female may be given special privileges over persons of other groups in the resche ing of missed appointments. Whereas the stated excuses of the white client mu accepted at facevalue, similar excuses from a young African American female migh viewed as a form of resistance (Tidwell, 2004). Discrimination is likely to have I experienced by many if not most ethnic minority clients. The special significaru the mental health counselor is that perceived discrimination has been found II related to decreased mental health (Cokley, Hall-Clark, &: Hicks, 2011).
Clinical mental health counselors should be prepared to skillfully address 1’1I1’1 and discrimination, whether it is part of implicit institutionalized practices, the I senting problem, or the client’s life history. Self-awareness and honesty are necr if mental health counselors are to recognize the operation of discrimination in II private or agency practices. Consultation and advocacy services may be useful III tims or vulnerable populations.
Various definitions of cross-cultural counseling are found in the professional III ture. Atkinson, Morten, and Sue (2003) define it as “any counseling in which IWII more of the participants are racially/ethnically different” (p. 21). When the 1111″ health professional assumes the ecological perspective, there is a sense in whk h counseling work is multicultural (Pedersen, 1991).
BARRIERS TO EFFECTIVE MULTICULTURAL COUNSELIN
Specific barriers, such as the implications of the concepts discussed in the puv: section, must be overcome if effective cross-cultural counseling is to be acln. Additional barriers that deserve mention include cultural encapsulation of the I 11 selor, systemic barriers within counseling delivery systems, misapplication 01 I’ tional theories of counseling, miscommunication, and mistrust.
Historically, the profession of counseling tended to assume the appropriaten universal application of its concepts, principles, and techniques. In doing s ally specific alternatives were excluded from serious consideration. For C)l11I111 Evans, Valadez, Burns, and Rodriguez (2002) note that mental health counselors I to choose traditional therapeutic approaches that are in accordance with ilu-h I cultural experience. In contrast, minority mental health counselors hold mou I,I able views of nontraditional techniques. Furthermore, traditional counseling 11111 and techniques have been developed primarily by persons of non-Hispank w!11 Western, male, middle-class heritage.
Wrenn (1962) coined the term cultural encapsulation to describe the Lentil’lIl counselors to (a) define and dogmatically cling t~ viewing reality according III I own sets of cultural assumptions to the exclusibn or alternative inlCl’pll’lllll1 (b) demonstrate insensitivity to persons or other cultural backgrounds Willi I alternative perspectives, (c) resist or simply not rl’coglllzl’ I he ncccssh y 01 1(”11111
validity of one’s underlying assumptions, and therefore (d) become trapped in what may be described as a cultural tunnel vision (Corey, Corey, &: Callanan, 2010). Too often students enter graduate training programs wearing monocultural lenses and quickly subscribe and adhere to specific theories as doctrinal truth. As Pedersen (1994) notes, good counselors can no longer ignore through their own encapsulation the fundamental role culture plays in their lives and the lives of their clients.
MISAPPLICATION OF TRADITIONAL THEORIES AND TECHNIQUES Frequently, the theories and techniques of counseling are presented and accepted as special sets of insights, principles, and approaches that have universal application for the understanding and treatment of the human condition. These are accepted as though they carry the strength of divinely inspired truths. They are so much a part of the predominant culture’s landscape that their presence and the implications of their operation are ignored. Only recently has the profession begun to unpack the cultural baggage encased in the traditional “tool kits” provided to graduates of coun- selor education programs. Historically, it has been common practice of many gradu- ate programs to offer a single course with a multicultural emphasis rather than to integrate the insights of multiculturalism across the curriculum (Das, 1995). Cur- rent standards for clinical mental health counseling encourage infusion of diversity and multicultural knowledge, skills, and practice across the curriculum (CACREP, 2009a).
A number of fundamental presuppositions undergirding traditional models of counseling can be identified. These models hold implicit assumptions that reflect the world view of predominant western culture:
1. Individualism There tends to be an unquestioned acceptance of the autonomous, self-preoccupied individual as being the primary psychological entity in the assessment, conceptualization, and treatment of the human condition. What the client thinks and feels represent the realities on which problems and therapeutic goals are based. Frequently, self-will and self-advancement are emphasized with- out an accompanying concern for others. When stuck in the treatment process, counselors-in-training are taught to move deeper in the psyche of the individual rather than expand the therapeutic system by actively including relevant eco- logical factors that take a client-in-situation/context orientation (Cook, 2012). Although human ecology may be given lip service, the theories and techniques of intervention, as used in professional practice, remain firmly entrenched in a very narrow individualistic perspective.
2. View of normalcy and pathology Most theories of counseling hold views of what constitutes normal and abnormal behavior. These views reflect a Western, Euro- American perspective and can stand in stark contrast to views held by other cul- tures. Indeed, the major distinction most theories make between physical and psychological/psychiatric disorders is not universally held. Mental health profes- sions and members of the predominant Western culture commonly talk about being anxious, depressed, or stressed and may attribute these conditions to non- physical causes. This assumption may not be strongly held among persons of
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different cultures (Angel &: Williams, 2000). Such clients might, therefore, ques- tion the rationale for the existence of autonomous professions that treat “emo- tional disorders.” Rather, it might make more sense within their cultural framework to be seen by a medical doctor, religious leader, or good friend. Indeed, concepts of mental health and mental illness are highly variable across cultures (Lefley, 2010). And these conceptualizations can determine the nature of resources dedicated to their service. For example, “talking out” or “working through” related/underlying issues to relieve emotional distress may seem odd to the culturally different client, who might be expecting a more direct intervention such as medicine, advice, or specific directives. Finally, the cross-cultural litera- ture is replete with descriptions of unique culture-bound syndromes, in which pat- terns of disordered or psychotic behaviors cluster in unique ways that are found only in particular cultural settings (Lefley, 2010; Smart &: Smart, 1997). Discus- sions of such syndromes are absent in the contents of traditional theories of counseling.
3. Functional agnosticism and antireligiousness Spirituality, organized religion, spiri- tual beliefs, and the role of priests and spiritual leaders may be central to the functioning and worldview of clients from different cultures. Although spiritual- ity is much more in vogue these days in our profession, most theories and tech- niques fail to acknowledge and integrate religious/spiritual dimensions into professional practice in ways that are respectful to indigenous people groups. Furthermore, mental health counselors receive more lip service than actual skills-building training in the integration of religion and spirituality.
4. Personal happiness as a legitimate goal of counseling In our culture, people often se the possession of personal happiness as an unalienable right and, thus, seek it as a measurable outcome in counseling. Being pleased with personal physical appearance or feeling good about self are important to many persons in Western culture but may be nonissues among those living in or emigrating from third world countries. Instead, persons from other cultures might place more value in the pursuit of personal contentment with their situation. Furthermore, the acceptance of one’s situation within the context of that person’s understanding of the common good may be viewed as a more legitimate goal.
5. Insight and process of change The traditional theories and techniques of counselin rely on self-awareness and insight as important change agents. It is assumed that personal adjustment can be enhanced by increasing knowledge and awareness about self, others, and the situation. The success of many approaches hinges on the client’s willingness and ability to engage in activities that can facilitate and enhance the client’s insight and awareness. However, many cultural groups do not value insight and self-exploration and, in fact, might see “thinking about it too much” as a causative factor of one’s emotional distress (Sue &: Sue, 2008).
SYSTEMIC BARRIERS WITHIN COUNSELING DELIVERY SYSTEMS A number of widely accepted conventions are buill Into t rndluonal delivery systems 01 counseling. The scheduling of a one-to-one meeting or It counselor and cllcnt, somctlm
