There are many different client groups for whom cultural considerations are important. In some countries indigenous people are actual and potential clients: for example, the Aborigines and Torres Strait Islanders in Australia, the Maoris in New Zealand, and the American Indians in the United States. Another broad client grouping is that of migrants and their children who are at varying levels of assimilation to the mainstream culture. Still another grouping is that of temporary visitors to a country, with overseas students and expatriate workers being prime examples. Furthermore, members of the mainstream culture often need to address issues connected with multiculturalism. Cultural considerations are also highly relevant to how all counsellors and therapists live and work.
Ethics - Diverse goals
The following are some goals, some of which overlap, when thinking about the broad field of multicultural counselling and therapy. These goals are listed in table I and each is discussed in turn.
There are special issues connected with the rights, past mistreatment of and current poor treatment of indigenous populations in countries like Australia and the United States. For example, Aboriginal culture was extremely different from early white settler culture and still is far removed from the current mainstream Australian culture. Issues that highlight these differences are the suicides in custody of young Aboriginal males and the feelings of grief and loss of the ‘stolen generation’ of Aboriginal people taken from their parents and brought up by whites. The many issues of respecting indigenous populations, prizing their difference, dealing with their special counselling needs and yet working towards an accommodation between indigenous and settler populations are grouped under this heading of reconciliation.
Migrants require culture-sensitive support when they first arrive in their new home countries. Think of the cumulative stresses involved in moving to a new culture including change of home, parting from loved ones and previous support networks, language difficulties, climate change, change in physical environment (for instance the countryside and buildings look different), homesickness, loneliness, financial worries, concerns about children's education, and, for many migrants, racist incidents. Students and expatriate workers who face many of the same issues also require support. However, they may be in better positions to return to their home countries if too unhappy in their new temporary home country.
Ethics - Coping with post-traumatic stress
Many migrants are refugees and some suffer from post-traumatic stress disorders. Reasons for their traumatization include being war victims, witnessing violence, living through missile attacks, torture, starvation, imprisonment, internment and rape. Such migrants, may suffer persistent re-experiencing of traumatic events, hyper-arousal, numbing of affect, or oscillate between hyper-arousal and numbing of affect. Traumatized migrants, with their families and support networks, require special culture-sensitive post-traumatic stress disorder therapy.
Assisting acculturation and assimilation
The multicultural literature is often overly negative about the virtues of mainstream cultures such as those in Britain, Australia and America. In addition much of the literature seems to insufficiently address the need for cultural cohesion as well as for cultural diversity. Most migrants move because the perceived benefits of their new countries far outweigh those of their former ones where often they have led terrible lives. Migration can be a time of great opportunity. However, it is also a time of considerable challenges. Migrants require practical help with such matters as language, housing, health, education, and employment. Furthermore, migrants may also require support in making the effort to understand and to acquire the skills to reach out to and interact properly with the mainstream culture. A fundamental skill is that of trying to become fluent in the language of the host country. Migrants may also require help in developing other communication skills that are sensitive to the mainstream culture in which, in most instances, they have chosen to live and work.
Avoiding further marginalization
Therapists need to be aware that, if they pursue cultural agendas clumsily, they can do more harm than good. For instance, statements like ‘Britain is a racist society’ are global and emotionally-charged overgeneralizations that can get in the way of a rational approach to the realistic problems of racism. Where appropriate, therapists can and should help ethnic minority group clients be assertive about attaining their human rights. However, there is a danger that therapists collude when some minority clients further marginalize themselves by unfairly ‘demonizing’ their host cultures, making their lives out to be worse than they are, and playing the psychological game of ‘Ain't it awful’, at the same time as doing little positive to change their situations.
When dealing with issues of acculturation and change, people of all cultures and races can be inflexible and self-defeating. Cultural insensitivity and racial stereotypes are not the sole preserve of members of mainstream cultures. Some migrants may require culturally-sensitive psychological assistance form counsellors so as not to activate self-defeating patterns for dealing with change and stress, for instance withdrawal, being unwilling to alter old ways of behaving, and aggressively disparaging their new countries. Sometimes therapists may need to challenge ethnic minority clients with basic questions like ‘How is this behaviour helping you?’ and ‘What is the evidence for and against thinking this way?’
Ethics - Addressing cultural and racial discrimination
Cultural discrimination exists among people within the same overall mainstream cultures, for instance the British social class system and the Indian caste system, so it should come as no surprise that it can be prevalent against people coming from ethnic minorities. Racial discrimination is also unfortunately a fact of life for non-whites in Britain, Australia and America. The author has heard tales of such incidents of varying levels of viciousness from his British-Indian sister-in-law's family, who nevertheless faced far worse racial discrimination in Idi Amin's Uganda. Helping minority group clients address the inner suffering of cultural and racial discrimination as well as develop the skills to survive in, cope with and combat it are extremely important goals for multicultural counselling and therapy.
Assisting clients to manage close cross-cultural relationships
Much of the multicultural counselling and therapy literature assumes cultural and racial aversion rather than attraction. Frequently, this assumption does not hold good and mixed cultural and racial relationships and marriages are becoming increasingly common. Any close relationship requires each partner in adjusting to and accommodating one another's different tastes, habits and customs, quite apart from adjusting to one another's families. The need for negotiation and compromise will almost certainly be greater where partners come from different cultures. Facilitating the development and maintenance of intimate cross-cultural relationships is an important and often overlooked area in multicultural counselling literature. The clients for such relationship counselling may be people from ethnic minorities and from the mainstream culture. In a multicultural migrant country like Australia, each partner in a close relationship may have parents from different cultures and so the situation can become even more complex, if poorly handled by those involved.
Therapists can also assist partners from different races face the many issues connected with cross-racial as well as cross-cultural relationships. Obvious issues concern helping families of origin adjust to their sons or daughters getting emotionally involved with someone from a different race and fears about the prospects and happiness of children of mixed race in a society where racial discrimination still exists.
Assisting with gender role and gender equality issues
Goals for multicultural and gender aware counselling and therapy overlap. Two important goals are freedom from restrictive and stereotypical gender roles derived from enculturation and enhancing gender equality. Cultures have both similarities and differences in the roles they assign to men and women. Furthermore, as Hofstede's (1980,1983) work shows, cultures vary in subscribing to masculine values, centred around success and money, and feminine values, which evolve around caring for others and quality of life. In addition, the acculturation of migrants can be much more difficult if there are large gender role differences between previous and new cultures. For instance, in their cultures of origin men may have mediated between the home and the outside world, whereas in their new cultures women may work outside the home and also be the main breadwinners (Eleftheriadou, 1999).
Gender can also be an important aspect of cultural change and conflict, with the changes in women's roles affecting men and vice versa. Cultural change can also influence how people learn gender roles: for example, with the movement from agrarian economies stemming from the industrial revolution, many men have spent less time with their families and local communities to the possible psychological impoverishment of all concerned. Consequently boys in Western cultures may have less opportunity than previously to learn from their fathers and other mentors how to be confident and at ease in being male (Biddulph, 1995).
Ethics - Attaining higher levels of development
The goals of some culturally different clients may be more oriented towards growth rather than adaptation to a mainstream culture. What constitutes higher levels of development can vary according to culture and to the therapeutic approach employed. For instance, Eastern cultures stress heightened concentration, mental purification, kindness, compassion, sympathetic joy in one another's accomplishments, equanimity, wisdom and selfless service (Walsh, 2000).
- Nelson-Jones, Richard; Diverse Goals for Multicultural Counseling and Therapy; Counselling Psychology Quarterly; 2002; Vol. 15, Issue 2.
The article above contains foundational information. Articles below contain optional updates.
Reflection Exercise #3
The preceding section contained information
about diverse goals for multicultural counseling and therapy. Write
three case study examples regarding how you might use the content of this section
in your practice.
Ethics CEU QUESTION 10
What cultural counseling issues are grouped under reconciliation? Record the letter of the correct answer