Associations between Multicultural Counseling Self-Efficacy, Culturally Responsive Practices, and Professional Quality of Life Among Clinicians Working with Bipoc and LGBTQ+ Youth

Background & Purpose: BIPOC (black, indigenous, and people of color) and LGBTQ+ (e.g., lesbian, gay, bisexual, transgender, queer) youth experience disproportionate challenges with their mental health compared to their white and straight peers. It is paramount that behavioral healthcare providers be educated on best practices for working with these youth to optimize their health outcomes. Greater cultural consciousness and multicultural counseling self-efficacy among clinicians have shown to be predictors of positive client outcomes. Separately, clinicians’ professional quality of life (ProQOL) has also been linked to better client outcomes. However, little is known about the relationship between clinicians’ multicultural counseling self-efficacy, culturally competent behaviors, and ProQOL. Understanding the relationships between these constructs has important implications for clinician and client well-being.

Methods: Data were collected from a larger project evaluating an training program among social work, psychology, and nursing students on culturally responsive practices. Eligible participants were enrolled in a practicum setting working with BIPOC/LGBTQ+ youth. Participants (N=113) were on average 30 years old (SD=9.23), majority female (n=88; 78%), white (n=86; 76%), and non-latine (n=103; 91%). At baseline, graduation (1-year later), and 9-months post-graduation, students completed the following measures: Anti-Racism Behavioral Inventory [ARBI], the Self-Reflection & Insight Scale [SRIS], the Intercultural Effectiveness Scale [IES], the Multicultural Counseling Self-Efficacy Scale [MCSE], and the Professional Quality of Life Scale (i.e., compassion satisfaction, burnout, secondary trauma). Bivariate associations examined associations between student demographic characteristics, multicultural counseling self-efficacy, cultural competencies, and ProQOL. Mediation models examined indirect effects of clinicians’ cultural competencies on the association between multicultural counseling self-efficacy and ProQOL. Models were run separately for each subscale of ProQOL.

Results: Higher levels of multicultural counseling self-efficacy were significantly associated with higher levels of intercultural sensitivity (b=.07; p<.001) and self-reflection and insight (b=.07; p=.036), but not anti-racist behaviors. Higher levels of anti-racism (b=.22; p=.001) and higher levels of self-reflection and insight (b=.13; p=.009), but not intercultural sensitivity, were significantly associated with greater compassion satisfaction. Self-reflection and insight had a significant indirect effect on the relationship between multicultural counseling self-efficacy and compassion satisfaction, F(5, 82)=2.52, p=036). Lower levels of multicultural counseling self-efficacy (b=-.03; p=.031), anti-racism (b=-.12; p=.043), and lower levels of self-reflection and insight (b=-.10; p=.022) were significantly associated with higher levels of burnout. Self-reflection and insight also had a significant indirect effect on the relationship between multicultural counseling self-efficacy and burnout, F(4, 82)=3.10, p=013). The mediation models examining secondary traumatic stress were not statistically significant.

Conclusions & Implications: Results confirmed our hypotheses that clinicians’ cultural competencies were associated with greater ProQOL and self-reflection and insight mediated the association between multi-cultural counseling self-efficacy and ProQOL, but no other mediation pathways were observed. Findings suggest the importance of multicultural counseling self-efficacy in facilitating culturally responsive care practices, as well as promoting clinicians’ ProQOL. The development of trainings to bolster multicultural counseling self-efficacy among clinicians is warranted to support clinicians’ well-being and reduce mental health disparities for BIPOC and LGBTQ+ youth. Future research should evaluate the effectiveness of these trainings among more diverse populations and within broader contexts.