On the last track, we discussed the treatment of fear in culturally different clients.
On this track, we will discuss relevant processes and goals in counseling culturally different clients. Obviously, counseling culturally different clients usually requires a different combination of skills, or processes, and goals from you, the therapist. Upon entering the process of counseling, therapists choose a general approach, style, or strategy in working with clients.
I have found that closely linked to the actual process of counseling are certain implicit or explicit goals. However, you may wonder how to ethically determine the effectiveness of those goals and processes. According to Ivey and Authier four conditions may arise in counseling a person from a different culture. These four conditions result from use of either appropriate or inappropriate processes, and appropriate or inappropriate goals.
4 Ethics Conditions in Counseling Culturally Different Clients
Condition #1 - Appropriate Process and Appropriate Goals
The first condition in counseling culturally different clients is Appropriate Process and Appropriate Goals. In this condition the client of a different culture is exposed to a counseling process that is consistent with his or her values and life experiences. As you probably are aware lower-class clients are concerned more with survival and making it through on a day-to-day basis. They expect immediate, concrete suggestions and advice.
Thus, obviously a counselor who uses counseling strategies that make sense to the client and defines suitable goals will often be the most effective and helpful.
For example, a black male student, Tyrone (tie’-rone), who is failing in school and gets into physical fights lacks the academic skills necessary to get good grades. He then fights other students who tease him about being "stupid." How would you consider treating Tyrone? For Tyrone, a therapist who attempts to teach him test-taking skills and gives advice may be the most effective counselor.
Condition #2 - Appropriate Process and Inappropriate Goals
The second condition in counseling culturally different clients is Appropriate Process and Inappropriate Goals. Obviously an ethical counseling strategy may be chosen by the counselor that is compatible with the client’s values, but the goals the strategy will help achieve are questionable. Let’s look again at the example of Tyrone who failed in school and got into physical fights. If his counselor defines the goal as the elimination of fighting behavior, the technique used may be behavior modification.
A behavior modification technique would be an appropriate process because it stresses observable behaviors and provides a systematic, precise, and structured approach to the problem. This tangible approach would reduce some of the mystique of counseling for the black student. Clearly a tangible approach would make the black male student client more open to counseling than an approach based on self-analysis and introspection.
However, I have found that while the process may be appropriate, it is possible that the goal is inappropriate. Ethically there is a danger regarding control and behavioral objectives.
As you probably guessed, if the black student is being teased because he is a minority student, the goal of "stopping fighting behavior" may be inappropriate. Thus, a counselor suggesting the behavior modification technique may be imposing his or her own standards and values on the client.
Do you have a culturally different client like Tyrone, with whom you may be using appropriate processes to accomplish inappropriate goals?
Condition #3 - Inappropriate Process and Appropriate Goals
In addition to Appropriate Process and Appropriate Goals; and Appropriate Process and Inappropriate Goals, the third condition in ethically counseling culturally different clients is Inappropriate Process and Appropriate Goals. As you are well aware therapists may tend to use inappropriate processes in working with clients of a different culture. These inappropriate processes often force the culturally different client to violate basic personal values.
Have you found as I have that a counselor who relies heavily on a form of intervention, like behavior modification, may be seen as coercive and manipulative by a culturally different client?
This is especially obvious in the case of Native Americans. As you are well aware, Native Americans value harmonious existence with nature. For a Native American client whose counselor stresses individual responsibility for changing and mastering the environment, the therapist is, in fact, asking the client to violate a basic personal value.
Thus, the counselor is using an inappropriate process. This leaves the question of whether it is possible to use an inappropriate process to arrive at an appropriate goal.
What do you think?
According to Derald Sue, if we look only at the techniques and goals of different counseling theories, the answer appears to be yes.
Cultural Diversity - Ethics : Case Study
For example, let’s consider Sylvia’s case. Sylvia (sil’-vee-ah), age 29 Native American, was just hired at an automobile manufacturing company. Sylvia was referred to the personnel director, a counseling psychologist, because she was frequently late. In addition, fellow employees frequently took advantage of Sylvia, asking her to share her lunch and borrowing money from her. The counselor believed Sylvia needed to learn to set limits on others and assert her rights, and suggested she be placed in assertion training.
Do you see the problem here?
While ethically the counselor’s goals may have been consistent with Native American values, like Sylvia’s, the technique was not. Some therapists use other techniques that are confrontational and controlling, as you know. All of these actions are often embarrassing to Native American clients as they conflict the Native American value system. Thus, while the combination of Inappropriate Process and Appropriate Goals is possible, it raises an yet another important ethical question: Do the ends justify the means?
Condition #4 - Inappropriate Process and Inappropriate Goals
Finally the fourth condition in ethically counseling culturally different clients is Inappropriate Process and Inappropriate Goals. It goes without saying that this particular combination of inappropriate process and inappropriate goals tends to lead to early termination of counseling. The blind application of techniques that clash with the culturally different client’s values, as well as the rigid adherence to a goal that does not fit the culturally different client’s values, places many of these clients at a disadvantage.
I find that this can best be seen in the case of an Asian American client. Obviously, Asian Americans value restraint of strong feelings and believe that intimate revelations should be shared only with close friends. For a feeling-oriented theapist, this poses a problem. In addition to using inappropriate processes with the Asian American client, such as reflecting feelings and asking questions of a deeply personal nature, the therapist may have also established an inappropriate goal of insight into deep underlying processes. A goal of insight, as you know, may not be valued by the Asian American client.
Can you see the ethical implications of using inappropriate processes to achieve inappropriate goals?
On this track, we have discussed the four conditions in culturally different counseling. These four conditions were Appropriate Process and Appropriate Goals, Appropriate Process and Inappropriate Goals, Inappropriate Process and Appropriate Goals, and Inappropriate Process and Inappropriate Goals.
Peer-Reviewed Journal Article References:
Claiborn, C. D., LaFromboise, T. D., & Pomales, J. (1986). Cross-cultural counseling process research: A rejoinder. Journal of Counseling Psychology, 33(2), 220–221.
Kim, B. S. K., Ng, G. F., & Ahn, A. J. (2005). Effects of Client Expectation for Counseling Success, Client-Counselor Worldview Match, and Client Adherence to Asian and European American Cultural Values on Counseling Process With Asian Americans. Journal of Counseling Psychology, 52(1), 67–76.
Pedersen, P. B., & Marsella, A. J. (1982). The ethical crisis for cross-cultural counseling and therapy. Professional Psychology, 13(4), 492–500.
Tormala, T. T., Patel, S. G., Soukup, E. E., & Clarke, A. V. (2018). Developing measurable cultural competence and cultural humility: An application of the cultural formulation. Training and Education in Professional Psychology, 12(1), 54–61.
Trevino, A. Y., Tao, K. W., & Van Epps, J. J. (2021). Windows of cultural opportunity: A thematic analysis of how cultural conversations occur in psychotherapy. Psychotherapy, 58(2), 263–274.
Tummala-Narra, P., Claudius, M., Letendre, P. J., Sarbu, E., Teran, V., & Villalba, W. (2018). Psychoanalytic psychologists’ conceptualizations of cultural competence in psychotherapy. Psychoanalytic Psychology, 35(1), 46–59.
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