When dealing with counseling and therapy there are an array of issues that are brought forth in light of cultures. The cultural differences pose as a challenge for many mental health professionals in a number of ways. Therapeutic approaches get interfered with in that psychologists have a difficult time first in reaching out to understand cultural values, world views as well as life circumstances of the culturally diverse clients (Lee, 2015). Second, freeing themselves from cultural conditioning of what they believe is correct therapeutic practice. Third, the development of new but culturally sensitive methods of working clients. And last but not least, psychologists have to play new roles in the helping process outside of the conventional psychotherapy. There are different barriers to effective individual and family counselling including class-bound, culture-bound values and linguistic issues.
Counselors and psychotherapists most often focus more on the internal dynamics and aspects without putting into consideration that external sources too may be the cause of the arising issues. Mental health practice most often has been ascribed to be a white middle class activity, thus fails to realize the economic implications in the delivery of mental health services. This brings to light the issue of class bound factor, socioeconomic statuses side line those in poverty thus denying them access to the much needed help (Baruth, & Manning, 2016). Language barrier poses as a disadvantage to culturally diverse clients, because talk therapy is the primary medium through which the mental health professionals get to do their work. Most often Standard English is used, this sidelines those clients with limited command of English. Linguistic differences and language barriers in psychotherapy needs to be looked at in detail with the aim of finding a solution. Culture bound issues seem to delay and deter service delivery to clients.
Counseling and therapy is characterized by interpersonal interactions, effective communication and social influence. Effective therapy involves sending and receiving messages both verbal and non-verbal in an accurate and appropriate manner. Generic characteristics of counselling have been intertwined with culture, middle class and language (Adams, Puig, Baggs, & Wolf, 2015). The drawbacks of counseling and psychotherapy are associated with its characteristics such as culture bound values which include openness and intimacy, individual centered, emotional expressiveness. Class bound values showcasing strict adherence to time schedules 50-minutes sessions, seeking long range goals. Lastly is language variable that confines clients to Standard English with emphasis on verbal communication.
Culturally Appropriate Intervention Strategies
Effective communication is key in the process of psychoanalysis of a patient or client. Different strategies are taught to counselors and therapists on how to handle different cases in psychotherapy. People come in seeking help for different issues that may be related but in a different setting. The approaches and strategies implemented by mental health professionals have on many occasions led to mistaken assessment, diagnosis and eventual treatment of culturally diverse clients. Counselors tend to have an implicit assumption that individualism is healthy thus tend to force it on clients without putting into consideration the collectivism aspect where family orientation is more embraced. Therapists need to keenly evaluate a client before embarking on the strategy of finding a solution to the problem at hand (Adams, Puig, Baggs, & Wolf, 2015). Forcing individualism especially on Asian Americans, Chinese, Japanese clients most of the time tends to scare them thus sending them away without knowledge.
Culture plays a big role in a clients help-seeking behaviors. The cultural dynamics of clients allows them to either freely open up or show reluctance in share their feelings, this is evident in the way Asian cultures showcase restrain of strong feelings. Counseling methods adapted by the therapists may be antagonizing the clients values culturally (Baruth, & Manning, 2016). The psychotherapy process needs to consider the values reserved by the client and their culture so as not to have conflict of understanding. The wrong method implementation often leads to misinterpretation of communication cues by the client, for instance lack of eye contact, unresponsiveness to questions as well as short and polite answers are most often interpreted as oppression by the therapist which is not always the case. The use of such methods as expression of feelings, role plays may work for some clients but not all, others may view the methods as oppressive and humiliation with culture in consideration.
It is evident that there is need for new adaptation of techniques in terms of tonal variation, content of remarks, and mode of verbal intervention in regard to the cultural background of a client. Communication with respect to a clients cultural frame of reference with respect to the meaningful and intelligent terms. Communication styles are strongly co-related with race, culture and ethnicity as well as gender.
Culture and race has a way of influencing nonverbal behavior for instance first is proxemics which is the perception and use of personal space (Adams, Puig, Baggs, & Wolf, 2015). Culture vary with regard of what is understood about proxemics, therapists need to keenly analyze their clients so as to avoid misinterpretation on the clients side. Second, kinesics meaning body movements such as facial expression, gestures, posture and eye contact, it is culturally conditioned any misinterpretation of any of the signs leads to ineffective communication between the therapist and client. Third is paralanguage, these are vocal cues used by an individual to communicate such as loudness of voice, silences, pauses in between discussion, hesitation and rate of speech.
Multicultural Evidence-Based Practice
Psychotherapy involves the interaction of culturally diverse clients with different cases and issues to be resolved by the therapists. The psychologists are mandated to find out the best solution to the clients problems, putting into consideration their multicultural background. Counselors have differing treatment perspectives depending on their areas of specialization, this raises important therapeutic issues that has brought to light evidence based practices. After careful assessment of a client by the mental health professionals through presenting the patients problem with its related factors, the therapist is left with the decision of choosing and applying the most appropriate treatments on individuals from an ethnic minority group. Depending on a counselors theoretical orientation, they tend to make diagnosis, assessments and treatment recommendations which seem correct.
Perspectives tend to limit the therapists view of totality of the human condition. For instance the cultural perspective views a patient as a cultural being, the psychodynamic perspective view patients as historical development beings while the cognitive behavioral approach looks at clients as behaving-and-thinking beings (Baruth, & Manning, 2016).
Historically therapeutic strategies most often used by mental health professionals were based on the clinicians specific orientation, ideas shared by experts in psychotherapy as well as the therapists intuition and experience derived from years of work with clients. This is conflicting approach considering the large number of schools of psychotherapy with experts all stating their approaches are valid. Ineffective treatment may result through overreliance on clinical intuition. Mental health practice in relation multicultural therapy has brought up questions on the role played by science and research in treatment of mental disorders.
Evidence based practices in relation to multiculturalism does not only focus on research supported therapies, but has broadened to include clinical expertise with regard to understanding the influence of individual and cultural differences on treatment as well as importance of considering client characteristics, preferences and culture in the assessment and treatment plans with therapeutic results. The evolution of evidence based with integration of empirically supported treatment and empirically supported relationships variables, have helped in the improvement of multicultural counselling with enhancement of cultural elements in therapy.
Non-Western Indigenous Methods of Healing: Implications for Counseling and Therapy
It is very common among cultures to have beliefs in spirit and spirit possession, this is prevalent in Southeast Asia (Adams, Puig, Baggs, & Wolf, 2015). With the regard to the fore mentioned beliefs, the western trained mental health professionals find it difficult to carry out their services to clients with such worldview differences. It is acknowledged by researchers that attitudes, beliefs and emotional states are correlated, thus have a powerful effect on the physiological responses and well-being of the client (Baruth, & Manning, 2016). It is important to recognize the ethnic and cultural factors related to psychiatric diagnosis. The mental health professionals working with immigrant and ethnic minority groups need to put into account the predominant means of manifesting disorders such as fatalism, possessing spirits, their perceived causes and the clients preferences for professional and indigenous sources of care.
Therapists and counselors working in a multicultural setting need to be familiar with the cultural background of their clients in order to be knowledgeable about the specific culture-bound syndromes. An effective multicultural professional requires the knowledge of cultural relativism and respect for the belief system of culturally different clients. When counseling refugees, accurate understanding of their life circumstances helps prevent the tendency of overpathologizing or underpathologizing the clients symptoms. Linguistic and cultural barriers need to be considered especially in circumstances that one lacks both experience and expertise. Lack of enlightenment about indigenous healing beliefs and practices by therapists and counselors can lead to inappropriate treatment as a result of lack of knowledge and cultural understanding.
All societies and cultural groups have developed not only their own explanations of abnormal behaviors but also their culture-specific ways of dealing with human problems and distress. Western forms of counseling for instance rely on sensory information defined by the physical plane of reality, on the other hand most indigenous methods rely on the spiritual plane of existence in seeking a cure (Adams, Puig, Baggs, & Wolf, 2015). In indigenous healing it is evident that three approaches were often used. Heavy reliance on use of communal, group and family networks to shelter the disturbed individual. Secondly, religious and spiritual beliefs and traditions of the community are used in the healing process. Last is the use of shamans, who are perceived to be keepers of timeless wisdom, constitutes the norm.
Racial/Cultural Identity Development in People of Color: Therapeutic Implications
The racial /cultural identity development has led to the realization and discovery that Asian American, African Americans, Latino/Hispanic Americans and American Indians have distinct cultural heritages that make each different from the other. Such cultural distinctions can lead to a monolithic view of minority group attitudes and behaviors. Numerous therapeutic problems have arose...
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