Instructor's Manual for the
Society of Indian Psychologist's Commentary on the American Psychological Association's
(APA) Ethical Principles of Psychologists and Code of Conduct
Introduction
The SIP Commentary on the American Psychological Association's (APA) Ethical
Principles of Psychologists and Code of Conduct (hereafter, the Commentary) represents the
culmination of a 2-year collaboration between representatives of the APA Ethics Committee and
Ethics Office and the Society of Indian Psychologists (SIP). SIP members had had many
discussions about the ways in which the APA Ethical Principles of Psychologists and Code of
Conduct (2010) (hereafter, the Ethics Code) creates challenges for psychologists trying to
practice ethically in Indigenous communities. These concerns resulted in an invitation to APA to
attend SIP's annual meeting in 2011. This meeting marked the beginning of a collaboration that
continues to the time of this writing.
One of the most significant outcomes of this collaboration grew out of the 2013 SIP
meeting in Logan, Utah. Everyone in attendance at that meeting was invited to contribute stories
from their experience with the APA Ethics Code. This Commentary is an assemblage of these
stories and comments from SIP members relating the stories to specific ethical standards.
Graduate students in courses on professional ethics will benefit from the opportunity to
reflect on the APA Ethics Code from the diverse individual and collective experiences of Native
psychologists. The following Instructor's Manual provides teachers of psychology graduate
courses in professional ethics with suggestions for enhancing their coverage of multicultural
issues in the context of ethics with emphasis on the incorporation of issues affecting indigenous
professionals, clients, supervisees, research participants, and students.
SIP Commentary Instructor’s Manual
Values Statement (pp. 13-15)
Overview
The APA Ethics Code does not include a corresponding "values statement," but the
Commentary provides an overview of the values imbedded in the Commentary. These values are
considered "shared" values common to Indigenous people of the Americas and Hawaii. These
values reflect a holistic and inter-relational view of health. Further, healing is considered
transpersonal: it extends beyond the physical person to the environment and society of which
they are a part. More specifically, these values include:
1. All things are considered sacred and have spirit.
2. Life and development are understood in terms of cycles.
3. Everything is connected (people, land, and past, present, and future events).
4. Life events are considered lessons.
5. Respect and honoring are essential to relationships.
6. Social, historical, and political contexts shape the lives, experiences, and perceptions
of Indigenous people and are therefore emphasized in healing.
7. Balance and harmony strengthen resiliency.
8. Collaboration is valued over competition.
9. Sustainability is essential for survival, and the impact of one's actions is considered
relevant. Consideration of the 7th generation yet to come exemplifies this value.
10. Mystery, awe, wonder, intuition, and miracles occur in everyday life.
11. Understanding of one's identity and place comes through consideration of past,
present, and future within one's community.
12. Consideration of the "Whole" is paramount.
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Classroom Activities and Discussion Questions
Organize small groups to discuss one or more of the 12 values described in the "Values
Statement." Each group could also select their top three most important values and compare, then
open a discussion about how and why their selection is important.
Invite students to consider:
How do you understand the relationship between values and ethics?
How are your own values, assumptions, and beliefs reflected in or different from those
values?
Identify one of your own personal values or assumptions that comes from your cultural
background. How might this value affect your ethical understanding and approach to
clinical work, research, or teaching?
Consider a time when you believe that you have experienced "harm" in an educational or
professional setting as the result of the abuse of power by someone in authority. How was
your personal or professional development affected? What have you learned from this
experience and how will this experience inform your work when you are in a position of
power?
Consider a time when you may have abused your power to the detriment of another
person, or consider how you might inadvertently do so when you are in a position of
authority or power in the future.
What fail-safe mechanisms can you develop to guard against such errors?
How can "cultural humility" help you develop strategies or actions that you could employ
to minimize the likelihood that you might abuse your power? Identify and describe some
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of these strategies. ***WE MIGHT NEED TO MOVE THIS ONE SINCE IT IS NOT
EXPLICITLY ONE OF THE VALUES.******
Consider the concept of "cultural relevance." How does this inform you understanding of
professional ethics?
Assignments
Reflect on and write about any of the above-listed questions.
Interview a psychologist whose cultural background differs from your own. Identify three
professional values espoused by that individual that reflect his or her culture. Contrast
them with your own values, and write about how your work with someone from that
culture might be influenced by what you have learned.
Create a list of movies or books people have heard of that are about Natives or have
Indigenous underpinnings.
Watch a film or read a piece of fiction by a Native or Indigenous author and featuring
characters from that individual's tribe or culture. (Examples include: Powwow Highway,
Smoke Signals, Winter in the Blood.) Consider how the values discussed in the
Commentary are reflected in the story and characters.
General Principles
Overview
The APA Ethical Principles include five principles that establish the profession's highest ethical
ideals. They are considered aspirational, that is, psychologists are encouraged to strive to reach
these ideals in their work. The five Principles are listed and followed by related comments and
stories of SIP members.
Class Activities and Discussion Topics
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Principle E Respect for People’s Rights and Dignity
Members of the Society of Indian Psychologists believes that Principle E should be the first
principle because the other four are subsumed within this Principle. Principle E must come
before the others can be learned.
How might the inclusion of "cultural relevance" and "humility" in the APA Ethical
Principles affect the practice of psychology?
What important concepts would be added to the Ethical Principles by the addition of
these two principles?
Participants of the Commentary overwhelmingly recommended that Principle E be listed
as the first Principle because, conceptually, this Principle undergirds all of the others.
Discuss your response to this recommendation.
Review the six comments and seven stories. Reflect on your own experiences as a
student, researcher, research participant, client, psychotherapist/clinician, or teacher.
Discuss some of your own experiences in terms of their similarity and differences from
those of the authors.
Principle A Beneficence and Nonmaleficence
Psychologists strive to ensure that their work is beneficial to those they serve, and to strive to
avoid harm.
What is your view of the aspirational goal to "do no harm?"
How does this apply to working with Native communities?
How does this apply to other communities?
Reflect on your own experiences and discuss the ways in which they mirror those
presented in the comments and stories in this section.
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Principle B: Fidelity and Responsibility
Psychologists strive to be trustworthy and to ensure that their decisions are guided by the best
interests of those with whom they work.
One comment regarding Principle B suggests that other professionals should include
"healers or medicine people, spiritual leaders, and elders." How do you understand the
role of these individuals within Native communities? What type of practitioner would
you consider “Professionals”.
In addition to your responsibilities to those individuals with whom you work, what are
your responsibilities to the communities in which they live?
Identify one way that you as a student researcher, educator, or clinician can be sure to
incorporate an understanding of the connection between mind, body, and the environment
into your work.
Principle C: Integrity
Psychologists promote honesty in and accuracy in all areas of psychology including science,
teaching, and practice.
How might the concepts of "accuracy, honesty, and truthfulness" be interpreted
differently in various cultures?
How can you monitor your actions to be sure that you are honest, truthful, and have
integrity?
What does it mean to say: “Accuracy, honesty, and truthfulness in teaching and practice
are culturally influenced by the “standard” or “scientific” view?” (Henrigh, Heine,
Norenzayan, 2010, as cited in The Commentary, p. 20)
Principle D: Justice
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Psychologists recognize that all persons are entitled to equal access to the contributions of
psychology, and they work to ensure that their biases and limitations of their competencies do
not lead to unjust practices.
What do you believe manuscript reviewers must understand in order to competently
review submissions by Native psychologists?
Should manuscripts related to Native communities be evaluated by at least one Native
reviewer?
What would you do if you were asked to review a paper for inclusion into your journal or
newsletter and you knew nothing about the topic or population?
If manuscript reviewers generally lack cultural competence, what effect will this have on
the building of knowledge in the profession of psychology?
The author of the second story in this section describes an experience as a supervisee
during a doctoral internship. What is your reaction to hearing about this individual's
experience?
With the benefit of this story, how would you have handled a similar situation if you had
been the supervisor?
If consulted in this case, how would you advise the supervisor? How does your own
cultural background influence your response?
Cultural Relevance (pp. 22-24)
How do you view the doctor's response to this individual's request regarding his surgery?
How did you feel reading this story? Did this change your thinking in any way?
How did the principle of cultural relevance inform the two professionals described in
these two stories?
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Ethical Standards
Standard 1: Resolving Ethical Issues
Standard 1 provides direction for psychologists encountering ethical issues. It addresses conflicts
between the Ethics Code and law, regulations, and organizational demands. Psychologists are
also instructed about how to informally resolve complaints, report and respond to complaints,
refrain from filing improper complaints, and avoiding unfair discrimination against complainants
and respondents. The Commentary includes remarks and stories focused on three of the eight
sections.
1.02 Conflict between Ethics and Law, Regulations, or Other Governing Legal Authority
Give an example of a Western European value or practice that may conflict with some of
the Native values and traditions described.
How might such a conflict affect the employment of a Native psychologist in a work
setting that adheres to the APA Ethics Code?
1.03 Conflicts between Ethics and Organizational Demands
One of the authors writes that treatment models that do not focus on "relationship"
require Native psychologists to choose between following their own cultural values and
risking their employment. Describe the conflict as you understand it, and consider how
you might navigate this dilemma, applying the directives in the APA Ethics Code.
1.05 Reporting Ethical Violations
What is your view of non-Native psychologists incorporating Native spiritual practices
into their therapeutic approaches?
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Do you believe that such practice is ethically permissible? Is this necessary with Native
clients?
Is there anything in the APA Ethics Code that provides guidance for Native or non-
Native psychologists who are considering the incorporation of Native spiritual practices
into their work with clients?
Standard 2: Competence
Standard 2 Competence requires that psychologists obtain the initial and ongoing education,
training, supervision, and consultation needed to ensure the competence of the services they
provide. Providing services in emergency situations, in circumstances in which no other
psychologist is available, and in emerging areas practice, psychologists are required to transfer
services to a qualified psychologist following emergencies, or seek the necessary training. An
understanding of particular factors is considered essential for competent practices (e.g., age,
gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation,
disability, language, or socioeconomic status).
Discussion Questions:
What themes do you detect in the comments and stories related to Standard 2?
One of the comments challenges the requirement that APA format be used in
psychological writing. Do you believe that using this format for writing is a basis for
competence as a psychologist? [IS APA FORMAT RELEVANT TO THIS
STANDARD?]***I am not sure we need this question.
How does this requirement relate to or agree with competent practice?
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What are the potential effects of requiring APA format on Native students and consumers
of psychological publications?
One of the requirements of Standard 2 is that psychologists base their work on
"established scientific and professional knowledge of the discipline" (APA, 2010, p. 5).
Describe the limitations of psychologists' reliance on research conducted with "WEIRD"
populations when working with Native populations. Question:is there a definition of
WEIRD in this section?????? If not perhaps just spell it out?
Standard 3: Human Relations
Standard 3 requires psychologists to treat those with whom they have professional relationships
(e.g., clients, students, research participants, supervisees, colleagues) fairly and professionally.
Specifically, this Standard includes prohibitions against unfair discrimination, sexual and other
harassment, harmful multiple relationships, and exploitative relationships. Further, psychologists
are instructed to avoid conflicts of interest, obtain the informed consent of consumers of
psychological services, cooperate with other professionals, and make provisions for clients in the
event of an interruption of services.
Discussion Questions
Describe your reaction to the first story (p. 42) about the comments of the NIH official to
young Native scientists regarding the research standards.
If you are Native, how might hearing this comment from an official have affected your
work as a researcher?
If you are not Native, imagine the potential impact of such a comment on a young Native
scientist. What might that be like?
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What is your understanding of the concept of "implicit bias?"
One author states that, "Microaggressions destroy cultural safety" (p. 45). Describe at
least one example of a microaggression that you have witnessed or experienced. What
was the impact on you and what do you imagine was the impact on others?
Reflecting on your own behavior, give an example of something you did or said that may
have been experienced as a microaggression by someone else. What have you learned
from that experience, and how has that learning affected your subsequent behavior?
An author described the common practice of "start-up negotiations" for junior faculty as
"culturally selfish" (p. 46). How do you see Native faculty being disadvantaged by the
system used for hiring negotiations and preparations for seeking tenure and promotions in
academia?
The author of the first story under 3.05 (p. 47) describes the experience of a Native
psychologist being respected by community members and then being approached for
advice in social situations. How do you understand the ethical challenges inherent in such
situations? What should be considered in decisions about how to navigate these requests?
How do you think Native Americans' history with the United States government affect
clients or research participants who are being asked to sign an informed consent? What
could psychologists do to address the concerns that may arise?
Standard 4: Privacy and Confidentiality
Standard 4 addresses the importance of privacy in the provision of psychological services.
Related issues include maintaining confidentiality, communicating the limits to confidentiality to
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consumers, and occasions for disclosure of confidential information without the consent of the
individuals.
Discussion Questions
The stories contained in this section of the Commentary describe circumstances in which
confidentiality was breached by a psychologist working with a Native client or
supervisee.
Describe the ways in which client confidentiality might be inadvertently breached by a
psychologist working in a Native community.
Discuss strategies that psychologists could use to obtain needed consultation about their
work with Native clients while protecting the privacy of those they serve.
What safeguards should researchers employ to protect the privacy of research participants
in small communities?
What are some ways that might commonly be seen as a breach of the
practitioner/researcher protection of confidentiality but might be allowed in a Native
Community?
Standard 5: Advertising and Other Public Statements
Psychologists are required to make accurate statements to consumers of their services and to the
public about their professional activities. This standard specifically prohibits psychologists from
making false statements about their training, degrees, credentials, affiliations, fees, publications,
and research findings. Further, the Ethics Code requires psychologists to accurately describe
their training and educational programs, and to base their advice to the public on appropriate
literature and practice. Clients must not engage in uninvited in-person solicitation of business
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and must not solicit testimonial from current clients or those vulnerable to the influence of the
psychologist.
Discussion Questions
What are some examples of misrepresentation by psychologists working in Native
communities?
What are the ethical issues inherent in non-Native psychologists offering traditional
Native ceremony to the public (e.g., sweat lodge, vision quest)?
One author refers to the Barrow Alcohol Study. What are the ethical issues that arose in
this study? What additional requirements regarding public statements might obviate the
harm that resulted from the dissemination of the results of this study? [GAYLE - I'M
NOT ENTIRELY SURE THAT THE CONCERNS ABOUT THE BARROW STUDY
ARE RELATED TO THIS PARTICULAR STANDARD. STILL, IT SEEMS
IMPORTANT TO HIGHLIGHT. YOUR THOUGHTS?] The researchers did not use
tools of measurement appropriate for the community and then made public
pronouncements to the public in both public news and journal that harmed the
community. Furthermore there was no community input with respect to the outcomes. It
was a big mess and included numerous and serious ethical violations.
How can psychologists obtain "community consent" before making public statements to
the media? Should they? Why?
Reflect on your own cultural background and your experiences in graduate school. How
do you feel about the multicultural training that you have or are receiving? Incorporating
the perspectives in the Commentary, what modifications would you suggest?
Standard 6: Record Keeping and Fees
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Standard 6 addresses requirements for the documentation of psychological services as well as
related issues such as confidentiality, maintenance, and transfer of records. Psychologists are
further required to establish a clear agreement about compensation and billing, accurately
represent their fees, and establish policies consistent with the law. Fee collections, bartering, and
referrals are also discussed.
Discussion Questions
One of the authors refers to the Havasupai DNA case. What are the ethical issues
involved in this case, and how does this Standard 6 apply?
Do you think that the APA Ethics Code adequately addresses the issues underlying the
Havasupai case?
Standard 6.04 addresses the ethics of bartering for services. How does this Standard
apply in Native communities?
What are the primary ethical issues a psychologist should consider when deciding
whether a bartering arrangement is potentially harmful or exploitative for a given client?
In what ways might these be the same or different in Native communities?
What is your response to the story of Sarco the goat? How would you have advised the
psychologist considering this arrangement?
What other Ethical Standards inform your thinking about this section?
Standard 7: Education and Training
Standard 7 addresses the ethical issues for those responsible for the education and training of
psychology graduate students. Programs must be designed to meet licensure and certification
requirements and described accurately. Requirements for course syllabi, policies regarding
student disclosure of personal information, and mandatory therapeutic experiences, and
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performance evaluation are described. Sexual relationships with students and supervisees are
prohibited.
Discussion Questions
One of the authors commented that, for most graduate programs, "Diversity is a box to
check." Describe three of the ways in which offering a "diversity course" may be
inadequate to prepare students to competently serve Native communities.
One author stated the following opinion: "I believe that it is unethical for a training
program to recruit ethnic minority students if they do not have ethic minority faculty" (p.
63). What are some of the risks to ethnic minority students if this is the case in their
graduate programs?
How can psychology instructors teach students about various cultures and cultivate
cultural competence without reinforcing stereotypes?
According to one of the stories (p. 64), of the 20 students recruited for a graduate
program in marriage and family therapy, only four graduated. What are some of the
factors that may have contributed to this rate of attrition? What steps could be taken to
improve this statistic?
How did you feel as you read about the experiences of Native psychology graduate
students?
What recommendations would you make to graduate faculty trying to create a program
that would address the difficulties facing Native students in these programs?
If you could develop an inclusive graduate program, what elements/classes/training
would you think are most important to be welcoming for ALL students?
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How would you recommend addressing the apparent lack of cultural competence
reflected in stories of program faculty?
Standard 8: Research and Publication
This Standard describes ethical requirements for designing, conducting, and reporting research.
The components of obtaining informed consent are listed, and ethical requirements related to
recruiting participants, use of deception, debriefing, and research with animals are described. The
Standard further describes the ethical dimensions of publishing research including publication
credit, data sharing, and confidentiality for reviewers.
Discussion Questions
Describe the role of cultural competence in psychological research design, execution, and
reporting.
How does the history of research with Native communities contribute to the current
challenges?
Psychological theories and practices are informed by research, much of which has been
conducted with majority culture individuals with European heritage. Consequently,
conclusions may not be relevant for Native and other ethnic minority individuals who
seek psychological services. How would you recommend this problem be addressed in
light of the harm that has been caused by research with Native communities?
The Commentary includes a table of differences between European and Indigenous
approaches to research. Examine the components Ethics Standard 8 and identify the ways
in which the values and characteristics are reflected.
The APA Ethics Code requires that psychologists make their data available to other
researchers who may want to replicate their study. One story (p. 75) requires that data be
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destroyed within a specified period of time. How might a psychologist reconcile these
conflicting requirements?
How should psychologists meet their obligation to maintain and share data for
verification purposes and agree that the tribe(s) involved own the data collected about
their communities?
Assignment:
Give examples of historical events that have contributed to the mistrust of psychology researcher
by Native communities. Research one of these notorious examples, and evaluate the behavior of
the researchers in light of relevant APA Ethics Codes.
Standard 9: Assessment
Standard 9 addresses psychological assessment and requires psychologists to ensure that they
establish an adequate basis for their assessments; use valid and reliable instruments which are
appropriate for their purposes; and obtain informed consent. Test data are to be released with
appropriate authorization, and the security of test materials is to be protected. Psychologists are
required to rely on current scientific and professional knowledge in test construction, scoring,
and interpretation.
Discussion Questions
9.02 The author of the first story (pp. 82-83) offers a solution to the problem that he/she
observed in using the projective assessment the Thematic Apperception Test (TAT) with
Navajo children. What do you understand to be the problem with the use of the TAT with
this population?
How do you think the proposed solution addresses the issue?
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How does this solution go along with or agree with the APA Ethics Codes? Identify
applicable sections.
Discus three obstacles to obtaining informed consent, as required by the APA Ethics
Code, of Native clients.
Discuss the potential advantages and disadvantages of using language interpreters with
Native clients.
9.05 What is your understanding of the recommendation regarding the use of “non-verbal
spirit-moved exchanges” (p. 84) in an assessment process?
What is your understanding of the distinction between an individual and community view
in the context of psychological assessment?
How would you assess, and then take into consideration a client’s level of acculturation
in determining the validity of a particular psychological assessment? (p. 84)
Standard 10: Therapy
Standard 10 includes requirements for psychologists conducting psychotherapy. It specifies
requirements for obtaining informed consent to therapy with individuals and couples, explaining
limitations to confidentiality with group members, and clarifying the nature of the psychologist’s
role relative to clients. Sexual intimacies with clients, former clients (within two years of the
discontinuation of the therapy relationship), and their significant others are prohibited, as is
accepting former sexual partners as therapy clients. Sexual contact with former clients following
the 2-year interval are prohibited except in unusual circumstances. Psychologists are also
required to make provisions for client/patient care in the event they cannot continue to provide
services. Psychologists are permitted to discontinue providing services if they are endangered by
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the client. Finally, psychologists are directed to “terminate” therapy when the client no longer
needs the services, is not benefitting, or is being harmed. Pre-termination counseling and the
provision of referral alternatives are required, if appropriate.
Discussion Questions
Informed consent typically includes some type of self-disclosure (e.g., the psychologist’s
credentials). According to the Commentary, more self-disclosure will be necessary in
order for clients to develop trust in the psychologist. Discuss how the APA Ethics Code
facilitates or impedes this type of informed consent.
Standard 10.01 discusses “obtaining informed consent for treatment for which generally
recognized techniques and procedures have not been established” (APA, p. 13). By
whom are these techniques to have been recognized? (p. 89-90) What are the implications
for Native psychologists who want to employ “traditionally based treatments?” (p. 90)
How would you respond to a Native client’s request to participate in a traditional healing
ceremony? In light of your own cultural heritage, what are some factors you would
consider in making the decision?
The first story presented in 10.01(c) (p. 90) describes an ethical dilemma for a Native
graduate student whose work is being overseen by a non-Native supervisor. What broader
ethical principles should be considered in thinking about this dilemma?
How did you feel reading the story (10.02, p. 90) in which the author describes an
intervention with a couple facing marital problems?
Choose one of the stories involving couples or family therapy (10.02, p. 90-91), and
highlight the salient ethical challenges and themes you have observed. Identify conflicts
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between the directives of the APA Ethics Code and common practice in Native
communities.
The APA Ethics Code uses the word “termination” to describe the discontinuation of
psychological services. What is your understanding of the difficulties associated with the
use of this term?
(Students could also be invited to examine the APA Multicultural Guidelines and identify
applicable sections related to the Commentary.)
Continuing Education or Exam Questions
(Such questions could make this useful for CE courses or graduate courses.)
1. Describe and discuss five shared values of Indigenous people as described in the
Commentary. Contrast these values with values or assumptions that are fundamental to
American psychology.
2. Identify three major concerns related to competency of psychologists providing services
to Native clients.
3. Give your opinion about each of the following and cite information from the
Commentary.
4. Native psychology graduate students and practicing psychologists do not need to obtain
training in multicultural counseling.
5. European-American psychologists should generally refrain from providing services to
Native clients.
6. Based on your reading of the Commentary, give some examples of steps that European
American/majority culture psychologists should take to develop and maintain the
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competence necessary to offer psychological services to Native clients.
7. Distinguish cultural awareness and cultural competence.
8. If you identify as Native, identify three stories or comments that particularly resonated
with your experiences, and discuss their applicability.
9. Describe something about your personal or professional experiences of Native cultures.
How are these experiences reflected in the Commentary?
10. What were you taught about Native cultures and Native people as you were growing up?
What were the sources of the ideas and beliefs you developed? What have you learned
reading the Commentary that has challenged or supported those beliefs?
11. Identify three recommendations would you make to a group of majority-culture faculty
members who wanted to make their psychology graduate program more culturally
hospitable to Native students. What in the commentary informs your thinking about these
recommendations?
12. What self-assessment strategies should be employed by psychology graduate programs to
help them identify deficits relative to cultural diversity in their curriculum, policies, and
practices.
13. Which of the following statements accurately reflects the themes in the stories and
perspectives included in the Commentary?
14. Majority culture psychologists should not provide psychological services to Native
clients.
15. A primary objective of any research conducted with Native participants should be the
benefit to the community.
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16. Native cultures throughout the United States are very similar in their values, beliefs, and
cultural traditions.
17. Membership in one tribe provides the expertise needed to work with Native clients in any
other tribe.
18. Faculty members should avoid turning to Native students to speak on behalf of all Native
people during class discussions.
19. Admission to graduate programs and academic and professional promotions and
recognition in majority culture psychology often requires individuals to describe their
achievements in glowing terms. What are some disadvantages of this approach to
individuals whose cultures discourage or condemn such behavior as bragging?
20. Discuss the practices described by a graduate instructor for teaching a doctoral course
(3.03, p. 44). As a student in that class, how would your experience be affected by these
strategies?
21. Standard 3.04 discusses "avoiding harm." How does this concept apply to psychologists
working with Native clients, research participants, and students?
References and Resources
Winter in the Blood
Smoke Signals
Rez Life
Sherman Alexie
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