Multicultural Therapy

Nature:

Therapy is an ongoing and interactive process between two or more individuals. The
effectiveness of counseling depends on many factors, but among the most important is for the
counselor and client to be able to understand and relate to each other. Such a relationship is
usually easier to achieve if the client and counselor are from the same or similar culture. The
cultural disparity between counselors and their clients often makes it difficult for many
individuals to find a counselor who understands specific issues related to their experience.
Therefore, multicultural counseling may be viewed generally as counseling ‘in which the
counselor and the client differ’. The differences may be the result of socialization in a unique
cultural way, developmental or traumatic life events, or the product of being raised in a particular
ethnic environment.

The American Psychological Association’s Multicultural Guidelines begin with this statement:
“All individuals exist in social, political, historical, and economic contexts and psychologists are
increasingly called upon to understand the influences of these contexts on individuals’ behavior”.

It is important to take into account that people from all walks of life and diverse backgrounds can
experience difficulties leading them to seek help through therapy. However, it is generally
acknowledged that some traditional forms of therapy may not be as effective at addressing the
concerns of minority groups in our society. Thus it is necessary to incorporate multicultural
therapy, which aims to effectively treat people from different cultural backgrounds. In a
multicultural approach, a therapist works with client to understand the difficulties that they are
experiencing from the unique perspective of their culture. The therapist takes into account the
mediating role of cultural factors in helping the client to address mental health problems or
challenging life events.

Although there is no single multicultural therapy, multicultural theory has influenced many
approaches to be more sensitive to the history of the oppressed and marginalized, acculturation
issues, and the politics of power. It refers to a theoretical difference in approach which can be
applied to many different types of therapy. This includes Cognitive Behavioral Therapy, Couples
Counseling, and Psychoanalysis, to name just a few therapy types. The important difference is
that your therapist adopts an approach that is sensitive to cultural diversity.
Multicultural therapy takes into account racial and ethnic diversity as well as diversity in
spirituality, sexual orientation, disabilities, and class, and the potential cultural bias of
practitioners. Matters of race or culture can impact on our psychological wellbeing in a negative
way. For example, people subjected to racism or discrimination may experience mental health
problems like depression or anxiety. Therapists who work in a multicultural framework
acknowledge that matters of race and cultural identity can have a powerful impact on our mental
health in both positive and negative ways.

Multicultural therapy should contain three elements:

 cultural sensitivity (an awareness and appreciation of human cultural diversity)

 cultural knowledge (including factual information about cultural variation)
 cultural empathy (the ability to connect emotionally with the patient's cultural
perspective)

Multicultural psychology is a major influence in contemporary psychology and includes such

broad topic areas as racial identity development, acculturation, prejudice and stereotyping, and
multicultural competence. It also takes into account disabilities, health conditions, gender, sexual
orientation, living conditions, and more.

The most prominent foci of multicultural therapy are distinct group uniquenesses and concepts
that facilitate attention to individual differences. A multicultural therapy encourages counselors
to become aware of their own biases, values, and assumptions by increasing their awareness of
other cultural groups. It also involves developing culturally appropriate intervention strategies to
address the particular needs of clients with regard to ethnicity, culture, spirituality, gender,
disability, sexual orientation, and socioeconomic standing to name a few.

Research focused on multicultural psychology differs from other schools of thought in

psychology because; in addition to a focus on individual and intrapsychic factors multicultural
counseling is rooted in a culture-centered tradition. Multicultural counselors do not conduct
therapy in a vacuum; they understand that patients’ backgrounds influence the ways in which
they view the world and that the counselor’s role must change to accommodate these
perspectives. Multicultural counseling can provide many marginalized individuals with the
necessary emotional and conceptual tools to make a success of their lives, without sacrificing
who they are.

Approaches:
Multicultural therapy is faced with the problem of searching for this unifying focal point. At the
moment two opposing forces divide the field. Some theorists hold that multicultural counseling
should be approached from a universal perspective (etic), while others believe that the specifics
of culture (emic) should be the starting point.

Etic Approach

The universalistic position rests upon the inclusive definition of culture holding that "to some
extent all mental health counseling is multicultural" (Pedersen, 1990). When culture is broadly
defined each person is considered to hold a unique cultural composition which means that all
forms of helping relationships must necessarily be defined as multicultural. Because all
counseling is multicultural, it is important to look beyond stereotypes and differences in order to
develop an authentic counseling relationship with each client (Vontress, 1988). The problem
with emphasizing culturally specific techniques in professional practice with diverse clients is
the risk that the cultural characteristics of the client may be overemphasized. The counselor may
fail to notice and experience the personal characteristics of the client, and thus fail to develop an
authentic therapeutic relationship.

The etic approach can be criticized for not taking important cultural differences into account.
Pedersen (1996) stressed that saying that all counseling is multicultural is not the same as
advocating a single universal system of counseling. Multicultural counseling is a generic
approach to counseling which encourages counselors to be aware of themselves and their clients
as cultural beings placed in the context of larger cultures. With this belief in mind the counselor
becomes able to see clients' cultural milieu changing from moment to moment. The counselor
learns to appreciate the complexity of the individual in constant struggle to balance the ever-
changing salience of each aspect of self.

Emic Approach

Supporters of the emic position espouse that to provide effective mental health service to the
culturally diverse client, the therapist must have knowledge specific to that client's culture. Often
culturally diverse clients receive an inferior quality of care because counselors are unfamiliar
with the cultural backgrounds of their ethnically diverse clients. Lack of knowledge of clients'
cultural background means that therapists are unable to devise culturally appropriate treatment
(Sue & Zane, 1987). Another premise of the emic position is the belief that most prominent
theories of counseling are based on western culture. Sue et al. (1996) reported that most Western
theories emphasize individualism and the development of a separate sense of self. However
majority of the culture around the world focuses on collectivism. Instead of adapting existing
Euro-North American based theories, the culture-specific approach asserts that counseling theory
would be enriched if theorizing began from the point of view of the host culture (Nwachuku &
Ivey, 1991). The emic approach can be criticized for placing too much emphasis on specific
techniques as the vehicle for client change.

Common Factors Approach:

Some professionals have tried to find common elements shared by these two approaches. For
example, Fischer et al. (1998) have been instrumental in developing the common factors that are
the most relevant to multicultural counselling and are transcultural in nature. He proposed four
conditions common to any type of counseling treatment:

 The therapeutic relationship: The therapeutic relationship is "the least controversial and yet
the most important aspect of all therapeutic systems". The therapeutic relationship links
client's perception of the strength of the relationship with the outcome of therapy
 A shared worldview between client and counselor: When therapist and client have a shared
worldview, the client is more likely to accept the therapist's explanation or rationale for
his/her problem and the interventions implemented in therapy, thereby enhancing the
expectation for a positive outcome.
 Client expectations: The setting of a psychologist, counselor, etc is marked as a place one
goes with the expectation of alleviation of psychological distress.
 Interventions believed by both client and counselor to be a means of healing: When a client
finds the courage to seek help, there is the expectation that some event will occur. These are
the rituals or interventions. The common element here is not the consistency of the
intervention, but that all healing processes contain them.

The common factors position has been criticized for being overly general and ambiguous and has
little practical value (Sue et al., 1996). Though this approach meets its goal of providing an
organizational framework for multicultural counseling literature, it gives little direction to
therapists who want to know what they can do to alleviate suffering of culturally diverse client.

Uses:

Today’s clients may look much different than it did in past decades, as an increasing number of
clients from all populations are seeking mental health services due to declining stigmatization
and increasing globalization. This changing landscape of professional practice means counselors
should be trained to work with clients (and colleagues) who lead lives different than their own.

Counseling from a multicultural lens is necessary in our diverse world and allows counselors to
help many marginalized individuals with the necessary emotional and conceptual tools to make a
success of their lives, without sacrificing who they are. The goal is to empower individuals and
groups to maintain their specific identity within a cultural matrix that may not match their own,
to remove the personally applied stigma of reduced income or other socioeconomic factors, and
enable your clients to pursue the life paths that are right for them in their own way.

The racial and ethnic disparity between counselor and clients often makes it difficult for
minorities to find therapist who understands specific issues related to their experience. Helping
those in therapy to better connect with their patients and be more sensitive to issues related to
experiences of culture and race is just one reason that multicultural therapy is so important.

Multicultural therapy can be applied to cognitive behavior therapy, couples counseling, family
therapy, and other types of therapy appropriate for children, adults, individuals, or families, as
long the therapist understands the psychosocial issues that affect the development of
marginalized clients and the unique problems they face. When therapy is eclectic, the influence
of the client’s culture must be weighed throughout every aspect of the therapeutic process.
Further multicultural counseling is an advantage for counselors as it allows them to gain
knowledge, sensitivity, disposition, and personal awareness.

Conclusion:

A common theme is that counselors who work with a variety of culturally different client must
be knowledgeable about them collectively, in sub-groups, and individually. Overcoming
traditions, prejudices, fears, and anxieties and learning new skill based on accurate information
and sensitivity are major parts of counseling in a multicultural society such as India, which has
numerous and diverse sub-cultures. Vast differences make it imperative for a counselor
practicing in India to be sensitive to these differences, to use indigenous approaches, and to make
referrals to counselors from suitable backgrounds if necessary.

International counseling is growing. As such, it is adding to cultural understanding of how

people are helped both within and outside a particular context. Thus, counseling is a worldwide
phenomenon with integrated and interrelated theories and methods being developed and
exchanged.