Multicultural Counseling

Multicultural counseling is one of the major theoretical forces in psychology. It emerged as a necessary backlash to traditional psychological theories that assumed that Eurocentric/White and middle-class values are societal norms. Competence in multicultural counseling is crucial in societies with multiple representations of cultural groups whose social power and privilege statuses are differentiated based on visible (e.g., race, gender) and invisible (e.g., homosexual/bisexual/trans-gendered orientation, language) attributes.

Minority Worldviews, Therapist Biases, and Relationship Dynamics

Multicultural counseling is best understood in relation to competence guidelines published and enforced by professional counseling and psychology associations in multicultural countries (e.g., United States). A tripartite model presented by Derald Wing Sue and his colleagues in 1992 provided a conceptual basis to delineate three key components of multicultural counseling competency: (1) knowledge of cultural minority groups, (2) awareness of therapist’s own worldview and cultural biases, and (3) application of culturally appropriate skills to intervene with client’s presenting concerns as well as therapist biases.

Cultural Knowledge

In the past, multicultural counseling has focused on knowledge of cultural characteristics (e.g., Asians are collectivistic) and culture-specific tactics purported to be preferred by minority clients (e.g., Asians prefer a directive counseling approach). Stanley Sue and Nolan Zane have argued that knowledge of this kind, however, is distal to positive treatment goals as it perpetuates cultural stereotypes and ignores the individual differences within the respective minority groups. What is more important is therapist knowledge of the within-group differences in minority clients’ cultural identity development. Some minority group members aspire to or internalize majority values, some embrace their cultural roots and reject the majority culture, and some attempt to appreciate and integrate both majority culture and cultural roots toward developing a bicultural identity. Theories of racial identity development, including the work of Janet E. Helms and her colleagues, and lesbian/gay/bisexual identity development, including the work of Reynolds and Hanjorgiris, have delineated the identity confusion and conflicts between self-acceptance and self-rejection among cultural minorities during the process of developing awareness of and confronting oppression and marginalization. As such, multicultural counseling competence entails therapist empathic understanding of the catalytic impact of majority oppression on the identity development and coping of minority clients.

Recognizing that both clients and therapists are products of cultural socialization that assigns them a majority or minority status, multicultural counseling emphasizes therapist knowledge of how cultural upbringing and ascribed status shaped their own worldview. Along with micro-knowledge of cultural group characteristics and macro-knowledge of societal forces that perpetuate and exacerbate client’s counseling concerns, multicultural counseling emphasizes therapists’ knowledge of their own attitudes and biases toward other cultural groups, especially therapists who are members of the majority group. Rather than developed through the lens of a single theorist, multicultural counseling is rooted in a culture-centered tradition, recognizing the therapists and the mainstream theoretical approaches they are trained to use are also culture bound. In a multicultural counseling relationship, therapist credibility is reflected by competence to discern and curb the therapist’s own biases that may result in discriminatory, oppressive, or racist practice throughout the assessment, diagnostic, and intervention process.

Minority Group

Multicultural counseling is concerned with the psychological development and psychosocial (mal)adjustment of clients who are ascribed a power-disadvantaged societal status due to their cultural group membership. Regardless of their numerical representation in a given society, these cultural groups are considered minorities in sociopolitical power. Consequently, they are subjected to experiences of discrimination, racism, or oppression. Multicultural counseling literature has focused on women, non-White Americans in predominantly White societies (e.g., Asians, Blacks, Latino/as in the United States), and people with homosexual/ bisexual/transgendered orientations.

Majority Group

Of equal if not more significance, multicultural counseling examines and delineates the psychosocial impact of oppression caused by people who internalized the power afforded by virtue of their cultural group membership. These people represent the majority group as the imbued sociopolitical power enables them to maintain and consolidate their privileged status at the expense of other minority groups. Sexism, racism, and heterosexism have been associated with the majority groups of men, Whites (e.g., White Americans), and heterosexual people in multicultural societies.

Multicultural Counseling Process and Intervention

To address the common problems of premature termination and attrition by minority clients in psychotherapy, therapist competence to establish credibility is considered essential to positive treatment outcome. Credibility refers to the client’s perception of the therapist as effective and trustworthy. Minority clients’ underutilization of and attrition from psychotherapy have been attributed to their perception that psychotherapy is a tool to conform them to the majority worldview. In other words, therapists and psychotherapy lose credibility when minority clients do not have trust and faith that their counseling concerns will be understood from their cultural belief system. Therapist credibility can be ascribed, achieved, or both. Ascribed credibility refers to the position or status assigned to the therapist by the minority client. Therapist race, gender, and age are some of the determining factors. Such status may be afforded independently of the therapist skills. For example, a Black client who had repeated experiences with White racism may ascribe low credibility to a White therapist. A female therapist may be perceived as more credible than a male therapist by a female client who is a victim of rape. Regardless of the therapist skills, ascribed credibility is somewhat beyond the therapist’s control. Achieved credibility refers more directly to skills demonstrated during the therapeutic encounter. Credibility is achieved when therapist actions lead a skeptical and guarded client to trust the therapist and stay in counseling. Achieved credibility is related to therapist skills to offer conceptualization that is congruent with the minority client’s belief system, as well as provide intervention strategies that are appropriate and acceptable within the client’s cultural system.

In a cross-cultural dyad, a minority client may ascribe initial credibility based on a particular therapist attribute (e.g., racial match in which a Black client believes a Black therapist would understand experiences of racism). Yet when a therapist fails to consider the client’s cultural system and minority status (e.g., a Black therapist who denies existence of societal racism) in the assessment, conceptualization, and intervention process, the therapist loses achieved credibility. Despite the initial ascribed credibility, low achieved credibility may result in client distrust of the therapist, nondisclosing behaviors, and attrition from therapy. On the other hand, a minority client may ascribe low credibility due to a particular therapist status attribute (e.g., cross-racial dyad in which therapist race triggers client’s feelings of racism). Yet, therapist ability to depersonalize, contextualize, and empathize with the client’s initial guardedness and skepticism may enhance the therapist’s achieved credibility, thereby decreasing client defensiveness and facilitating client retention in therapy.

Beyond credibility, social justice is the ultimate concern for which therapists and the profession of psychotherapy enable and empower minority clients. Multicultural counseling, therefore, focuses on therapist knowledge of the intricate factors that facilitate and impede the counseling relationship and dynamics between a therapist and client from different cultural groups.

In clinical practice, multicultural counseling positions and conceptualizes clients’ presenting concerns within the context of societal discrimination, racism, or oppression. It seeks to help clients whose counseling concerns are rooted in their minority status to re-attribute sources of distress to contextual rather than personal causes. In training and supervision, multicultural counseling delineates and analyzes if the power differential due to counselor and client’s majority-minority group statuses adversely affects the quality of the therapeutic relationship, such as premature termination or conforming minority clients to majority values. As such, effective intervention focuses not only on the minority client, but also on the therapist cultural biases, as well as the interplay of majority-minority values in the therapeutic relationship. Recognizing the catalytic impact of majority oppression, multicultural counseling intervenes at both the individual and the systemic level. Beyond individual psychotherapy, multicultural counseling engages in advocacy for, and empowerment of, minority clients to achieve social justice.

In sum, multicultural counseling entails therapist competence in the following three domains: (1) empathic knowledge of the impact of societal oppression on the identity development and conflicts of clients who are ascribed a minority status by virtue of cultural characteristics, (2) recognition and confrontation of the therapist’s own cultural biases and internalized worldview of the majority group, and (3) skill to discern and apply cultural knowledge to instill trust and credibility in the cross-cultural therapeutic relationship. Beyond individual psychotherapy, therapists also intervene in social advocacy and empowerment of minority clients for the cause.

References:

  1. American Psychological Association. (2002). Guidelines on multicultural education, training, research, practice, and organizational change for psychologists. Washington, DC: Author.
  2. Helms, J. E., & Cook, D. A. (1999). Using race and culture in counseling and psychotherapy: Theory and process. Needham, MA: Allyn & Bacon.
  3. Reynolds, A. L., & Hanjorgiris, W. F. (1999). Coming out: Lesbian, gay, and bisexual identity development. In R. M. Perez, K. A. Debord, & K. J. Bieschke (Eds.), Handbook of counseling and psychotherapy with lesbian, gay, and bisexual clients (pp. 35-56). Washington, DC: American Psychological Association.
  4. Sue, D. W., Arredondo, P., & McDavis, R. J. (1992). Multicultural counseling competencies and standards: A call to the profession. Journal of Counseling & Development, 70, 477-183.
  5. Sue, S., & Zane, N. (1987). The role of culture and cultural techniques in psychotherapy: A critique and reformulation. American Psychologist, 42, 37-15.

See also: