Multicultural Counseling

F. Kenneth Freedman

Introduction

How to recognize the individuality of a client while simultaneously acknowledging and honoring the deep cultural values held by the client?

My contention, and the one espoused by Sue and Sue (1990), is that the counselor or therapist must be extremely sensitive to cross-cultural issues: to the individual, to the culture of the client, and to his or her own prejudices and racism. Belief and attitude, they contend, might rank as high on the building-trust scale as cultural awareness, which would augur against my being right because I’m Gay; and so I backed off. But not without reservations about the groups’ understanding of cultural differences (including the Gay man and the Lesbian!)

In this Paper I will explore those issues--and discuss counseling considerations from a cultural standpoint--and look at 4 distinct cultural groups: African Americans, Hispanic Americans, Asian Americans, and American Indians.

 

...on the politics and pitfalls of multicultural counseling

First, racism is a basic and integral part of U.S. life and permeates all aspects of our culture and institutions. Second, Whites are socialized into U.S. society and, therefore, inherit the biases, stereotypes, and racist attitudes, beliefs, and behaviors of the society. In other words, all Whites are racist whether knowingly or unknowingly. Third, how Whites perceive themselves as racial beings seems to follow an identifiable sequence that can be called stages. Fourth, the stage of White racial identity development in a cross-cultural encounter (counseling minorities, counselor training, etc.) affects the process and outcome of an interracial relationship. Last, the most desirable stage is the one where the White person not only accepts his/her Whiteness, but defines it in a nondefensive and nonracist manner (Sue and Sue, 1990, p. 113).

Perhaps the most difficult admission I had to make reading Sue and Sue’s (1990) book was the fact of my own racism (which was also discussed in a workshop at the May, 1997 Prescott College colloquium). I was raised in a predominantly White middle-class Jewish home, and went to a school that reflected that upbringing (except that there weren’t too many other Jews, either, of whom I was aware). I don’t think I encountered an African American face-to-face until junior high school, and then didn’t know what to do or say. In college I briefly dated an African American woman, a Jewish woman from South America, and a White woman from Kansas. In Alaska I was briefly lovers with an African American man and then with an Inupiaq man (Alaska Native). In nearly all instances I was out of my element. I was dealing with cultural values I knew nothing about, and wasn’t conscious enough to know that I had homework to do. In the last relationship, I took my first awkward steps into multicultural awareness, an awareness that there was more to a cross-cultural relationship than going to the museum to see how "they" used to live. I am not free of my racism; but I am "awake."

Sue and Sue (1990) believe that

[a]s mental health professionals, we have a personal and professional responsibility to (a) confront, become aware of, and take actions in dealing with our biases, stereotypes, values, and assumptions about human behavior, (b) become aware of the culturally different client’s world view, values, biases, and assumptions about human behavior, and (c) develop appropriate help-giving practices, intervention strategies, and structures that take into account the historical, cultural, and environmental experiences/influences of the culturally different client (Sue and Sue, 1990, p. 6).

Aside from the obvious implications of such a statement, I think it’s important to look also at our sometimes unconscious attachment to the idea that our world view (as individuals) is better than anyone else’s, regardless of race. It is far too easy to assume that a client will "get better" after seeing the world though "my" ideological eyes. The hard part is to work with a client, helping him or her find his or her own best way (within the laws of the country). Moral values are much harder to assess in a multicultural environment, since there are so many different ones. The work a therapist must do (for him- or herself), I believe, is around feeling threatened by the client’s values or, worse yet, ignorant of what exactly a client is expressing by espousing certain values. An example of this is my own belief about monogamy. I prefer it and feel it’s a better way to conduct a relationship. In Gay culture, however, and to a similar but lesser degree in Lesbian culture, open relationships are considered acceptable. When a Gay man or Lesbian comes to me with personal problems and mentions the fact that they are in an open relationship, I have to take a step back and wonder if this is really a part of the problem, and further, if my values around monogamy are going to interfere with my treatment planning.

Sue and Sue (1990) state that much of the reason minority populations generally tend to avoid counseling is the counselor’s (general) lack of cultural sensitivity and mistrust of a practice that essentially is geared toward White middle-class America. Their contention is that

we need to expand our perception of what constitutes mental health practices. Equally legitimate methods of treatment are nonformal or natural support systems (Brammer, 1995; J. C. Pearson, 1985) so powerful in many minority groups (family, friends, community self-help programs, and occupational networks), folk-healing methods (Padilla and DeSnyder, 1985), and indigenous formal systems of therapy (Draguns, 1981). Instead of attempting to destroy them, we should be actively trying to find out why they may work better than Western forms of counseling and therapy (Sue and Sue, 1990, p. 8).

One of the concepts that has fascinated me ever since I became involved in the counseling process is the idea that not all therapy works. Not that it has to. I refer to the idea that some clients can stay in therapy for years and may still not come out of the process with a relatively satisfying life. I have wondered (in addition to the possibility that some pathologies are, indeed, incurable) if there isn’t a direct relationship between the client’s perception of the counselor, the counselor’s perception of him- or herself, and the counselor’s intention regarding the client. Could it be that an unconditional and nonjudgmental acceptance of the client where he or she is in a given psychological moment, and the counselor’s detachment from the outcome of the session (and, indeed, his or her own concepts of healing), would go a long way toward the client’s having his or her own internal permission (under the counselor’s ægis) to touch and respond to their own healing process? It seems that the indigenous and Eastern "psychologies" are based on this assumption, one which many Western counselors and therapists want to study. (I realize there is a Pollyanna attitude here, but somehow can’t yet shake the feeling that unconditional love coupled with a strong belief in the healing abilities of the client and his or her fundamental wholeness and goodness could go a lot farther in helping a client heal than mere uninvolved and unattached application of technique. (This sounds naive as I re-read it--I wonder if I’m completely off track with this idea of "intent.")

There is no question that cross-cultural counseling needs to be taught to would-be counselors.

The curriculum must also be designed to stimulate this awareness not solely at a cognitive level. It must enable students to understand feelings of helplessness and powerlessness, low self-esteem, poor self-concept, and how they contribute to low motivation, frustration, hate, ambivalence, and apathy. Each course should contain (a) a consciousness-raising component, (b) and affective component, (c) a knowledge component, and (d) a skills component (Sue and Sue, 1990, p. 16).

Would that it could be a part of our national consciousness! If our desire to explore diverse nations and cultures were as powerful as our so-called sex-drive (and the myriad gyrations we’ll put ourselves through to get it), the need for cross-cultural counseling might lessen significantly. I believe cross-cultural counseling is more than a subject to be taught in school--it is a way of life; the effective person, much less counselor or therapist must have a wide-world view to be effective, in my opinion, even if his or her friends or clients are exclusively from one culture only!

Sue and Sue (1990) talk about the politics of counseling, and in that regard call to the profession to

demonstrate, in no uncertain terms, its good faith and ability to contribute to the betterment of a group’s quality of life. This demonstration can take several directions.

First, the counseling profession must take initiative in confronting the potential political nature of counseling (Katz, 1985)....

Second, the counseling profession must move quickly to challenge certain assumptions that permeate our training programs....

Third, research can be a powerful means of combating stereotypes and of correcting biased studies....

Fourth, there is a strong need for counseling to attract more ethnic minorities to the profession, complex as this issue is....

Fifth, counselors must realize that many so-called pathological socio-emotional characteristics of ethnic minorities can be directly attributed to unfair practices in society....

Last, making research with minorities a community endeavor can do much to lower hostility and develop trust between researcher and subject (pp. 24-26).

In working at Southcentral Foundation as part of my Practicum, I have discovered that some clients enjoy the one-on-one office atmosphere, and talking about their problems. Some, however, particularly enjoy being out of the office, walking and talking, having a soda and talking, or sitting in the park and talking. With one Aleut youngster (in addition to the age factor) being indirect has been more of a conversation starter than being direct. (This is part of the culture but may also be related to the age difference.) Once he discovered that I had family, however, and after he got to talking about my earrings (and how he wanted some, too), and after we went to get a soda together, his attitude changed. Some of this is cultural and some relational, but his cultural and spiritual upbringing is a major consideration for me in the counseling process. I agree with Sue and Sue (1990) that there need to be different approaches based on cultural needs, yet I have found mostly resistance to this idea (except at Southcentral Foundation where alternative therapies are actively used) when I raise the subject of alternative counseling practices, regardless of cultural considerations.

Rather than demanding that the client adapt to the counselor’s culture, it may be better for the counselor to adjust to and work within the client’s culture. In other words, alternative roles involve the counselor more actively in the client’s life experiences than what we have traditionally been trained to do. Outreach roles, consultant roles, change-agent roles, or the use of the client’s indigenous support systems may be more appropriate., Many minority group individuals find the one-to-one/in-office type of counseling very formal, removed, and alien. When counselors move out of their offices into the environments of their clients, it again indicates commitment and interest in the individual (p. 28).

While I have not yet made any particular commitments to any methodology, I do tend toward Rogers’ thinking--though I differ in that I don’t generally remain in the non-directive arena: I will push, cajole, coax, coach, teach, laugh with, provoke, and show my caring for a client, just as might happen in real life. My philosophy is that we must be able to accomplish comfortably in the office what they client expects to do in the real world. Introspection is a part of that--including how to be quiet and sad and reflective and alone and even to find the solace there (and not panic), as much as finding the humor and intimacy and assertiveness. I will do anything that works to jog the client out of whatever space they’re in, even if for a few moments, so they can see even just one more option than they’d seen before; felt even just one feeling they hadn’t been aware of before; move even just one step closer to the person they feel inside they can be.

In a cross-cultural situation, techniques have to be carefully tailored. Some two-culture clients are marginalized and that is a whole area of consideration in itself. In many of my previous papers (Freedman, 1996, 1997a, 1997b, 1997c, 1997d) I have discussed stages of identity and development that many Gay men and Lesbians process through before reaching a positive sense of self living in two distinct but intertwined worlds. The racial acculturation process is similar, so much so, that when I gave a speech recently referring to this issue, people asked me afterwards where I dreamed up this marvelous theory: apparently they hadn’t seen Gay and Lesbian development as clearly as when they understood that it is tantamount to growing up in a foreign culture and having to learn two languages, new social customs, mores, values, and habits.

For example,

not all cultures view individualism as a positive orientation; rather, it may be perceived in some cultures as a handicap to attaining enlightenment, one that may divert us from important spiritual goals. In many non-Western cultures, identity is not seen apart form the group orientation. The personal pronoun I in the Japanese language does not seem to exist. The notion of atman in India defines itself as participating in unity with all things and not limited by the temporal world.

Many societies do not define the psychosocial unit of operation as the individual. In many cultures and subgroups, the psychosocial unit of operation tends to be the family, group, or collective society (Sue and Sue, 1990, p. 35).

Sue and Sue (1990) also point out that many cultures don’t value verbalizations the same way U. S. Americans do. In fact many Japanese clients respond with silence to a counselor who is older, "wiser," and who occupies a position of higher status (p. 37). At issue is how to work with clients from different cultural backgrounds, respect their customs and culture, not allow racism and judgments to color the sessions, and still be of help.

Too, insight isn’t necessarily prized for many clients from different cultures:

After all, insight assumes that one has time to sit back, to reflect and to contemplate about motivations and behavior. For the individual who is concerned about making it through each day, this orientation proves counterproductive.

Likewise, many cultural groups do not value insight. In traditional Chinese society, psychology is not well understood. It must be noted, however, that a client who does not seem to work well in an insight approach may not be lacking in insight or lacking in psychological-mindedness. A person who does not value insight is not necessarily one who is incapable of insight (Sue and Sue, 1990, p. 38).

This is my Achilles’ heel. I have "processed" so much over the past 7 years, and psychologically gone through so much in the years before that, that insight is where I naturally tend. Even to the extent of somewhat pooh-poohing behavioral methodologies. This is not good. What I need, and what a good counselor needs, in my opinion, is to develop an intake procedure that helps determine what the client wants and what the counselor can offer. I realize I can’t be effective for all clients, and referrals may be in order if I’m being called on to offer, for example, and existentialist approach, or even a formal behavioral approach. I can use those techniques, if I study up, but they are not my forte, as of yet. It seems that there’s a need for counselors to understand their strong and weak spots so as to be better able to serve his or her clients.

A very interesting footnote to the Western value of insight is the belief in some cultures that symbolic logic is very much not the way to healing:

For example, American-Indian world views emphasize the harmonious aspects of the world, intuitive functioning, and a holistic approach--a world view characterized by right-brain activities (Ornstein, 1972), minimizing analytical, reductionistic inquiries. Thus, when American Indians undergo counseling, the analytic approach may violate their basic philosophy of life (Sue and Sue, 1990, p. 41).

How, then, does a counselor work in right brain therapy? The answer to that question is probably the subject of several books and dissertations; however, my momentary answer, is to work in right brain activities and not much analysis; to work in stories, music, drawing, and so forth, activities that can call the body, mind, spirit, and feelings into the process without necessarily sitting in a chair pointing specifically, but abstractly to matters pertaining to those areas.

Another important cultural distinction is what is expected from a counselor by a culturally different client. For many Third World clients, anything not physical is taken to the priest, minister, or physician (Sue and Sue, 1990, p. 41). Many times, a culturally different client will expect a counselor to effect change just as a physician might, and at the least, give directions that will help cure the problem. Disclosure in counseling might bring shame on the family, and the counselor is not seen as someone in whom to confide, but rather as someone to mend the hurt. It is significant to note that for some people, "avoidance of morbid thoughts is the way to deal with psychological problems, not sitting down and talking about them" (Sue and Sue, 1990, p. 42).

Another area to be aware of is class distinctions. Psychotherapy has tended to be a middle-class phenomenon, and counselors can easily fail to recognize "attitudes that result from physical and environmental adversity" (Sue and Sue, 1990, p. 43). The irony is that counselors historically attribute mental conditions to lower class clients. In one sad incident, counselors, when given a lower-class boy’s chart disguised as an upper-class boy, "expressed a willingness to become ego-involved with the student," yet unwilling when they were told the boy was lower-class (Sue and Sue, 1990, p. 44). What is apparent, and important, is the counselors’ values and judgments. While clients may come with preconceived notions of what is to happen in therapy (which may or may not serve them effectively), it is equally necessary for therapists to not enter into a therapeutic relationship with preconceived notions of what they are "going to do" with the client. The very process of negotiation around what might work and what might not is a valuable part of the mutual adaptation process. It is, to me, a travesty for a counselor to treat a client from a different class, culture, sexual orientation, race, creed, or sex with anything but the utmost respect and caring. After all, this hour is an intimate sharing of souls, regardless of what is spoken or left unsaid: two people sitting in a room, knowing there are issues, knowing that one needs to unburden in some manner or another, wanting the solace that counseling supposedly offers--how else can one come to be an agent of change without honoring the fundamental goodness, integrity, and health of the client? regardless of presenting problems, affect, behavior, feelings, class, or culture?

The caution, always, is that people are unique. Stereotypes are not acceptable, and counseling must not be based on culture-bound ideas:

Individuals within a group, however, also differ. The background offers a contrast for us to see individual differences more clearly. It should not submerge but rather increase the visibility of the figure. This is the figure-ground relationship that should aid us in recognizing the uniqueness of people more readily (Sue and Sue, 1990, p. 48).

For the greater part of the (straight) White, male dominated U. S., communication styles tend toward a "low-keyed, dispassionate, impersonal, and issue-oriented approach" (Sue and Sue, 1990, p. 50). And yet, many communication styles exist, and many, if not most, of them contain great power in their ability to convey a message. Nor is it true that the "low-keyed, dispassionate, impersonal, and issue oriented approach" is the best way to get an idea or feeling across.

For effective counseling to occur, both the counselor and client must be able to send and receive both verbal and nonverbal messages accurately and appropriately. In other words, counseling is a form of communication. It requires that the counselor not only send messages (make himself or herself understood), but also receive messages (attend to what is going on with the client). The definition for effective counseling also includes verbal (content of what is said) and nonverbal (how something is said) elements. Furthermore, most counselors seem more concerned with the accuracy of communications (let’s get to the heart of the matter) rather than with whether the communication is appropriate. In traditional Asian culture, for example, subtlety is a highly prized art. The direct and confrontive techniques in counseling may be perceived by traditional Asian clients as "lacking in respect for the client," a "crude and rude form of communication," and a "reflection of insensitivity." In most cases, counselors have been trained to tune in to the content of what is said, rather than how something is said (Sue and Sue, 1990, p. 51).

In later sections of this Paper, I’ll address counseling considerations for a number of distinct cultural groups, but I wanted to introduce here the idea that corroborates the prior material, which is that understanding a client’s communication method is crucial to the counseling process. Not only understanding it, but being able to converse in it, at the very least, to let the client know you’re tuned in in some way. How can a client be comfortable in an already uncomfortable situation (two cultures) if the counselor gives little or no acknowledgment of the differences in communication methods? For example, "[s]ome Eskimos may actually prefer to sit side by side rather than across from one another when talking about intimate aspects of their lives" (Sue and Sue, 1990, p. 54). When some Japanese "smile and laugh, it does not necessarily mean happiness but may convey other meanings (embarrassment, discomfort, shyness, etc.). Many Asians believe that smiling may suggest weakness" (Sue and Sue, 1990, p. 54). "An educated Englishman may consider the lifting of the chin when conversing as a poised and polite gesture, but to U. S. Americans it may connote snobbery and arrogance (‘turning up his nose’)" (Sue and Sue, 1990, p. 54). "In many cases, it is not necessary for Blacks to look at one another in the eye at all times to communicate (Smith, 1981). A Black individual may be actively involved in doing other things when engaged in a conversation" (Sue and Sue, 1990, p. 55). A personal note: at lunch some time ago with an ex-lover and his sister (Inupiaq Eskimo) I was much more silent and nonverbally attentive than I usually am (talkative and actively engaged). Later, I was told I showed respect for their communication style and custom. Upon reflection, I realized I was tuning into their way of dealing with each other’s energy and blending my own ways with theirs--though I couldn’t have said, at lunch, that I was conscious of the choice.

A very interesting concept is what’s called high-context and low-context communication. In the former the message is anchored in the physical context, or internalized in the person, and there is less reliance on the explicit message. This form of communication relies heavily on "nonverbals and the group identification/understanding shared by those communicating. For example, a normal-stressed ‘no’ by a U. S. American may be interpreted by an Arab as a ‘yes’" (Sue and Sue, 1990, p. 58). The latter (low-context) places greater reliance on the verbal message.

It appears that the United States is a LC culture (although it is still higher than the Swiss, Germans, and Scandinavians in the amount of contexting required), China, perhaps, represents the other end of the continuum where its complex culture relies heavily on context. Asian Americans, Blacks, Hispanics, American Indians, and other minority groups in the United States also emphasize HC cues (Sue and Sue, 1990, p. 58).

This is a very important point for counselors to get. Even regardless of culture, how does the client communicate? And if the client is from a different cultural background, this knowledge is key to the success or failure of therapy. Black culture has been characterized as "nonverbal, inarticulate, unintelligent, and so forth" (Sue and Sue, 1990, p. 59), and well-founded charges of racism and paternalism aside for the moment (leading to reticence to disclose in therapy), Blacks tend to be a high-context culture and therefore needing fewer words than their White counterparts to get an idea across. A counselor could make a crucial mistake and remain ignorant of the high-context meanings if he or she believed that the Black client was resisting because he or she was using "shorthand" to describe a situation or feeling.

The flip side of the coin is the "color-blind" approach to race relations. For counseling it could spell disaster. Sue and Sue (1990) see race as an integral part of one’s identity, and that "those who advocate a ‘color-blind’ approach seem to operate under the assumption that ‘Black is bad’ and that to be different is to be deviant" (p. 77). My Inupiaq friend is very attuned to the racist overtones in a conversation, and when he raises the issue he is generally met with hostility. I suppose one reason for this might be his presentation. He is generally gentle but can be abrasive. On the other hand, the strength of people’s reaction seems to overshoot the intent of the confrontation. My opinion is that the people he confronts generally don’t like looking in a mirror and seeing racism. Ironically, they try to be "color-blind" missing all the while the beauty of being able to see and appreciate human colors--meaning diversity. A person may or may not identify with their racial heritage, but to deny that it exists (for a person who is culturally different or for a counselor) is burying one’s head in the sand.

The effects of racism can be handed down from generation to generation in the form of stories, behaviors, and feelings. It cuts both ways--from the person who is culturally different to the person in the dominant culture:

During slavery, in order to rear children who would fit into a segregated system and who could physically survive, Black mothers were forced to teach them (a) to express aggression indirectly, (b) to read the thoughts of others while hiding their own, and (c) to engage in ritualized accommodating-subordinating behaviors designed to create as few waves as possible (Willie, et. al, 1973, in Sue and Sue, 1990, p. 78).

Strange as it may sound, this phenomenon is similar in Gay and Lesbian culture. American Sign Language (ASL) has a communication technique called code-switching (where the signer "switches" from "real" ASL (used among the profoundly deaf) to the sort of sign that a hearing person can read when involved in the conversation). Gays and Lesbians, too, have a sort of shorthand and "code" they use when together, but "switch" when non-Gays are around. It is subtle, to be sure, but there nonetheless. It is the difference between high-context and low-context communication (which also speaks to my position mentioned in the introduction of this Paper.

The mandate, then, is for minorities to monitor their behavior carefully and not expose themselves to the point that their survival or psychological well-being might be threatened (Sue and Sue, 1990, p. 79). And so, for a counselor, the trust and rapport must be built carefully and on a foundation that, often, is laid stone by painful stone. For a minority culture member to open up completely, as is necessary for most Western therapies to succeed, would represent tremendous risk, both personally and in the context of a race consciousness. Open acknowledgment of racism and prejudice is a good place to start.

For myself, I find that as a counselor who is Gay and very out, building rapport is very much a two-way street. So far, I have not had to deal with homophobic or even homo-ignorant clients; but I will. And that process will be as important as it is for a culturally different client to deal with me in my racism and ignorance of their culture. We will have to establish ground rules, work through our mutual feelings of wariness and protection, build a history and way of communicating, be alert to our cultural differences in communication style and need, and slowly ease into a therapeutic relationship. This very process is a tremendously fertile ground for therapy in itself, and the astute and open counselor (and the willing client) will grow immeasurably as a result.

Another consideration (discussed in previous papers: Freedman, 1996, 1997a, 1997b, 1997c, 1997d) is that of racial similarity. Studies have frequently shown that when the counselor and client share cultural identity, there is better rapport. However,

[t]he studies on this are quite mixed as there is considerable evidence that membership group similarity may not be as effective as belief or attitude similarity. Furthermore, a number of studies (Parham, 1989; Parham and Helms, 1981; 1985) suggest that the stage of cultural or racial identity affects which dimensions of similarities will be preferred by the minority client (Sue and Sue, 1990, p. 85).

Sue and Sue (1990) devote a chapter to racial identity development. I wish to discuss it briefly but acknowledge that I cannot do justice to the model or psychology of it in this short Paper. I do wish to state, however, that a serious cross-cultural counselor will peruse the literature and immerse him- or herself in the culture or cultures. Incidentally, this model is very similar to Gay and Lesbian identity and development, which have also been discussed in my previous papers (see previous references).

The Cross model (1971; Hall, et. al., 1972) delineates a four-stage process (originally five) in which Blacks in the United States move from a White frame of reference to a positive Black frame of reference: preencounter, encounter, immersion-emersion, and internalization. The preencounter stage is characterized by individuals (Blacks) who consciously or unconsciously devalue their own Blackness and concurrently value White values and ways. There is a strong desire to assimilate and acculturate into White society. In the encounter stage, a two-step process begins to occur. First, the individual encounters a profound crisis or event that challenges his/her previous mode of thinking and behaving; second, the Black person begins to reinterpret the world and a shift in world views results. Cross points out how the slaying of Martin Luther King was such a significant experience for many Blacks. The person experiences both guilt and anger over being "brainwashed" by White society. In the third stage, immersion-emersion, the person withdraws for the dominant culture and immerses himself or herself in Black culture. Black pride begins to develop, but internalization of positive attitudes toward one’s own blackness is minimal. In the emersion phase, feelings of guilt and anger begin to dissipate with an increasing sense of pride. The final stage, internalization, is characterized by inner security as conflicts between the old and new identities are resolved. Global antiwhite feelings subside as the person becomes more flexible, more tolerant, and more bicultural/multicultural....

Although [this] identity development [model] pertain[s] specifically to the Black experience, we have already pointed out how various other groups have proposed similar processes (Sue and Sue, 1990, pp. 94-95).

The note for the counselor is to be aware of the stage the culturally different client may be processing, if at all. It is important to know, for example, if a client comes in disparaging his or her culture, he or she might be in stage 1 development and not merely a rebellion stage or even, perhaps, narcissistic wounding. The point is that it takes tremendous energy to hate oneself and put down the dominant culture; and the real focus--who a person really is and what to they want to do with their lives--is lost. Without some insight into one’s own racism (assuming the counselor is of the dominant culture), it would be easy to misread the presenting problem and the deeper hereditary legacy, and completely bungle a treatment plan.

Sue and Sue (1990) proselytize for a broader role for the counselor when dealing with culturally different clients, to the point of advocacy and community involvement. While I know there is some worry about dual relationships, I, personally, find myself moving away from the strict admonition that the client and the counselor can’t be involved in any relationship except for the one hour once a week and only in the office. I do not espouse a socially intimate relationship, but rather one in which the counselor can play several roles on behalf of the client (assuming there has been discussion and agreement well in advance of such interaction).

Sue and Sue (1990) also go into some detail on the subject of White identity development. Strange as it may sound, there are models for this process as there are for minorities (picture a White child growing up in Hong Kong, or in Egypt--even in the U. S.). For White counselors, however, and to be successful cross-cultural helpers, honesty about cultural differences becomes vital. "White people do benefit from the dominant-subordinate relationship evident in our society. It is this factor that Whites need to confront in an open and honest manner" (p. 114).

Sue and Sue (1990) wonder about social movements vis á vis identity development:

...identity transformations are seen as being triggered by social movements that have powerful effects on the culturally different individual’s identity. Does this mean that if social situations change, many of the cultural identity development models would also change? (P. 117).

My view of this is that were everyone in the world, for example, to suddenly discover that cultural differences (or even sexual orientation) wasn’t an issue any longer, there would indeed be a cessation of the Civil Rights movement. No one would need to advocate for their cultural group because a dominant culture was oppressing them. Cultural identity models would change radically, where there could be open celebration of different cultures, their values, their customs, their beliefs. There might be much more cross-breeding, perhaps even a greater dilution of some racial purity, if such a thing exists. What is important, I believe (and there isn’t enough space to discuss this subject even if it were the topic of a lengthy dissertation), is that the trauma around identity development would disappear and the celebration of life would take on a whole new meaning. Certainly other psychological problems would still exist and want healing; but the self-esteem issues around being culturally different would be eliminated, thus sweeping away the "damaged goods" feeling that so many culturally different people live with 24/7.

How do you see the world? How do you think about it? In terms of time? Space? Now? The future? The past? Who is responsible for you? God? Yourself? Buddha? Mother Earth? A person’s world view is important insofar as it contrasts with the counselor’s. Many minority cultures live in present time where Whites tend toward a future orientation. Other cultures see being as more important than doing (another predominantly White orientation). Then there is the concept of relationships. Some minorities see relationships as lineal, authoritarian, and hierarchical (traditional Asian), where American relationships tend to be more individual, and yet others are more collateral and horizontal (Sue and Sue, 1990, pp. 138-139).

To be aware of these orientations aids greatly in therapy. Without a conscious awareness, the counselor’s values may be imposed on the client, which leads to a client believing that their world orientation isn’t good enough, which is a mistake. To proceed with therapy on that basis can lead to harm being done to the client and the counselor wielding power inappropriately.

Some cultures emphasize external control as the locus of their lives, and some see the control as internal. Interestingly, research shows that ethnic group members, lower class people, and women score higher than others on the external end of the control continuum (Sue and Sue, 1990, p. 141). There is not always a judgment that one is better than the other, although that is sometimes true. It’s useful, however, to know that when an American Indian talks about not being able to control his or her problematic family life, it isn’t necessarily a call to be assertive and independent.

Flip the coin. Being assertive is more highly prized in White America than in some minority cultures. For a counselor to impose the value that assertiveness is the desired goal of therapy (or a part of it) might be a mistake.

[I must stop and note here that this field is vast and I am not trying to cover the myriad stories and theories that abound in this area. I acknowledge that these notes and my thoughts represent the tip of the iceberg in this huge area of multicultural counseling. Please refer to the References at the end of this Paper for deeper and more in-depth studies.]

Before launching into the four cultural groups mentioned in the introduction to this Paper, I’d like to mention a few summarized points which define, for Sue and Sue (1990) a culturally skilled counselor.

First, a culturally skilled counselor is one who is actively in the process of becoming aware of his/her own assumptions about human behavior, values, biases, preconceived notions, personal limitations, and so forth. Second, a culturally skilled counselor is one who actively attempts to understand the world view of his/her culturally different client. In other words, what are the client’s values and assumptions about human behavior biases, and so on? Third, a culturally skilled counselor is one who is in the process of actively developing and practicing appropriate, relevant, and sensitive intervention strategies/skills in working with his or her culturally different client (p. 166).

In addition to the counselor working on his or her own internal processes around cultures different from his or her own, Sue and Sue (1990) believe strongly that counselors working with culturally different people must be prepared to "exercise institutional intervention...when appropriate" (p. 171). This goes against the grain of a good deal of traditional practice as it exists in the U. S. My view is that the counselor, whether working with culturally different people or his or her own culture must be able to see and step beyond the traditional roles and barriers and boundaries where appropriate. That this action must be done from an ethical and moral standpoint can almost go without saying. I see my practice as involved with the client (though not sexually) in order that they may see and know unconditional love and realize that they can find acceptance from themselves, for themselves, and in themselves, and that they can take learned skills from the crucible of the counseling session to the wide world. And find happiness and fulfillment into the bargain. For me, that doesn’t connote non-involvement, though it does connote detachment.

My brief disclaimer to the following section is, again, an acknowledgment of the brevity of the explanations and information. I want to touch on salient issues, discuss some of them in a bit of depth, and cover as much ground as the scope of this Paper allows. The issue of counseling with the populations mentioned here (as well as all others) is far more vast and complex than these few words can convey.

 

Counseling American Indians

Many American Indians see themselves as extensions of their tribe (or Nation, as I’ve been told is preferred). "This identity provides them with a sense of belonging and security, with which they form and interdependent system.... Indians who leave the reservation to seek greater opportunities often lose their sense of personal identity since they lose their tribal identity" (Anderson and Ellis, 1988. in Sue and Sue, 1990, p. 177).

One of the initial questions I might ask an American Indian client is not only the degree of their biculturality, but their beliefs around tribal (or Nation) identity and belonging. It is not that I would automatically consider them abnormal if they didn’t hold all the views Sue and Sue (1990) outline, but rather I’d want to be sensitive enough to ask and learn. I don’t want to make an assumption that problems which are framed as adjustment disorders are necessarily a function of acculturation; but I don’t want to miss the reference either.

There is the additional factor of traditional Indian values and emerging bi-cultural values:

Indian children and adolescents not only face the developmental problems faced by all young people, they are also in a state of conflict over exposure to two very different cultures. They are caught between expectations of their parents to maintain traditional values and the necessity to adapt to the majority culture. These and other stressors may account for the fact that among Indian youth rates of truancy, school failure, drug use, and suicide are high (Red Horse, 1982; Shore, 1988, in Sue and Sue, 1990, p. 178).

The dilemma for a counselor might play out as the desire to see the client adjusted to being bi-cultural but seeing the client reject American Indian ways. Not that it is crucial to totally embrace one’s birth culture, but that it is a rich source of identity. My job as a counselor is to find out where the client is with his or her cultural identification, help determine if there are conflicts, and work from there. Without acknowledging the culture, I would feel at a loss, right from the start.

Some broad generalizations about American Indians include the following:

1. Sharing. Among Indians, honor and respect is gained by sharing and giving while in the dominant culture status is gained by the accumulation of material goods....
2. Cooperation. Indians believe that the family and group take precedence over the individual. Indian children may be seen as unmotivated in schools because of a reluctance to compete with peers in the classroom....
3. Noninterference. Indians are taught not to interfere with others and to observe rather than react impulsively. Rights of others are respected.
4. Time orientation. Indians are very much involved in the present rather than the future. Ideas of punctuality or planning for the future may be unimportant.... Things get done according to a rational order and not according to deadlines....
5. Harmony with nature. Rather than seeking to control the environment, Indians accept things as they are (Sue and Sue, 1990, pp. 178-179).

Even with the broad generalizations the preceding points represent, it would be in the best interests of a culturally aware counselor to at least ask about cultural values whether a client presents with cultural issues or not. To delve into problems without understanding the basic belief system of the culturally different client would be irresponsible.

I have a 12 year-old Aleut boy in counseling, who, so far, has not described much involvement with his culture. At his age, I wouldn’t expect much, unless his parents were more involved, which they aren’t. This saddens me in that he could be learning about his roots in a safe and story-filled environment, which would serve to enhance and enrich his life, whether or not he closely identifies with Aleut culture later in life. I am sad, personally, that we didn’t have more family stories about being Jewish or where our ancestors came from. I realize that when I was young I wasn’t much interested in sitting around and hearing about such "grown-up stuff," but I find it hard to believe that I couldn’t have listened to the stories. Some of my fondest memories of childhood were the stories that were filled with adventure: stories my Mother made up when we were driving long distances in the car. Would that some of those stories might have been filled with the real-life adventure that I am now hearing about as I ask my parents for information about our family tree.

"Substance abuse is one of the greatest problems faced by the American Indian. Cases of terminal liver cirrhosis are 14 times greater among Indians than non-Indians between the ages of 25 and 34" (Indian Health Service, 1978, in Sue and Sue, 1990, p. 182). "Suicide rates for American Indians are twice that of the national average, with adolescence to adulthood as the time of greatest risk" (Shore, 1988, in Sue and Sue, 1990, p. 182). Dealing with substance abuse is more than the scope of this Paper can encompass, but suffice it to say, it needs to be dealt with openly and honestly. I personally am not qualified to handle such cases and would want co-counseling or to make a referral should a person with substance abuse present in my office.

In counseling American Indians, Sue and Sue (1990) feel there needs to be open discussion, from the beginning, especially with Native adolescents, about the Indian/White relationship (assuming the counselor to be White). Both client and counselor get to consider their feelings about "values, self-identity, and relationship with the majority society" (p. 185).

They also point out that American Indians often have difficulty expressing strong emotions (except when drunk when not being responsible for one’s behavior makes such expressions acceptable). If this were the case with a client of mine, I would initiate discussions aimed at learning how one could express one’s feelings acceptably, especially if it were apparent that the client felt the need to do so. White U. S. Culture values anger workshops where American Indians might not. As with Asian Americans, the manner in which feelings and thoughts are expressed is frequently as important as the expression.

Before working with American Indians, it is important to be aware of our own cultural biases. Much of what we do is based on Western values and influences. We expect clients to establish good eye contact, to discuss inner feeling, and to verbalize concerns. American Indians often will not display these behaviors. In working with adolescents, we often work toward having them develop increasing independence from their parents. We also see the nuclear family as the basic unit. For American Indians, interdependence with the extended family might be the goal (Sue and Sue, 1990, p. 186).

More important than learning these generalizations about American Indians would be the attitude a counselor brings to the session. Openness may be as important as any knowledge about a given culture. Each client is unique, and while they may respond to certain cultural values and beliefs, it’s best to ask, to observe, to discuss. At present I have a middle aged Aleut man whose wife left him to go to school, got involved with another man, had a child, and now wants to get back together, and him to adopt the child. My client is considering the matter, getting to know the little boy, and trying to determine if he wants the responsibility that might be his should the ex-wife run off again. All this in the first session, and barely a word about how he feels about having been abandoned. My question for our next session, is how important does he think it is to work through the feelings? Is it more important, perhaps, to consider the implications of getting back together, meaning, preservation of the interdependence?

American Indians often will not open up with feelings right away. Trust must be developed. And American Indians sometimes expect the counselor to "offer alternatives and solutions to the problem. The appropriate combination of client-centered with behavioral approaches might be very effective" (Sue and Sue, 1990, p. 187).

As with all minority populations, there is sometimes a need to explain what counseling actually is. In addition to the mistrust about White folks and the "talking cure," there is the question of what the counselor will "do" to the client, what the client is supposed to "do," and how, exactly, the "cure" will take place. It is important to discuss questions of process and procedure up front if there is any question at all about how the process works, and what the expected roles are (and are not).

 

Counseling Asian Americans

There are at least 29 distinct subgroups in the Asian American population that differ in language, religion, and values (Sue and Sue, 1990, p. 189). As with other cultures, there are many within-group differences, and different degrees of assimilation and acculturation, etc. etc. Generalizations will be difficult, as they are with all cultures, but the first one is somewhat of a sacred cow, at least in the U. S. That is that all Asian Americans are successful economically, educationally, and socially. It seems that the success story is mitigated by reports of an "equal prevalence of poverty despite the higher median income...and... lower poverty assistance and welfare than the general population, and...a discrepancy between education and income" (Sue and Sue, 1990, p. 191). There seems to be a high education level for some, with a large population that is undereducated; and there is a lack of English mastery even among Asians who have lived in the U. S. for several generations. There are other caveats to the Asian "success story," but the point is well taken: there is a wide variance between the stereotypes we hold of various cultural groups and the reality, with some of the stereotypes being visible some of the time and none of them some of the time, too. Which means a counselor has to look at the cultural values in general when the Asian American client comes in the door, while simultaneously respecting this individual’s particular personality make up.

The history of Asian immigrants to the U. S. is littered with discrimination and murder, concentration camps and legal sanctions against them as a (composite) race. Like their African American counterparts, Asians (as well as Hispanic Americans, American Indians, and Gays and Lesbians) have a rich history from their countries of origin and a sometimes tortured sometimes happy one in the U. S. The difference between cultural minorities and U. S. "Whites" is one of historical "ownership," meaning they are the ones who (let us not forget, came from a foreign port) invaded, pillaged, conquered, and settled the land ("America") in spite of American Indians being here and "owning" the land for, perhaps, centuries before. Whites (or shall I say straight White men?) live here and have inherited all that America has to offer without having to consider discrimination. When covert or overt oppression is present, the counseling ethos changes dramatically. Now there are layers upon layers of psychological detritus through which to sift, and the going can be arduous. So, it is more complex when an Asian male comes for counseling, because of (among many other factors) that lack of ownership (an assured and automatic place at the table) to deal with, for example, relationship issues or job problems.

Remember, also, that "psychotherapy is a foreign concept to the east-Asian countries" (Sue and Sue, 1990, p. 197).

Physical complaints are a common and culturally accepted means of expressing psychological and emotional stress. It is believed that physical problems cause emotional disturbances, and that these will disappear as soon as there is appropriate treatment of the physical illness. Instead of talking about anxiety and depression, the mental health professional will often hear complaints involving headaches, fatigue, restlessness, and disturbances in sleep and appetite. Even psychotic patients typically made somatic complaints and sought treatment for those physical ailments (Nguyen, 1985, in Sue and Sue, 1990, p. 199).

In any instance where a client presents with physical problems, I’d want him or her to get a physical exam before deciding on a diagnosis. In the case of culturally different people, and in this instance of Asian Americans, it is a red flag that must be noticed. After that, there is still the matter of discussing issues in such a manner that shame will not be brought down on the individual or the family. Sue and Sue (1990) list some treatment strategies that might be of use to know:

1. Use restraint when gathering information. Because of the stigma against mental illness, the norm against sharing private matters with outsiders, the lack of client knowledge of the mental health field, the therapist should refrain from asking too many questions.
2. Prepare the clients for counseling by engaging in role preparation. Lambert and Lambert (1984) found that Asian immigrants who were told about (a) what happens in therapy, (b) the need for verbal disclosure, (c) problems typically encountered by clients in therapy, (d) the role of the therapist and client, (e) misconceptions of therapy, and (f) the need for attendance adjusted better to counseling than a control group who did not receive role preparation.
3. Focus on the specific problem brought in by the client, and help the client develop his or her goals for therapy.
4. Take an active and directive role. Because of cultural expectations and a lack of experience with mental health therapy, the clients will rely on the counselor to furnish direction.
5. Do a thorough analysis of current environmental concerns, such as the need for food and shelter.
6. In working with families, consider intergenerational conflicts especially due to changes in role, culture conflict, and differences in acculturation levels.
7. The therapy should be time limited, focus on concrete resolution of problems, and deal with the present or immediate future (pp. 199-200).

While these generalizations must be tailored to each client, they are useful information, if for nothing more than starting a dialogue between the counselor and client about cultural considerations, pitfalls, and values.

U. S.-born Asians have a different (or additional) problem from their immigrant relatives: they have two cultures in which to live, and their process is often about how to respect the ancestral and familial values but also fit into their new culture and feel accepted. I have partly discussed the process of discovering one’s culture and "coming out" as a bi-cultural person, embracing the values of both the dominant and the hereditary cultures. The Yellow Power Movement (not unlike the Black Power Movement) is a phenomenon that needs study. Rebellion alone may be suspect, but in the process of forging a new identity, this kind of rebellion can be quiet healthy:

Like the marginal person, the Asian American is rebelling against parental authority, as he or she attempts to develop a new identity that will enable him or her to reconcile viable aspects of his/her heritage with the present situation (Sue and Sue, 1990, p. 202).

The first, and perhaps most important, issue for a counselor to know is that when a traditional Asian American seeks counseling, he or she will probably be feeling "intense shame and guilt at admitting that problems exist" (Sue and Sue, 1990, p. 204). These problems might be presented indirectly, meaning complaints of bad grades or difficult vocational decisions. Sue and Sue (1990) suggest that a counselor deal with the presenting problems first, as a way to build rapport and trust before trying to delve behind the sometimes superficial issues. Asian Americans, in some studies, seem to

prefer a logical, rational, structured, counseling approach over an affective, reflective, ambiguous one. Since Asians respond more to structured situations and direct suggestions, the counselor must make modifications to his or her counseling style to incorporate these in order to be therapeutically effective (Mau and Jepsen, 1988; Yuen and Tinsley, 1981, in Sue and Sue, 1990, p. 204).

The need for flexibility is key. In counseling with one culture only, it is possible to ignore some of these considerations, though I feel a knowledge of other cultures and ways of living and coping and finding love and happiness are priceless tools for an enriched life. Nonetheless, I believe it is vital, for a counselor to be effective, to be able to change his or her methodology in order to develop trust with the client in order to help from a place where the client can recognize, appreciate, utilize, and assimilate the help.

Sue and Sue (1990) also believe that a counselor has an obligation to help the client sort out his or her identity conflicts by some form of education:

Specifically, the marginal person must be helped to distinguish between positive attempts to acculturate and a negative rejection of his or her own cultural values. Also, many Asians who desire independence from parental control are confusing independence for rejection of parental control (p. 206).

Any cultural conflict deserves attention, and particularly attention that is borne of insight and awareness on the part of the counselor. In addition to all the considerations that I haven’t had a chance to delve into here, one vital area is to help Asian Americans, when there are identity problems, to forge a new identity that neither adheres slavishly to the old traditions that may not work in the dominant culture nor denies its existence utterly.

The emphasis on the inequities of society and the feeling that change must be instituted in racist institutions make many Asian Americans suspicious of counseling services. Many feel that counseling services are agents of the Establishment and that their primary goal is to adjust clients to society. This can cause difficulties for both the client, whose political beliefs may mask his/her problems, and for the counselor, who must deal appropriately with certain challenges before counseling can proceed effectively (Sue and Sue, 1990, p. 207).

Counseling African Americans

It is easy to look at the pathology of minority cultures while ignoring the strengths inherent in every person, group, culture, and society. In African American families (which have been maligned for their dysfunction and absent fathers),

there exists an extended family network that provides emotional and economic support. Among families headed by females, the rearing of children is often undertaken by a large number of relatives, older children, and close friends. Within the Black family there exists an adaptability of family roles, strong kinship bonds, a strong work and achievement ethic, and strong religious orientation (Bass, et. al, 1982; Boyd, 1982, in Sue and Sue, 1990, p. 211).

In spite of the problems with racism and prejudice, Black families have been able to instill positive self-esteem in their children (Norton, 1983, in Sue and Sue, 1990, p. 211).

Not all families are nuclear in concept. I note the Gay and Lesbian families that are cropping up in greater numbers. Some families have two mothers and a father (the donor), and some have just two mothers, or just two fathers, and some have two fathers with a mother (the one who carried the baby). A counselor would do well to consider the structure of a family and its overall strengths before judging that the "problem" is due to the lack of nuclear structure.

Religious considerations may play an important role in dealing with Black families. And it might be appropriate to involve the minister in family therapy, even in individual therapy. If there is strong church affiliation it might even be useful to suggest church-related activities that could lend support to the therapy.

I don’t intend to go into family therapy here (nor in any part of this Paper, as it is a whole area in itself). I do, however, wish to acknowledge the need for such a discussion.

Given the racism inherent in the U. S. structure, it could be difficult to build rapport right from the start:

Franklin (1982) cautions that the counselor be vigilant and not be misled by information that is being provided. A streetwise youth might deliberately attempt to frighten or shock the counselor by describing use of drugs and sexual behaviors in graphic detail. Others might adopt a highly confrontive and aggressive stance or engage in "rapping" or telling tales as a means of "testing" out the therapist (Sue and Sue, 1990, p. 214).

Considering the ubiquity of racism in the U. S., I would be shocked if an African American client came in and didn’t test me. There is no particular reason to put trust in a system that itself systematically denies civil rights and denigrates whole cultures out of hand. Why would a White counselor be any more accommodating and understanding? It seems to me that the early discussions would have to include the relationship between the White counselor and African American client: the cultural differences; the value differences; the communication differences; the expectations from counseling; the expectations of the client, and of the counselor; and so on.

Biracial clients will present a different set of problems, though they might be similar to those previously discussed in the section on Asian Americans. However, this is more difficult because the client is not just trying to adjust to the dominant culture, but he or she is genetically part of it. How to acculturate to a society that oppresses you of which you are a genetic member?

An interesting note made by Sue and Sue (1990) is that "overall, it appears that Black Americans view counseling positively but may encounter difficulties during the counseling process itself" (p. 218). In this regard we might look at communication style. Much of African American culture depends on a more aggressive verbal style than White culture. There is a more confrontative stance and the language is largely high-context. There is an expectation that others understand that the seeming aggressiveness is merely normal communication and it is expected to be returned; mistrust may build up when it isn’t. Anger, too, is expressed differently, and it’s important for the counselor to know the difference.

Knowing that a client is black fails to inform adequately about his views of psychotherapy, about his personality and psychological conflict, and about his aspirations and goals in therapy, let alone about educational level, social background, or environmental context. There is enormous within-group variability. The question is not how to treat the black client, but how to treat this black client (Jones, 1985, p. 175, in Sue and Sue, 1990, p. 226).

Counseling Hispanic Americans

Sue and Sue (1990) use the term "Hispanic" to refer to "individuals living in the United States who come or are of ancestry from Mexico, Puerto Rico, Cuba, El Salvador, the Dominican Republic, and other Latin American countries" (p. 227). "Hispanic" as a term isn’t accepted, however, by all groups, some preferring "Latinos" or "La Raza" or (in the case of people from Mexico, "Mexicano," "Mexican-American," "Chicano," or "Spanish-American" ).

The demographics don’t bode well for Hispanics as a general rule: they are "overrepresented among the poor, have high unemployment, and often live in substandard housing. Most are blue-collar workers and hold semi-skilled or unskilled occupations" (Carillo, 1982, in Sue and Sue, 1990, p. 228). Students have a high dropout rate, which rises with age.

Cummins (1986) feels that a variety of factors, including intergroup power relationships, has much to do with the lack of educational success of Hispanic Americans. For example, Finnish students have a relatively poor academic performance in Sweden where they are considered a low-status group but are successful academically in Australia where they are a high-status group (Sue and Sue, 1990, p. 229).

I’m fascinated with the syndrome of how someone is seen by others as directly affecting his or her performance and, perhaps, self-esteem. There is truth in the legend of the ugly little girl who is told by her parents she is the most beautiful girl in the world and who grows up to marry the handsomest boy in town (with gender appropriately changed where applicable for Gay and Lesbian legend). Could this really apply to other cultures? In some form, this is one of the founding principles of my therapeutic style.

Again, as with the other minority groups discussed in this Paper, it is important to take a history and evaluate, along with the client, their social status, educational level, language ability, and other environmental factors, in order to avoid attributing problems inappropriately to racism or pathology alone.

Hispanic families, like many other cultural minorities, are generally close-knit, and family tradition plays an important part in that closeness. Competition is not as valued as cooperation, and interpersonal relationships, along with a large family network, are stressed. The Catholic religion "often has a major influence in Hispanic groups and is a source of comfort in times of stress" (Sue and Sue, 1990, p. 230). Because of this strong influence, and the belief that sacrifice is good, charity is a virtue, and wrongs need to be endured, assertiveness is sometimes difficult (Sue and Sue, 1990, p. 231). As with Asian Americans, I’d want to help a client discover how to be appropriately assertive without jeopardizing the family structure, assuming that to be an important consideration for the client.

Additionally, being is valued more than doing. Being with the family is more important than running off and doing "things." The family structure is generally hierarchical and special authority is "given to the elderly, the parents, and males" (Sue and Sue, 1990, p. 232). "Children are expected to be obedient and are usually not consulted in family decisions" (Sue and Sue, 1990, p. 233). This latter point could pose big problems for a bicultural person in that the U. S. attitude is that children are people with distinct personalities and need to be treated with respect. Growing up in a family that didn’t prize a child’s feelings and ideas could lead to problems later in life--ones that might be in direct conflict with the culture.

Sex-role conflicts can arise, especially considering that men are supposed to be macho and in charge; women obedient and long-suffering. When this equilibrium is disrupted, for economic or other reasons, conflict can occur, both within the family as a group (things are not going the way they’re supposed to go), and for an individual (I’m not fulfilling the role I was supposed to play).

As with any cultural minority, where value is placed on being a male or being a female, the counselor must help the client look at the values versus the necessities and stack it all up against the need to express oneself as an individual within the family structure. While it is possible to strike out on one’s own, that might cause others within the family and the ethnic group to reject or look down on the person who made such a radical shift, causing even more anxiety. Care must be taken in any culture where the family is the core of identity before radical change is undertaken.

Because of the importance of the extended family and the relationships among its members, family therapy is often recommended in working with Hispanics. This is especially important since changes in the client in an individual session may have profound effects on the family (De La Cancela, 1985; Padilla and DeSnyder, 1985, in Sue and Sue, 1990, pp. 239-240).

As with other cultural minorities, it is sometimes helpful to start with a respectful, warm introduction. And it’s certainly important to pronounce the client’s name correctly. Nothing is as off-putting as a counselor who mispronounces your name!

Knowing the proficiency with English is equally important. Relative knowledge isn’t the same as mastery, especially in a counseling situation. There is much writing about clients who use English, for example, to discuss strategy and day-to-day issues, and Spanish, for example, to discuss feelings. A culturally skilled counselor would be showing considerable integrity by acknowledging and working with a client on how to bridge this gap.

Conclusion

This Paper has surveyed the some of the political and educational issues for what Sue and Sue (1990) call culturally-skilled counselors. I have discussed counseling techniques and recounted personal stories relevant to that process and limned 4 cultural groups and their relationship to White counselors (keeping in mind that cultural stereotypes must be avoided and people treated as individuals regardless of their heritage).

I have pointed out, among other things, that many non-White cultures don’t prize assertive individuality or instant self-disclosure, may prefer a more subtle approach to discussing feelings, may not deal in direct eye contact, and may, in fact, be distrustful of the whole concept of psychology. African Americans may prefer what seems a more confrontational style of communicating, and it will probably be more high-context than White communication, as is true for most non-White cultures--even ASL!

The main point of the Paper is that counselors, to be effective in what is rapidly becoming a truly multi-cultural U. S., will have to adapt to the cultural exegencies of their clients in many ways, and try to accommodate their belief systems more, perhaps, than trying to fit them into a neat U. S. psychology which is no longer (if it ever was) a one-size-fits-all movement. Additionally, it will become increasingly important for the culturally-skilled counselor to have more out-of-office experiences, sometimes advocating for their clients and sometimes getting involved in social and political causes.

A final point is that while it is necessary for the culturally-skilled counselor to have a working knowledge of the client’s culture, it may be as important that the counselor bring an attitude and belief system to the session that the client perceives to be trustworthy. It is in the fundamental areas of communication (with self and others), trust (in self and in others), and the basic hope and faith that there can be a reasonably happy future that healing may begin

.

References

Anderson, M. J. & Ellis, R. H. (1988). "On the reservation." In N. A. Vacc, J. W. Wittmer & S. DeVaney (Eds.), Experiencing and counseling multicultural and diverse populations (2d Edition), pp. 107-126. Muncie, IN: Accelerated Development.

Avila, D. L. & Avila, A. L. (1980). "The Mexican-American." In N. A. Vacc & J. P. Wittmer (Eds.) Let me be me, pp. 225-281. Muncie, IN: Accelerated Development.

Bass, B. A., Acosta, F. S., & Evans, L. A. (1982). "The Black patient." In F. S. Acosta, J. Yamamoto, & L. A. Evans (Eds.), Effective psychotherapy for low-income and minority patients, pp.83-108. New York: Plenum Press.

Boyd, N. (1982). "Family therapy with Black families." In E. E. Jones & S. J. Korchin (Eds.), Minority mental health, pp. 227-249. New York: Praeger.

Brammer, L. (1985). "Nonformal support in cross-cultural counseling and therapy." In P. B. Pedersen (Ed.), Handbook of cross-cultural counseling and therapy. Westport, CT: Greenwood Press.

Carillo, C. (1982). "Changing norms of Hispanic families." In E. E. Jones & S. J. Korchin (Eds.), Minority mental health, pp. 250-266. New York: Praeger.

Cross, W. E. (1971). "The Negro-to-Black conversion experience: Towards a psychology of Black liberation." Black World, 20, 13-27.

Cummins, J. (1986). "Empowering minority students: A framework for intervention." Harvard Educational Review, 56, 18-36.

De La Cancela, V. (1985). "Toward a sociocultural psychotherapy for low-income ethnic minorities." Psychotherapy, 22, 427-435

Draguns, J. G. (1981). "Cross-cultural counseling and psychotherapy." In A. J. Marsella & P. B.

Pederson (Eds.) Cross-cultural counseling and psychotherapy. New York: Pergamon.

Franklin, A. J. (1982). "Therapeutic interventions with urban Black adolescents." In E. E. Jones & S. J. Korchin (Eds.), Minority mental health, pp. 267-295. New York: Praeger.

Freedman, F. K. (1996). Study Packet #3. Anchorage, AK/Prescott College. Unpublished.

Freedman, F. K. (1997a). Study Packet #5. Anchorage, AK/Prescott College. Unpublished.

Freedman, F. K. (1997b). Study Packet #6. Anchorage, AK/Prescott College. Unpublished.

Freedman, F. K. (1997c). Study Packet #7. Anchorage, AK/Prescott College. Unpublished.

Freedman, F. K. (1997d). Study Packet #8. Anchorage, AK/Prescott College. Unpublished.

Hall, W. S., Cross, W. E., & Freedle, R. (1972). "Stages in the development of Black awareness: An exploratory investigation." In R. L. Jones (Ed.), Black Psychology. New York: Harper & Row.

Indian Health Service (1978). Indian health trends and services. Washington, DC: U. S. Government Printing Office.

Jones, A. C. (1985). "Psychological functioning in Black Americans: A conceptual guide for use in psychotherapy." Psychotherapy, 22, 363-369.

Katz, J. (1985). "The sociopolitical nature of counseling." The Counseling Psychologist, 13, 615-624.

Lambert, R. G. & Lambert, M. J. (1984). "The effects of role preparation for psychotherapy on immigrant clients seeking mental health services in Hawaii." Journal of Community Psychology, 12, 263-275.

Mau, W. C. & Jepson, D. A. (1988). "Attitudes toward counselors and counseling processes: A comparison of Chinese and American graduate students." Journal of Counseling and Development 67, 189-192.

Nguyen, S. D. (1985). "Mental health services for refugees and immigrants in Canada." In T. C. Owan (Ed.), Southeast Asian mental health treatment, prevention, services, training, and research, pp. 261-282. Washington, DC: NIMH.

Norton, D. G. (1983). "Black family life patterns, the development of self and cognitive development of Black children." In G. J. Powell, J. Yamamoto, A. Romero, & A. Morales (Eds.), The psychosocial development of minority group children, pp. 181-193. New York: Brunner/Mazel.

Ornstein, R. E. (1972). The psychology of consciousness. San Francisco: Freeman.

Padilla, A. M. & DeSnyder, N. S. (1985). "Counseling Hispanics: Strategies for effective intervention." In P. B. Pedersen (Ed.) Handbook of cross-cultural counseling and therapy, pp. 157-164. Westport, CT: Greenwood Press.

Parham, T. A. (1989). "Cycles of psychological nigrescence." The Counseling Psychologist, 17, 187- 226.

Parham, T. A. & Helms, J. E. (1981). "Influence of a Black student’s racial identity attitudes on preference for counselor race." Journal of Counseling Psychology, 28, 250-257.

Parham, T. A. & Helms, J. E. (1985). "Relation of racial identity attitudes to self-actualization and affective status of Black students." Journal of Counseling Psychology, 32, 431-440.

Pearson, J. C. (1985). Gender and communication. Dubuque, IA: W. C. Brown.

Red Horse, Y. (1982). "A cultural network model: Perspectives for adolescent services and paraprofes- sional training." In S. M. Manson (Ed.), New directions in prevention among American Indian and Alaska Native Communities (pp. 173-184). Portland, OR: Oregon Health Sciences University.

Shore, J. H. Introduction. (1988). American Indian and Alaskan [sic] Native Mental Health Research, Vol. 1, pp. 3-4.

Smith, E. J. (1981). "Cultural and historical perspectives in counseling Blacks." In D. W. Sue & D. Sue, Counseling the culturally different: Theory and practice. New York: Wiley.

Stonequist, E. V. (1937). The marginal man. New York: Charles Scribner’s Sons.

Sue, D. W., & Sue, D. (1990). Counseling the culturally different: Theory and practice (2nd ed.). New York: Wiley.

Willie, C. V., Kramer, B. M., & Brown, B. S. (1973). Racism and mental health. Pittsburgh: University of Pittsburgh Press.

Yuen, K. W. & Tinsley, H. (1981). "International and American student’s expectations about counsel- ing." Journal of Counseling Psychology, 28, 66-69.