Domain VI: Implement and Evaluate Culturally Responsive and Socially Just Change Processes

CC17 Mesolevel Change

Engage in culturally responsive and socially just change processes at the mesolevel (i.e., schools, organizations, and communities) in collaboration with, or on behalf of, clients.

Recommended Reading

Collins, S. (2018). Culturally responsive and socially just change processes:
Implementing and evaluating micro, meso, and macrolevel interventions. In S. Collins (Ed.), Embracing cultural responsivity and social justice: Re-shaping professional identity in counselling psychology (pp. 726–748). Counselling Concepts. https://counsellingconcepts.ca/

From a CRSJ counselling perspective, many client problems require systems level change processes. Core competency 17 of the CRSJ counselling model (Collins, 2018) positions change at the mesolevel as targeting intervention in schools, organizations, communities, and other relatively small systems in which clients participate. The feminist and multicultural movements encouraged an expansion of the boundaries of change processes to the contexts of clients’ lives (Singh & Moss, 2016). Learners often struggle to move beyond recognition of the social determinants of health and the impact of systemic oppression to engage in mesolevel change processes. The table below provides examples of mesolevel interventions designed to support change within the immediate contexts of clients’ lives; some of these change processes are mirrored in other competency models (Lewis et al., 2003; Ratts et al., 2015, 2016). At the mesolevel, learners require new skills to both collaborate with, and to act on behalf of, clients to identify, advocate for, and implement change.

CRSJ Counselling Key Concepts

The activities in this chapter are designed to support competency development related to the key concepts listed below. Click on the concepts in the table and you will be taken to the related activities, exercises, learning resources, or discussion prompts.

Advocacy

Acting on behalf of clients (Self-study)

Review the Advocacy Competencies of the American Counselling Association (Lewis et al., 2002), paying particular attention to the model at the beginning of the article. Focusing on the bottom half of the cube (acting on behalf), consider the following client scenario:

Claude is a first nations man with early onset Alzheimer’s. He has been living with extended family on a reserve near a large urban centre. His primary caregiver is his mother. However, she has become ill herself, and Claude’s needs for supervised care have increased substantively. There are insufficient resources on the reserve to support his continued care, and other members of the extended family don’t have the time, space, or energy to take his care on full-time. There are no facilities in the urban centre that have specific Aboriginal health foci or resources. The family, 4‒5 members at a time, have visited three of facilities and experienced a very cool reception from the staff, particularly in response to questions about space for the family to meet and opportunities for them to practice their own cultural healing rituals with Claude. They have noticed that these rituals seem to ground him and bring him peace.

Identify two specific examples of advocacy for Claude and/or his family that would fit in each of the three cells: (a) client advocacy, (b) systems advocacy, and (c) social/political advocacy. Review the relevant sections of the article for ideas. Identify both what you believe needs to change and the locus of change or intervention.

[Permanent link: https://crsjguide.pressbooks.com/chapter/cc17/#acting]

Effecting change in the contexts of clients’ lives (Partner activity)

In some cases, systems-change might mean collaborating with our clients to advocate for change or engaging in systems-change processes directly on behalf of our clients. Advocacy involves direct action to alter the status quo by facilitating change processes targeting the systems that negatively impact client well-being.

With your partner, imagine a short client scenario or a theme(s) that could emerge across work with a number of clients (e.g., barriers to job application for people who are unhoused, lack of childcare services for new immigrant mom seeking counselling services). Be explicit about the connections between their presenting concerns and the broader contexts or systems that impact their lived experiences. Advocacy may initially fall outside of your comfort zone. However, you don’t need to aim for major systems level change; there are many opportunities for advocacy within organizations or other groups in which you regularly participate. Be creative in considering the many ways to advocate with, or on behalf of, clients in our day-to-day practices as counsellors.

Based on your scenario or client theme(s), map out a plan for either advocating with, or on behalf, of your client(s) to effect change, providing rationale for your choice. The advocacy process below builds upon the Advocacy Competencies of the American Counselling Association (Lewis et al., 2002). You may modify this process; these are not intended as fixed or comprehensive steps.

  1. Identify the social, political, economic, and cultural factors that pose barriers to the well-being of individuals and vulnerable groups.
  2. Evaluate the appropriateness, ethical implications, and process of allying with clients to advocate for change.
  3. Develop a working alliance with potential allies for change in the contexts or systems impacting client lived experiences.
  4. Identify challenges, opportunities, and preferred outcomes.
  5. Identify the target of change (typically mesolevel—schools, organizations, communities)
  6. Engage in constructive collaboration to develop achievable and well-defined goals, along with a vision to guide change.
  7. Analyze the sources of power and the influencers within the system (both barriers and facilitators).
  8. Negotiate relevant services and resources with or on behalf on behalf of clients.
  9. Develop and implement change processes to reduce barriers and promote social justice (e.g., cultural awareness, interprofessional collaboration, organizational policy change, health promotion).
  10. Engage in constructive collaboration to foster buy-in to change.
  11. Evaluate outcomes and plan for sustainability.

Reflect together on what it might be like to implement this plan. Consider what you might need, personally and professionally, as supports for your engagement in advocacy work.

[Permanent link: https://crsjguide.pressbooks.com/chapter/cc17/#effectingchange]

Allyship/Solidarity

Our responsibility to act as allies (Self-study)

Take a moment to watch this short video on allyship in workplaces, extrapolating the key principles that you might apply allyship in the professional practices of counselling and psychology. Allyship involves taking direct action to promote equity and social justice while intentionally standing alongside persons or peoples experiencing those inequities in educational systems, work environments, and healthcare services.

© Lean In (2021, November 13)

The second video below attends to the importance of recognizing and activating your positional power and relative privilege. We all hold positional power to varying degrees and this power shifts across contexts depending on our cultural identities, relationalities, and social locations. Take a moment to reflect on the contexts in which you hold positional power. Consider ways in which you might engage in allyship in the personal and professional contexts of your life, attending to possibilities at the individual, interpersonal, and structural levels.

© Lean In (2021, November 13)

These videos describe initial steps towards allyship and solidarity in workplaces. As noted in the video, there are risks in using positions of relative power and privilege and those risks are only mitigated by deep commitment to acting in solidarity with the persons and peoples on whose behalf you act as an ally. As counsellors and other healthcare practitioners grapple with the realities of systemic oppression in society, the meaning of allyship and solidarity deepens.

One person deeply committed to these principles is Dr. Vikki Reynolds. You may want to check out the Solidarity Talks on her website through which she highlights the work of colleagues engaged in activitism, resistance, and justice-doing in response to systemic and structural oppression.

[Permanent link: https://crsjguide.pressbooks.com/chapter/cc17/#allyshipresponsibility]

Community Engagement

Building community engagement (Partner activity)

Community engagement involves working together with affected communities to foster positive change in a spirit of respect, reciprocity, and transparency. Community engagement forms an important foundation for working effectively within and with communities to enhance healthcare services, address social determinants of health, and support culture-centred community care. There are various models of community engagement, each drawing on some combination of the following principles.There are five concentric circles in this image, labelled as consultation, collaboration, involvement, empowerment, and information sharing.

Spend a few minutes individually exploring various models of community engagement on the Internet, making note of how the various elements of the diagram above are described. You may need to translate the information you find into the context of counselling and other healthcare initiatives.

Then together, draw on what you have learned from the CRSJ counselling model, your Internet search of community engagement models, and your own experience working with, and living in, various communities to fill in descriptors on the Community Engagement model (MS Word version). Consider how you  might apply this model to challenges faced by marginalized communities in particular.

[Permanent link: https://crsjguide.pressbooks.com/chapter/cc17/#buildingcommunity]

Consultation

Meeting the needs of underserviced populations through CRSJ consultation (Self-study)

One of the ways that counsellors can increase their influence on the contexts of clients’ lives is by engaging in consultation with individuals, groups, organizations, or communities to enhance quality of service delivery to particular groups of clients or client populations. Consultation is an effective means for  (a) reducing barriers to services and resources and (b) fostering culturally responsive and socially just service delivery. The distinguishing feature of consultation is that the counsellor has no direct control over the outcomes of the systems-change process.

Identify a population within your local community for which there appear to be inadequate or underutilized counselling services. Consultation may occur in both casual and spontaneous ways (as illustrated in the example below) and more substantive and formalized ways. Then consider how you might support change through a consultation process. You may modify this process; these are not intended as fixed or comprehensive steps. The consultees are the service providers.

  1. Build a working alliance with consultee(s) to support constructive collaboration.
  2. Ally with community members (clients) to invite their voices, perspectives, and directions.
  3. Ally with consultee(s) to assess the needs of individual clients or client populations they serve.
  4. Apply a contextualized/systemic lens to identify challenges, opportunities, and preferred outcomes.
  5. Co-construct achievable and well-defined goals.
  6. Collaborate to identify specific change targets and processes in line with those goals (e.g., cultural auditing, policy change, training, problem solving, conflict resolution, organizational development, change management).
  7. Collaboratively support the consultee(s) in implementation of the change process(es). 
  8. Evaluate the outcomes for the consultee(s) and client(s) and plan for sustainability.

[Permanent link: https://crsjguide.pressbooks.com/chapter/cc17/#underserviced]

References

Collins, S. (2018). Embracing cultural responsivity and social justice: Re-shaping professional identity in counselling psychology. Counselling Concepts. https://counsellingconcepts.ca/

Lewis, J., Arnold, M. S., House, R., & Toropek, R. L. (2002). American Counseling Association advocacy competencies. Alexandria, VA: Advocacy Task Force, American Counseling Association. http://www.counseling.org/Resources/Competencies/Advocacy_Competencies.pdf

Ratts, M. J., Singh, A. A., Nassar-McMillan, S., Butler, S. K., & McCullough, J. R. (2015). Multicultural and social justice competencies. Association for Multicultural Counseling and Development, Division of American Counselling Association. http://www.counseling.org/docs/default-source/competencies/multicultural-and-social-justice-counseling-competencies.pdf?sfvrsn=14

Ratts, M. J., Singh, A. A., Nassar-McMillan, S., Butler, S. K., & McCullough, J. R. (2016). Multicultural and social justice counseling competencies: Guidelines for the counseling profession. Journal of Multicultural Counseling & Development, 44(1), 28-48. https://doi.org/10.1002/jmcd.12035

Singh, A. A., & Moss, L. (2016). Using relational-cultural theory in LGBTQQ counseling: Addressing heterosexism and enhancing relational competencies. Journal of Counseling and Development, 94(4), 398-404. https://doi.org/10.1002/jcad.12098

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