesperson to explain to the rest of the class the rationale for their selection and ranking. The instructor takes notes of areas that need addressing and conducts a review at the end of the exercise. Students should be encouraged to disagree with one another and to explain their point of view fully. Professional vocabulary Hand out a sample informed consent form. Divide the form in three segments; assign a segment to each of three students; have students write translation on the board/overhead transparency/computer; ask another three students in the class to each correct a segment. After everyone is done, the instructor does the final correction for everyone to see. Have students role play explaining the consent form to a client. Each student presents a topic of his or her choosing, provided it is work-related. Other students are to take notes and be prepared to ask questions or offer comments at the end of the presentation. The instructor then assists the class in summarizing what was presented and asks for students’ opinions on specific issues/topics. Provide students a handout describing a social issue of interest to the students, e.g., teen pregnancy. Facilitate a group oral discussion and role play to elicit conversation and use of pertinent vocabulary. Services to Spanish-speaking populations Supplemental Appendix B: Sample Topics and Activities for Cultural Proficiency and Application Topic Cultural Identity Heterogeneity of Latino Population Identity Development Activity Provide students with questions to help them assess cultural identity. Discuss identity as a construct and how experience contributes to formation of personal identity Provide a case scenario and have students discuss: Initial interaction and entry Establish the issues and clarify client‘s goals. Develop a set of understanding about client. Identify level/basis of rapport. Explore approaches. Exercise 1 1. Write down individual personal attributes/descriptors for 1 person you’ve met here. 2. Have that person provide descriptors of their most salient or valuable attributes. Discuss how and why these may differ. Exercise 2 1. Provide your most salient attribute. 2. Pick someone you know fairly well in the room and assign an attribute. 3. Discuss how you arrived at these conclusions. Case Study Use sample case scenarios to discuss the following: 1. Language preferences 2. Ethnic identity 3. Family dynamics 4. Cognitive style 5. Coping style 6. Affective behavior 7. Interpersonal behavior 8. Sociopolitical behavior Divide into groups to explore case issues and potential case needs: Discuss workplace issues that may present conflicts with culturally sensitive practice and suggested use of developed interview format. Services to Spanish-speaking populations Redefining Diversity Spirituality and Health Practice Assessment and Clinical Issues Discuss socioeconomic influences and social trends that have affected changes and redefined the family unit. Discuss differences and likenesses of different Latino groups as they relate to characteristics, lifestyles, etc. Discuss acculturation and assimilation over the years and generations. Discuss how some values have remained and are expressed and how some have changed dramatically. In class discussion Generational point of acculturation, adaptation, or change. How are values compromised by assimilation or acculturation? How are mental health services affected by core values of family? For example: o Confidentiality issues o Sharing personal information Discuss the importance of pursuing a language and culturally sensitive sequence for intake interviews across counseling scenarios. Spirituality and religion. How knowledge can be incorporated in working process. Issues and constraints in practice. Likeness and differences between counseling/therapy/consult and folkhealing and/or alternative medicine available in community. What are Latino cultural values represented by key terms? Orgullo Personalismo Simpatía Respeto Familismo Folk-healing Curanderismo Espiritista La Virgen de Guadalupe Altar Bautismo Día de los Muertos Si Dios quiere Empacho Susto Ataque de nervios Brujería (o mal de ojo) Curanderos Santería/Santeros Botánica Botica Review the list of available instruments in Spanish and English. Discuss the appropriate use of each and combinations that may be selected given bilingual/bicultural aspects of Latino clients. If possible, demonstrate (or review) the contents of each kit or instrument to familiarize the participants with the construction and use Services to Spanish-speaking populations Latino Families in Transition Initial Stages of Counseling of the sample tests. Discuss translation issues inherent in conducting psychological assessments. Discuss the integration of information obtained through the use of a culturally sensitive interview format. o Thorough sensitive interview formats help shape the processes that may need to follow in case work, whether treatment or assessment oriented. Questions for class discussion Q#1: What values drive the Latino family regarding: Marriage Children Welfare of the individual Roles (expected duties, responsibilities, and benefits) o Economic stability o Intimacy o Procreation o Household responsibilities Example: I work hard to support everyone and they still give me a hard time. Q#2: Attitude about marriage, intimacy and cohabitation Example: Is it okay to live together outside of marriage? The intact family: o Has roles defined o Communicates solidarity o Contends with changing values over generations. Q#3: What changes can be expected as family characteristics change? Example: Single parent families, bicultural families, immigrant families. Form groups to exchange ideas about each type of family. In class exercise Discuss How awareness of family values helps in defining family structure. How conflicting values in generational differences leads to conflict. Create a sample scenario in groups of how this may go. Discuss importance of understanding family values and beliefs versus individual family member’s value adaptation. Does acculturation play a role in family conflicts? How so? How do culture and language affect treatment planning? What do we mean by cultural linguistic approach? Discuss using case studies or scenarios previous created o Importance of understanding family versus individual values and beliefs. o Dilemmas and conflicts that arise out of differences in level of acculturation and individual family member’s value adaptation o How would you adapt interview schedule to explore within family differences to uncover stressors and variables operating? Services to Spanish-speaking populations o What do you think about client-counselor match and interpersonal etiquette? Exercise Review list of dichos. Discuss possible interpretations due to regional differences. Review Middle and Last Stages of Counseling Expressiveness of emotions within a therapeutic relationship (stories, language use, etc.). Type of counseling (brief, crisis, or long term) and the purpose it serves depends on acculturative levels. Ethical considerations. Exercise Ask participants to make a short list of dichos and cuentos they are familiar with and/or have used. Share the lists with the group. Exercise Ask participants to name some common folktales in Latino/Hispanic culture. Discuss variations among Hispanic subgroups. Discuss how these could be utilized in therapy. Exercise Hold a conversation with a classmate and practice code-switching. Exercise Discuss superstitions. Ask participants to identified superstitions that are held by them or their families. Are some superstitions value-based and thus reinforced? Dichos Exercise Divide class into groups Assigned 5 dichos to each group and have them discuss potential messages of each dicho. The group should come to a consensus about the meaning or interpretation. Discuss interpretive possibilities among groups. Latino Family Discuss Latino family values that could be misinterpreted or Counseling misconstrued in the therapeutic context, e.g., closeness versus enmeshment. Discuss psychosocial stressors embedded within families (language differences, differing levels of acculturation, generational differences, history, etc. Case Analysis In small groups: Identify a case. Ask for examples of the above. Discus how to integrate future casework. Case Analysis Review videotapes of therapy sessions conducted in Spanish (either tapes of the participants or training tapes). Ask participants to observe and discuss cultural and language issues that are relevant to the case. Services to Spanish-speaking populations Future Directions Development of competence has required what of each participant? Have participants reflect on their development of skills and knowledge and the challenges they have faced in the process. In small groups or as a class, discuss Skills of culturally skilled counselor. Challenges faced in own sociopolitical reality as providers. Challenges of including clients’ spirituality as an important dimension of the “new Latino.”