Counseling the Culturally Diverse. Laura Smith L.

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CHAPTER 3 Cultural Perspectives and Barriers: The Individual Interplay of Cultural Experiences

      Full Counseling Session video (Part I): “Barriers to Effective Multicultural Counseling” (features “Melissa” and “Ruri”)

      CHAPTER OBJECTIVES

      1 Identify the basic values, beliefs, and assumptions that characterize U.S. society, and how these can manifest in counseling practice.

      2 Develop an awareness of how taken‐for‐granted, generic characteristics of counseling and psychotherapy may be barriers to culturally diverse clients.

      3 Describe how the cultural values and characteristics of diverse populations may affect the counseling process.

      4 Understand the relevance of culture‐related communication barriers as pitfalls for counselors, given that verbal communication is the basic vehicle by which counseling and therapy take place.

      5 Learn how Western conceptions of the family may detrimentally impact counseling and therapy with diverse families.

      6 Understand the linguistic barriers that may arise in working with clients whose first language is not English.

      7 Describe how socioeconomic class issues can also create cultural barriers that undermine mental health services.

      8 Learn how Western conceptions of the family may detrimentally impact counseling and therapy with diverse families.

      Full Counseling Session video (Part I): “Communication Styles and Counseling” (features “Joel” and “Reiko”)

       It would be weeks of replaying that conversation (over and over again in my head) before I would pick up the phone and call [the therapist's] office … I told you about me, my struggles and how I was feeling inside. You sat there in your expensive clothing, your perfectly decorated office, and smiled at me the entire time. When I finished being open, vulnerable and raw, you said words that would haunt me to this day: “You seem like a strong Black woman, and found ways to cope. I'm proud of you. Please come back if you feel like life is too much to handle” … Why didn't you hear me? Why didn't you acknowledge the internal battle between me, my culture and my faith that I had to overcome? Why didn't you see all of me? Why did you ignore the tears that streamed down my cheeks? Why didn't you know that I had had enough of being “strong?” (Cooper, 2017, para. 5)

       “You're always moderating yourself,” [says] a Latina executive, who feels that Latinas “are always tagged with the emotional thing. They're always told, ‘Calm down. You've got to be more cool. Be careful with your voice, be careful with your hands’.” Hispanic men echo her observations. One ruefully told of moving from a Hispanic‐dominated company, where he could gesture eloquently and speak passionately, to a Caucasian workplace where he had to “scale back” his expressiveness. (Hewlett, Allwood, & Sherbin, 2016)

       Asian cultures generally don't have a huge vocabulary for feelings or value them highly in the first place; we simply aren't encouraged to pay attention to them. Thus, many of us have limited awareness of our emotional experiences, let alone words to describe them. On top of that, talking about yourself is generally viewed as immodest in Asian cultures, which place a high premium on modesty. Through that lens, making regular appointments to talk about yourself seems self‐indulgent at worst and uncomfortable at best. The hurdles don't end there. Asian cultures tend to be vastly different than the Western ones from which most therapists, and the process of therapy itself, originated. In some regards, such as the emphasis on the individual vs. the group, the cultures are diametrically opposed. Thus, there's often a fear that cultural issues will be misunderstood or pathologized in therapy. (These fears are not unwarranted; the field has an embarrassing history of misinterpreting cultural nuances as personal shortcomings.) (Lin, 2014, para. 32)

      REFLECTION AND DISCUSSION QUESTIONS

      1 Based on what you've learned thus far, discuss the connections between sociohistorical factors and the cultural impasses mentioned in the examples.

      2 What might their effect be on a client? On a therapist? On the treatment?

      The preceding excerpts illustrate the cultural impasses that can prevent therapists from working effectively with their clients. The women speaking in each example had become aware of a clash between her experience of herself and the assumptions made by a therapist or other professional. We can assume the professionals in these situations had every intention to be helpful, but because they could not see beyond the limits of their own expectations and values, the women were left feeling misunderstood and disrespected. In this chapter, we discuss the culture‐related characteristics of conventional mental health practice that can act as barriers between helping professionals and clients.

CHARACTERISTICS OF CONVENTIONAL COUNSELING

      All theories of counseling and psychotherapy are influenced by assumptions that theorists make regarding the goals for therapy, the methodology used to invoke change, and the definition of mental health and mental illness (Corey, 2013). Given the Western European origins of conventional psychotherapeutic practice, it is not surprising that counseling and psychotherapy have historically and traditionally been conceptualized via Western individualistic concepts and terms (Ivey, Ivey, Myers, & Sweeney, 2005). Whether particular theories are psychodynamic, existential‐humanistic, or cognitive behavioral in orientation, multicultural specialists (Ivey, Ivey, & Zalaquett, 2014; Ponterotto, Utsey, & Pedersen, 2006) have explained that they usually share certain common components of White European American culture at the level of their underlying values and beliefs. Because this cultural worldview predominates in U.S. society, its assumptions have come to be taken for granted. This means that the mark that it makes on practices like psychotherapy can almost be invisible to mental health professionals, yet for individuals from diverse cultural backgrounds, it can be readily apparent, as illustrated in the passage that opened the chapter.

      In addition to their origins in White European culture, standard psychotherapeutic practices have developed largely among middle‐class and affluent segments of the population (Smith, 2010). For this reason, the values, assumptions, and goals associated with psychotherapy correspond primarily to the lives and experiences of people with social class privilege rather than those of people living in poverty. Just as culturally diverse clients may not share the values and lifestyles assumed within the goals and the processes of therapy, neither may clients from poor or working‐class backgrounds (APA Task Force on Socioeconomic Status, 2007; Reed & Smith, 2014).

Katz (1985) has isolated some of the components of White European American culture that can be reflected in the goals and processes of clinical work. These components are summarized in Table 3.1. The sections that follow will refer to some of these components as we explore the ways in which culturally diverse clients may be excluded or inappropriately served by therapists who cannot see beyond dominant‐culture assumptions. This discussion of taken‐for‐granted mainstream values is just as important to the pursuit of multicultural competence as is a discussion of the traditions of diverse cultural groups. Learning about traditions, holidays, and other characteristics of various cultures around our country and around the world is, in fact, usually the easier part of the work—much easier that becoming aware of the everyday, taken‐for‐granted assumptions that can obstruct our full understanding of ourselves and the client who sits just across from us. As we explore these issues, what you'll find ahead in the chapter is:

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