JULY 28, 2010
VCU WEBCAST

Services Provided By:  Caption First, Inc.
					


   >> ALLEN LEWIS:   Greetings.  Welcome to another Webcast for 
Project Empowerment.  I'm Allen Lewis.  We are here at 
Virginia Commonwealth University in the Department of 
Rehabilitation Counseling in the School of Allied Health 
Professions in Richmond, Virginia in the United States of 
America. 
   Project Empowerment has a goal of improving the capacity of 
the vocational rehabilitation system in the United States, in 
terms of its ability to produce research that squarely focuses 
on persons who are members of culturally diverse backgrounds 
who have disabilities.  Our goal is to increase the capacity 
of the system to do more research on ethnic minority 
populations with disabilities. 
   Today, our focus will be on addressing a tool called a 
Three-Factor Model, a tool for multicultural counseling of 
individuals with disabilities.  This tool helps us to begin to 
have a strategy to try to serve persons with disabilities who 
are from culturally diverse backgrounds in a competent manner. 
   Today we have two presenters:  Aisha Shamburger, doctoral 
student, and yours truly, Allen Lewis. 
   We are going to try to be somewhat organized today in terms 
of the information we present to you.  We have key tasks we 
want to lay out at the outset here to make sure we proceed 
systematically through the process of describing this tool and 
its utility. 
   First we are going to do an introduction and background to 
the tool.  We are going to describe the tool.  We are going to 
talk about the purpose followed by the rationale for the tool.  
We are going to talk about the three domains that are parts of 
the tool.  We are going to go through the process of, the 
explicit process of developing the tool itself.  There is 
steps that we recommend that you go through. 
   We are going to expose you to several samples of Three-
Factor Model tools that have already been developed, so you 
can get an idea of what a finished product can look like.  We 
are going to talk about next steps in terms of things we are 
doing from this point forward to further develop and validate 
the tool.  And then we are going to give you information on 
things you can read further if you want more information 
beyond today's Webcast about the Three-Factor Model tool. 
   With that, I'm going to stop and invite our other presenter, 
Aisha Shamburger, to move into the introduction of the actual 
tool itself. 
   
   >> AISHA SHAMBURGER:  In the 21st century there is basically 
a need for vocational rehab professionals to do more with 
less.  There is a need for them to provide greater services 
with fewer resources, while still remaining effective in the 
services they are providing. 
   Disability disparities has been defined as a disparity 
between incident, contemplation, access, participation and 
outcomes as it relates to individuals that are receiving 
services. 
   In 2010, disability disparities have been well-documented.  
However, few strategies have been implemented in order to deal 
with these particular disability disparities.  The Three-
Factor Model is one tool to address disability disparities. 
   Use of the Three-Factor Model tool has the potential to 
render its user, the vocational rehabilitation counselor, as 
more efficacious.  This is particularly important as 
vocational rehabilitation professionals are encouraged to 
become more culturally competent.
    
   >> ALLEN LEWIS:  Let's move into the background on this 
Three-Factor Model tool.  It evolved as part of the graduate 
course development process and basically as a teaching aid in 
an attempt to make the high volume of material in 
multicultural counseling courses manageable for students. 
   There was a desire to provide a meaningful culminating 
course experience or activity for students, realizing that the 
sheer amount of information that students get exposed to in 
traditional multicultural counseling courses is so large, it 
would be a good thing to let students leave the course with a 
tool, something tangible or concrete, if you will, that they 
can take beyond the course into their professional practice 
and use to help them with multicultural counseling. 
   We wanted this to be a real world application, something 
that will be useful beyond the actual graduate degree course 
work, and very useful in practical terms in clinical practice. 
   Let's move into describing the tool a little bit.  The tool 
is a multicultural counseling assessment tool.  It is an 
interview protocol.  It is conceptually grounded, theory-
driven, and developed by its user to maximize integration 
between, one, an approach toward understanding the clients in 
three key domains which we will talk about later, and two, the 
user's usual counseling style. 
   The idea is that once it's developed by a particular 
counselor, based on his or her understanding, it will 
automatically be useful and likely to be used because the 
person has actually developed this and will integrate this 
into their usual counseling style. 
   The goal of the tool is to gain information on culturally 
different clients for assessment purposes, to ultimately 
maximize individualized outcomes.  The tool evaluates who the 
client is in the three domains of cultural identity, 
adjustment to disability and stage of development. 
   The tool serves as the preconstructed interview prompt, that 
is preconstructed before the actual interface happens with the 
client.  It is a set of guiding questions or areas for 
potential exploration, that ensures that the client assessment 
process is systematic and intentionally conducted in each new 
clinical encounter with culturally different clients. 
   The tool attempts to render the all important initial 
assessment activity automatic because, one, there is high 
ownership of the tool, because it's been developed by the 
user, and two, there is optimal integration of the tool within 
the user's typical style because it offers a set of areas to 
explore that though they have already been identified 
beforehand can be flexibly deployed in a given situation by 
the user, based on what things come up in terms of meeting the 
client, where he or she is.  And the visual attributes of the 
tool increases the ease of recall, rendering the tool almost 
always acceptable to the user, because the user has a picture 
of the tool in his or her mind.  So they are not bound by 
papers and notes or having an interview protocol in front of 
them.  They have a visual of this tool in their mind that 
allows them to recall what those areas or exploration really 
need to be in those three domains. 
   The tool reveals critically important client information 
about, one, cultural identity, two, adjustment to disability, 
and three, stage of development, to promote an optimal 
counselor/client fit and ultimately promote culturally 
relevant outcomes of the vocational rehabilitation process. 
   First of all, it maximizes the fit between the person who is 
receiving services and the person providing services, and then 
when that fit is maximized, it offers a good game plan for 
ensuring that the outcomes are positive of the counseling 
process. 
   The rationale for the Three-Factor Model tool is that it's a 
single most important, is that the single most important 
ingredient in a successful counseling outcome cross-culturally 
or otherwise is building a strong counselor/client alliance, 
and obtaining maximum information on the client necessarily 
promotes this. 
   Having a critical mass of information on the client augments 
the second and third of the three multicultural counseling 
competencies specified in the similar work by Sue, Arredondo, 
and McDavis of 1992.  The second competency is understanding 
the worldview of clients who are culturally different without 
imposing negative judgments.  And the third competency is the 
ability to develop and practice appropriately with culturally 
different clients.  The three-factor tool helps you to have 
the information you need to be successful with both the second 
and third competency in the similar work by Sue, Arredondo and 
McDavis in 1992. 
   It is unwise to totally rely on generalized information on 
how to successfully counsel specific cultural groups found in 
many multicultural counseling textbooks, but rather it is more 
effective to collect key client information needed in 
particular situations brand-new right then and there. 
   No counselor can expect to achieve perfect cross-cultural 
functioning every day.  Therefore, having a personally 
developed tool that is fully integrated into one's 
professional context, that is, it matches one's own 
understanding, clinical style and is visual to enhance recall, 
having this tool optimizes cross-cultural function because it 
guarantees a systematic and intentional holistic effect that 
will be conducted in each new clinical situation involving a 
culturally different client. 
   
   >> AISHA SHAMBURGER:  There are three domains to the three-
dimensional model.  These domains are not listed in any 
particular order.  They do not have to be addressed in any 
particular order.  The first one though that we will discuss 
is cultural identity. 
   This particular domain is particularly important as the U.S. 
census projects that racial and ethnic minorities will 
increase from 32 percent in 2008 to 54 percent in 2050.  As a 
result, cultural influences in the vocational rehab process 
must be addressed. 
   The adjustment to disability is also particularly important.  
The VR counselor must help the client establish where they are 
in the continuum of their adjustment to disability.  For 
example, if the client has recently experienced a point of 
trauma, more attention may be given to this particular domain 
versus someone who has experienced their disability many years 
ago. 
   Finally, the stage of development, developmentally speaking, 
disability is the ultimate nonnormative experience.  So 
understanding where an individual is with a disability 
function is very important, and again, their culture may 
indeed influence their stage of development. 
   
   >> ALLEN LEWIS:  As Aisha explained, there are three domains 
in the Three-Factor Model tool:  Cultural identity, adjustment 
to disability, and stage of development. 
   What we try to get people to do in construction of their own 
tool is to be exposed to a menu of options, basically a menu 
of conceptual or theoretical ways of thinking about each of 
those domains. 
   In the course that we deal with multicultural counseling 
here at Virginia Commonwealth University, one of the goals of 
the course is to offer a limited menu of ways of thinking 
about those three domains conceptually and theoretically. 
   I'll give you a small menu of several ways to think about 
both cultural identity, adjusting to disability and stage of 
development, so you can begin to see how the tool begins to 
take shape, because first and foremost, the tool is a 
conceptual or theory-driven application. 
   It starts with understanding what cultural identity is, what 
adjustment to disability is or what stage of development 
really is, theoretically or conceptually within each of those 
separate domains.  And then the user has to go through a 
process of understanding and making sense out of which way of 
thinking about those, each domain conceptually or 
theoretically, makes sense to he or she; so the intuitive 
matching process. 
   Let's talk about cultural identity. 
   Keep in mind these are basically just a few of the options.  
Literally there are dozens, probably 50 or 100 options of 
theoretical and conceptual frameworks that could be evaluated 
in each of these three domains.  We are going to talk about 
the few that we tend to expose to in the multicultural 
counseling course, and the idea is each student will pick a 
theoretical or conceptual framework to anchor their prompts 
and questions that will be developed for each of the domains 
of their tool. 
   Cultural identity, these are sample conceptual and 
theoretical domains or frameworks.  The first thing we talk 
about is philosophical aspects of cultural difference.  This 
is a model that was developed by Edwin Nichols out of 
Washington, D.C., where he makes the argument that world view 
is in fact a real difference as it relates to culture because 
sometimes folks doubt their differences really in world view. 
   So what Dr. Nichols does is talk about philosophical 
processes such as axiology which has value; epistemology, how 
it is we come to know things and have knowledge; he talks 
about logic, the process that is used to arrive at a 
conclusion.  He talks about methodology, the process of 
formalized inquiry and how that varies according to world 
view.  He talks about pedagogy, the process of teaching.  He 
talks about various philosophical processes.  And he talks 
about how different cultures approach those processes, and 
they approach them in different ways depending on their world 
view. 
   That is one way to begin to think about cultural identity.  
Essentially a student can have that philosophical process or 
several of those processes to undergird their conceptual 
thinking about cultural identity, and then from that questions 
or prompts or areas for exploration have to emanate out. 
   Another way of thinking about cultural identity would be 
identity development models.  The literature of course is 
replete with models that address identity development.  I 
included a few of them here as samples.  The Helms white 
racial identity model is one model.  Morten and Atkinson have 
a minority identity development model.  Cross has a black 
racial identity model, that looks at the process of 
nigrescence versus deracination, nigrescence being the process 
of becoming black, deracination the process of becoming less 
black. 
   Helms also has a model called the people of color racial 
identity model; and Cass, the homosexual identity formation 
model. 
   This is just a small sampling of identity development 
models.  It could be that in developing one's tool around the 
idea of cultural identity, that the user or developer of the 
tool will decide to anchor the exploration of cultural 
identity in one of these models. 
   One of these models can serve as the conceptual or 
theoretical underpinning for those prompts and questions that 
emanate out from that. 
   There are also several acculturation models.  I've included 
three here:  The uni-dimensional model of looking at 
acculturation, which says it is viewed on a continuum from 
one's indigenous culture to highly acculturated to a majority 
culture.  The more acculturated one is, the less one is 
focused on his or her indigenous culture.  There is a bi-
dimensional acculturation models which looks at two 
continuums.  One continuum talks about high and low commitment 
to one's own culture, and the second talks about commitment to 
the broader culture. 
   There is also a multi-dimensional model which looks like a 
star.  Each of the prongs on the star or wheel or spoke 
represents an area of functioning, and it's possible for one 
to function in the majority culture in one area of one's life, 
to function in one's indigenous culture in another area of 
life, and select many different cultures as it relates to the 
various life areas we find ourselves in. 
   What you have on this slide are just beginning potential 
theoretical frameworks, conceptual frameworks that allow you 
to then think about if any of these make sense to the user; 
intuitively in terms of cultural identity they then become the 
basis for the questions or prompts or areas of exploration 
that then derive from these frameworks to become the basis for 
the tool development process in this particular domain. 
   Let's move on now to adjustment to disability, looking at 
sample conceptual and theoretical frameworks.  There is the 
generic awareness-acceptance-adjustment-continuum that talks 
about one adjusting to a disability and going through three 
explicit phases from becoming aware of the fact that one has a 
disability and basically gaining general education and 
awareness about the aspects of a disability, and moving to the 
next phase which is acceptance of disability, where one is 
beginning to think about how one's life can begin to move on 
and get back to a point of normalization, even with 
limitations that are imposed by the disability; then 
adjustment, where there is actual activity focused on moving 
ahead to the optimal functioning level. 
   That is one way of conceptualizing adjustment to disability 
that undergird this part of one's tool.  There is something 
called a whole person model by Sharon Wegscheider-Cruse, who 
did work in the addiction world, and talks about the fact that 
adjusting to one's disability, particularly addiction-based 
disabilities, requires one to have a certain amount of balance 
in many areas of one's life in a holistic kind of way, both 
areas being one's volition, ability to make decisions, social 
function, mental function, physical functioning, spiritual 
functioning.  She talks about all of those life domains being 
in balance. 
   That is another way to think about grounding one's approach 
in looking at adjustment to disability conceptually with this 
tool in the development process. 
   You can also look at a resilience approach.  There are many 
of those out.  One of the most well-known ones by Hawkins and 
Catalano, where they look at risk factors, protective factors 
and resilience, is high to the extent that there would be more 
protective factors relative to the number of risk factors.  
You can also look at state of change.  Many of you are 
familiar with that, by Prochaska and DiClemente, looking at 
one's ability to, readiness to adjust to disability based on 
where they are in the readiness process, the readiness 
continuum the state of the change models offers us. 
   You can look at theory of change, which is a process of 
matching programmatic theory of change, all programs and all 
services have an underlying logic or underlying theory of 
change, something that articulates why it is that you would 
expect that a person who is exposed to an intervention in a 
given program or service would get better or will achieve some 
benefit.  There is some value in looking at adjustment by 
matching that theory of change process that is implicit in a 
program with individual change dynamics that a particular 
person with a disability goes through. 
   Again here we have offered you a few different ways of 
thinking about adjustment to disability, each one being a 
conceptual or theoretical framework that the potential 
developer of this tool can consider these various ways of 
thinking about adjustment, and determine which one feels more 
intuitive to how they view the world of adjustment and to how 
they want to apply the tool. 
   This is a limited menu of options.  There are probably 
several dozen out there easily that one could consider.  When 
we teach the course, we make it our business to expose folks 
to this limited menu of options, where we also encourage folks 
to look well beyond information in the frameworks in the 
conceptual approaches that we offer in the course.  So they 
can certainly have the entire literature to look for 
frameworks. 
   Moving now to stage of development as a third and final 
domain of this tool, and again looking at sample conceptual 
and theoretical frameworks, there are several here.  Many of 
you may be familiar with Urie Bronfenbrenner, who has been one 
of the leading thinkers, done a lot of similar work as it 
relates to social ecological theory and social ecological 
models. 
   We talk specifically in the course about two particular 
typologies.  Bronfenbrenner has two typologies, one that 
speaks about four levels that progress from the micro-level 
systems all the way up to macro-level systems, that speak to 
how one develops based on where they are and the relationships 
with those four levels of systems. 
   Bronfenbrenner has a second typology that is four levels, 
but instead of being macro to microsystems, he talks about 
biological to cultural context.  He is talking about context, 
different ways of conceptualizing the levels of influence in a 
person's life developmentally.  The approach would be two 
ideas or two conceptual ways of thinking about development. 
   There are many life span development frameworks out there.  
Life span development frameworks tend to offer sort of an age-
based progression of what one can expect to address in the way 
of challenges and tasks at each age break point along the way.  
Some are just for young development or youth development.  
Some are adult development, some are entire life spans where 
they move from basically cradle to grave and each age range 
there, the set of tasks that must be managed either 
successfully or not so successfully, and there are challenges 
that go with that.  Papalia and Olds offer a life span 
development process, one of many where you can look at how one 
is functioning developmentally based on where they are in 
terms of the stage of development, which is based on 
chronological age and which tasks they are grappling with at 
that point in time and how successful they are in addressing 
those tasks. 
   We are moving into traditional developmental theories with 
the psychoanalytical approach.  Both Freud and Erickson have 
theories that can be looked at.  Many of you may be familiar 
with Erickson's stage theory, very similar to a life span 
development framework, certain stages and tasks that need to 
be mastered along the way. 
   There is a mechanistic approach that deals with 
behavioralism and social learning theory.  Social learning 
theory is pervasive.  Many of you are familiar with that.  
There is the organismic approach by Piaget, where he talks 
about cognitive development and cognitive schemas and 
functional variance, processes within our brains that don't 
vary from one person to the next, and they give us a 
systematic way of dealing with the stimuli that we face in 
life. 
   There is a humanistic theory by, one of the most popular 
ones within this category of theories, would be Maslow's 
hierarchy.  There is Albert Adler's eight levels of social 
interest.  What stage of development we offer here are some 
sample, a limited menu of options, if you will, of conceptual 
and theoretical ways of grounding and anchoring one's thinking 
about stage of development.  And then from this, users will 
pick one of these or combinate several of these, put several 
together in a hybrid manner, and from that develop questions 
or prompts that emanate out from the theory, out from the 
conceptual theoretical premise to speak to what kinds of areas 
will be explored when addressing a client who is different 
culturally.
    
   >> AISHA SHAMBURGER:  There are five basic steps in creating 
the three-dimensional model.  The first one is considering 
various conceptual and theoretical frameworks for creating the 
tool. 
   Those would be the theories and frameworks that Dr. Lewis 
previously spoke about.  In particular, you want, the 
counselor wants to identify cultural identity, adjustment to 
disability and stages of development. 
   The second step is to decide which conceptual framework one 
will use.  As Dr. Lewis described, there are a myriad of 
choices, and so the counselor will want to select whichever 
theory or framework seems more intuitive to them in order to 
bring the entire tool together. 
   For example, one may want to consider a preferred counseling 
approach such as cognitive or behavioral, psychoanalytic, 
Adlerian, person-centered or Rogerian.  Whatever seems 
intuitive to the VR counselor is fine for this particular 
model; just the three particular modalities need to come 
together. 
   The third step is to think about the interactions between 
these three domains, in whatever particular cultural identity 
theory that one chooses or the adjustment to disability and 
the stage of development.  How do the three interact?  Is 
there interplay?  Is there overlap?  These are all things that 
the individual creating the tool will need to consider. 
   The next step, step 4, is to decide on a visual presentation 
for the tool.  The idea here is to use graphic attributes.  
This can be particularly helpful for those who are very 
visual.  The goal here would be to have the VR counselor use 
one sheet of paper where they have a visual that also includes 
various steps, various concepts that they want to remember 
pertaining to the model.  But it is a visual, so that they can 
easily go back to it in the interview process or while they 
are speaking with their client, and pull from their memory. 
   The fifth step is to hypothetically test or pilot the tool 
in a real life situation.  This is best if it's used with 
clients that are culturally different from the counselor.  
It's these questions that will be developed from the tool.  
They are not necessarily to be pulled directly to the client, 
so we want to prevent the client from feeling as if they are 
being judgmentally or as if a judgment is being made or as if 
they are being interrogated; but rather, the questions are 
posed as prompts for the VR counselor to learn more about 
their particular client and for the VR counselor to be mindful 
of various things that they may need to address throughout the 
client/counselor experience. 
   We are now going to go through a couple of examples of the 
Three-Factor Model. 
   You will notice that these models are, the two models that 
we are going to look at are very different from one another. 
   The first model is a very generic model.  If you can use 
your creative eye, you can see it resembles a human body.  The 
circle at the top resembles the head, if you will, and it's 
the location of cultural identity or experience as one would 
assume someone's cultural experience resides in their brain or 
in their memory. 
   The middle portion or the rectangle would represent the 
adjustment.  An adjustment to disability would involve some 
emotional component.  So that would be the torso or where the 
heart is located. 
   And the final triangle at the bottom will be the sum total 
of one's life experiences.  These are the legs to the model, 
the legs that actually take the person forward in their 
experience. 
   So, you see in this particular model, for example, that the 
VR counselor wouldn't necessarily have to remember all of 
these components, but when they sit down in front of their 
client, they can remember off of the top of their head that 
they have created a visual concept:  The head, which talks 
about cultural identity, the torso, that talks about 
adjustment to disability, and the legs which talks about stage 
of development. 
   Next we will look at a drastically different model, but 
again the concepts are still the same. 
   This model relies on the idea of a sailboat or a boat.  The 
middle section as you will see is anchored, and that is 
primarily the main portion of this particular model. 
   Awareness, knowledge of condition, acceptance, advocacy and 
adjustment to disability are the anchor in this particular 
model. 
   The individual that created this model believes that the 
anchor is where the VR counselor needs to begin their 
vocational process.  They need to understand what is it, this 
individual's adjustment to their disability. 
   From there, the VR counselor can either go to the stern or 
bow of the boat, the back or the front of the ship, and they 
can address development or diversity.  The bow and the stern, 
it's like a balancing scale.  They are equal.  They must be 
balanced out in order to keep the ship in balance, but either 
one at any particular time point can be addressed to maintain 
balance, direct the vocational process. 
   The stage of development, again, which is in the stern, 
talks about things such as one's life experiences, self-
concept, self-esteem, a sense of belonging, acceptance, 
relationship, self-actualization, or factors influenced by 
age. 
   The diversity piece or the bow considers concept such as 
race, ethnicity, gender, age, socioeconomic status, values, 
beliefs and attitudes.  Again the bow and the stern are 
balancing each other out.  As the client is going through the 
vocational process, these concepts may in fact change, as the 
individual is changing throughout the vocational process. 
   However, again, the creator of this particular model 
believes that the anchor which will primarily remain the same 
will be their adjustment to disability, and as that changes, 
then the concepts on the front or the back end of the boat in 
turn will also change. 
   This particular model is geared at, is also a generic model 
that can be used throughout the vocational process, but it is 
particularly geared at individuals that are returning to work 
after an acquired disability. 
   
   >> ALLEN LEWIS:  We are going to move now into wrap-up mode.  
We want to talk about next steps and sources for further 
reading.  Then Aisha and I will do something we hadn't planned 
to do, but we will do it anyway, which is to have a little bit 
of free-flowing dialogue at the end, so we can have a 
discussion and try to bring this three-dimensional model tool 
down to earth for folks.  One of the things we recognize is 
that this is a somewhat esoteric kind of process, or at least 
it feels that way from the outset. 
   When we expose students to developing this tool in the 
context of a multicultural counseling class which spans an 
entire semester, early on it's interesting because you can see 
the students's eyes roll over as we begin to talk about a 
conceptually theory driven tool that they have to develop 
themselves.  It is the kind of assignment that people 
typically haven't been accustomed to addressing.  It feels 
challenging at first, but this is an interview tool basically.  
You are developing this tool for your own use. 
   The idea is that if you develop it before you have to use 
it, at least you have a planned approach that theory, 
theoretically driven, that allows you to have areas that you 
have already thought about beforehand, that will then prompt 
and guide your exploration process as you are getting 
acquainted with the person that you are providing services to. 
   The extent to which you can do this systematically and 
intentionally every time is the extent to which you can almost 
guarantee you will get to know who the person is in the three 
domains of cultural identity, adjustment to disability, and 
stage of development.  That is the point of the two.  The 
heavy lifting relative to the tool development process is 
going through the activity and thinking conceptually about 
what approach is going to undergird your process of exploring 
who this person is in each of the three domains.  That is a 
hard process. 
   At the end we are going to have a little bit of a free-
flowing dialogue to bring this thing back down to earth for 
you as much as we can. 
   There are some next steps that we have in mind, in terms of 
further development of this strategy or approach or tool for 
providing culturally competent or culturally efficacious 
services.  Currently there are 300 to 500 voc rehab counselors 
in the field that developed the Three-Factor Model tool as 
part of the multicultural counseling experience at the 
university, and have been using this approach for over ten 
years, over a decade.  We have a good cohort of professionals 
out in the field who are using this approach. 
   One of the things we are going to do is to begin to talk to 
those folks about how it's going.  Thus far, the thinking 
behind this tool we think has been robust enough and solid 
enough to have withstood over a decade of graduate student 
scrutiny in the classroom.  Better than a decade, we have been 
having students who develop these tools, and for the most part 
students eventually get it and eventually develop a tool that 
they take out into clinical practice, and hopefully will be 
using these tools. 
   One of the things we are going to do is begin to contact 
these three to 500 individuals we estimate are out there who 
were trained on the tool, to begin to find out to what extent 
they are achieving success; to what extent, first of all, they 
are using the tool, and to what extent they are achieving 
success. 
   Within the next year, we have in mind to do a formal 
validation study, which is planned to tap into the counselors 
in the field who develop a tool to understand what they are 
doing relative to this tool.  We fully expect some persons 
have put it on the shelf and are not using it.  We fully 
expect some persons are using it and have gone through several 
iterations in the development process to be something that 
they could actually use.  And so we really do have in mind to 
look at contacting those individuals to see to what extent 
they are using the tool, if at all, and if they are using it, 
with what success. 
   After our Webcast today, if you have an interest in doing 
additional reading as relates to this tool, there are two 
things in print that relate to it.  There is a journal article 
in the Journal of Vocational Rehabilitation that was published 
in 2006 called Three-Factor Model of multicultural counseling 
for consumers with disabilities.  You can access that journal 
article and get the complete discussion of the tool and how to 
develop it and its uses. 
   I think we may actually have that citation and maybe even 
the article itself at the Website at Project Empowerment.  I'm 
not sure about that. 
   There is a book chapter Aisha and I did a couple years ago 
that now appears in the newest book that is on the street, 
that is called Race, Culture and Disability, Rehabilitation 
Science and Practice, by editors F. Balcazar, Y. Suarez-
Balcazar, T. Taylor-Ritzler, and Christopher Keys.  So this 
three-dimensional model for multicultural rehabilitation 
counseling appears in chapter 12.  It is a great book.  It is 
the most up-to-date, latest thinking as relates to 
rehabilitation culture and disability and science and practice  
and the three-factor approach, three-dimensional model is in 
there in a chapter.  That is another place to get further 
information. 
   Let me say a few comments.  Then I'll ask Aisha to come up 
and we will have a dialogue to clear up a few things here. 
   Keep in mind, this tool, three-dimensional model tool is 
developed by its user, which increases ownership of the tool 
and likelihood that it will be used, and hopefully maximizes, 
because it has been developed by its user, that fact maximizes 
the fact that it will be integrated to one's clinical style.  
It is probably not likely you will develop a tool to work 
cross-culturally in terms of understanding who the client is 
in those three domains that is going to be incompatible with 
your traditional typical comfortable clinical style. 
   We think if one develops the tool, it is going to 
automatically coincide and align well with one's clinical 
style.  Like most things, the three-dimensional model is not a 
panacea.  It is, however, a predeveloped systematic way to 
routinely ensure that individuals that you see in clinical 
practice, you have a good opportunity to evaluate who they are 
and understand who they are as relates to cultural identity, 
stage of development and adjustment to disability.  
   If you can get a good handle on who people are, what their 
goals are, what they are coming from in the three domains, it 
will give you one leg up and a good running start to provide 
services that will be culturally efficacious to those 
individuals. 
   Like exercise, it is less important what you do, but more 
important that you do it regularly.  Every tool is different.  
No two people will have the same tool, which is not that 
significant.  But the most important fact is that everybody 
has their own process, that systematic and intentional, that 
each clinician has developed, that will guide how they explore 
getting to know people in those three domains. 
   After today's Webcast we fully expect to have questions, and 
we hope that we do, and will be willing to try to do what we 
can to clarify things as much as possible.  
   One thing I want to go back to is in the tool development 
process, the idea of the step that Aisha spoke about in terms 
of drawing a picture of the tool, making a visual model or 
representation you can commit to memory.  We recognize that 
persons who have visual impairments, that particular step may 
not be as relevant to those individuals. 
   There is certainly an assumption on our part that when you 
think about committing this to memory and enjoying a visual 
representation of the tool so you can commit it to memory, 
that there are certain amounts of functionality there in terms 
of visual aspects.  And we recognize that not everybody that 
will be developing these tools in the way of counselors will 
necessarily have that.  We want to at least mention we are 
aware of that.  That particular step may or may not be 
meaningful, depending who you are and what your functionality 
is in terms of visual aspects. 
   With that I'm going to wrap up.  I will say a couple things.  
We will have another Webcast in September, where we are going 
to be dealing with the topic of traumatic brain injury and 
culture, and that particular Webcast will be in Spanish.  That 
will be a different experience for some of us. 
   Again, keep in mind that we are doing these Webcasts 
essentially every other month, with Project Empowerment.  If 
you have ideas and topics that you would like to see us 
address, we will certainly be happy to hear that, entertain 
those ideas. 
   And so what we are going to do right now is, we are going to 
ask Aisha to come up, and we are going to have a free-flowing 
discussion about the three-factor model tool to try to hit 
final relevant points that need to be made at this point of 
the discussion. 
   Here we are again.  As we wrap up our discussion today on 
this three-dimensional model tool, Aisha Shamburger joined me 
in front of the camera.  We are going to try to have a little 
bit of an unplanned free-flowing dialogue that we hope will 
illuminate some of the points that will help further clarify 
this tool, and let me start off by saying a couple things 
about the derivation of the tool. 
   The point of the tool really is to have students to leave 
the course and to actually have something that they have 
actually created in the way of this tool that will go beyond, 
will last them longer than their memory of what the notes were 
or what the readings were. 
   My contention is that a course like multicultural 
counseling, there is so much information that people are 
exposed, students are exposed to, it is useful if the student 
has the opportunity of developing something and having a 
culminating experience in the development of a tool, something 
concrete or tangible they can take beyond the course and 
actually begin to integrate into their professional life 
outside of graduate school.  That is the purpose of the tool. 
   If you think about it, almost any interview tool that is 
being used in clinical practice, we at least hope that it's 
conceptually grounded and theoretically based.  I think that 
is the part of creating this tool that tends to throw most 
people early on, the idea that you have got to think about a 
theory or concept or set of concepts to undergird, form the 
foundation for how you explore each of the three domains.  
Once you get that part nailed, usually it's easier to think 
about what questions or prompts or areas of exploration 
naturally flow out of those conceptual points of view, those 
underpinnings. 
   That is more of the background with this tool.  I'm going to 
ask Aisha to begin to address, if you would, Aisha, what do 
you think are some of the typical sticking points that people 
have when they are trying to initially begin to wrap their 
mind around this process of developing a tool?
    
   >> AISHA SHAMBURGER:  One of the challenges for me, when I 
originally looked at the tool and teaching it to students, 
some of the questions they tend to bring up are, how am I 
going to take all of these theories and combine it into one 
tool, that is going to be restricted to one page?
   I think the idea around that is, it doesn't necessarily have 
to be a large number of theories that they are bringing to the 
tool, but it can be concepts from those theories that really 
speak to the creator of the tool, because again, as you said a 
minute ago, we really want the individual to walk away and not 
have to remember every intricate piece of every theory, but 
something that really speaks to them, they really believe is 
germane for the vocational rehab process that they can easily 
pull from memory. 
   
   >> ALLEN LEWIS:  Yeah, that is true.  Many times what you 
have is a student who actually decides there is a theory in 
each of the three domains that really resonates with how they 
understand development, cultural identity and adjustment to 
disability, or we also encourage students if there is a single 
theory that does it for them in its entirety, we ask them to 
think about putting theories together, an eclectic or hybrid 
model where you say I like the stage of development domain, I 
like Maslow but also Erickson's stages. 
   You have flexibility, since it's your tool, as creator, to 
put those pieces together, a little of Maslow and Erickson, or 
maybe use them both, maybe you want to go to two levels of 
exploration, find out where they are functioning in terms of 
Maslow's hierarchy, what their needs are and how primary they 
are.  You want to find out where they are in terms of stage of 
development using Erickson's tool.  You have a combination 
approach, and together you have strength in those two 
frameworks in providing data for how you explore getting to 
know this person. 
   The idea is that the user has to pick the tool, has to pick 
the conceptual framework or theory that makes sense to him or 
her, because if you understand it, it's easier for you, if you 
understand theoretically what a particular concept or if you 
understand a particular theory of development or cultural 
identity or stage of adjustment says, then it's easier for you 
to take that and build out from it the kind of questions you 
want to ask base on that.  That is the whole idea. 
   We want you first to think about what makes sense to you as 
the user.  Then the second screen is to think about how you 
actually are going to use the tool.  If you are going to use 
the tool for persons who are brain injured, think about 
adjustment to disability, you may think of it one way.  But if 
you are going to use it with a person who has schizophrenia, 
the way you think about adjustment requires different 
theoretical framework.  That is where the difference in 
variation comes in how the tool plays out, both in terms of 
how the user understands these concepts intuitively in each of 
the domains, three domains, and then how the user plans to 
apply their tool. 
   Therefore, you come up with a very unique and individualized 
tool that is different for each person, but the main point is 
that it doesn't matter that my tool is different from Aisha's 
tool. The important point, the big picture is we both have our 
own process that we have created that we are wedded to, that 
integrates well within our own clinical style that we can then 
use as we see fit. 
   The point is that when you see a brand-new client, you want 
to remain flexible and meet the person where he or she is.  
Your tool becomes a visual reminder, if you will, of the three 
areas that you need to explore, adjustment, stage of 
development, and cultural identity, and some way of exploring 
them that will be both conceptually grounded and results in 
some real world practical questions that you can actually ask 
in a way that allows you to integrate them into your clinical 
style, without feeling like you are always structured or 
overly rigid in your approach.  That is the beauty of the 
tool.  Because you are creating it, you have the ability to 
modify it. 
   Aisha, what would you say is the -- people sometimes 
struggle at the outset of wrapping their minds around this.  
Tell me what you think happens ultimately after a person 
struggled with this and gets to a point where they are feeling 
like they are developing a tool. 
   
   >> AISHA SHAMBURGER:  I think that as one pulls it together, 
that initial development or that initial draft might not be 
ultimately the one that they really hold onto and ascribe to 
memory.  That is the beauty of it, is that it's a tool that 
can be tweaked. 
   The one that you make on day one does not have to be the one 
that you use two years from now.  But as you begin to work 
with different populations, as you begin to utilize the tool 
and acknowledge that maybe this is an area that I need to go 
back and redefine or refine, the individual can say, okay, now 
I can really ascribe this to memory, and I can utilize it in a 
better fashion, because I've used it in practice and I have 
found that certain aspects of it work better than others. 
   I think one of the things we also pointed out to our 
students is that research has shown that there is a 
significant lag between research and application of research 
in practice.  This tool is really great, because it allows the 
VR counselor to really take information that has been utilized 
in research and basically knowledge translation, they can 
actually take the research and apply it in their actual 
practice, and it reduces that lag of time that we are used to 
seeing between research and application.
    
   >> ALLEN LEWIS:  The other thing, in the process of 
deploying your tool in clinical practice, when you are 
actually engaged in talking to a new client, and you are 
trying to get acquainted with who this person is in terms of 
those three domains, if your tool is well-integrated to your 
clinical style, the fact that you are asking these kinds of 
questions, get at who that person is culturally in terms of 
their identity and where they are in terms of stage of 
development and what constitutes their (indecipherable) forge 
a bond and rapport between you and the person you are working 
with, because you talk about things that matter in the rehab 
process. 
   The person receiving services is feeling good about the fact 
that you are taking an interest in them.  Here you are asking 
them who they are in these three areas.  And that does speak 
to enhancing the alliance between you and that person, and the 
therapeutic bond and rapport.  And we know from the literature 
that that is the single most important ingredient to 
successful outcome. 
   Without this kind of tool, what happens is you attend 
graduate school, you have different classes, and multicultural 
counseling is one of them.  You go out and you are in the 
field, and some days it is going to be days that you are 
having a good multicultural counseling day, and you may 
remember things from your notes and readings and theories in 
the classroom.  Some days you may not, because we are all 
human.  We don't always have a great day.  But the fact you 
have a tool that you already developed gives you the ability 
to not have to rely on having that good, quote-unquote, 
multicultural counseling day. 
   You have a tool you have already front loaded in terms of 
putting the effort and preparation into developing it, and so 
it's already committed to memory because it's your tool.  You 
have created it.  It already jibes well and aligns well with 
your clinical style.  There you are.  You have a very easily 
used and deployed process to get to know the person that is 
before you. 
   The other thing is, we talk about this tool being used 
across cultural lines.  But in rehab, rehabilitation 
counseling, we take an individualized approach.  The fact is 
that anybody that you are providing services to is going to be 
different from you culturally whether they look like you or 
not. 
   This is the kind of tool that will have applications, 
benefits, even if you use it with pretty much everybody you 
work with, because the reality is that when a person comes in 
for services, whether you make the assessment in your own mind 
that person is like you culturally or not, you don't really 
know that.  Exploring who they are in terms of cultural 
identity, exploring who they are in terms of adjustment to 
disability and in stage of development will help you to not 
miss anything that is important that you need to be aware of 
as you begin to form that therapeutic alliance and put 
together the plan that will allow you to move the person to 
the point of a successful voc rehabilitation outcome. 
   Anything else, Aisha, we need to tell our viewers today? 
   
   >> AISHA SHAMBURGER:  I want to say the last point you made 
was really good.  We talk about diversity in our multicultural 
class as just that, diversity.  It can span cultural 
diversity, ethnic, gender, class, varying levels of diversity.  
And so today, we may have focused more on ethnic and racial 
minorities, but even within ethnic and racial groups there are 
subsets. 
   There is diversity even within cultures.  This tool again is 
another example to help individuals realize what those 
differences are, and not just make broad assumptions or rely 
on what they are used to in particular groups.  The client may 
very well may look like you, but may be culturally different 
in various aspects. 
   That was a good point that you pointed out. 
   >> ALLEN LEWIS:  Yeah.  Yeah.  The other thing, another 
point I want to make, is that if you look at the status of 
research, that voc rehabilitation to this point, we spend a 
lot of time, as we should have, documenting disability 
disparities, as Aisha said early on in one of her segments. 
   We haven't done yet enough research that begins to look at 
what interventions, what strategies or what solutions there 
are that can help us not just document that there is a problem 
when it comes to culture and disability, but that actually 
helps us begin to turn the corner and move to a solution or 
point of actually providing what services that are culturally 
competent or efficacious.  We believe this particular approach 
is at least one beginning point in the research dialogue 
around looking at interventions and approaches and strategies 
to begin to provide services that are more culturally 
efficacious. 
   It is not an indictment of our system or status of our 
research in this discipline.  It is just where we are 
developmentally.  We are at a point of understanding the 
phenomenon of disability and disparities in disability 
(indecipherable) research process to the point of becoming 
more solution focused that we get much more into providing 
solutions like this particular tool. 
   We think this tool is one way, one example of beginning to 
turn that corner to offer a way to begin to provide services 
that are more culturally relevant.  Of course, the tool hasn't 
been validated.  And that is part of what we said early on in 
terms of the next steps.  We plan to put effort into trying to 
put together theories of studies that will begin to get at to 
what extent people actually are using the tools in the real 
world of voc rehabilitation, and to what extent they feel like 
those tools are actually helping them to achieve success in 
working with persons in terms of producing culturally relevant 
outcomes. 
   Anything else we need to say, Aisha, at this point? 
   
   >> AISHA SHAMBURGER:  That's all.  We want to thank you for 
taking the time to view the Webcast today.  We encourage you 
to continue to stay abreast of the events that are going on in 
the Project Empowerment Website.  It is www.VCU-
projectempowerment.org.  We look forward to having you at our 
next Webcast in September. 
   >> ALLEN LEWIS:  Thanks for joining us.  Have a good day. 
   (End of Webcast at 1:55 p.m. CST)
   

	


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