Development of the Multicultural Therapy Competency Inventory-Client Version

Abstract

This study reports the development of a thirty-two item instrument to assess clients’ perceptions of their therapists’ multicultural competence that can be used in couple, family and individual therapy. This instrument was developed through three phases: item generation and theme development, client feedback and evaluation of interrater reliability, and pilot and validity testing. We used Winsteps (Linacre in Winsteps Computer Program Version 3.21. MESA Press, Chicago, 2001) software to scale the measurement data to the Rasch Rating Scale Model, and evaluate the dimensionality, rating scale use, item fit, person fit, reliability and precision. We also created norms to interpret the measure. Preliminary data support the reliability and validity of the Multicultural Therapy Competency Inventory-Client Version (MTCI-CV). Additionally, we found that positive client perceptions of therapist cultural competence (on the MTCI-CV) significantly contribute to the probability of clients expressing satisfaction and goal attainment in therapy.

Appendices

Appendix 1: Item Development Matrix

Category themes	Indicator categories
	Attitudes and beliefs	Skills	Knowledge
Counselor awareness of own cultural values and biases	My therapist values both his/her own perspective as well as my/my family’s perspective	My therapist is open about her/his values	My therapist is aware of how discrimination and oppression can affect relationships
Counselor awareness of client’s worldview	My therapist has an accepting attitude towards my/my family’s personal values and beliefs	My therapist acknowledges the perspective of each person in therapy	My therapist appears to have some knowledge about my culture and background
Culturally appropriate intervention strategies	My therapist shows respect for my/my family’s ideas and behaviors in therapy	My therapist provides suggestions that fit my/my family’s context (i.e.: race, class, gender, culture, sexual orientation, etc.)	My therapist appears to be knowledgeable about several different approaches to helping me/my family
Respectful curiosity	My therapist takes a curious attitude towards learning about me/my family	My therapist asks me/my family to tell him/her about my/our expectations for care	X
Naiveté	My therapist is interested in my/my family’s expertise on my/our life	My therapist is receptive (through body language and communication) to the differences between us	X
Multicultural counseling relationship	My therapist focuses on building a relationship with my family and me in a culturally appropriate manner	My therapist uses relationship-building skills, such as listening, attending, and paraphrasing	My therapist knows basic principles that are helpful in my life/family relationships

Appendix 2: The Multicultural Therapy Competency Inventory-Client Version

Multicultural Therapy Competency Inventory

Please check the box under the description that most accurately describes your perception of a therapist with whom you have met. Please note that the statements are written as if they are occurring now, but you may also fill this out for a therapist you are no longer seeing.

		Does this very well	Does this adequately	Does this poorly
1	My therapist uses relationship-building skills, such as listening and attending	□	□	□
2	My therapist appropriately applies his/her own values in therapy	□	□	□
3	My therapist has a positive and warm attitude	□	□	□
4	My therapist values his/her own perspective	□	□	□
5	My therapist knows about the customs of his/her culture, accepted behaviors, and general values	□	□	□
6	My therapist accepts my/my family’s values and beliefs	□	□	□
7	My therapist asks me/my family to tell him/her about my/our unique expectations for care	□	□	□
8	My therapist encourages me/my family to share my/our point of view	□	□	□
9	My therapist cares about building relationships with people	□	□	□
10	My therapist knows about several different ways of helping people	□	□	□
11	My therapist cares about helping me/my family in appropriate ways	□	□	□
12	My therapist appears to have some knowledge about my/my family’s culture and background	□	□	□
13	My therapist is able to explain things in a way that demonstrates familiarity with my/my family’s ethnicity/culture	□	□	□
14	My therapist appears to understand that therapy needs to fit me/my family (i.e.: race, class, gender, culture, sexual orientation, religion, etc.)	□	□	□
15	My therapist shows openness to my/my family’s perspective	□	□	□
16	My therapist desires to know me as an individual with unique experiences	□	□	□
17	My therapist is able to see things from my perspective without judgment	□	□	□
18	My therapist provides the opportunity to discuss his/her values related to family, culture, religion, etc. when they are relevant to therapy	□	□	□
19	My therapist displays a genuine interest to learn about me/my family	□	□	□
20	My therapist is open to my/my family’s expertise on my/our life	□	□	□
21	My therapist acknowledges my/my family’s values and beliefs	□	□	□
22	My therapist is open to my/my family’s uniqueness	□	□	□
23	My therapist is open (through body language and communication) to the differences between us	□	□	□
24	My therapist provides suggestions that fit my/my family’s context (i.e.: race, class, gender, culture, sexual orientation, religion, etc.)	□	□	□
25	My therapist is knowledgeable about how my/my family’s background may affect my/our availability of resources	□	□	□
26	My therapist values my/my family’s ideas, behaviors, and feelings in therapy	□	□	□
27	My therapist knows about how his/her biases can affect me/my family	□	□	□
28	My therapist is familiar with how culture, religion, and gender can shape me/my family	□	□	□
29	My therapist respects his/her cultural heritage as well as valuing differences	□	□	□
30	My therapist connects well with people in socially appropriate ways (e.g., eye contact, touch, greetings)	□	□	□
31	My therapist knows basic principles that are helpful in relationships	□	□	□
32	My therapist believes it is important to look beyond stereotypes to uncover what fits for me/my family	□	□	□