Multicultural counseling competence and client outcome

The purpose of this study was to investigate the relationship between multicultural counseling competence and client outcome. Though the importance of multicultural competence is widely heralded in counseling psychology, a link has not yet been made between multicultural competence, as it is currently understood and measured, and quality of care. This study was an attempt to demonstrate that link, as well as to validate the California Brief Multicultural Competence Scale (CBMCS) by showing that scores on that scale relate positively to improved service to clients. In order to achieve these tasks, client outcome was examined by using information collected at the University of Utah Counseling Center (UCC): Specifically, client scores on the Outcome Questionnaire-45 (OQ-45), a measure of client distress and functioning. Therapists who scored higher on the CBMCS were predicted to see larger reductions of their clients' OQ-45 scores. Hierarchical linear modeling was used to examine the relationship between therapists' multicultural competence and client outcomes. This study found significant relationships between multicultural competence and client outcome. The nature of the relationships, however, was unexpected: The aspect of multicultural competence termed Awareness of Cultural Barriers was positively related to client outcome, whereas the aspect termed Multicultural Knowledge was negatively related to client outcome. This result demonstrates the first link between multicultural counseling competence and quality of care. The positive relationship between Awareness of Cultural Barriers and outcome suggests that at least some forms of multicultural competence indeed play a role in delivering effective counseling to clients. On the other hand, the negative relationship between Multicultural Knowledge and outcome points to a need to revisit assumptions about multicultural counseling competence as it is currently theorized and measured.