Multicultural Implications

-Multicultural
factors
-Multicultural
consideration
 What is multicultural counseling?
• Multicultural counseling considers the different factors that affect racial,
ethnic, and other types of minorities, including historical oppression and its
effects on society.
• Multicultural counselor 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.
• Hackney and Cormier (2013: Most clients approach counseling with two conflicting motivations:
• (1) “I know I need help”
• (2) “I wish I weren’t here.”
• Given this dual set of motivations, the client may be expected to convey conflicting and even
contradictory communications at times. It is essential that the helper remains aware of such conflicts in
communication patterns. In addition to these contradictory communications, interactive communication
patterns are also influenced by the cultural variables (race, ethnicity, gender, sexual orientation and
gender identity, disability, and immigration/refugee status).
Multicultural factors
 Race and Ethnicity
• Sue and Sue (2013) note that different racial and ethnic groups differ in their communication
styles.
• For example, “many cultural minorities tend not to value verbalizations in the same way that
Americans do. In traditional Chinese culture, children have been taught not to speak until
spoken to. Patterns of communication tend to be vertical, flowing from those of higher prestige
and status to those of lower prestige and status.
• In a therapy situation, many Chinese clients, to show respect for a therapist who is older and
wiser and who occupies a position of higher status, may respond with silence. Unfortunately, an
unenlightened counselor or therapist may perceive this client as being inarticulate and less
intelligent” (Sue & Sue, 2013, p. 187).
• Communication barrier: verbal and nonverbal language problems, interference from
preconceptions and stereotyping, erroneous evaluation, and stress.
 Multicultural Consideration
(Race and Ethnicity)
1. Expand your repertoire of helping styles and roles in order to shift your helping style
to meet the cultural dimensions of your clients. Recognize that there is not a “one size fits
all” approach to communicating with clients in general and with clients of racial and
ethnic minorities in particular.
2. Become knowledgeable about how race, culture, and gender affect communica- tion
styles.
3. Obtain additional training and education on a variety of theoretical approaches and
orientations, particularly those that consider not only individual characteristics but also
contextual and systemic factors. Such training helps you to see how systems affect
individuals.
4. Think holistically about clients, for example, recognizing that people are not just a
product of their thinking or behavior, but are “feeling, thinking, behaving, cultural, spir-
itual, and political” beings (Sue & Sue, 2013, p. 232).
 Gender
• Communication patterns are also influenced by gender. While biological sex is the degree to which a client
was born genetically into a male or female body, gender refers to the clients’ personal sense of feeling and
behaving as a woman or a man. Gender communication is communication both about and between men and
women. Ivy (2012, p. 21) states that “communication becomes gendered when sex or gender overtly begins
to influence your choices—choices of what you say and how you relate to others.” Gender roles and
schemata cannot help but spill over or infiltrate the helping process, so both ritualized and responsive
patterns between same-gender and different-gender helper and client pairs are likely to vary somewhat.
• Wood (2013, p. 136) points out that men and women have learned to relate experiences via varying
communication styles, which can often result in breakdowns in the communication process. She states:
• Masculine speech tends to follow a linear pattern, in which major points in a story are presented
sequentially to get to the climax. Talk tends to be straightforward without a great many details. The
rules of feminine speech, however, call for more detailed, less linear storytelling. Whereas a man is
likely to provide rather bare information about what happened, a woman is more likely to embed the
information within a larger con- text of the people involved and other things going on. Women include
details, not because they are important at the content level of meaning but because they matter at the
relationship level of meaning. Recounting details is meant to increase involvement between people . . .
Because feminine and masculine rules about details differ, men often find feminine accounts wandering
and tedious. . . . (p. 136)
 Multicultural Consideration
(Gender)
1.Support clients’ desires to break free from the oppression of traditional gender norms.
2.Communicate empathy for the plight of both genders.
3.Use gender inquiry questions to help understand messages clients have received
4.about gender, such as “Do you remember anything that happened when you were growing up
that strengthened your sense of being a girl or boy?” or “What did you learn about how you
should be acting as a girl or boy?” and “How do these messages still affect you?”
5.Attend to ways in which other aspects of culture affect gender development in cli- ents’ lives.
For example, how have dimensions such as religious affiliation, ethnicity, geography, age, and
so on, affected the client’s sense of being a woman or a man? Have these other dimensions
restricted or expanded the client’s sense of gender?
6.Be especially attentive to the ways in which powerlessness and helplessness char- acterize
the client’s communication and stance in therapy. Be mindful of the ways in which you as the
helper may be perpetuating patriarchal assumptions in your communication with clients. We
especially like the questions that Brown (2010) recommends for communicating about power
with clients, including the following:
7.“What is the most powerful thing you could do right now?” (p. 35) “What are the power
dynamics in this situation?” (p. 30
 Sexual Orientation
• The difference between sexual orientation in this part will discussed about clients who are identified as lesbian, gay,
bisexual, transgender, and questioning (LGBTQ), meaning persons who have an emotional, romantic, sexual, or
affectionate attraction to persons of the same sex (lesbian women and gay men); persons who have a sexual attraction to
persons of both sexes (bisexuals); persons whose identification with their gender is different from their biological sex
(transgender); and persons who are questioning their sexuality. Note that trans- gender status reflects gender identity and
is separate from sexual orientation. In some parts of the world, attitudes toward LGBTQ persons are becoming more
accepting; in other areas, attitudes are becoming more punitive and restrictive, and LGBTQ clients still live in a world
privileged by heterosexuality. As a result, many LGBTQ individuals face discrimination, prejudice, harassment, and
bullying.
 Multicultural consideration
(Sexual Orientation)
1.Develop awareness about how heterosexual privilege (accrued benefits from belonging to a dominant societal group,
heterosexual in this instance) can affect both verbal communication and nonverbal aspects of communication with LBGTQ
clients. Heterosexual privilege can affect everything from reading material, brochures, intake forms, pictures, and calendars
on office walls, as well as language.
2.Be sensitive to your language and try to minimize heterosexist bias in your language. This is an important thing to do
with all clients because the client’s sexual orientation may be unknown to you for a period of time. It is always important
never to assume your client’s sexual orientation or gender identity. A big part of using nonheterosexist language also has to
do with understanding and using terms that describe this client population accurately. Dermer, Smith, and Barto (2010)
have written a very useful article on this topic. As they state, “[A] larger pool of language now exists to describe negative
attitudes and actions toward sexual minorities, and it is important for clinicians to understand the various terms and the
possible consequences of a particular language,” especially when it comes to the nuances of terms that describe sexual
intolerance. They prefer the terms homonegativity and heterosexism to homophobia. Also, particular clients may have
another term to describe themselves, so one way to facilitate effective communication with LGBTQ clients is simply to ask
them how they self-identify and prefer to be described or how they describe themselves.
3.The ALGBTIC competencies state that helpers need to be aware that language with these clients is always evolving,
varies from person to person, and has been used to oppress LGBTQ clients. They also indicate that certain labels used to
describe LGBTQ clients require contextualization to be used appropriately. Be attentive to the language used in your intake
forms and your diagnostic ques- tions and history taking. Provide a space for the client to write in gender status in addition
to the traditional boxes of male and female, and use terms such as partnered and spouse and relationship dissolution in
addition to the more tradi- tional terms of married and divorced. Include a question about sexual attraction and orientation.
 Multicultural consideration
(Sexual Orientation)
4. Engage in self-reflection about your own gender identity and sexual orientation, and know how this affects your process
and the helping relationship. ALGBTIC standards of competence state that helpers should use self-disclosure about their
own affectional status and sexual orientation carefully and only when it is clearly in the best interest of the LGBTQ client
to do so. Be aware, however, that an occa- sional client may ask you if you are straight or not, so be prepared to address
their questions about your sexual orientation, your prior experience working with LGBTQ clients, your comfort level
discussing LGBTQ issues, and your personal beliefs about LGBTQ issues. It would not be uncommon now, for example, to
have a client ask you about your views on gay marriage.
5.Be careful about any communication that suggests negative assumptions concerning pathology or dysfunction in LGBTQ
individual clients, couples, and families; at the same time, do recognize and be prepared to communicate about the
potential impact of societal stigmatization and poor legal protection for these clients. Realize that a client’s LGBTQ
identity may or may not be part of their presenting concerns.
6.Recognize the positive impact on communication of becoming an ally for LGBTQ clients. Having a Safe Zone sticker on
your office door communicates this informa- tion to clients right away. Remember that a Safe Zone sticker lets clients
know that you have been through training that means you are supportive toward and sensitive to the needs of LGBTQ
persons. Develop your advocacy skills and your comfort level in speaking up and speaking out. Anyone can join ALGBTIC
as an ally member.
7.Recognize how ethical practices affect communication with LGBTQ clients. Consult the ALGBTIC competencies, and
use other resources as well to be informed and stay abreast of knowledge that affects your work with LGBTQ clients.
 Disabilities
• An increasing number of clients are persons with chronic health issues and conditions that have some disabling effects.
Some of these clients have sensory disabilities involving sight or hearing; some have a condition limiting basic physical
activities; others have a condition that affects their learning, remembering, or concentration; and still others have a
condition that affects their ability to work at a job.
• Some disabilities are more visible than others, the word itself refers to functional limitations a person experiences as a
result of an impairment.
• A helper’s sense of discomfort in working with someone with a disability—particularly a client with a visible disability
— may consciously or unconsciously result in the helper’s communication withdrawal, for fear of saying the wrong
things. As a result, the client may feel more invisible or more stigmatized simply by the helper’s absence of or limited
communication. Issues in communication patterns between helpers and clients with disabilities may include awkward or
biased use of language, shorter interactions and prematurely terminated helping sessions, greater interpersonal distance
between helper and client during the session, and restricted or stiff oral communication. Helpers also may shut down
their communication patterns by not asking questions, by wondering how helpful they should be, or by internal reactions
about their own real or potential disability status.
 Multicultural consideration
(Disabilities)
1. Be aware of and sensitive to language. Language has the possibility of healing or hurting. Use affirmative phrases, such
as the “client with a disability” rather than “my disabled client.” Avoid using the word handicapped to refer to any
client! Similarly, a helper can refer to his or her client as a person with a psychiatric disability rather than a crazy
person, or a client who uses a wheelchair rather than a client confined to a wheelchair. This is language that considers
the person first rather than the disability, avoids sensationalizing the disability, and avoids verbs that suggest images of
passivity (Artman & Daniels, 2010). Similarly, it is important to avoid using descriptors that refer to clients with
disabil- ities in ways that evoke pity, such as “afflicted by,” “the victim of,” “struck by,” “crippled with,” and so on. As
Artman and Daniels (2010, p. 444) point out, these kinds of phrases represent the projections of able-bodied
practitioners and are actually expressions of negativity toward clients with disabilities.
2. Use supportive, nonverbal communication. For example, it is appropriate when meeting a client with a disability to
offer to shake hands, using either the right or left hand. Also, when working with a client using crutches or using a
wheelchair, place your- self at eye level with the person. Do not pat a client in a wheelchair on the head or shoul- ders.
Avoid shouting at a person with a hearing impairment. Look directly at the client and speak clearly, slowly, and
expressively, especially if this is a client who is reading lips. Rephrase your communications if necessary but do not
keep repeating yourself word for word as this tends to be insulting. If the client is using an electronic communication
device, stand in front of the person and refrain from reading over her or his shoulder when engaged in typing. Be
mindful of environmental space and potential obstacles and barriers in the office areas. If the client is there with an
accompanying individual, be sure to address the client directly rather than the other person.
3.
 Multicultural consideration
(Disabilities)
3. Develop a communication style that is direct and respectful rather than avoidant or condescending. Address clients with
disabilities in the same way you would other clients. For example, do not talk with clients with disabilities as though they
are childlike or ill. Address clients with disabilities by their first names only if this is a practice you use with all your
clients. If some clients have difficulty in speaking or understanding, listen carefully, do not rush the communication in the
session, and do not pretend to under- stand when you do not. Instead, rephrase what you do understand, and give the client
time to respond. Avoid finishing or completing sentences for the client. At the same time, if you do not understand a
particular client because he or she uses a communication aid or has difficulty with speech, do not automatically assume he
or she cannot understand you! If the client with a disability has a communication issue, he or she will probably let you
know and indicate a preferred method of communicating. You can facilitate the com- munication process by asking the
client what she or he needs from you as a communicator and then adapting your communication style accordingly. Ask
rather than assume that a person with a disability automatically needs or requires some sort of assistance from you.
4. Develop cultural competence in working with clients with disabilities and gain as much information as you can, but
recognize that reading about disabilities in books and articles is somewhat self-limiting. When possible, seek consultation
with mental health professionals who have disabilities such as deafness, visual impairment, and so on (Whyte, Aubrecht,
McCullough, Lewis, & Thompson-Ochoa, 2013). Maintain good con- nections for referral options with other mental health
professionals who self-identify as having various disabilities because some clients with disabilities may request or prefer a
referral to a helper who is living with a disability. At the same time, remember that you cannot deny services to a client
with a disability nor should you separate or give unequal service to clients with disabilities (American Psychological
Association, 2013). Remember too that disability status is a relatively porous state; often a person can move in and out of it