Cultural competence as part of multicultural counselling - Essay Example

Cultural competence as part of multicultural counselling In developing multicultural counselling techniques, understanding the cultural context of the situation and behaviour is a primer. When various ethnic groups and minorities are involved, it is imperative to know the background of the person being treated. Psychotherapy and multicultural counselling involves very sensitive issues that lie not only the behaviour of the person being treated but also in the depths of culture and society. One must have cultural competence, which includes awareness and sensitivity in dealing with people different from one’s race. Cultural competence is demonstrated through the following qualities: cultural sensitivity, an awareness and appreciation of cultural diversity, cultural knowledge, a factual understanding on cultural variations that can be learned through trainings, workshops and meaningful interactions with individuals of diverse backgrounds, and cultural empathy, the ability to connect emotionally with the patient’s cultural perspective (Vasquez, p.128, Richardson and Jacob, p.63). Since there is a natural bias that resides within each individual, the therapist must learn to distinguish between his bias and what is happening outside his bias (Wilson and Sandhu, p.131-132; Flanagan and Flanagan, p.417). These personal biases may be detrimental to his way of handling situations and helping out the patient. These personal biases roots from each individual’s cultural experiences. Moreover, the social and economic structure adds to these biases. Society has constructed societal representations of groups which affect social order and impacts the way how people see and view each other. Thus, it greatly influences our attitudes, perception, belief and approach towards people different from us. And because this is embedded in each one’s personalities, living and learning with these biases throughout one’s life, this may affect the cultural competencies needed to be successful in multicultural counselling. To address this particular issue, the American Counselling Association created and established The Code of Ethics which prohibits engaging in acts of discrimination based on age, culture, disability, ethnicity, race, religion, gender, sexual orientation, status, language and socioeconomic status (Vasquez, p.131). But since individual biases are present, and can unconsciously affect one’s attitudes and behaviour, counsellors and therapists should make an effort to determine what biases one has in order to prevent this from affecting the individuals they are treating. The Code of Ethics is designed in a way to prevent unconscious and undeliberate actions of the therapist that may be perceived as offensive on the patient’s perspective. Stereotypes and generalizations are always subconsciously present because of how one has been exposed through the society’s many changes and developments. The important thing that therapists have to remember is an awareness of one’s own subconscious stereotypes and generalizations. This will enable them to be sensitive about it during their counselling sessions, especially when dealing with minority patients. Aside from stereotyping and generalizing, it is also a common practice of people to categorize each person they encounter in box-types, in which one relates another to a particular group because of an association of traits and behaviours (Vasquez, p.132). And because of this one tends to have more compassion with someone that they feel they belong with rather than someone who is outside of the group. These catagorizations, much like in stereotyping and generalizing, impacts one’s behaviours towards that particular group or individual because they do not belong to a part where “we” belong. One particular example of these stereotyping, categorizing and generalizing are hate crimes. Because African Americans do not belong to the majority White Americans, then they should be wiped up. That is the type of perspective of one who lacks in cultural competency. One would think superior of another because of these generalizations and this would lead to conflicts. In the field of multicultural counselling, this perspective is definitely biased and is an act of discrimination against color and race. Instead of being able to help and counsel an individual of that minority, the counselling session will not be effective since the therapist already boxed himself in and boxed the patient out. This also implicates that therapist and patient of the same cultural background will have a more positive outcome rather than a White American therapist and an African American patient since one thinks highly of his self than his patient. Also, these negative stereotypes are reinforced by selective perception thus keeping these people on the out-group and not allowing them to have the chance to be in the in-group (Vasquez, p.132 - 133). Subconscious aversion and biases can be as harmful as conscious aversion to ethnicity and race. These subconscious thoughts bring off negative body language like less eye contact or unnatural tone of voice (Vasquez, p.133; Flanagan and Flanagan, p.417). It has to be understood by therapists that these minorities are more sensitive to feelings of rejection, dislike and discrimination since they have been through this throughout the society and all the days the live. Racism and discrimination is actually a long existing problem that cannot be easily erased as it has its roots deep into one’s identity. This was caused by the many years that humans are exposed to this idea of thinking that one race should and must be better than another. The problem with this lies in the belief that there was nothing wrong with what he is doing and there is absolutely no intention of thinking and doing what others may think. It is a tendency of psychotherapists to be able to relate, if not understand completely, to their patients. As such, there are certain ethical implications that need to be considered, especially when dealing with race and ethnicity different from him, the doctor. To practice ethically, the doctor should be able to exercise understanding, sensitivity and empathy towards the patient’s situation or issue. It is important to look into the patient’s cultural values, beliefs, norms and behaviour. Cultural issues play an important factor in determining how to deal with the patient. Knowledge and sensitivity to these cultural issues enable the practitioner to appropriately decide on which technique to use in helping out the patient deal with whatever issue he has. Developing a therapeutic alliance between the therapist and the patient is the most important factor that increases the success rate of the session. And this is being challenged by racial and ethnic diversity as the perspectives between cultures are subjective and encompassing all genders, groups of people and societies (Vasquez, et.al., p.127). Aside from multicultural competency, another important aspect of turning a multicultural counselling into a success is a diversity training that would make a person believe in the capabilities of the people they are treating (Vasquez, p.128). One of the probable causes why a member of the minority group seeks professional help is discrimination And this is where some therapists fail to give or show empathy. Being unfamiliar with norms and culture other one’s own would prove to be fatal in a counselling session. Missed empathetic opportunities usually happen when the therapist is of another culture or race than his patient (Vasquez, p.134). A good way of dealing with these kinds of situations, wherein there is awkwardness between the therapist and the patient is to learn a common language based on patient’s use of words (Vasquez, p.134; Wilson and Sandhu, p.131). Through this, the therapist will be able to gain the trust and confidence of the patient as he will be able to address the issue using the perspective of the patient. Because of the threat of being discriminated, many individuals belonging in the ethnic minority tend to face discrimination with fear and humiliation, along with the fear and humiliation of failing (Vasquez, p.134). Because of this, most often than not, they end up failing or not delivering results as expected even if they have the skills and capabilities to do so. One of the most important values of a psychotherapy session is accountability, for the client to accept and be responsible for his actions and behaviour. But this is reconceptualised in multicultural counselling wherein empowerment, or to be able to accept control over one’s actions and to learn from one’s mistakes (Vasquez, p.135). The model of multicultural psychotherapy, then, is transposed to a model that will focus on the following: identify the oppressive aspects of the experience, the patient’s resourcefulness and survivability, and convey messages of honor and respect to share with the process of recovery from the trauma (Vasquez, p.135). One of the most effective strategies in a successful multicultural counselling session is to emphasize the strengths and identify the resilience of the patient. Through this, it will emphasize the value and importance of the patient and the therapist will be able to strengthen the belief in oneself. This will also help gain the trust of the patient and establish a connection between the therapist and the patient. By developing this relationship, the therapist will be able to reach through the defences of the patient and will be able to address the underlying issues of feelings of humiliation and shame when faced with discrimination. This will also establish the belief of the patient on one’s own capabilities and not let discrimination affect his behaviour and activities. Stress-based theories of health reveal that poor physical and mental health may be attributed to lack of access to economic and social resources and other forms of social disadvantages due to racism and discrimination (Vasquez, p.140). This indicates that physical health is ultimately affected by the negativity that surrounds minority groups. Because they face social disadvantages and struggle against discrimination everyday, it takes a toll in their psychological well-being and is ultimately translated to poor physical and mental health. In relation to this, individuals with multiple personalities, such as African Americans or those with cross-cultural backgrounds, may experience stress and tension, even within themselves. For example, individuals with a Mexican Asian cultural background who was born and who lived from childhood in the United States have to deal with three cultural backgrounds or identities. Because of having three intersecting cultural backgrounds, they experience multiple oppressions compared to Africans who migrated to the United States (Vasquez, p.140). Being disadvantaged may induce feelings of empathy and concern but being privileged may incite feelings of resentment and anger towards the struggling unprotected individuals. This can also result to feelings of hate towards the people who are experiencing the privileged and protected lives that they have, questioning them on why there are others who do not experience it. Historical experiences that the race may have faced have an effect on the general perspective of the individual belonging to that race even years after (Wilson and Sandhu, p.131; Flanagan ann Flanagan, p.417). Since racism and discrimination is a deeply rooted societal problem, the solution to changing this perspective is not an easy one to find and implement. Knowing and understanding the effects of such worldwide cultural problem will help the therapist in assessing the level of problem or issue of his patient regarding discrimination. Some individuals may not share those with severe discrimination and racism views. To summarize, there are three multicultural competencies essential to be able to practice multicultural counselling effectively. These are: awareness and acceptance of one’s own biases, cultural background and experiences and of other culture’s as well, knowledge about other cultures and skills to which language and nonverbal communication is important to portray a stance that is not discriminating or biased. Being able to realize and practice these competencies, the counselling session will push through effectively and the client will be able to feel the relationship building trust and confidence with the counsellor. Through this, the client will be able to relate with the counsellor and vice versa and with this, the counselling session will be able to address the needs and concerns of the client. Not only will it focus on the client’s needs, it will also focus on the diversity of human race and culture and how it impacts one’s behaviours, actions and perspectives. Multicultural Counselling Theories Traditional counselling techniques and practices are beginning to be replaced by multicultural counselling theories and models. The difference of multicultural counselling from the traditional approach is its ability to address issues and concerns that may be and is impacted by culture and diversity. In a traditional approach, the focus is on individualism and most often are in contrast with the worldviews originating from Euro-American cultures (Gregoire and Jungers, p.69). For these traditional models of counselling to be relevant in the diverse society of today, it should incorporate an interactive person-to-environment focus (Corey, p.42). With this, the counsellor will understand the deeper cause and reason for the actions and behaviour of the client. Each traditional counselling theory is based on a specific group or culture’s perspective. Most of the traditional counselling theories are based on the Euro-American perspective. There is very little study or proposal to use a technique that encompasses and crosses all borders of social barriers. Most techniques are derived from counselling approaches developed by and for Whites, males, middle-class and Western clients (Corey, p.42). This alone shows biases and preferences that makes the members of the minority groups feel even more marginalized and discriminated. Value assumptions lead to culturally biased counselling that can be more detrimental than helpful to the client. There are several multicultural counselling theories but no one is better than another. Each may supplement and complement each other, as such to be able to effectively and efficiently apply this to the counselling practice. One basis of a multicultural counselling theory is human development. Using this base, it focuses on addressing particular aspects in an individual’s life, a particular category or group of people, and a particular form of influence (Wilson and Sandhu, p.131). There are four common aspects of psychotherapy: the intellectual and emotional relationship between the patient and the counsellor, the extent to which the patient and the counsellor have the same worldview, the degree to which the client expects positive change to result from the counselling session, and the nature of rituals or interventions that the counselling provides (Wilson and Sandhu, p.132-133). The broad conceptual framework that unifies multicultural counselling incorporates the counsellor’s level of cultural awareness, assessment of the patient’s cultural background, cultural adaptation processes, cultural identity development, the socio-political influences on both client and counsellor, the use of both traditional and indigenous counselling techniques and the complex interactions among the client, counsellor and the societal context surrounding them (Lee, et.al., p.20). Cultural diversities resulted to combined frameworks for multicultural counselling. An example of this is the theory of Introspective Development Counselling. The IDC focuses on how the life histories of the patient impact their present experiences and situations (Wilson and Sandhu, p.135). This is deeply rooted from the Buddhist belief and practices by which the focus is one’s self and his relation to other people. It reflects into past behaviours of the individuals and how it affected himself and other people around him. Multicultural counselling theories are designed to support and integrate the culturally universal and culturally specific approaches to counselling. This is to address the increasing and broadening cultural perspectives of individuals seeking counselling. Culturally universal theories are as follows: theory of multicultural counselling, internalized culture and the multicultural model of psychotherapy (Wilson and Sandhu, p.138). The theory of multicultural counselling focuses on socio-political realities and how it affects counselling processes and results. The internalized culture theory focuses on the role of an internalized culture on the individual’s worldviews. It is important to understand oneself first before one can be able to counsel another. It is important also to transcend one’s own beliefs and cultural egocentrism in order to be successful in counselling. The multicultural model of psychotherapy is based on cognitive behavioural approaches wherein there is flexibility for the clients to adjust in diverse environments. This model also promotes a multicultural environment that is responsive to the needs of a diverse population. It also encourages clients to become change agents in accepting and being receptive to what other people may need, like appreciation or encouragement. Specific cultural counselling theories are based on experiential perspectives wherein it supports a need for multiple theories from diverse environment (Wilson and Sandhu, p.139). This theory emphasizes the differences and variety in the experiences, ideas and perceptions of individuals. Advantages of multicultural counselling are as follows: allows understanding of multiple oppressions, promotes recognition of the collectivist identity, allows clients to define wellness within their own context, encourages counsellors to recognize the multiplicity of strengths of the client, recognizes the numerous roles counsellors may have to fill in response to client diversity (Gregoire and Jungers, p.71). This shows the importance of flexibility and adaptability towards dealing with diverse clients. With the multicultural counselling model, the counsellor will be able to be more sensitive and aware of the cultural and social implications towards the behaviour of the patient. By this, he will be able to determine what could possibly be the root cause of the concern and thus, will be able to address it and work on eliminating the problem. The African Americans and Multicultural Counselling 12.8 percent of African Americans comprise the largest non-White group in the United States (Looby and Webb, p.144). They populate the United States mainly because of the American Dream of happiness, freedom and prosperity. The American dream reminds all men the legacy and dignity for one’s worth (Lee, p.1). The history of African Americans’ quest to freedom from discrimination and racism started with Africans being sold as slaves during the colonization era. Because of intercultural relationships, it resulted to a new race called the African Americans. However, because they are of a different color from the superior White men of those times, they were seen as second or even as third class citizens. There were a lot of psychological and emotional obstacles the African race had to overcome during the times of struggle. One of the emotional and racial obstacles is the discrimination of race and its credibility. During the time of the African struggle for freedom from slavery African voices was always in doubt and its credibility was always questioned especially during debates on slavery (Bruce, p.276). It is very difficult to have reason with other people especially if your credibility is always questioned by others. Racism has been going on in the Americas since the slavery era, however, the racism issues that other cultures had experienced would seem invisible in contrast to what the African American race had experienced and endured for a very long time (Kivel, p.82). It was carved in the history of the America that the race of the African Americans was once slaves to the white Americans and other races. The African American race was oriented and socialized in a community or society that had racial, gender and sexual oppression orientation. These kinds of discriminations are psychological stressors which the African Americans must learn to address. Most of the bearing of sexual discrimination is being burdened by African American women. In addition to that, the effect on the psychological wellbeing will be negatively high especially for women (Tobach and Rosoff, p.122). In the United States of America and for many countries, it is a psychological fact that people tend to make assumptions on an individual’s lifestyle, education, behaviour and character based on an individual’s class status (Hill and Rothblum, p.36). This is definitely a wrong way on how to judge people. African Americans were always a victim of this kind of discrimination. But these circumstances of discrimination have not been such of an issue to the African American culture nowadays. Looking at this historical evaluation of discrimination and racism towards African Americans, it can be concluded that this issue indeed is a struggle for the individual. There may be other races which experienced the same amount of inhumane acts of injustice like the Asians but the impact on African Americans is greater since they have been the target of such oppression for such a long time. Their existence in the American society is longer than that of other races that they have experienced this discrimination and racist acts longer than most. With this knowledge, the therapist will be able to identify and understand what would be the most appropriate approach towards African Americans seeking professional help or psychotherapy. As such, what is important in dealing with African Americans and other victims of discrimination in a multicultural counselling session is to focus on the situation at hand, what is felt and experienced by the patient at the moment. The historical evaluation of one’s perspectives of discrimination and oppression is important only in understanding how deeply this may have affected the patient (Richardson and Jacob, p.63). The question of its level of impact is based on the premise of whether the feelings of the patient is connected with this historical perspective or as a result of one’s own experiences of discrimination. It is also important to address aspects of spirituality, humanness and love in counselling African Americans (Richardon and Jacob, p.63). Spirituality and religion are important for the African culture (Smith and Richards, p.108). By emphasizing these values, the counselling session would be more effective as it increases their level of worth and importance because their values are being considered as part of addressing their issues and concerns. This is a way to develop their identities and self-esteem in order to build their confidence in fighting their imbedded feelings of oppression. This will enable them to adapt to the different cultures present in the society. The African value system is important to be considered in the counselling practice. It gives a more Afrocentric counselling approach that will help establish the identity of the patient. The African value system consists of seven major principles: unity, self-determination, collaborative work and responsibility, cooperative economics, purpose, creativity and faith. This increases the productivity of a counselling session since it allows a relationship of trust wherein the patient will believe that the counsellor will be able to help him with his issues. Conclusion The social construction of groups within the society impacts personal points of view and perspectives for and against groups that is different from one’s own. No one is safe from biases and generalizations but the important role of a therapist is to be sensitive to the patient’s needs and not to allow these subconscious biases affect their dealings with their patients. It is important to recognize and identify one’s own biases in order to prevent unconsciously behaving in such manners. Aside from this, it is also important to understand the history or background of the culture to be able to address the issue properly. In this manner, the therapist will understand whether it is part of a historical perspective deeply rooted within the individual’s identity and belief or just an effect of his own experiences. The most important aspect in the multicultural counselling approach is the ability of the counsellor to develop cultural competencies that will make him aware of his own cultural perceptions and egocentrism, allow him to be sensitive and conscious of his actions and behaviours towards a client of the minority, and to be able to understand and learn what are the cultural implications and impacts of the cultural experiences of the client. The multicultural counselling sessions enables the counsellor to see the world through the perspective of the client. It allows a multifaceted outlook that actually helps in the process of resolving the issue of the client. Because he is part of the minority group, he has the tendency to be defensive of his perspectives in life. Through the multicultural counselling model, there is more emphasis on cultural diversity, pluralism and cultural differences that affects and impacts the views, attitudes and behaviour of both the client and the counsellor. By using this model, there is an increased chance of being able to address the issues of the client without being individualistic and without prejudice. Because of various cross-cultural experiences, counselling techniques are remodelled in order to address issues that weren’t addressed before, mainly issues of racism and discrimination. The traditional approach of presenting factual basis in order to solve problems and issues are replaced by a modern approach of looking into the different perspectives and experiences of individuals. Counselling models are revamped to accommodate the changing needs of the individuals. It is now specific to the diverse cultural backgrounds within the society. It actually aims to break down the barriers between groups. As it cures and counsels the patients, these multicultural counselling sessions also cures and addresses the various problems of the society, mainly about cultural egocentrism, racism and discrimination. It is important to adapt to the changing world. Being a more diverse and pluralistic society today, it is an essential for therapeutic and psychotherapy techniques to be congruent with the range of values and behaviour of the society. A traditional approach may be able to address certain personal issues, but issues that are deeply rooted with cultural values, norms and experiences cannot be placed in an individualistic strategy. What should be addressed right now with the development of multicultural counselling techniques is a specific model that will guide the various strategies present in multicultural counselling. It is also important to always evaluate the present practices in order to define whether there are still traces of cultural discrimination. It is important to always take into account that different perspectives of individuals, whether client or counsellor. But the main focus should always be the needs of the client, and that is to help him build his identity and to resolve his personal issues in order to function well for the good of the society. References Bruce, D. The origins of African American literature: 1680-1865. VA: University of Virginia Press, 2001. Corey, G. Theory and practice of counselling and psychotherapy, 7th ed. OH: Cengage Learning, 2005. Gregoire, J. and Jungers, C. The counsellor’s companion: what every beginning counsellor needs to know. NJ: Lawrence Erlbaum Associates, Inc., 2007. Flanagan, J and Flanagan, R, Counseling and psychotherapy theories in context and practice: skills, strategies and techniques. NJ: John Wiley & Sons, 2004. Hill, M. and Rothblum, E. Classism and feminist therapy: counting costs. London: Routledge, 1996. Kivel, P. Uprooting racism: how White people can work for racial justice, 2nd ed. Canada: New Society Publishers, 2002. Lee, L. Making the American dream work: A cultural history of African Americans in Hopewell, Virginia. VA: Morgan James Publishing, 2008. Lee, W. et.al. Introduction to multicultural counselling for helping professionals, 2nd ed. NY: Routledge, 2007. Looby, E. and Webb, T. Counselling ethnically diverse families. Multicultural counselling: context, theory and practice and competence. NY: Nova Science Publishers, 2002. Richardson, T. and Jacob, E. Contemporary issues in multicultural counselling: training competent counsellors. Multicultural counselling: context, theory and practice and competence. NY: Nova Science Publishers, 2002. Smith, T. and Richards, P. Multicultural counselling in spiritual and religious contexts. Multicultural counselling: context, theory and practice and competence. NY: Nova Science Publishers, 2002. Tobach, E. and Rosoff, B. Challenging racism and sexism: alternatives to genetic explanations. NY: Feminist Press, 1994. Vasquez, M. Ethics in multicultural counselling practice. Handbook of multicultural counselling, 3rd ed. CA: Sage Publications, 2009. Wilson, S. and Sandhu, D. Multicultural Counselling Theories. Multicultural counselling: context, theory and practice and competence. NY: Nova Science Publishers, 2002. Read More