Many individuals will need the help of a professional counselor at some point in their lifetime. Due to the growing diversity of the United States population, there is a high likelihood that a counselor will have clients from cultures different than their own at some point, regardless of the counselor’s area of concentration.
Depending on whether or not a counselor has any background in multicultural counseling, can have a significant impact on their effectiveness when working with clients from different cultures. As of 2010, minority groups make up roughly one-third of the United States’ population (U. S. Bureau of the Census, 2010). Minority groups are the fastest growing segment of the United States population and foreign-born people now make up more than 11 percent of the population. It is important to understand that the diversity of the population in the United States is not reflected just by race and ethnicity, but it applies to other aspects of culture such as socioeconomic status, religion, spirituality, sexual orientation, and ability status. Clients from diverse backgrounds present a counselor with their cultural traditions, habits and behaviors, belief systems, ideologies, and life experiences, in a counselling session. The approach a counselor takes towards multicultural issues can have an effect on the client’s perception of treatment and the therapeutic relationship. Therefore, in order for a counselor to be culturally competent, it is necessary that multicultural counseling be a core component of every counselor’s education.
In recognizing the importance and necessity of multicultural counseling in a counselor’s education, I will address the following regarding its’ value: (1.) Definition and Understanding multicultural counseling; (2.) Identifying cultural characteristics and therapeutic techniques; and (3.) Personal reflection and conclusion.
Definition and Understanding Multicultural Counseling:
Multicultural counseling occurs when a counselor works with a client, whose cultural background is different from the counselor’s, and how those differences can affect the counselor-client relationship (Sue & Sue, 2007). These differences include race/ethnicity, age, gender, religion, sexual orientation and socioeconomic status. This requires counselors’ to recognize cultural differences in the counselor-client relationship in counseling sessions. Multicultural counseling entails cultural awareness on the counselor’s behalf, awareness of the counselor’s own cultural values and biases, an awareness of the client’s worldview, and applying culturally appropriate methods of treatment.
Cultural awareness is an understanding of the history/traditions, lifestyle, beliefs and values of minority groups (Pedersen, 1997). This requires me, as a counselor, to understand cultural family structures and dynamics, non-verbal forms of communication, cultural behaviors and sensitivities that may impact the effectiveness of counseling sessions.
As a counselor, when working with multicultural clients, I must recognize my own cultural values and resolve any biases towards individuals of other cultures. Any biases or preconceived notions about clients from cultures different from the counselors can not only negatively affect the counselor-client relationship, but can result in the client dissolving the counselor-client relationship prematurely.
An awareness of the client’s worldview requires me, as the counselor, to ‘see the world through a different set of eyes.’ Meaning, as the counselor, I must be open to learning and understanding a worldview perspective that may differ from mine. This is beneficial in learning how to effectively communicate with the client with respect to their culture.
As a counselor, when applying various methods of treatment, it is important that they are culturally appropriate. If not, I would be ineffective as a counselor to the client. And, in essence, I would be re-enforcing one of the reasons why individuals from non-Western cultures are hesitant to seek the help of mental health and counseling services.
Identifying Cultural Characteristics and Therapeutic Techniques
Asian Americans are the second fastest growing ethnic minority group in the United States (U.S. Bureau of the Census, 2010). They are one of the most diverse racial groups in the United States, consisting of at least 43 different ethnic groups when grouped with Pacific Islanders.
Initially, as a counselor, I need to educate myself of the basic traditions that are recognized in the Asian American/Pacific Islander cultures. An awareness of cultural behaviors and non-verbal communication will work to my benefit upon introduction. Characteristics attributed to the Asian American culture are: self-control, solidarity, deference to authority, and achievement. For the purposes of this paper, I will refer to the Asian American culture as Asian culture.
Self-control is very important in the Asian culture and may be demonstrated by restraint in highly emotional and stressful situations. Modesty, in regards to one’s own accomplishments, is also displayed. When communicating with others, members of this group tend to appear passive and quiet.
Solidarity is best demonstrated in family relationships by a strong sense of commitment and obligation in satisfying group interests and goals. There is a huge emphasis placed on family relationships in this culture, where the family unit, not the individual, comes first. Any individual family member’s achievement is attributed to the family’s accomplishments. To the contrary, shame from family members are expressed when an individual behaves in a way that might tarnish the family’s reputation; any family member’s successes or failures impact the family as a whole.
Traditionally the Asian culture is patriarchal, in that the father is the dominant figure. Cultural expectations require Asian women to be obedient helpers to their husbands and to respect their authority. Parental respect is important, as the children’s role is to respect their parents and obey norms and expectations established by the family. The role of extended family is highly regarded, as elders in the family are revered as having wisdom and life experience.
Priority is placed on educational and occupational achievement in the Asian culture. Discipline, intelligence, and hard work are highly regarded and lead to successful academic achievements and career accomplishments. Due to the high expectation of educational and academic achievement, mental health issues such as depression and anxiety are more prevalent in the Asian culture (Sue & Sue, 2007).
Family problems (including both mental and physical problems) are discouraged from being shared with people outside the family. Problems within the family are expected to be shared and kept among family members.
The need for counseling services in the Asian culture consists of a variety of issues including academic and occupational achievement, dating, family difficulties due to acculturation, difficulties relating to subgroups, and racism, just to name a few (Leong, 1986). Methods of treatment can vary depending on the problem presented for counseling. Treatment methods such as Cognitive Behavior Therapy (CBT) are appropriate for issues of depression and anxiety related to educational and occupational achievement. Developed by psychotherapist Aaron Beck, Cognitive Behavioral Therapy (CBT) focuses on how people’s thinking can change feelings and behaviors. I would choose this approach because it is problem focused, brief in nature and goal-oriented (Capuzzi and Gross, 2007). This approach places less emphasis on internal conflicts, which could potentially result in feelings of blame and shame.
As the counselor, in order to be most effective with an Asian client, upon introduction I would address the client in a polite and formal manner. To establish rapport, I would briefly discuss my educational and professional background to demonstrate expertise, with the intent of earning the client’s confidence (Williams, Foo, et al., 2006). Keeping in mind that the Asian culture tends to keep family problems internal in order to avoid bringing negative attention to themselves or their family, I would assure my client that resolution to the presenting problem is possible and the confidentiality of the counseling sessions, with the intention of reducing any apprehension regarding the counseling process.
Throughout counseling sessions, I would be mindful of nonverbal cues that might impact my effectiveness as a counselor when working with Asian clients. For example, lack of eye contact is regarded as a sign of respect in the Asian culture. It is important to be mindful of personal space and gestures, such as, offering a handshake or touching is often viewed as inappropriate in the Asian culture. Also, I would be mindful of my own physical gestures such as hand and arm movements, posture, facial expressions and vocal tones when communicating with my clients so as not to misinterpret any lack of respect towards my client’s culture.
The Hispanic/Latino population, as of 2010, has become the largest minority group in the United States (U.S. Bureau of the Census, 2010). The Hispanic/Latino population consists of individuals living in the United States with ancestry from Mexico, Puerto Rico, Cuba, the Dominican Republic, and both Central and South American Spanish-speaking countries, with the largest number of immigrants coming from Mexico.
As the counselor, it is my responsibility to learn as much as I can to become familiar with the Hispanic/Latino culture. It would be beneficial for me to become familiar with the cultural values and strengths, family structure, spiritual/religious values, and level of education within the Hispanic/Latino community (Sue & Sue, 2007).
Interpersonal relationships are central to the Hispanic/Latino culture. The family structure is patriarchal and there exists a strong allegiance to family. Unity, respect, and tradition are highly regarded and are the cultural strengths of the Hispanic/Latino culture. Success is attributed to family, where there is significant social and emotional support for both the individual and family. Cultural traditions and values are often passed down by extended family (grandparents, aunts and uncles), whom play an important role within the family structure.
This group adheres to traditional gender roles, in that the male is viewed as dominant (machismo) and the female is viewed as submissive (marianismo). Cultural expectations require the Hispanic/Latino male to be strong and provide for his family and require the Hispanic/Latino female to be nurturing and focus on the welfare of the family.
Educational characteristics of the Hispanic/Latino population describe them as having difficulty in the school system. Limited English proficiency and level of education prior to entering into the United States play a huge factor. Statistically, Hispanic/Latino students experience higher dropout rates, lower admission to college, and higher rates of teenage pregnancy when compared to other ethnic groups.
Acculturation is a risk factor closely associated with the Hispanic/Latino culture. Acculturation is described as the process that occurs when members of different cultures are in contact with one another. Cultural features are exchanged, yet the groups remain distinct. Some members will assimilate to the dominant culture while other members choose to maintain more traditional values and lifestyle.
A treatment methodology, like Adlerian is acceptable regarding problems with acculturation and assimilation, and is adaptable in using with various cultures. Adlerian counseling was developed by Alfred Adler, he believed that a person’s actions determined what they valued or wished to attain. In theory, Adler believed that a person’s responses were driven by goals, purpose, and imagination. Adlerian counseling emphasizes the individual’s needs for fulfillment, connectedness with others, and contributions to society as being hallmarks of mental state (Carlson, Watts and Maniacci, 2006). Its’ focus is on the future, rather than the past. In Adlerian counseling there’s a four stage approach, they are: engagement/creating a relationship, assessment, insight and reorientation.
My responsibility as the counselor is to first create a relationship with the Hispanic/Latino client. Because of the strong family structure, I would invite the family to attend the first visit with the individual. Although I would be counseling only the individual, the purpose would be to build trust with the client and family by engaging them in the counseling process before exploring the presenting problem. This would allow me the opportunity to share a little personal background about myself and clarify who I am and my role (as facilitator) regarding the presenting problem.
The second stage of Adlerian counseling is assessment. My goals at this stage are to assess the degree of acculturation with the client, identify the client’s ethnic identity, and inquire as to how the client identifies him or herself. It is important to understand how the client identifies him or herself in regards to ethnic identity. For many, the term ‘Hispanic’ is generic and non-specific, it only refers to language and not country of origin. The term ‘Latino’ conveys diversity and refers to country of origin. I would ask open-ended questions in order to gain information about the client’s background. Some of my questions would concern; generational status, primary language, history of residency, religious status, degree of acculturation and acculturation conflicts, and reason for immigration (if they are immigrants). The intent is to learn information about the client and family such as, any language barriers, degree of family support from the client’s perspective and to discern the degree of acculturation and assimilation.
The third and fourth stage of Adlerian counseling is insight and reorientation. It requires me, as the counselor, understanding the client and helping them to gain insight into their own behaviors and responses as pertaining to their goals for counseling, and then redirecting the client in finding healthy solutions and alternatives to destructive behaviors and beliefs.
When counseling Hispanic/Latino clients, I would keep mindful of how I communicate with the client in counseling sessions. For example, I would shake hands when introducing myself to the client. I would spend more time asking non-threatening questions, in an effort to put the client at ease and allow trust to build. In terms of cultural behavior, Hispanic/Latino people value interpersonal relationships, so it may not be out of the ordinary for the client to bring a gift (soup, favorite dish, etc.) to the counseling sessions. For this reason, after the first counseling sessions, the counselor-client relationship may be less formal.
In 2010, 56.7 million people, nearly 19 percent of the population were reported to have a disability in the United States (U. S. Bureau of the Census, 2010). The term ‘disability’ is defined as one having a lack of adequate power, strength, or physical or mental ability; incapacity (MLA Dictionary). People with disabilities seek the help of a counselor for many reasons, whether it is career/vocational rehabilitation or for help coping with the effects of chronic illness or disability. They are a diverse group that includes all minority groups, children and adults of all ages, with African Americans and Native Americans having the highest rate of disability among racial minorities (U. S. Bureau of the Census, 2010).
There are three types of disabilities, they are: cognitive impairments, physical/medical disabilities, and non-visible disabilities. Cognitive impairments are described as difficulties in processing information when reading, writing, listening, speaking, problem solving and social skills. Cognitive impairments are also described as learning disabilities.
Physical/Medical disabilities concern poor gross motor coordination, poor fine motor coordination, and hearing and visual impairments. Non-visible disabilities include seizure disorders, psychiatric disorders and traumatic head injuries, just to name a few.
As a counselor working with clients with disabilities (cognitive, physical or invisible), it is important to understand the difficulties people with disabilities experience. Economically, individuals with disabilities experience higher levels of unemployment and lower monthly income earnings in comparison to non-disabled individuals. They face barriers to workforce participation regarding employment limitations, the type of employment or amount of work available (U. S. Bureau of the Census, 2010).
Individuals with disabilities experience the same social stigmas as those from ethnic minorities: discrimination, stereotypes and prejudice. For those with physical disabilities, many experience the stereotype as having lower intelligence or they are either helpless or dependent due to the physical limitation. Or, many experience discrimination in being treated as inferior, due to ignorance on the part of the able-bodied individual. Socially, individuals with disabilities also experience high occurrences of social isolation.
As a counselor, when working with clients with disabilities, it is important for me to educate myself on local and national laws and movements concerning disability related issues. Also, it would be helpful to become familiar with disability related resources within the community as sources of information for personal reference or to share with the client. Self-examining my own beliefs, assumptions, stereotypes and emotional reactions to individuals with certain types of disabilities should be resolved.
Scheduling counseling sessions with disabled clients may require extra considerations. Considerations when scheduling appointments may include the client’s mode of transportation. Can they drive themselves? Will they rely on family members or public transportation? Another consideration may be whether or not the client takes prescribed medications that may alter alertness; this may determine if appointments should be scheduled for earlier or later in the day. Also, is the office location handicap accessible for those in wheelchairs or are mobile with the use of crutches? Is the office brightly or dimly lit for clients with sensory issues? Will communicating with the client require electronic devices? Or, will I need to communicate with the client via sign language interpreter?
There are various counseling theories that provide a framework in which to work with clients with varying disabilities, some of them are: Cognitive Behavior Therapy (CBT), Adlerian, Reality Therapy and Solution-focused counseling. For the purposes of this paper, I will use Solution-focused counseling as the method of treatment.
In Solution-focused counseling, clients choose the goals. Very little attention is given to a diagnosis, unless the diagnosis is part of the problem. The focus is primarily on the client’s strengths and the goal of the counselor is to empower the client to fix their own problems without always relying on a counselor (Corey, 2013). Solution-focused counseling is clear cut and solution focused rather than focusing on the problems. Both the counselor and the client work in collaboration to take small steps in order for the client to achieve small goals.
In order to be most effective in working with a client with disabilities, upon introduction, I would ask questions in regards to the nature of the presenting problem. Also, I would ask questions with regard to the client’s disability and its nature, with the intention of understanding whether or not the disability is part of the presenting problem. In some cases, it may be necessary to invite a family member or primary caregiver to the first counseling session. Next, I would ask the client to communicate their goals in what they wish to accomplish in counseling sessions. After the introduction and rapport building, I would clarify my role in the counselor-client relationship.
Following sessions would consist of solution building questions for the client that would focus on past successes and identify strengths. Future sessions would be identifying ways of coping for the client in crisis situation and scaling questions that would help the client assess crisis situations. I believe that it is important to understand the client’s extent of family support during the counseling process, and a session inviting family members would be helpful for me, as the counselor, to help the client recognize other sources of support that the client may not have previously recognized.
It is important, as the counselor, when working with a client with a disability to focus on the client and the problem presented and not the disability. It is acceptable to ‘ask the client what you don’t know,’ in counseling sessions. Asking questions demonstrates a sincere desire to learn more about the client and their disability, and can be helpful to the counselor in terms of addressing coping tools and sources of support.
Conclusion and Reflection
For multicultural counselors, multicultural education does not solely take place in a classroom environment. It is a personal and professional choice to become open-minded in learning about those around you who are not like you. It is taking opportunities to learn about one’s cultural values, lifestyles and worldviews that are different from our own. Empathy requires counselors to understand the beliefs, values, and perceptions of their client’s culture without embracing it as their own. The opportunities present themselves on a daily basis, if we pay attention.
In an effort to understand and have better communication with the clients, it has been my experience, to ‘ask what you don’t know.’ Demonstrating a sincere desire to learn more about what I don’t understand requires research or simply asking in a non-offensive, respectful manner.
In establishing rapport with the client, it is acceptable to acknowledge any cultural differences, as long as it is not the main focus when communicating with clients from different cultures or ethnicity. Communication is key in counseling sessions with clients from various cultures. It is important, for me (as the counselor), to understand the non-verbal cues from various cultures, so as not to appear disrespectful or impolite, and to be aware of my own non-verbal communication and body language, which could impact establishing rapport and building trust and confidence with the client. Also, when communicating with clients, reframing the question is helpful. Reframing questions to the client helps them to see the question from a different perspective and allows them to better understand what the counselor is asking. Reframing leads to better understanding and communication in counseling sessions.
Do I believe that I am prepared to work with people from other cultures? Yes, the Masters of Human Relations program has allowed me the opportunity to learn about various cultures, perspectives, and approaches when working with people from diverse backgrounds, whether it is in the work/employment or counseling environment. It has allowed me to demonstrate empathy and understanding in situations where I may have been closed minded. As a result, I have learned the value of empathy and how to extend it to others, and it has allowed me to teach it to my kids and to demonstrate it in action.
Learning to work with people from other cultures is an on-going process, it is continuous and beneficial to the employee, employer, or counselor who is open to learning and extends beyond the working environment. The Masters of Human Relations program has equipped me with the tools that are applicable to working with people from diverse cultures and backgrounds in order to create positive outcomes, and for that I am appreciative.