Substance use counsellors' understanding and incorporation of ethnocultural diversity factors: An interpretive description

The objective of this study was to explore how counsellors understand and incorporate ethno-cultural (EC) diversity factors in alcohol and drug (A&D) counselling, in order to glean practical information that may contribute to culturally competent and safe practices. Qualitative interviews within an Interpretive Description (Thorne, 2008) approach were conducted with 23 A&D counsellors, 4 of whom reported serving as both counsellors and supervisors. As per design, additional information rich sources were sought that included interviews with 4 participants identifying as other professionals affiliated with A&D services (program managers, directors and consultants). All participants were affiliated with the Lower Mainland, British Columbia, health authorities. Interviews were analyzed using Miles and Hubermans’ (1994) framework. Counsellors demonstrated varying levels of awareness and positions towards EC differences with conversations ranging from overemphasis on similarities to consideration of EC factors as an ethical and integral part of practice. Participants’ view of “addiction” also seemed to inform how they spoke about the relevance of EC factors in therapy. An integrated approach to A&D care revealed multiple levels of analysis and consideration of clients’ socio-cultural contexts. The addiction as a disease model, however, constructed A&D problems as universal and EC factors as secondary. The A&D organizational context included a discussion of strengths and barriers to provision of services to diverse clients. Perspectives that constructed EC differences as secondary seemed to be accompanied with limited self-reflection and examples of application into practice. On the other hand, reflexive practices embedded within social justice elements pointed to counsellors articulating specific examples of integrating EC factors in therapy. Relevant ethical dimensions as well as implications for practice, theory and research were identified.