The HIV/AIDS Pandemic (excerpt from a working paper)

According to the UNAIDS data (2006), Southern Africa is the world region most affected by HIV/AIDS, and that is where most of the children living with HIV live. Other high infection regions are in the Caribbean, Latin America, and South/Southeast Asia. South Africa, where I have direct experience, has the 6^th highest prevalence in the world; almost 20% of its citizens are estimated to be infected, and new infections are increasing with no sign of reaching a natural limit. However, the disease is not equally distributed among South African society: Black Africans have the highest prevalence (18.4%) compared to other racial groups (whites-6%; coloured-7%; indians-2%).

Indeed, while anyone can get the virus under the right conditions, HIV/AIDS is not an egalitarian disease; even in affluent countries the groups most at risk for contracting the virus have shifted to the poor, and particularly the female poor. Like the history of Tuberculosis, which today can only be found in impoverished and abandoned communities in the poorest regions of the world (or the poorest sections of western cities), global economic inequities insure that HIV/AIDS is selective of its victims; it is most virulent among the poor in the poorest nations and there is evidence that the highest rates of infection now occur in women (Farmer, 2001; Walker, 2007). The highest death rates occur among employable adults, decimating the income-generating members of communities, leading to lower tax income to support community infrastructures, such as education and the now over utilized health services.

This cycle of AIDS and poverty has meant that South Africa has dropped dramatically over the course of the last five year on the scale of economic development, creating greater numbers of poor and people vulnerable to the virus and without adequate services.

In South Africa, the afflicted in the early years were predominantly heterosexual men who, due to Apartheid’s system of separate homelands for Black South African employable men, who were forced to become migrants in order to earn a living for white mines and factories in large cities. Far from their rural village homes and their wives, these men caught and spread the virus through their exchanges with sex-workers, who also had migrated to cities for money to survive. By 2003, the HIV/AIDS epidemiology showed a gender switch: women came to make up two-thirds of Africans infected with HIV (Hunter, 2003). South African women also came to have a higher prevalence than men; 18% compared to 13%, and that gender infection gap is thought to be widening. Women, like children, are more vulnerable than adult men because they have no power or rights in their communities.

However, global statistics remind us that, even in our own country, it is poverty that makes misogyny so toxic [UN on Women].

The high occurrence of HIV in southern African women has meant that, due to vertical infection, rates of HIV in children have also risen. About 90% of infected children get virus from their mothers during pregnancy, birth, and/or breast milk. Without antiretroviral treatment (HAART): (a) 1 in 3 infected newborns will die before age one, (b) over ½ die before reaching their 2^nd birthday, and (c) most are dead before 5 years. In Zimbabwe and Botswana child mortality rates have doubled since 1990. Tragically, only 15% of the 780,000 children living with HIV in these regions were receiving treatment at the end of 2006; every hour, 40 children die due to AIDS.

As the greatest number of infections and deaths are adults ages 20-35, the physical, emotional and cognitive impacts of HIV/AIDS on infants and children has reached a tragic scale; more and more poor households are headed by grandmothers and children who have, respectively, lost their children and parents to AIDS-related diseases. In addition to suffering the stresses of multiple losses, upheaval of their family systems, inadequate care from ill-prepared or frail caregivers, and removal from their homes, infants have been infected with the virus by their HIV+ mothers. Before ART, infection was an early death sentence for a child; with treatment, these children still face the stresses above, and many will grow up in institutional settings.

US-AID (Smart, 2003) was the first to use the term “Orphaned and Vulnerable Children” to recognize the burden HIV/AIDS has laid upon the world’s children. Linda Richter and colleagues of South Africa’s Human Sciences Research Center (HSCR) report that “it has been argued, particularly where children are concerned, HIV/AIDS needs to be treated as a broad developmental concern rather than as a narrow health or even public health issue” (Richter, Manegold & Pather, 2004, p. 4).

HIV/AIDS has torn apart South African family structures more effectively than Apartheid’s homeland and migrant worker systems. Here is a partial list of the impact of the virus on South African families (Richter, Manegold & Pather, 2004, p. 5):

1. The emergence of child- or adolescent-headed households

2. An increase in elderly caregivers, and children caring for old people;

3. Increases in household dependency ratios;

4. Separation of siblings

5. Family breakdown

6. Child abandonment

7. Remarriage”

AIDS has also impacted communities by producing declines in skilled and professional services, strains on health care and educational service delivery, and extreme stress on small communities who must absorb the children of the dead and dying into their care (Richter, Manegold & Pather, 2004, p. 6). HIV/AIDS is ravaging sub-Saharan societies, especially by diminishing health, welfare & education systems due to the extreme volume of needs due to the epidemic, loss of people to staff these institutions due to AIDS-related illness & death, and reduced tax-base because of the illness & death of employable persons (Richter, Manegold & Pather, 2004, p. 5).

The next set of influences on the impact of AIDS in South Africa will leave us in no doubt of its complex web of psychological, social, physical forces and needs. This set consists of the influences of gender, age, and household location (Richter, Manegold and Pather, 2004, p. 7-8):

1. Gender

a. Education for boys valued more highly (they are considered to be potentially more economically productive), so girls are often the ones to leave school or work to care for the sick or younger children;

b. Female-headed households are poorer than those headed by men;

c. Female-headed households tend to allocate more of the family’s resources to children’s healthcare and education than male heads;

2. Age

a. Infants and toddlers are most vulnerable to effects of AIDS and health risks;

b. Preschoolers are vulnerable to malnourishment, abuse and neglect, poor stimulation, and lack of opportunities for schooling;

c. Adolescents are vulnerable to school drop-out, sexual exploitation, and overwork;

d. All children are vulnerable to the emotional consequences of multiple losses, including parents, and to being separated from their homes and communities.

3. Location of household

a. Rural households are typically poorer and have fewer employed adults than urban households;

b. Children are expected to contribute substantially to subsistence activities

c. Social networks in informal urban areas are less developed and less supportive;

d. Caregivers often leave their children alone because of their “livelihood activities.”

As they are on the global stage, South African HIV positive children’s mental health and cognitive developmental needs have historically been neglected in the child development research and in most intervention programs. South Africa is not the only developing country lacking national psychoeducational data. Most child development research and programming has been done with U.S. and European samples, and few psychologists in western nations have concerned themselves with internationalizing their theories and studies, particularly in those parts of the globe with the greatest needs for help and understanding. In the international and national responses to the HIV/AIDS pandemic in southern Africa, “psychological” has, until recently, been considered a less important or less acute problem than HIV/AIDS affected children’s nutrition and shelter, as if, Linda Richter (2003) suggests, their “need for food and shelter is greater than their need to feel loved by others and to respect themselves” (p. 245). The 2007 HIV and AIDS and STI Strategic Plan for South Africa, 2007-2011, makes no mention of insuring that children’s conditions actively contribute to rather than undermine their emotional and social development, and by extension their academic achievement and potential to contribute to South African society. This oversight confirms the relative neglect of orphans’ and vulnerable children’s mental health and its influence on achievement by funders and policy makers, at least in South Africa, in spite of this country’s impressive budget allocations to social support systems when compared to other nations. National policies that support multifaceted treatments in the services of children’s development are crucial components of meeting the first and second UN Millennium Development Goals: (a) eradication of extreme poverty and hunger, and (b) insuring that all children complete primary schooling.

As the preceding suggests, we know a fair amount about the risks and stressful conditions that occur under conditions of chronic poverty and HIV/AIDS; however, there are as yet only a few studies on the psychological effects of HIV/AIDS and poverty on South Africa’s (and other severely affected nations’) children, including their cognitive functions, academic achievement, and mental health (Cluver, 2007; Richter, 2003; Walker, 2007). For example, studies on the mental health of AIDS orphans are not only few in number but incapable being interpreted across studies; the variabilities of procedures, measures and samples used makes it impossible to come to firm conclusions. There are strong suggestions, however, that conditions of poverty lead to higher levels of psychological problems in AIDS African orphaned children, such as internalizing problems (hence depression and anxiety), symptoms of post-traumatic stress, behavioral problems, and delinquency (Cluver & Gardner, 2007; Cluver, Gardner & Operario, 2007). However, more research on the mechanics of increased mental health problems in these children is needed in order to better understand the factors in their lives “which are acting as stressors or buffers in mental health outcomes” in order to inform options for therapeutic intervention” (Cluver & Gardner, 2007, p.9).

A 2003 round-table on mental health consequences of the pandemic, compiled by South Africa’s Human Sciences Research Council includes a list of people projected to be likely to experience mental health problems due to AIDS by 2015: people uncertain about their HIV status, people living with the infection, families and caregivers of people with HIV/AIDS, children and adolescents orphaned by AIDS, people caring for AIDS orphans, and those who fit into more than one of the previous categories (Social Aspects of HIV/AIDS and Health Research Programme, 2003, p. 40).

International and national studies are unanimous on calling for internationally accepted measures and indicators for child development for planning, monitoring, and assessment (Cluver & Gardner, 2007; Engle, et al., 2007; Irwin, Siddiqi, & Hertzman, 2007; Social Aspects of HIV/AID and Health Research Programme, 2003). “Very few of the programs that try to intervene for children, families and communities have been monitors systematically and none have been rigorously evaluated (experimentally). This has meant an over-reliance on local knowledge to the detriment of building a knowledge base on “the real impacts of AIDS” and “what the responses should be in any given context” (Richter, Manegold & Pather, 2004, p. 7).

Transcultural Education for Clinical Psychologists, Part #3

Postcolonial Theories

“I think postcolonial scholarship provides a theoretical and historical focus to multiculturalism that makes it attractive to scholars who want to escape the narcissism of mere identity scholarship” Spivak in Hegda & Shome, 2002, p. 271.

“The theoretical base of postcolonial studies also allows for multiplicity to be thought of in a way that is different from just simply the Rainbow Coalition. Within the context of globalization, to be postcolonial seems more appropriate than to be merely metropolitan multicultural. It is a way of dealing with globalization which is after all a fairly recent phenomenon. In order to give globalization historical depth you must move it to postcoloniality” Spivak in Hegda & Shome, 2002, p. 271-272.

Gayatri Chakravorty Spivak’s quotes speak to two of the reasons underlying my proposal for incorporating Postcolonial Theory in a social justice curriculum: (a) the limits of liberal identity politics, and (b) the need to attend to cultural oppression everywhere, particularly now when the politics and economics of globalization are impacting everyone. There are two other reasons, (c) learning from the oppressed, and (d) attending to the psychology of oppression, voiced by Homi Bhabha:

1. "it is from those who have suffered the sentence of history—subjugation, domination, diaspora, displacement—that we learn our most enduring lessons for living and thinking" (p. 172).
   
2. "the affective experience of social marginality—as it emerges in non-canonical cultural forms—transforms our critical strategies. It forces us to . . .engage with culture as an uneven, incomplete production of meaning and value, often composed of incommensurable demands and practices, produced in the act of social survival" (p. 172).

While there is no single uniting definition of what is meant by Postcolonial studies, Homi Bhabha’s elegant introduction captures those elements most relevant to my purpose in this paper:

"Postcolonial criticism bears witness to the unequal and uneven forces of cultural representation involved in the contest for political and social authority within the modern world. Postcolonial perspectives emerge from the colonial testimony of Third World countries and the discourses of ‘minorities’ within the geopolitical divisions of East and West, North and South. . .[their aim is to] intervene in those ideological discourses of modernity that attempt to give a hegemonic ‘normality’ to the uneven development and the differential, often disadvantaged, histories of nations, races, communities, peoples. They formulate their critical revisions around issues of cultural difference, social authority, and political discrimination in order to reveal the antagonistic and ambivalent moments within the ‘rationalizations’ of modernity . . .The postcolonial project, at the most general theoretical level, seeks to explore those social pathologies ‘loss of meaning, conditions of anomie’--that no longer simply ‘luster around class antagonism, [but] break up into widely scattered historical contingencies."

The controversial writings of Fanon, Said, Spivak and Bhabha have decentered European intellectual hegemony in Europe through their criticism of white, patriarchal eurocentrism (Young, 2001). Said extended Foucault’s critique of western epistemic disciplinary power exercised by academic institutions to Orientalism, arguing that European studies of the Middle East had the effect of securing and maintaining western hegemony over the Arabs and Islam (Sharpe, 2005). Gayatri Chakravorty Spivak has revealed imperialism’s “epistemic violence” perpetrated upon colonized women.

Homi Bhabha carried on Said’s poststructural critique incorporating the ‘psychopolitics’ of Antillean Franz Fanon, whose writings demonstrate the unprecedented challenge to understanding unleashed by colonial racism and violence, and convinced one “that the colonial moment of epistemic, cultural, psychical and physical violence makes for a unique kind of historical trauma” (Hook, 2005). Bhabha observed the failure of ideological and discursive approaches “to account for the persistence of racism, its pronounced irrationality, its compulsive qualities, the visceral quality of its hatred, its continuous, seemingly repetitive nature” (Hook, p. 487). Derek Hook suggests that Fanon’s and Bhabha’s application of a psychoanalytic lens to understanding “the vicissitudes of colonial power and its resistances” reflects the hope that these analyses would result in opportunities to intervene “within the life of power” (Hook, 2005, p. 481).

There is a reserved hope that destabilizing the Western canon through resistance could lead to new ways of being that no longer are dependent upon, through accommodation or opposition, imperialist hegemony. For example, Robert Young considers the emergence of postcolonial studies to be “an historical moment of new tricontinental forms of critical analysis and practice” (2001, p.XX) that could lead to the end of western hegemony.

Lyn Carter in Australia, one of the few educators I have found to apply postcolonial theory to diversity issues in teaching (Carter, 2004; 2005), attributes postcolonial theory the means to:

"construct more complex conceptualizations of cultural difference as hybridized and fluid, always in the making, and recast culturally diverse students’ homogenized identities into multiple, mobile, and provisional constructions, more accurately attune to conditions of living and learning under the indeterminacy of the transforming global world” (Carter, 2004, p. 833).

Carter (2005) appreciates in postcolonial criticism what she perceives to exceed western epistemologies, and the practice of double consciousness as “thinking about how thinking intersects with the disciplinary categories themselves” (p. 917).

The postcolonial attitude implicitly calls for immersing oneself in the world of the other. The critical imperative of postcolonial critique, which is addressed by those of the tricontinents to us in the West, is to suspend one’s hegemonic assumptions and disciplinary methodologies and, in true dialogic presence, open oneself to the other from a position of not-knowing. For example, Obioma Nnaemeka asserts that,

"imperialists and colonists never learn from the colonized: they teach them. They do not ask questions; they manufacture answers in search of questions. Border crossing has its dangers, its seduction, its unpredictability, its humbling moments, but it also has its enriching rewards. Border crossing entails learning about the ‘other,’ but more importantly, it should entail learning from the other. Learning about is a gesture that is often tinged with arrogance and an air of superiority; learning from requires a high dose of humility tinged with civility. Learning about often produces arrogant interrogators; learning from requires humble listeners" (2003, p. 374).

From her experiences as an African feminist, Nnaemeka argues for a postcolonial critique that critique lead to the “clearing” of a dialogic third space between borders, where theory and practice, planning and action coexist. She explains:

"Theorizing in a cross-cultural context is fraught with intellectual, political, and ethical questions: the question of provenance (where is the theory coming from?); the question of subjectivity (who authorizes?); the question of positionality (which specific locations and standing [social, political, and intellectual] does it legitimize?). The imperial nature of theory formation must be interrogated to allow for a democratic process that will create room for the intervention, legitimization, and validation of theories formulated ‘elsewhere.’ In other words, theory making should not permanently be a unidirectional enterprise---always emanating from a specific location and applicable to every location---in effect allowing a localized construct to impose a universal validity and application. I argue instead for the possibilities, desirability, and pertinence of a space clearing that allows a multiplicity of different but related frameworks from different locations to touch, intersect, and feed off each other in a way that accommodates different realities and histories" (Nnaemeka, 2003, pp. 362-363).

Nnaemeka’s words point me to the importance of service learning requirements for multicultural education for social justice and a better world. Humbleness and service, combined with openness and not-knowing are the ontological components of a professional’s integration of a heartfelt engagement in social justice work.

Conclusion

I have tried in this essay to articulate a vision of a multicultural education that fosters the commitment to social justice, nourishes the interest in theory, challenges the comfort zones of unconscious hegemony, insists upon informed action, and embodies dialogic reflexivity. I welcome your comments and suggestions.

Transcultural Education for Clinical Psychologists, Part #2

Curriculum: The Linguistic Turn

The position from which my proposed multicultural curriculum emerges is located in the ideas generated since the “linguistic turn” in the humanities and certain branches within the social sciences, including psychology. For the sake of brevity, I will quote Stuart Hall’s definition. The linguistic turn is,

"[a conviction of ] the crucial importance of language and of the linguistic metaphor to any study of culture; the expansion of the notion of text and textuality, both as a source of meaning, and as that which escapes and postpones meaning; the recognition of the heterogeneity, of the multiplicity, of meanings, of the struggle to close arbitrarily the infinite semiosis beyond meaning; the acknowledgement of textuality and cultural power, of representation itself, as a site of power and regulation; of the symbolic as a source of identity" (Stuart Hall, as cited in Chrisman, 2003, pp. 148-149).

In the following section, I will introduce two interrelated, interdisciplinary, humanities disciplines, Culture Studies and Postcolonial Theories, both of which are legacies of the linguistic turn and could provide conceptual frameworks for multicultural education.

Culture Studies

Culture can be conceptualized as a way of life made up of the relationships between all its elements (Golby & Purdue, 1999), or more discursively as “the constant process of producing meanings of and from our social experience, and such meanings necessarily produce a social identity for the people involved” (Fiske, 2000, p. 1). Culture studies seem most interested in understanding how culture is made; how it shapes and is shaped by people various locations and historical settings, its contradictions and its systems of power relations.

Three foci may characterize a critique based on contemporary culture studies. First, it would address the junctures of language, meaning, and power in the construction of cultural meanings and in material practices (Barker & Galasinski, 2001; di Leonardo & Lancaster, 1997). That is, culture studies are in the tradition of poststructuralist thought, which conceives of discourse as the structure through which we perceive reality and views social realities as “organized by signs and meanings patterns in relations of identity and difference” (Seidman, 1997, p. 67). Institutions and social practices are produced by and founded within discursive formations, and are the basis upon which knowledge, values, and norms are justified (Edgar & Sedgwick, 2002). Discourses can and do have hegemonic (repressive) functions. Hegemony, as conceived by Gramsci (2000), is the regulation of social relations by the dominant class through forms of culture. Morag Shiach clarifies:

Gramsci offers us another explanation of the nature of dominant culture. It can be understood as the site of hegemonic representations: those which ‘foster forms of consciousness which accept a position of subordination’. It is also, therefore, a sphere that must be won over by any social group aspiring to social leadership: struggles over definition of culture can thus be seen as struggles for intellectual, moral and philosophical hegemony.” (Schiach 17)

Similarly, sociologist Pierre Bourdieu’s (1984) analysis of the unequal distribution of “cultural capital” (the collection of accepted and esteemed cultural resources) reveals how social hierarchies are reinforced and reproduced in cultural forms. He argues, far from being a neutral expression, cultural consumption is the “means by which [distinctions and differences in social classes] are produced, maintained and reproduced” (Storey, 1999, p. 44). Michel Foucault understands discourse as both “an instrument and effect of power” (Foucault, 1978, pp. 100-101), no matter what one’s social standing is, individuals are both subjects of and subject to discourses. Foucault’s understanding of power as relational rather than material extends the reach of a critique of dominant discourses to resistant “reverse” discourses, the structural necessities of dominant discourses.

Second, a culture theorist is likely to focus in on specific events, intimate relationships, and experiences in relation to their historical contexts, including “changes in production, consumption, technology, and law that set the stage for everyday life” (di Leonardo & Lancaster, 1997) as influenced by Foucault’s geneology of subjectification, which

"focuses directly on the practices that locate human beings in particular ‘regimes of the person’. It does not write a continuous history of the self, but rather accounts for the diversity of languages of ‘personhood’ that have taken shape . . . and the norms, techniques, and relations of authority within which these have circulated in legal, domestic, industrial, and other practices for acting upon the conduct of such persons."

Third, a culture studies critique would incorporate a focus on the co-production of popular culture by consumers, because ideological implications in cultural discourse do not translate automatically into ideological effects. The Italian Marxist, Gramsci (Forgacs, 2000) wrote that, in order for hegemonic forms to be taken in by the subordinated, they had to be chosen, not passively interpolated. Michel Foucault’s theory of power has particular relevance for exploring the boundary phenomenon of popular culture consumption (Foucault, 1978). He conceptualizes power as relations that are immanent in all interrelationships, non-binary and rooted in “local oppositions” and differences (p. 94), “intentional and nonsubjective” (p. 94), and as always co-generative with resistance.

The approach explores the webs of power in both the producers of official and mass discourses and the consumers. Resistance to the oppressive psychological and material effects of the dominant culture for the unprivileged begins with education as critique, as with Friere (2000), including that the persistence of hegemonic power in discourse relies upon everyone’s complicity, and discourse’s multisemic characteristics provides openings for resistance through deconstruction. The culture studies view of the audience has direct relevance for how those of us in the West objectify and erase the Other; we underestimate their powers of resistance because we assume the superiority of our epistemology. The assumed radical potency of Culture Studies lies in the power attributed to making meaning or, to use Foucault’s words, discovering and applying the power of reverse discourses.

Transcultural Education for Clinical Psychologists, Part #1

I will now propose a transcultural expansion to diversity training in which I hope to integrate the critical dialogism of Paulo Friere (2000) and Ignacio Martín-Baró (1994), with the more recent ideas appearing under the label of "postcolonial".

Pedagogy

This section on pedagogy is curriculum-wide proposal. It is crucial that liberation pedagogy not be marginally located only in certain courses, typically those concerned with minorities, such as a required diversity course, but rather should be both the norm in the majority of courses and linked to the establishment of public community dialogue events. Boyle-Baise and Gillette (1998) urge us to prioritize pedagogy in multicultural education, which would include providing “an intellectually safe, respectful place for learning, a place to share personal knowledge, agree to disagree, experiment with new ideas, and wrestle with contested issues…(p. 23). They suggest that educators involve themselves in “encouraging student-generation of knowledge, creating democratic teaching and learning communities, pursuing cultural critique, and fostering activism that makes a difference” (Boye-Baise & Gillette, 1998, p. 23).

In order to address issues of social justice, training in multicultural diversity must be grounded in processes of conscientization. Ignacio Martín-Baró said, “the task of the psychologist must be to achieve the de-alienation of groups and persons by helping them attain a critical understanding of themselves and their reality” (p. 39), and “can only be realized through dialogue” (p. 42). His proposal for a liberation psychology included three elements: (a) focus on serving the needs of the poor rather than on preserving the status of the discipline, (b) view knowledge as something that is created by thinking with the oppressed rather than for them, and (c) recognize that knowledge is informed by taking action in real life for social change, through “a new praxis” (Martín-Baró, 1994, pp.27-28). He warned:

"Thus, to acquire new psychological knowledge it is not enough to place ourselves in the perspective of the people; it is necessary to involve ourselves in a new praxis, an activity of transforming reality that will let us know about what is but also what is not, and by which we may try to orient ourselves toward what ought to be" (Martín-Baró, 1994, pp.28-29).

Conscientization refers to a process of developing critical awareness of contradictions in one’s economic, political and social world, which is followed by action to undue oppressive social structures. Conscientization’s most distinctive feature is its critical attention “to how power and meaning are employed in the construction and organization of knowledge, desires, values, and identities” (Giroux, 1992, p. 52). To my mind, a commitment to conscientization in the training of clinical psychologists for social justice would mean that each learning context (classroom, supervision, advising, collaboration) would involve the co-examinination of power and meaning, as suggested by Giroux, in combination with creative engagement in envisioning and enacting alternatives, however local.

In order to facilitate Paulo Freire’s process of conscientization, there would be instructor-supported dialogic opportunities for engaging students in uncovering and reducing those power differences in their own learning situation (Freire, 2000). Faculty would bear the responsibility of creating an atmosphere that would foster students’ capacities to criticize and affect both the nature and processes of their education, which means a greater commitment from faculty to view education holistically. As bell hooks (1994) explains, in “progressive, holistic education, ‘engaged pedagogy’ is more demanding than conventional critical or feminist pedagogy. For, unlike those two teaching practices, it emphasizes well-being” (p. 15). I would say that engaged pedagogy emphasizes and models “being,” and that an educator embodies specific characteristics of dialogue: an immediacy of presence, openness to unanticipated consequences, willingness to be surprised, vulnerability (openness to being changed, persuaded), belief in human interdependence, and genuineness (Cissna & Anderson, 1994).

I am proposing that an engaged pedagogy founded on dialogue, as described above, that is facilitated and modeled by the teacher, parallels our educational objective: that students feel morally committed to engaging in the dialogic process of multicultural awareness as a practice for social justice. The structural demands for dialogue to occur do not reflect our current social or academic order. Necessary conditions for dialogue are fair and equal access to speech, listening, and decision-making without retaliation (safety). Only when these conditions are met can optimal conditions for dialogue, such as openness, curiosity, reflexivity, occur. Therefore, a teacher will implement basic formal structures and ground rules to build in safety for students. In addition, she will perform a practice of “dialogic reflexivity” (Hawes, 1997) as part of the course’s commitment to conscientization. Dialogic reflexivity is an explicit engagement in “reflexive critique” of oneself, the particular context of hierarchical power relations, the institutionalization of these power relations, and “the multiple, shifting ways in which power is exercised and contested in and across each of these domains.

The next section will argue for the inclusion of postcolonial theories as an important expansion of multicultural training for clinical psychologists, beginning with a brief introduction to some of the ideas most relevant for professional psychology.