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ADDRESSING Model

The ADDRESSING Model focuses on improving clinical understanding of clients and is informed by diversity identifiers, such as age, developmental disabilities, acquired disabilities, religion/spiritual orientation, ethnic and racial identity, sexual orientation, socioeconomic status, indigenous heritage, nationality, and gender. Developed by Pamela A. Haysin 1996, the model recognizes that traditional psychological modalities are constructed around dominant cultural norms demonstrated by middle-aged, white males. As a result, many counseling theories incorporate limited consideration for the influence of diverse cultural identities on the mental health presentation of clients from nondominant cultures. This model serves as a framework for the counseling community as the number of individuals from nondominant cultures continues to grow in the United States. This entry defines each of the diversity identifiers of the ADDRESSING model and reviews the importance of clinician awareness.

Facets of the Model

Culturally humble and competent clinicians are needed to meet the psychological needs of an increasingly diverse population. The ADDRESSING model helps clinicians identify unrecognized personal bias that could influence treatment. Hays theorized that in identifying a client’s unique culture-related identities and experiences, clinicians can more clearly identify their own personal bias impacting clinical intervention. Awareness of brief and unintentional discriminatory gestures or remarks (i.e., verbal and nonverbal microaggressions), and their negative impact on the therapeutic relationship is possible when clinicians view their clients through the lens of the ADDRESSING model. This model equips mental health professionals with the tools to help clients with varying intersecting identities and from cultures different than their own.

Age

Ageism is discrimination or negative perceptions based on age. While the term is used primarily in reference to older adults, it can also target individuals across the developmental spectrum, including children, adolescents, adults, and the elderly. Older adults are often either overdiagnosed or underdiagnosed with both physical and mental illnesses due to lack of research on aging. Physicians may feel reluctant to specialize in work with geriatric populations because of low Medicare reimbursement and the likelihood of poor medical prognosis and outcomes. Many older adults may also face discrimination related to wages, employment, promotion, equitable benefits, discipline and discharge, and other age-related discriminatory practices. The intention of the U.S. Congress’ enactment of the Age Discrimination in Employment Act of 1967 was to address the disadvantages experienced by workers over the age of 40 and advance employment protections based on skill, aptitude, and competence, rather than age. While ageism may affect individuals of any age, legal protections in the United States do not protect those under the age of 40 from such discrimination. Intersections of age with race, gender, poverty, and disability highlight compounding marginalizing factors that negatively impact physical, psychosocial, and mental health outcomes for older adults.

Developmental Disability

Disabilities are physical or mental impairments that limit life activities. Developmental disabilities exist from birth, such as autism, cerebral palsy, spina bifida, hearing loss, and intellectual or learning disabilities. The mental and emotional health of individuals with disabilities is often overlooked, and, despite high suicide rates in teens with disabilities, very little research on assessment and population-specific treatment is available.

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