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MULTICULTURAL COUNSELLING - Coggle Diagram

- - - - A presumed classification of all human groups on the basis of visible physical traits or phenotype and presumed biological or visible characteristics such as skin, hair, eye colors, physical features, bone structures and in some cases, language.
      - Biologically-driven concept
      - http://www.diffen.com/difference/Ethnicity vs Race
      - Race is also defined as a grouping of human beings determined by distinct physical characteristics that are genetically transmitted.
    - - Ethnic:
        
        One in which the members share and transmit a unique cultural and social heritage passed on from one generation to the next.
        
        A sense of identity that stems from common ancestry, history, nationality, religion and race.
        
        Socially driven concept
        
        A quality assigned to a specific group of people historically connected by a common national origin or language.
      - Ethnic Minority Group: A group of people who have been singled out for differential and unequal treatment and who regard themselves as objects of collective discrimination.
      - Ethnocentrism: The practice of using a particular ethnic group as a frame of reference, basis of judgment, or standard criteria from which to view the world. Ethnocentrism favours one ethnic group’s cultural norms and excludes the realities and experiences of other ethnic groups.
        The view that one’s own culture is the center of everything and that all others are scaled and rated against it.
    - - Ableism: Discrimination against persons with mental and/or physical disabilities and/or social structures that favour able-bodied individuals.
      - Ageism: Discrimination against individuals because of their age; often based on stereotypes (e.g. senior citizens are not able to perform tasks such as driving, or that all young people are irresponsible)
      - Assimilation: The process whereby an individual of a minority group gradually adopts characteristics of the majority culture. This adoption results in the loss of characteristics of one’s native culture, such as language, culinary/ cookery tastes, interpersonal communication, gender roles, and style of dress.
      - Acculturation:
        
        The extent to which an individual synthesizes, incorporates, and adopts the ideas of mainstream/majority culture.
        
        Acculturation is a process in which an individual adopts, acquires and adjusts to a new cultural environment.
        
        Japanese people dressing in Western clothing is an example of acculturation.
      - Ethics: A system of moral standards / The study of standards of conduct and moral judgment / The system of morals of a particular person or group and is enforced by professional associations.
        
        Being Ethical: Having to do with ethics or of conforming to moral standards, conforming to professional standards of conduct.
      - Classism: Biased attitudes and beliefs that result in, and help to justify, unfair treatment of individuals or groups because of their socioeconomic grouping.
        “Classism” can also be expressed as public policies and institutional practices that prevent people from breaking out of poverty rather than ensuring equal economic, social, and educational opportunity.
      - Cultural specific
        
        Cultural Encapsulation: The term cultural encapsulation was first introduced by Wrenn (1962) and it now refers to a process in which counsellors cannot see beyond their belief system and fail to address cultural issues with the client.
        The danger of being a culturally encapsulated counsellor is enormous because it can lead to misunderstandings and misdiagnosis during a therapeutic process.
        
        Culture Shock: Anxiety associated with not knowing how to act/behave when in a new or different culture.
        
        Cultural Empathy: Therapists’ awareness of clients’ worldviews, which are acknowledged in relation to therapists’ awareness of their own personal biases.
        
        Cultural Identity: Individuals’ psychological membership in a distinct culture.
        
        Diversity: The process of recognizing and accepting the various differences and similarities found among individuals in a given society.
        
        Cultural Diversity: The spectrum of differences that exists among groups of people with definable and unique cultural backgrounds.
        
        Cultural Diversity Competence: A practitioner’s level of awareness, knowledge and interpersonal skill when working with individuals from diverse backgrounds.
      - Disability: A disability is defined as a physical or mental impairment that substantially limits a major life activity; the individual has a record of such an impairment; and the individual is being regarded as having such an impairment
      - Discrimination: Unfavourable or unfair treatment towards an individual or group based on their race, sex, colour, religion, national origin, age, physical/mental abilities, or sexual orientation. An act that negatively affects opportunities based on race, colour, religion, sex, handicap, national origin, sexual orientation, or other factors, such as age.
      - Emic: Cultural specific approach- tackles culture specifically and individually because take care of the cultural differences around the world individually.
      - Etic: Cross-culture approach - tackles culture with one general approach because socially acceptable norms are different in different cultures.
      - Marginalisation: The placement of minority groups and cultures outside mainstream society. All that varies from the norm of the mainstream is devalued and at times perceived as deviant and regressive.
      - Melting pot: The idea that a nation in which all nationalities and ethnicities blend into one unique culture.
      - Multi-racial: A term that describes people whose ancestry comes from multiple races, in this case more than two races
    - - Bisexualism: most often used to describe a person whose sexual orientation is to persons of either sex. This term can also be used to describe a person who has both reproductive organs, known as “hermaphrodites.”
      - Gay: A term that signifies same sex attraction, predominantly pertaining to men, though sometimes used by women-loving-women, and sometimes used as an umbrella term for a community identity that includes, gay, lesbian and bisexual persons
        A homosexual. This term was said to originate in Paris during the 1930’s and referred to the male homosexual underground community. The term was reclaimed during the Gay Liberation Movement as a source of pride. “Gay” is commonly used only to refer to homosexual men and not women.
      - Lesbian: A term that signifies same sex attraction, pertaining to women. A woman who has romantic and sexual feelings, attractions, and/or relationships with other women.
      - Transgender: This term is often used to describe persons whose gender identity “differs from conventional expectations for their physical sex.” “Transgender” is a term that can be used to refer to “transsexuals, masculine women, feminine men, drag queens/ kings, cross dressers, butches, etc.” Transgender persons can be heterosexual, homosexual, or bisexual.
    - - Gerontologists have recognized the very different conditions that people experience as they grow older within the years defined as old age. ... One study distinguishes the young old (60 to 69), the middle old (70 to 79), and the very old (80+)
        
        Old age is when a person is old and near the time when he or she dies. Often people of old age have wrinkly skin, move slower, and become constantly cold
        
        The scientific study of old age, the process of aging, and the particular problems of old people - gerontology
  - - - The view which is common in Euro-American world (dominant group) that places high value on individual achievement and distinction.
      - Those who highly value the needs and rights of the autonomous self belong to the individualism dimension.
      - Some researchers reported that cultures that value individualism more than collectivism emphasise on rights, freedom and independence.
    - - The view which is common in Asia, Africa, Latin America and Middle East (minority groups) that values group loyalty and pride over individual distinction.
      - value of group harmony more than individual needs
      - The more collectivist cultures, in general, emphasise the social networks to which the groups belong and social rules for behaviour.
  - - - Malays (80%)
      - Indigenous: (20%)
- - - - Theoretical Revision Approach
        
        This approach argues that some traditional counselling theories have room for further refinement to suit the needs of clients from multicultural settings.
        For example, Glauser and Bozarth (2001) support Rogers’ theory and claim that the theory provides a rich foundation for multicultural counselling.
        
        They argued that counselling in any multicultural context must embody basic elements of effective counselling.
        Thus, the Rogerian concepts, according to them, play an important role in multicultural counselling which include the importance of the counsellor-client relationship; core therapeutic conditions such as empathy, respect and genuineness; the emphasis on the client’s frame of reference for action implementation; and the phenomenological perspective (Jaladin, 2013).
        
        These concepts have been considered and can be incorporated within a multicultural framework and counselling to address issues of individual differences and diversity (MacDougall, 2002).
        In view of the universal elements in Rogerian model, perhaps its revised version can be considered as a multicultural counselling model for Malaysians.
        
        Theoretical Integration Approach
        
        (i) Integrating several theories of counselling; or(ii) Integrating indigenous methods of healing in counselling.
        
        An example for the first strategy is Egan’s (2007a) approach called “the skilled helper”. This model is a flexible, humanistic, broadly based problem-management and opportunity-development model which helps clients manage problems and develop unused resources (Jaladin, 2013).
        
        Thus, Egan’s model seems to work well for counselling culturally diverse clients because he managed to demonstrate how the skills described in the model apply to situations with people from different cultures (Egan, 2007b). It is predicted that Egan’s model can also be considered for use in the Malaysian context.
        
        Examples of indigenous healing practices available in the Malaysian context are bomoh therapies (which are either Quranic therapy or Malay magic), Islamic therapies, Ayurveda, qigong and many others (Haque, 2008). This highlights the need for Malaysian counsellors to consider integrating indigenous helping practices or resources into their counselling practice with diverse clients (Jaladin, 2013).
        
        Another perspective on theoretical integration involves inclusion and integration of indigenous methods of healing in counselling and psychotherapy (Jaladin, 2013). In literature, such an attempt has been overlooked and received minimal attention from practitioners and scholars in the US.
        Based on Malaysian literature and my research findings (Jaladin, 2011, 2013), the scenario is different in Malaysia. This is because the locals are more likely to seek help from the local healers and religious leaders instead of seeking help from professional counsellors especially among the three major ethnic groups of Malay, Chinese and Indian (Haque, 2008).
        
        Grounded Theory Approach
        
        The third approach urges counsellors to deconstruct counselling in a cultural context because in a grounded theory, we can “achieve a better understanding of the nature of psychological problems and the interpersonal dynamics involved in the problems as well as the solutions” (Cheung, 2000).
        However, this approach is very challenging to carry out because it requires a specific empirical framework to advance research in this direction (Jaladin, 2013).
        
        Overall, the earlier attempts are made based on the current thinking in conceptualising culture and addressing cultural differences. The underlying assumption is that no culture is superior or more desirable than another and to explore the legitimacy and benefits of any differences between cultures (Jaladin, 2013).
        This is the viewpoint from which the current field of multicultural counselling has developed, which also implies a valuing of diversity (Jaladin, 2011, 2013).
        
        Major critiques of Current attempts to incorporate multicultural concepts into the selected counselling theories
        
        Ethnocentric monoculturalism: The culture-bound nature of contemporary counselling theories and practices (Sue & Sue, 2008)
        
        Supremacy?
        
        The culturally encapsulated manner of mainstream counsellors (perhaps including those Western-trained professionals from non-Western contexts) (Wrenn, 1985)
        
        The ignorance (or lack of integration) of traditional and indigenous healing methods and approach (Constantine, Myers, Kindaichi & Moore III, 2004)
  - - - Exploring the client's Existing Situation
      - Open-ended questions
      - Silence
      - Focusing
      - Empathy
      - Paraphrasing & Reflecting
      - Paraphrasing & Reflecting Feeling
      - Structuring
      - Summarising
      - Meaning
    - - Helping the Client Establish Aims and Goals
      - Recognising Patterns & Themes
      - Alternate Frames of Reference
      - Self-disclosure
      - Immediacy
      - Challenging
      - Timing & Pacing
      - Advanced empathy
    - - Help the Client to Develop Strategies
      - Divergent Thinking
      - Goal Setting
      - Decision Making
      - Problem Solving
      - Programme Choice
      - Evaluate Knowledge of Resources
      - Using Knowledge of How Behaviour is Changed
      - Using Knowledge of How Useful Behaviour is Maintained
      - Teaching skills & Promoting Learning skills
  - - - Conceptualization of Multicultural Counselling MCC models
        
        The counsellor ability to integrate, develop, achieve the awareness, worldview, and strategic interventions. For example the similar behaviors or activities (e.g. smiling) have different functions in various cultures, their parameters cannot be used for multi-cultural comparison (Jahoda, 1966; Lonner, 1985).
        
        Certain behaviors and concepts (e.g. help seeking) may vary in meaning across cultures. (whether they seek help, types of help they seek… )
        
        Psychologists often study their own culture with the goal of benefiting people in that culture. The focus of such studies is the development of a psychology tailored to a specific culture without a focus on generalization outside of that cultural context (cf. Adamopolous & Lonner, 2001).
      - Operationalization of Multicultural Counselling MCC models
        
        Counsellor awareness of own cultural values and biases, client's worldview, culturally appropriate intervention strategies
        
        Multicultural approach assuming both the universal Etic approach and the group culture- specific Emic approach. Etic refers to universal elements while emic refers to culture-specific elements.
        
        Pernell-Arnold, Finley, Sands, Bourjolly, and Stanhope (2012) advocated for a shift from being culturally encapsulated (Wrenn, 1962; 1985) to a multi-perspective or a multicultural worldview.
        
        Limited cultural knowledge resulted in a reliance on stereotyped generalizations about racial-cultural groups that increased the likelihood of inappropriate understanding and decision-making (Tomlinson-Clarke, 2000).
      - Assessment of Multicultural Counselling MCC models
        
        Available tools for evaluating counsellors' awareness, knowledge, and skills for working with culturally diverse clients, knowledge of the potential bias in assessment instruments
        
        The bias can result from poor translation or poor item formulation and because item content may not be equally relevant or appropriate for the cultural groups being compared (e.g., Malpass & Poortinga, 1986; van de Vijver & Poortinga, 1997).
        
        An item on an instrument is considered biased if persons from different cultures having the same standing on the underlying characteristic (trait or state) measured yield different average item scores on the instrument.
        
        Assessment bias - one or more items on a test offend or unfairly penalize the participant because of his/ her personal characteristics such as race, gender, socioeconomic status, or religion.
    - - This development highlights the importance of MCCs multi-dimensional “cultural competency” needed to work effectively and ethically in a culturally diverse society (Sue & Sue, 2008; Whaley, 2008).
        Although MCC research literature has made significant contribution to the counselling profession, its rapid development poses some challenges, especially for international scholars and researchers, to operationally conceptualise and measure the construct of MCC and to design culturally relevant research methodologies when transporting multicultural counselling knowledge and practice into their specific cultural contexts.
        Ultimately, such paradigms can contribute to the preservation of different cultures worldwide and enhance individuals’ quality of life.
      - This, in turn, gives rise to some conceptual and methodological issues and challenges when communicating research in other cultural contexts such as Malaysia.
        Some of these issues raise concern about potential problems with the validity of MCC constructs (factor structure or internal validity and reliability issues) and the generalisation of its findings (external validity issues) (Cokley & Awad, 2008; Ponterotto & Mallinckrodt, 2007).
      - The current issues and debates related to MCC research
        
        Is multicultural counselling a narrow (an exclusive) or a broad (an inclusive) concept?
        
        Do the same basic counselling principles and techniques apply to everyone regardless of cultural background (either using a/an universal/ etic approach to multicultural counselling or culture-specific/ emic approach)?
        
        Should counsellors adapt traditional counselling to meet the needs of non-traditional clients or examine non-traditional counselling to enlighten traditional approaches (whether to modify the traditional Western approaches when counselling non-Western clients or conduct cultural anthropology/ study of human research to come up with a culture-specific non-Western approach to counselling)?
        
        Should multicultural training be required for licensure or certification of counsellors in counselling?
- - - - Conformity: This is the first stage whereby disadvantaged people or mostly non-Caucasians are seeking peer approval. They often try to identify with the dominant culture and may try to alter their appearance and mannerisms in order to fit in with the dominant culture.
        At this stage, the target person normally has strong negative attitudes toward his or her own self, his or her own cultural group and other minority groups. For him or her, belonging to or resembling the ways showed by dominant groups are what he or she desires.
        
        Attitudes
        
        Towards self: Self-depreciating attitudes and beliefs.
        
        Towards others of the same minority: Group depreciating attitudes and beliefs.
        
        Towards others of a different minority: Discriminatory.
        
        Towards dominant group: Group-appreciating attitudesand beliefs.
        
        Therapeutic Implications
        
        Most conformity clients from people of colour group would prefer to choose a White therapist over a minority therapist because the former is seen as more competent and capable than are members of one’s own race.
        
        Clients are less receptive to approaches aimed at cultural identity exploration as these are viewed as very threatening.
      - Dissonance and Appreciating: The second stage is dissonance. In this stage, personal conflict or dissonance often arises between appreciating one’s own ethnic heritage or finding this heritage as a barrier to personal identity and goals.
        At this stage, a target person usually has a conflicting view of the self. What appear to be positive views of the self may not be positive anymore and a similar denial happens to negative views of the self. This process happens slowly as the person constantly questions his or her attitudes towards the dominant group’s culture.
        
        Attitudes
        
        Towards self: Conflict between a self-depreciating andself-appreciating attitudes and beliefs.
        
        Towards others of the same minority: Conflict betweengroup-depreciating and group-appreciating attitudes and beliefs.
        
        Towards others of a different minority: Conflict betweendominant-held views of minority hierarchy and feelings of sharedexperience.
        
        Towards dominant group: Conflict between group appreciating and group-depreciating attitudes.
        
        Therapeutic Implications
        
        Clients prefer a counsellor or therapists who possess good knowledge of the client’s cultural group.
        
        Clients are more receptive to self-exploration approaches aimed at helping them come to grips with their identity conflicts.
      - Resistance and Immersion: The third stage is resistance and immersion. The minority group/ people in this stage begin to resist the dominant culture and completely immerse themselves in the qualities of their own culture. The dominant culture is viewed as oppressive and as a result, one might express displeasure and might have negative reactions towards the dominant culture.
        At this stage, the target person often has mixed feelings mostly involving self guilt or shame, as well as anger, distrust and dislike towards the dominant group. He or she has a new desire to find out more regarding his or her cultural roots and heritage.
        
        Attitudes
        
        Towards self: Self-appreciating attitudes and beliefs.
        
        Towards others of the same minority: Group appreciating attitudes and beliefs.
        
        Towards others of a different minority: Conflict betweenfeelings of empathy for other minority group experiences andfeelings of culture-centrism.
        
        Towards dominant group: Group depreciating attitudesand beliefs.
        
        Therapeutic Implications
        
        Therapists are viewed as a symbol of the oppressive society.
        
        Therapists will be constantly tested by the clients
        
        Clients are more receptive to action-oriented approaches, which aimed at external change (challenging racism)
      - Introspection: The fourth stage of Sue and Sue’s (2008) R/CID model is introspection. In this stage, one begins to see the effects of their attitudes towards the dominant culture and realises that their energy could be focused more on exploring their own culture.
        At this stage, the target person develops greater autonomy in finding a balance in his or her own attitudes towards the dominant culture and own cultural group. The person is willing to learn more about other minority cultures and becomes supportive towards oppressed people.
        
        Attitudes
        
        Towards self: Concern with basis of self-appreciatingattitudes and beliefs.
        
        Towards others of the same minority: Concern with theunequivocal nature of group appreciation.
        
        Towards others of a different minority: Concern with theethnocentric basis for judging others.
        
        Towards dominant group: Concern with the basis ofgroup depreciation.
        
        Therapeutic Implications
        
        Clients prefer a therapist of their own race and those who understand their worldviews.
        
        Clients are more receptive to self-exploration approaches, which are aimed at helping the clients integrate and incorporate a new sense of identity.
      - Integrative Awareness: The fifth and final stage is integrative. One accepts his or her own culture as well as the dominant culture. He or she works on understanding both positive and negative aspects of each culture and begins to work towards balancing their identity within the dominant culture.
        At this stage, the target person has a cultural insight as he or she fully develops a positive sense of group pride and an inquisitive nature towards group values.
        
        Attitudes
        
        Towards self: Self-appreciating attitudes and beliefs.
        
        Towards others of the same minority: Group appreciating attitudes and beliefs.
        
        Towards others of a different minority: Group appreciating attitudes.
        
        Towards dominant group: Attitudes and beliefs of selective appreciation.
        
        Therapeutic Implications
        
        Clients develop multicultural perspective and appreciate other cultures and races.
        
        Clients respond positively to action-oriented or system-oriented approaches aimed at community and societal change.
        
        Both clients and counsellors work towards attitudinal similarity rather than membership-group similarity.
    - - Be aware that the R/CID model should be viewed as dynamic, not static. The stages of identity are not fixed entities.
      - Do not fall victim to stereotyping in using these models.
      - Know that minority development models are conceptual aids and that human development is much more complex.
      - Know that identity development models begin at a point that involves interaction with an oppressive society.
      - Know that racial/cultural identity is not a simple, global concept.
      - Begin to look more closely at the possible therapist and client stage combinations.
- - - - - What Should Guests Wear to the Funeral? Guests are recommended to wear black and to avoid red or bright colours.
      - - What Happens During the Funeral? A wake takes place and during the wake, family and friends bring elaborate wreaths that include banners with couplets written on them and white envelopes filled with cash. A funeral procession to the cemetery or crematorium takes place.
      - - How Do Family and Friends Prepare for the Funeral? Obituary in newspaper
- - - - Restrictions
        
        Endagomy: Marrying within own caste
        
        Age: Minimum age – Male: 18, Female, 16
        
        Monogamy
        
        Prohibition on marrying certain relations
        
        Homosexual marriage
        
        Parental control over marriage choice: Arranged marriages common
        
        Arranged Marriages: Jathakam or Janam Kundali (astrological birth chart), 18–36 score. >28 successful.
    - - Head of family: Father > son
      - Low status of women
      - Occupational restrictions: In joint family, work for family business
  - - - Saivism: Siva, Supremem & Compassionate God
      - Shaktism: Shakti/Devi, supreme divine mother
      - Vaishnavism: Lord Vishnu and his incarnations, Krishna and Rama
      - Smartism: Supreme in one of 6 forms; Ganesha, Siva, Shakti, Vishnu, Surya, and Skanda
  - - - Campaigns on Violence Against Women
        (i) Improving the quality of the services provided to women in crisis by One Stop Crisis Centres (OSCC) at general hospitals in Selangorthrough training and monitoring.
        (ii) Supporting and empowering women facing domestic violence, especially clients from OSCC at hospitals in Selangor, by providing counselling, support group, legal information, and empowerment training.
        (iii) Developing and conducting educational modules for youths andyoung adults on matters relating to sexual and reproductive health and rights, and violence against women.
      - One Stop Crisis CentresThe One Stop Crisis Centre (OSCC) was established in 1996 in general hospitals nationwide, after intense lobbying by All Women's Action Society (AWAM) and other women’s groups, to enable survivors of violence including domestic violence and sexual assault, to access comprehensive treatment and services at one centralised location. The services provided at the centres include medical treatment, lodging a police report, legal support, and counselling.
      - (a) Campaigns on Violence Against Women
        (b) One Stop Crisis Centres
        (c) No Excuse for Abuse Campaign
        This is a public education campaign on domestic violence by the Women’s Aid Organisation.
        The ‘No Excuse for Abuse’ campaign aims to target the earlier phase of domestic abuse and put an end to violence against women. The exhibition highlights the thoughts that each survivor had told themselves while enduring physical abuse.
- - - - Oversimplified and uncritical/ accepting generalizations about individuals who are identified as belonging to a specific group.
      - A generalization about a group of people in which identical characteristics are assigned to virtually all members of the group, regardless of actual variation among the members.
      - Racial remarks, sexual remarks, and gender remarks are the biggest stereotypes.
      - Example: A are lazy and conservative. B are greedy and dishonest. C are dirty and smelly.
    - - Any pattern of behaviour that, solely because of race or culture, denies access to opportunities or privileges to members of one racial or cultural group while perpetuating access to opportunities and privileges to members of another racial or cultural group.
      - An example of racism is believing that Caucasians are superior to African Americans.
      - An example of racism is refusing to hire a Malay/ Indian/ Chinese person for a job.
      - Employers in the business sector are actively looking for X candidates
      - Particular race has better privileges as compare to others
    - - Unjustified negative or harmful action towards a member of a group simply because of his or her membership in that group.
      - Harassment – inappropriate jokes, insults, name-calling or displays such as a poster or cartoons directed at a person because of their race, colour, sex or gender, sexual orientation, etc
      - Wage discrimination – An example would be when an employer offers a lower wage for a woman doing similar work as a man
      - Discrimination in hiring – During a job interview, being asked inappropriate questions about your age, your religion or any other personal characteristic protected under human rights; and not getting the job based solely on your answer to these questions and not your qualifications or experience.
      - Being fired when you are pregnant (sex discrimination) or are injured and need time off to heal (discrimination based on disability and the duty to accommodate).
      - Discrimination in housing – When seeking an apartment for rent, the landlord tells you that “no children are allowed” (discrimination based on family status) or they won’t rent to people under 25 years (age discrimination) because “they’re too noisy and won’t look after the place”.
    - - A hostile or negative attitude towards a distinguishable group of people, based solely on their membership in that group
      - For example, a person may hold prejudiced views towards a certain race or gender etc. (e.g. sexist)
      - Until the early years of the twentieth century, women were not allowed to vote.
      - Women are not allowed to drive in Saudi Arabia and they are required to walk behind the man who is with them.
      - After 9/11, anyone who looked Middle Eastern was looked at suspiciously and was often the victim of prejudice.
      - In the past, some companies only hired females to be secretaries.
      - Some corporations hire women but do not promote any of them to supervisory positions.
      - Some people assume someone is gay because of the way they act.
- - - - Counsellor Characteristics
        
        Language barrier;
        
        Lack of practice experience and exposure to diverse cultures (macro and micro) in Malaysia;
        
        Perceived multiculturally incompetence;
        
        Counsellors’ value conflicts.
      - Client Characteristics
        
        Clients' resistance - Lack of acceptance, trust and confidence;
        
        Clients’ misconception or pre-judgmental beliefs about counselling or counsellor;
        
        Clients’ dependency.
      - Presenting Issues / Problems
        
        Culturally sensitive issues: Passivity rather than assertiveness; quiescence/ inactive rather than verbal articulation/ expression; self-effacement/ humble rather than confrontation. Being open to learning about the traditions and beliefs of other cultures. Being aware of your own culture and how it has influenced you. Examining your own biases and prejudices. Seeking knowledge about other cultures, especially those that you encounter often.
        
        Culturally complex issues: Counselling and multicultural counselling; individualism and collectivism; Although it is impossible to change backgrounds, pluralistic counsellors can avoid the problems of stereotyping and false expectations by examining their own values and norms, researching their clients' backgrounds, and finding counselling methods to suit the clients' needs.
        
        Counsellors cannot adopt their clients' ethnicity or cultural heritage, but they can become more sensitive to these things and to their own and their clients' biases.
        
        Clinical sensitivity toward client expectation, attributions, values, roles, beliefs, and themes of coping and vulnerability is always necessary for effective outcomes (LaFromboise, 1985).
        
        Examination of their own assumptions, acceptance of the multiplicity of variables that constitute an individual's identity, and development of a client centred, balanced counselling method will aid the multicultural counsellor in providing effective help.
      - Third-party characteristics (such as organisation, client’s support system, society)
        
        Stigmas and misconceptions;
        
        Negative societal labelling;
        
        Organizational expectations or pressures;
        
        Resistance and lack of support systems.
      - Counselling Context
        
        Inappropriate counselling room – unsuitable physical setting and infrastructure;
        
        Conflicting work values and work cultures.
- - - - By having a clear understanding of multicultural counselling in which they must understand, respect and appreciate differences in sociocultural background of a client, indigenous healing, beliefs and values; counsellors are able to avoid multicultural issues such as racism, prejudice, discrimination, stereotyping and ethnocentrism.
      - Multicultural theorists suggest that before one attempt to learn about the other, one must first learn about themselves in order to avoid assuming that their clients see and experience the world as they do. Attaining multicultural counselling competence requires that we choose interventions that are respectful of a cultural group’s intact beliefs and values, including the indigenous healing.
      - Understanding Malaysian culture and traditions especially the indigenous healing, is helpful in addressing counselling approach and practice in Malaysia.
      - Moreover, many counsellors are trained outside the country. Therefore, it is important for counsellors to have creativity in the adaptation of the skills, knowledge and techniques learnt inclusive the indigenous healing, in order to contribute to the sensitivity, efficiency and effectiveness of services provided.
      - Little effort has been emphasized in promoting the importance of understanding religious diversity in counselling.
      - For that reason, counsellor educators should deconstruct counselling in a cultural context by modifying the traditional counselling approach to a more effective and more culturally appropriate approach by way of integrating religion andspirituality into counselling.
      - It is essential to know that counsellors learn the most from practical experience inclusive the indigenous healing, rather than from formal counselling education in order to be multiculturally competent.
- - - - Do not allow your own emotional reactions to negate the stories of the most disempowered in society.
      - Increase your personal interactions with diverse groups; experiential learning is as important as intellectual learning.
      - All of us have inherited biases—try to acknowledge them openly so that you can listen to your clients in a non-defensive way.
      - Experiences with people of minority will enhance one’s cultural competence.
      - Explore yourself as a racial/cultural being.
      - Try to understand what your intense emotions mean for you when they arise.
      - Do not squelch/ suppress dissent or disagreements. Open dialogue is crucial.
        Take an active role in exploring yourself.
  - - - Describes your beliefs and attitudes about religion and spirituality & how it might conflict with the views of your client
      - Client Assessment:
      - What is the client’s religious/ spiritual beliefs?
      - How strongly does the client’s religious /spiritual beliefs affect his/her life?
      - Counselor Assessment:
      - How does your religious/ spiritual beliefs influence your life in general and your work as a behavioral health professional in particular?
    - - Client’s cultural background or racial or ethnic identity may have profound effect on attitudes toward eye-contact, body language, verbal tracking……
      - Client Assessment: Recognize the within and between group differences
      - Counselor Assessment: What sort of biases and preferences did I develop from my up-bringing? How do these biases influence my work with diverse clients?
    - - Stating feelings and content/ comfortable; self disclosure; view of LGBT; understanding gender and gender roles
      - Client Assessment: How does this factor impact the client’s psychological disposition? (clear, confused, frustrated)
      - Counselor Assessment: How does your own sexual orientation/ identity influences working with the diverse client (comfortable, confident, uneasy). How will lack of confidence/ comfort influence your counseling effectiveness?
    - - shows limited desire control in social interactions;
      - has a low capacity for self-awareness;
      - able to discuss the problems with much insight
      - Client Assessment: What is the client’s psychological maturity from a structural developmental frame work? (Piaget, Kohlberg). What is the client’s strengths at this level/ stage? What are the challenges?
      - Counselor Assessment: What is my level of maturity and what clients will I work best with? (sensory motor, concrete, abstract)
    - - Researches have shown how a person’s attitudes, values, worldview, and behaviors are all affected by social economic class standing & background
      - Client Assessment: Ask about Social Economic Status SES level - (low, middle, or high)
        
        How one’s SES affects the way the client was raised. How does it affect current issues in life, in the family, one’s values and biases?
        
        Look at SES more from Maslow Hierarchy of needs and make sure that basic needs are met before higher order needs are addressed
      - Counselor Assessment: How does SES affect my current way of thinking and acting, my biases and values
    - - The developmental tasks and challenges based on chronological development
      - The bodily changes and the sequencing of motor skills; the development of perception, language, learning, memory, thinking skills
      - Client Assessment: Erik Erikson’s theory of psychosocial development
      - Counselor Assessment: What are the strengths and limitations of my age and the age of the client that I am working with
    - - Stressful situations put people at risk of psychological danger and harm; poor, homeless, unemployed; pregnant teenagers; divorce cases; HIV carriers……..
      - Client Assessment: What are the stressors or traumas experiences by this client and what are the weaknesses/ strengths (if any)?
      - Counselor Assessment: How do the stressors or trauma affect my work with clients, and what shall I do to nurture my own mental health and well-being?
    - - Normal family life; healthy family functioning; single-female-headed family; extended family, gay or lesbian family
      - This involves the way the client past and current family influence on his/ her life
      - Client Assessment: How does the client define family, how does the family dynamics affect his/ her life
      - Counselor Assessment: How has family history influenced me, how has this influenced my choice in this profession, what types of families that clients come from may be uncomfortable for me?
    - - Stress and dissatisfaction with physical characteristics/ build up; irrational thinking about their own sense of self worth
      - The unique physical characteristics that may cause stress or maybe a source of personal pride
      - Client Assessment: How do the unique physical characteristics (blindness, hearing impairment, obesity etc) influence the clients development.
      - Counselor Assessment: What are the biases towards the client’s “physicalness” and how does that affect counseling the client?
    - - Geographical region and setting where one resides. Climate patterns; geological landscape/ environment; occupations; industry.
      - Dialect or language use
      - How does the location of residence and language difference influence client’s development?
      - Client Assessment: The impact of living in rural, suburban, urban areas - What are the different needs, stressors, sources of support in each area?
      - Counselor Assessment: Awareness that stressors, strengths, values and life styles differ based on location of residence and language difference
  - - - Nonverbal communication and behavior varies between cultures.
        
        Nonverbal occurs outside our levels of awareness but influence our evaluations and behaviors.
    - - Proxemics refers to the perception and use of personal and interpersonal space (e.g., norms of physical distance).
      - T. Hall (1969) identified four interpersonal distance zones characteristic of U.S. culture: intimate (from contact to 18 in.); personal, from 1.5 ft. to 4 ft; social, from 4 ft to 12 ft; and public (lectures and speeches), greater than 12 ft.
      - In Western culture, people seem to grow more uncomfortable when others stand too close rather than too far away.
      - Different cultures dictate different distances in personal space. Many ethnic minorities prefer a much closer stance than is normally comfortable for White Americans.
    - - Kinesics refers to bodily movements (e.g., facial expression, posture, characteristics of movement, gestures, and eye contact).
      - Much of our counseling assessments are based upon facial expressions. We assume that facial cues express emotions that demonstrate the degree of responsiveness or involvement of the individual. Smiling is generally believed to indicate contentment.
      - However, some Asian groups believe that smiling may suggest weakness.
      - Various cultural norms are discussed related to head movements, squatting, shaking hands, and eye contact.
    - - Paralanguage refers to other vocal cues that individuals use to communicate (e.g., loudness of voice, pauses, silences).
      - U.S. is a very outspoken, verbal culture, however, other cultures are not—this should not be pathologized.
      - Also, volume and intensity of speech in conversation are also influenced by cultural values.
      - Directness of a conversation or the degree of frankness also varies considerably among various cultures.
    - - A High-context (HC) communication is anchored in the physical context (situation) or internalized in the person. Less reliance is placed on the explicit code or message content.
      - An HC communication relies heavily on nonverbal.
      - Example a Filipino nurse where her subtle, high-context communication was misinterpreted by the doctor.
      - Low-context cultures communicate with a greater reliance on the verbal part of the message (e.g., U.S. culture).
    - - When the counseling style of the counselor does not match the communication style of the client, many difficulties can arise: premature termination, inability to establish rapport, or cultural oppression of the client.
      - Counselors need to realize that proxemics, kinesics, paralanguage, and high-low context factors are all important elements of communication, and they may be highly culture-bound.
      - It is important for counselors to understand their own personal communication styles and attempt to adapt to our client’s preferred form of communication.
      - A culturally diverse client may not open up and self-disclose until you, the helping professional, self-disclose first. Thus, to many minority clients, a therapist who expresses his or her thoughts and feelings may be better received in a counseling situation.
      - White American therapists tend to view their client’s problems as residing within the individual rather than society. However, many minorities give great weight to systemic and societal factors that adversely impact their lives.
      - Thus, active systems intervention is called for where environmental stressors are directly addressed through an active approach.
    - - Recognize that no one style of counseling will be appropriate for all populations and situations.
      - Become knowledgeable about how race, culture, and gender affect communication styles.
      - Become aware of your own communication and helping styles.
      - Obtain additional training and education on a variety of theoretical orientations and approaches.
    - - Think holistically rather than in a reductionist manner when conceptualizing the human condition. We are thinking, feeling, behaving, social, cultural, spiritual, and political beings.
        Training programs need to use an approach that calls for openness and flexibility in conceptualizing issues and skill building.
- - - - Individualism;
      - Verbal/ emotional/ behavioural expressiveness;
      - Openness and intimacy/ Self-disclosure;
      - Scientific empiricism; and
      - Patterns of communication.
    - - Strict adherence to time schedules (50-minute once or twice a week meetings),
      - Ambiguous or unstructured approach to problems and
      - Seeking long-range goals or solutions.
  - - - Marriage counselling
      - Career Counselling
      - Family Counselling
      - Multicultural Counselling
      - School Counselling
      - Addiction Counselling
  - - - Belief in superiority
      - Belief in the inferiority of others
      - Power to impose standards
      - Manifestation of ethnocentric values and beliefs in the programme, policies, practices, structures and institutions of the society
  - - - Implications for Clinical Practice
        
        Understand the terms “socio-demographic” and “diverse backgrounds” in the MCT definition to be inclusive and encompass race, culture, gender, religious affiliation, sexual orientation, elderly, women, disability, and so on.
        
        When working with different cultural groups, attempt to identify culture-specific and culture-universal domains of helping.
        
        If you are planning to work with the diversity of clients in our world, you must play roles other than that of the conventional counselor (e.g., consultant, advisor, change agent, facilitator of indigenous healing systems).
        
        Use modalities that are consistent with the lifestyles and cultural systems of clients.
        
        Realize that MCT (and cultural competence) is inclusive because it includes all groups (including minority and majority) because conventional counseling and therapy are exclusive and narrow and are based on dominant norms. As such, cultural competence is superordinate to clinical competence.
    - - Broadens the roles that counselors play and expands the repertoire of therapy skills considered helpful and appropriate in counseling.
      - Uses modalities and defines goals that are consistent with the racial, cultural, gender, and sexual orientation backgrounds of clients.
      - Acknowledges the individual, group, and universal dimensions of identity.
      - Utilizes cultural specific strategies of helping (e.g., using more self-disclosure with Euro-American clients.)
      - Balances the individualistic approach with a collectivist reality with clients of minority.
      - Assumes a dual role in helping clients (e.g., counselor and advocate).
    - - 1 Cultural universality (etic) versus cultural relativism (emic)
        In this instance the professor embraces an etic (culturally universal) perspective whereas the student values an emic (culturally specific) perspective.
      - 2 Emotional consequences of race
        
        In the dialogue, the professor seems to downplay or negate race as a powerful variable in the therapeutic process.
        
        He also becomes defensive when the student raises the issue of race.
        
        The professor is likely uncomfortable with open discussions of race because of the embedded feelings he has been culturally conditioned to hold.
        
        In order for productive change to occur, these difficult feelings need to be expressed and explored rather than avoided (as the professor does).
      - 3 Inclusive versus exclusive nature of multiculturalism
        
        The professor shifts the focus from race to other group differences to minimize the importance of race.
        
        While other demographic variables such as gender, ethnicity, sexual orientation, social class, and disability are important elements of multiculturalism, in this case the professor uses their existence to avoid dealing with the hard issues related to race and racism.
      - 4 Sociopolitical nature of counseling/ therapy
        
        The dialogue illustrates the symbolic meanings of power imbalance and oppression.
        
        Since the professor has authority and control in the classroom, he has the power to define reality.
      - 5 Nature of multicultural counseling competence
        
        The student seems to question the professor’s competence to effectively treat a family of color in a therapeutic setting.
        
        The professor retorts that “good counseling” is good counseling, implying that cultural competence and counseling competence are synonymous. However, Dr. Sue contends that cultural competence is superordinate to counseling competence.
        
        The standards of professional competence are based on theories that were created by and for European Americans and therefore reflect the belief systems and cultural assumptions of the larger society.