COUN226 Lecture 3: Week 3 Lecture
19 May 2018
School
Department
Course
Professor
COUN226 Ethical & Professional Issues in Counselling
Lecture 3 – Culture & Diversity Dr Michelle Delaney
Overview
• Frameworks for Viewing Cultural Difference
• Multiculturalism
• Aboriginal and Torres Strait Islander Clients
• Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual (LGBTQIA)
clients
• Ethics
Ancestry
Ancestry
• DNA studies suggest all humans descended from a group of African
ancestors
• Began a journey about 60,000 years ago
• The Genographic Project is charting the migratory history of the human
species using computer and laboratory analysis of DNA
–Maternal Lineage: mitochondrial DNA
–Paternal Lineage: Y chromosome
Ethnicity
• Ethnicity: Sense of identity that stems from common ancestry, history,
nationality, religion, and race
• Ethnic Minority Group: groups who have been singled out for differential
and unequal treatment and who regard themselves as objects of collective
discrimination
Culture
Culture – a Broad Interpretation
Cultural & Biological Transmission
• People learn about norms and beliefs using various forms of cultural
transmission
• Parallels notion of biological transmission, with genetic mechanisms
perpetuating certain features of a population over time across generations
Cultural Transmission
• A group can perpetuate its behavioural features among subsequent
generations employing teaching and learning mechanisms
–Vertical transmission – from parents
–Horizontal transmission – from peers
–Oblique transmission – from others of the parental generation in
society
• Can be from within a person’s own cultural group or from another cultural
group
• Enculturation: general “enfolding” of individuals in context of their culture
• Socialization: more specific instruction and training
Stereotypes
• Oversimplified and uncritical generalizations about individuals who are
identified as belonging to a specific group
Racism
• Any pattern of behavior 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
Terminology
• Cultural Diversity
–Spectrum of differences that exists among groups of people with
definable and unique cultural backgrounds
• Cultural Diversity Competence
–Practitioner’s level of awareness, knowledge, and interpersonal skill
when working with individuals from diverse backgrounds
• Cultural Empathy
–Therapists’ awareness of clients’ worldviews, which are
acknowledged in relation to therapists’ awareness of their own
personal biases
• Cultural racism
–Belief that one group’s history, way of life, religion, values, and
traditions are superior to others
• Unintentional racism
–Often subtle, indirect, and outside our conscious awareness; this can
be the most damaging and insidious form of racism
• Cultural tunnelvision
–Perception of reality based on a very limited set of cultural
experiences
Unintended Racism
• Avoiding the issue of cultural differences by claiming to be ‘colour blind’
and treating all people as if they were alike
• Being too ‘colour conscious’, thus attributing problems to a client’s
background
• Failing to recognise one’s own countertransference feelings and issues
• Facilitating co-dependency relationships with ethnic clients out of the need
to be needed
• Misunderstanding a client’s defensive reactions to therapist’s stereotypical
thinking
• Misinterpreting a client’s culturally learned patterns of communicating or
behaving
IAT task
• Implicit Association Test(IAT)
• Computer-based task
• Detects the strength of a person’s automatic association between mental
representations of concepts in memory
Frameworks for Viewing Cultural Difference
High Context
• Messages based on a broad set of culturally based rules
• Rules reside within individual and environment
• Clients may attend more closely to the non-verbal behaviour of the
counsellor
• May not speak as much and expect others to understand unstated rules
• More time may be required in clarification to avoid misunderstanding
• E.g. Japanese, Arab, Greek, Spanish
Low Context
• Reliance placed upon specific content of message
• Less attention paid to culturally based contextual rules
• Verbal messages very important as not as much information received from
the environment
• More time may be required in clarification to avoid misunderstanding
–Pamphlets, reading material
• E.g. Swiss, German, American
Context
Individualism vs. Collectivism
Individualistic
• Focus on the individual
• Emphasize individual needs
• Autonomy in health care decisions
• E.g. United States, Canada, Australia
Collectivist
• Interests of group paramount – focus on group
• Emphasize group harmony
• Consensus in health care decisions
• Careful regulation of non-verbal communication
–Ensure it is appropriate to status hierarchies
• Show emotions that facilitate group cohesiveness and harmony
• Use of avoidance strategies and face- saving behaviours in conflict
situations
• E.g. Japan, Pakistan, Thailand and South America
Multiculturalism
• Generic term that indicates any relationship between and within two or
more diverse groups
Need for Multicultural Emphasis
• Counselors have an ethical responsibility to provide professional services
that demonstrate respect for the cultural worldviews, values, and traditions
of culturally diverse clients
• If counselors are focused on the values of the dominant culture and
insensitive to variations among groups and individuals, they are at risk for
practicing unethically
Multicultural Counselling
• Helping intervention and process that defines contextual goals consistent
with the life experiences and cultural values of clients
• Balancing the importance of individualism versus collectivism in
assessment, diagnosis, and treatment
Reaching Diverse Client Populations
• Most contemporary theories of therapy are grounded in Western
assumptions, yet most of the world differs from mainstream U.S. culture
• Models of helping based on Western assumptions have not always
considered the influence and impact of racial and cultural socialization
• Cultural traditions may contribute to the underutilization of traditional
counselling services by minority clients
• Therapists must be willing to go outside of the office to deliver services in
the community to decrease suspicion and enhance trust
Obstacles to Helping
• Several obstacles exist to helping people who are culturally different to the
counsellor:
–Fear of not being adequate as a counsellor
–Rear of rejection
• Can be partly overcome by understanding client’s:
–History and present issues
–Language
–Gender roles
–Family background
–Religion
–Social order
–Future, past or present time orientation
Differences
Communication with Culturally Diverse Groups
• Effectiveness of counsellor is dependent upon ability to communicate
within the verbal and nonverbal language framework of clients
• Techniques vary between cultures
Self Disclosure
• Assumption: Self-disclosure is a characteristic of a healthy personality
–BUT Some clients view self-disclosure and interpersonal warmth as
inappropriate in a professional relationship with an authority figure
Directness and Assertiveness
• Assumption: Directness and assertiveness are desirable qualities
–In some cultures, directness is perceived as rudeness and something
to be avoided
Self Actualization
• Assumption: It is important for clients to become authentic and self-
actualized
–A creative synthesis between self-actualization and responsibility to
the group may be a more realistic goal for some clients
Eye Contact
• Assumption: Direct eye contact is a sign of interest and presence, and a
lack thereof is a sign of being evasive
–Prolonged and direct eye contact is considered rude in some cultures
–In the Middle East public eye-to-eye contact is permitted between
two men but not between a man and a woman
Distance - Proxemics
• Term “proxemics” originated with Edward Hall in 1950’s and 1960’s
• Studied use of space and how differences can make people feel more
relaxed or anxious
• Comfortable distance between client and counsellor varies between
cultures
Culturally Sensitive Care
• View client as an informant to provide knowledge about cultural beliefs
and practices
• Elicit explanations about own illness
• To what extent do clients believe in a bio-psycho-social model?
–Incorporation of traditional healing practices
• Sociocultural background can influence how:
–Symptoms are perceived
–Cause of illness
–Type of treatment needed
• Respect
Obstacles to Verbal Communication
• Language Barriers
–Communicating symptoms
–Making assessments
–Establishing a therapeutic relationship
Different dialects and verbal expressions •
Interaction Styles •
–Rushing into discussions vs lengthy formalities
–Use of metaphor
• Battles
–“battling the disease”
• War
–“winning the war against disease”
• “Take the medication as a weapon to fight the disease”
• Information Preferences
–Comfort with asking questions
• Disclosure Preferences
Aboriginal & Torres Strait Islander Clients
Mental Health Policy Implementation
• Pervasive trans-generational impact of colonisation
• Several reviews of Australian Indigenous mental health policy
implementation suggest that much of the work done in this area has been
ineffective
• Attributed to:
–Silos within government agencies and services
–Boundaries between different health professionals
–Services and organizations that are inappropriate and unresponsive
to needs of individuals, families and communities
–Assumptions and attitudes of practitioners, especially non-
Indigenous practitioners
• Influenced by:
–Colour or cultural blindness
–Overt racism
Working with Aboriginal & TSI Clients
• Number of national and community-based ethical guidelines, protocols
and principles of practice available
• Encourage practitioners to familiarize themselves with local:
–History, customs and ways of working
–Mental health issues
• APS has produced a set of guidelines when researching or delivering health
services to Indigenous people
• Australian Health Ministers Advisory Council has developed the national
“Cultural Respect Framework for Aboriginal and Torres Strait Islander Health
2016 –2026”
–Sets out principles and examples of practice
Cultural Respect Framework 2016 – 2026
CRF has identified 6 focus areas:
Whole of organisation approach and commitment 1.
Communication 2.
Workforce development and training 3.
Consumer participation and engagement 4.
Stakeholder partnership and collaboration 5.
Data, planning research and evaluation 6.
Working in Partnership
• Practitioners need to work in partnership with Indigenous Australians
• Very different model from conventional individualistic Western way of
working that has important implications for practice
• Recognize that the individual “Client”, their family, community and
Indigenous co-workers are equally experts in the process
• Development of an effective partnership takes time, trust and personal
relationship
–who you are is more important than what you are
• Have regard for Indigenous protocols in community contexts
–E.g. a process of vouching is required – one or some of the
community members will attest to the person wishing to enter the
community
• Work in collaboration with cultural consultants
Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual
(LGBTQIA) clients
Sex and Gender
• The terms sex and gender are often confused:
• Sex refers to biological differences
• Gender refers to roles, behaviours and attitudes expected of people based
on their biological sex
Sex and Gender . . . cont
• Assumption that women have achieved equality
• Therefore, sometimes make the mistake of assuming marginalisation is not
like to be an issue that women will bring to counselling
• Most practitioners are now female: it is assumed women have the skills to
counsel women effectively
Sex and Gender . . . cont
• Both men and women are influenced by gender role socialisation
experiences.....
• If we don’t examine this, can lead to accidental
discrimination/incompetent counselling
• Examine client beliefs + what the client feels is expected of them by those
around them cultural influence
Sexual Orientation
• Terminology: LGBTQIA = Lesbian, Gay, Bisexual, Transgender, Queer,
Intersex, Asexual
• In order to change therapeutic strategies, one must be open to changing
assumptions about sexual orientation
• Therapists need to become conscious of their own faulty assumptions
• Therapists are challenged to confront their personal stereotypes regarding
sexual orientation
Socioeconomic Status
Socioeconomic Status
• SES is considered a cultural variable and another factor for consideration
• SES effects many dimensions of a person’s life:
Self worth 1.
Access to mental health care 2.
Exposure to violence 3.
4. Sense of personal power
Socioeconomic Status
Social class transcends other cultural dimensions such as:
1. Race
2. Religion
3. Gender
4. Ability status
Ethical Considerations
• Ethical responsibility to provide professional services that demonstrate
respect for the cultural worldviews, values & traditions of culturally diverse
clients
• Important for counsellors to confront own ethnocentrism, race-based
assumptions and stereotypic thinking
• If counsellors are focused on the values of the dominant culture and
insensitive to variations among groups and individuals, they are at risk of
practicing unethically
• Become familiar with cultural considerations contained in the Code of
Ethics of your professional association
Week 3 Lecture
Wednesday, 14 March 2018
1:27 PM
COUN226 Ethical & Professional Issues in Counselling
Lecture 3 – Culture & Diversity Dr Michelle Delaney
Overview
• Frameworks for Viewing Cultural Difference
• Multiculturalism
• Aboriginal and Torres Strait Islander Clients
• Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual (LGBTQIA)
clients
• Ethics
Ancestry
Ancestry
• DNA studies suggest all humans descended from a group of African
ancestors
• Began a journey about 60,000 years ago
• The Genographic Project is charting the migratory history of the human
species using computer and laboratory analysis of DNA
–Maternal Lineage: mitochondrial DNA
–Paternal Lineage: Y chromosome
Ethnicity
• Ethnicity: Sense of identity that stems from common ancestry, history,
nationality, religion, and race
• Ethnic Minority Group: groups who have been singled out for differential
and unequal treatment and who regard themselves as objects of collective
discrimination
Culture
Culture – a Broad Interpretation
Cultural & Biological Transmission
• People learn about norms and beliefs using various forms of cultural
transmission
• Parallels notion of biological transmission, with genetic mechanisms
perpetuating certain features of a population over time across generations
Cultural Transmission
• A group can perpetuate its behavioural features among subsequent
generations employing teaching and learning mechanisms
–Vertical transmission – from parents
–Horizontal transmission – from peers
–Oblique transmission – from others of the parental generation in
society
• Can be from within a person’s own cultural group or from another cultural
group
• Enculturation: general “enfolding” of individuals in context of their culture
• Socialization: more specific instruction and training
Stereotypes
• Oversimplified and uncritical generalizations about individuals who are
identified as belonging to a specific group
Racism
• Any pattern of behavior 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
Terminology
• Cultural Diversity
–Spectrum of differences that exists among groups of people with
definable and unique cultural backgrounds
• Cultural Diversity Competence
–Practitioner’s level of awareness, knowledge, and interpersonal skill
when working with individuals from diverse backgrounds
• Cultural Empathy
–Therapists’ awareness of clients’ worldviews, which are
acknowledged in relation to therapists’ awareness of their own
personal biases
• Cultural racism
–Belief that one group’s history, way of life, religion, values, and
traditions are superior to others
• Unintentional racism
–Often subtle, indirect, and outside our conscious awareness; this can
be the most damaging and insidious form of racism
• Cultural tunnelvision
–Perception of reality based on a very limited set of cultural
experiences
Unintended Racism
• Avoiding the issue of cultural differences by claiming to be ‘colour blind’
and treating all people as if they were alike
• Being too ‘colour conscious’, thus attributing problems to a client’s
background
• Failing to recognise one’s own countertransference feelings and issues
• Facilitating co-dependency relationships with ethnic clients out of the need
to be needed
• Misunderstanding a client’s defensive reactions to therapist’s stereotypical
thinking
• Misinterpreting a client’s culturally learned patterns of communicating or
behaving
IAT task
• Implicit Association Test(IAT)
• Computer-based task
• Detects the strength of a person’s automatic association between mental
representations of concepts in memory
Frameworks for Viewing Cultural Difference
High Context
• Messages based on a broad set of culturally based rules
• Rules reside within individual and environment
• Clients may attend more closely to the non-verbal behaviour of the
counsellor
• May not speak as much and expect others to understand unstated rules
• More time may be required in clarification to avoid misunderstanding
• E.g. Japanese, Arab, Greek, Spanish
Low Context
• Reliance placed upon specific content of message
• Less attention paid to culturally based contextual rules
• Verbal messages very important as not as much information received from
the environment
• More time may be required in clarification to avoid misunderstanding
–Pamphlets, reading material
• E.g. Swiss, German, American
Context
Individualism vs. Collectivism
Individualistic
• Focus on the individual
• Emphasize individual needs
• Autonomy in health care decisions
• E.g. United States, Canada, Australia
Collectivist
• Interests of group paramount – focus on group
• Emphasize group harmony
• Consensus in health care decisions
• Careful regulation of non-verbal communication
–Ensure it is appropriate to status hierarchies
• Show emotions that facilitate group cohesiveness and harmony
• Use of avoidance strategies and face- saving behaviours in conflict
situations
• E.g. Japan, Pakistan, Thailand and South America
Multiculturalism
• Generic term that indicates any relationship between and within two or
more diverse groups
Need for Multicultural Emphasis
• Counselors have an ethical responsibility to provide professional services
that demonstrate respect for the cultural worldviews, values, and traditions
of culturally diverse clients
• If counselors are focused on the values of the dominant culture and
insensitive to variations among groups and individuals, they are at risk for
practicing unethically
Multicultural Counselling
• Helping intervention and process that defines contextual goals consistent
with the life experiences and cultural values of clients
• Balancing the importance of individualism versus collectivism in
assessment, diagnosis, and treatment
Reaching Diverse Client Populations
• Most contemporary theories of therapy are grounded in Western
assumptions, yet most of the world differs from mainstream U.S. culture
• Models of helping based on Western assumptions have not always
considered the influence and impact of racial and cultural socialization
• Cultural traditions may contribute to the underutilization of traditional
counselling services by minority clients
• Therapists must be willing to go outside of the office to deliver services in
the community to decrease suspicion and enhance trust
Obstacles to Helping
• Several obstacles exist to helping people who are culturally different to the
counsellor:
–Fear of not being adequate as a counsellor
–Rear of rejection
• Can be partly overcome by understanding client’s:
–History and present issues
–Language
–Gender roles
–Family background
–Religion
–Social order
–Future, past or present time orientation
Differences
Communication with Culturally Diverse Groups
• Effectiveness of counsellor is dependent upon ability to communicate
within the verbal and nonverbal language framework of clients
• Techniques vary between cultures
Self Disclosure
• Assumption: Self-disclosure is a characteristic of a healthy personality
–BUT Some clients view self-disclosure and interpersonal warmth as
inappropriate in a professional relationship with an authority figure
Directness and Assertiveness
• Assumption: Directness and assertiveness are desirable qualities
–In some cultures, directness is perceived as rudeness and something
to be avoided
Self Actualization
• Assumption: It is important for clients to become authentic and self-
actualized
–A creative synthesis between self-actualization and responsibility to
the group may be a more realistic goal for some clients
Eye Contact
• Assumption: Direct eye contact is a sign of interest and presence, and a
lack thereof is a sign of being evasive
–Prolonged and direct eye contact is considered rude in some cultures
–In the Middle East public eye-to-eye contact is permitted between
two men but not between a man and a woman
Distance - Proxemics
• Term “proxemics” originated with Edward Hall in 1950’s and 1960’s
• Studied use of space and how differences can make people feel more
relaxed or anxious
• Comfortable distance between client and counsellor varies between
cultures
Culturally Sensitive Care
• View client as an informant to provide knowledge about cultural beliefs
and practices
• Elicit explanations about own illness
• To what extent do clients believe in a bio-psycho-social model?
–Incorporation of traditional healing practices
• Sociocultural background can influence how:
–Symptoms are perceived
–Cause of illness
–Type of treatment needed
• Respect
Obstacles to Verbal Communication
• Language Barriers
–Communicating symptoms
–Making assessments
–Establishing a therapeutic relationship
Different dialects and verbal expressions •
Interaction Styles •
–Rushing into discussions vs lengthy formalities
–Use of metaphor
• Battles
–“battling the disease”
• War
–“winning the war against disease”
• “Take the medication as a weapon to fight the disease”
• Information Preferences
–Comfort with asking questions
• Disclosure Preferences
Aboriginal & Torres Strait Islander Clients
Mental Health Policy Implementation
• Pervasive trans-generational impact of colonisation
• Several reviews of Australian Indigenous mental health policy
implementation suggest that much of the work done in this area has been
ineffective
• Attributed to:
–Silos within government agencies and services
–Boundaries between different health professionals
–Services and organizations that are inappropriate and unresponsive
to needs of individuals, families and communities
–Assumptions and attitudes of practitioners, especially non-
Indigenous practitioners
• Influenced by:
–Colour or cultural blindness
–Overt racism
Working with Aboriginal & TSI Clients
• Number of national and community-based ethical guidelines, protocols
and principles of practice available
• Encourage practitioners to familiarize themselves with local:
–History, customs and ways of working
–Mental health issues
• APS has produced a set of guidelines when researching or delivering health
services to Indigenous people
• Australian Health Ministers Advisory Council has developed the national
“Cultural Respect Framework for Aboriginal and Torres Strait Islander Health
2016 –2026”
–Sets out principles and examples of practice
Cultural Respect Framework 2016 – 2026
CRF has identified 6 focus areas:
Whole of organisation approach and commitment 1.
Communication 2.
Workforce development and training 3.
Consumer participation and engagement 4.
Stakeholder partnership and collaboration 5.
Data, planning research and evaluation 6.
Working in Partnership
• Practitioners need to work in partnership with Indigenous Australians
• Very different model from conventional individualistic Western way of
working that has important implications for practice
• Recognize that the individual “Client”, their family, community and
Indigenous co-workers are equally experts in the process
• Development of an effective partnership takes time, trust and personal
relationship
–who you are is more important than what you are
• Have regard for Indigenous protocols in community contexts
–E.g. a process of vouching is required – one or some of the
community members will attest to the person wishing to enter the
community
• Work in collaboration with cultural consultants
Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual
(LGBTQIA) clients
Sex and Gender
• The terms sex and gender are often confused:
• Sex refers to biological differences
• Gender refers to roles, behaviours and attitudes expected of people based
on their biological sex
Sex and Gender . . . cont
• Assumption that women have achieved equality
• Therefore, sometimes make the mistake of assuming marginalisation is not
like to be an issue that women will bring to counselling
• Most practitioners are now female: it is assumed women have the skills to
counsel women effectively
Sex and Gender . . . cont
• Both men and women are influenced by gender role socialisation
experiences.....
• If we don’t examine this, can lead to accidental
discrimination/incompetent counselling
• Examine client beliefs + what the client feels is expected of them by those
around them cultural influence
Sexual Orientation
• Terminology: LGBTQIA = Lesbian, Gay, Bisexual, Transgender, Queer,
Intersex, Asexual
• In order to change therapeutic strategies, one must be open to changing
assumptions about sexual orientation
• Therapists need to become conscious of their own faulty assumptions
• Therapists are challenged to confront their personal stereotypes regarding
sexual orientation
Socioeconomic Status
Socioeconomic Status
• SES is considered a cultural variable and another factor for consideration
• SES effects many dimensions of a person’s life:
Self worth 1.
Access to mental health care 2.
Exposure to violence 3.
4. Sense of personal power
Socioeconomic Status
Social class transcends other cultural dimensions such as:
1. Race
2. Religion
3. Gender
4. Ability status
Ethical Considerations
• Ethical responsibility to provide professional services that demonstrate
respect for the cultural worldviews, values & traditions of culturally diverse
clients
• Important for counsellors to confront own ethnocentrism, race-based
assumptions and stereotypic thinking
• If counsellors are focused on the values of the dominant culture and
insensitive to variations among groups and individuals, they are at risk of
practicing unethically
• Become familiar with cultural considerations contained in the Code of
Ethics of your professional association
Week 3 Lecture
Wednesday, 14 March 2018
1:27 PM
COUN226 Ethical & Professional Issues in Counselling
Lecture 3 – Culture & Diversity Dr Michelle Delaney
Overview
• Frameworks for Viewing Cultural Difference
• Multiculturalism
• Aboriginal and Torres Strait Islander Clients
• Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual (LGBTQIA)
clients
• Ethics
Ancestry
Ancestry
• DNA studies suggest all humans descended from a group of African
ancestors
• Began a journey about 60,000 years ago
• The Genographic Project is charting the migratory history of the human
species using computer and laboratory analysis of DNA
–Maternal Lineage: mitochondrial DNA
–Paternal Lineage: Y chromosome
Ethnicity
• Ethnicity: Sense of identity that stems from common ancestry, history,
nationality, religion, and race
• Ethnic Minority Group: groups who have been singled out for differential
and unequal treatment and who regard themselves as objects of collective
discrimination
Culture
Culture – a Broad Interpretation
Cultural & Biological Transmission
• People learn about norms and beliefs using various forms of cultural
transmission
• Parallels notion of biological transmission, with genetic mechanisms
perpetuating certain features of a population over time across generations
Cultural Transmission
• A group can perpetuate its behavioural features among subsequent
generations employing teaching and learning mechanisms
–Vertical transmission – from parents
–Horizontal transmission – from peers
–Oblique transmission – from others of the parental generation in
society
• Can be from within a person’s own cultural group or from another cultural
group
• Enculturation: general “enfolding” of individuals in context of their culture
• Socialization: more specific instruction and training
Stereotypes
• Oversimplified and uncritical generalizations about individuals who are
identified as belonging to a specific group
Racism
• Any pattern of behavior 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
Terminology
• Cultural Diversity
–Spectrum of differences that exists among groups of people with
definable and unique cultural backgrounds
• Cultural Diversity Competence
–Practitioner’s level of awareness, knowledge, and interpersonal skill
when working with individuals from diverse backgrounds
• Cultural Empathy
–Therapists’ awareness of clients’ worldviews, which are
acknowledged in relation to therapists’ awareness of their own
personal biases
• Cultural racism
–Belief that one group’s history, way of life, religion, values, and
traditions are superior to others
• Unintentional racism
–Often subtle, indirect, and outside our conscious awareness; this can
be the most damaging and insidious form of racism
• Cultural tunnelvision
–Perception of reality based on a very limited set of cultural
experiences
Unintended Racism
• Avoiding the issue of cultural differences by claiming to be ‘colour blind’
and treating all people as if they were alike
• Being too ‘colour conscious’, thus attributing problems to a client’s
background
• Failing to recognise one’s own countertransference feelings and issues
• Facilitating co-dependency relationships with ethnic clients out of the need
to be needed
• Misunderstanding a client’s defensive reactions to therapist’s stereotypical
thinking
• Misinterpreting a client’s culturally learned patterns of communicating or
behaving
IAT task
• Implicit Association Test(IAT)
• Computer-based task
• Detects the strength of a person’s automatic association between mental
representations of concepts in memory
Frameworks for Viewing Cultural Difference
High Context
• Messages based on a broad set of culturally based rules
• Rules reside within individual and environment
• Clients may attend more closely to the non-verbal behaviour of the
counsellor
• May not speak as much and expect others to understand unstated rules
• More time may be required in clarification to avoid misunderstanding
• E.g. Japanese, Arab, Greek, Spanish
Low Context
• Reliance placed upon specific content of message
• Less attention paid to culturally based contextual rules
• Verbal messages very important as not as much information received from
the environment
• More time may be required in clarification to avoid misunderstanding
–Pamphlets, reading material
• E.g. Swiss, German, American
Context
Individualism vs. Collectivism
Individualistic
• Focus on the individual
• Emphasize individual needs
• Autonomy in health care decisions
• E.g. United States, Canada, Australia
Collectivist
• Interests of group paramount – focus on group
• Emphasize group harmony
• Consensus in health care decisions
• Careful regulation of non-verbal communication
–Ensure it is appropriate to status hierarchies
• Show emotions that facilitate group cohesiveness and harmony
• Use of avoidance strategies and face- saving behaviours in conflict
situations
• E.g. Japan, Pakistan, Thailand and South America
Multiculturalism
• Generic term that indicates any relationship between and within two or
more diverse groups
Need for Multicultural Emphasis
• Counselors have an ethical responsibility to provide professional services
that demonstrate respect for the cultural worldviews, values, and traditions
of culturally diverse clients
• If counselors are focused on the values of the dominant culture and
insensitive to variations among groups and individuals, they are at risk for
practicing unethically
Multicultural Counselling
• Helping intervention and process that defines contextual goals consistent
with the life experiences and cultural values of clients
• Balancing the importance of individualism versus collectivism in
assessment, diagnosis, and treatment
Reaching Diverse Client Populations
• Most contemporary theories of therapy are grounded in Western
assumptions, yet most of the world differs from mainstream U.S. culture
• Models of helping based on Western assumptions have not always
considered the influence and impact of racial and cultural socialization
• Cultural traditions may contribute to the underutilization of traditional
counselling services by minority clients
• Therapists must be willing to go outside of the office to deliver services in
the community to decrease suspicion and enhance trust
Obstacles to Helping
• Several obstacles exist to helping people who are culturally different to the
counsellor:
–Fear of not being adequate as a counsellor
–Rear of rejection
• Can be partly overcome by understanding client’s:
–History and present issues
–Language
–Gender roles
–Family background
–Religion
–Social order
–Future, past or present time orientation
Differences
Communication with Culturally Diverse Groups
• Effectiveness of counsellor is dependent upon ability to communicate
within the verbal and nonverbal language framework of clients
• Techniques vary between cultures
Self Disclosure
• Assumption: Self-disclosure is a characteristic of a healthy personality
–BUT Some clients view self-disclosure and interpersonal warmth as
inappropriate in a professional relationship with an authority figure
Directness and Assertiveness
• Assumption: Directness and assertiveness are desirable qualities
–In some cultures, directness is perceived as rudeness and something
to be avoided
Self Actualization
• Assumption: It is important for clients to become authentic and self-
actualized
–A creative synthesis between self-actualization and responsibility to
the group may be a more realistic goal for some clients
Eye Contact
• Assumption: Direct eye contact is a sign of interest and presence, and a
lack thereof is a sign of being evasive
–Prolonged and direct eye contact is considered rude in some cultures
–In the Middle East public eye-to-eye contact is permitted between
two men but not between a man and a woman
Distance - Proxemics
• Term “proxemics” originated with Edward Hall in 1950’s and 1960’s
• Studied use of space and how differences can make people feel more
relaxed or anxious
• Comfortable distance between client and counsellor varies between
cultures
Culturally Sensitive Care
• View client as an informant to provide knowledge about cultural beliefs
and practices
• Elicit explanations about own illness
• To what extent do clients believe in a bio-psycho-social model?
–Incorporation of traditional healing practices
• Sociocultural background can influence how:
–Symptoms are perceived
–Cause of illness
–Type of treatment needed
• Respect
Obstacles to Verbal Communication
• Language Barriers
–Communicating symptoms
–Making assessments
–Establishing a therapeutic relationship
Different dialects and verbal expressions •
Interaction Styles •
–Rushing into discussions vs lengthy formalities
–Use of metaphor
• Battles
–“battling the disease”
• War
–“winning the war against disease”
• “Take the medication as a weapon to fight the disease”
• Information Preferences
–Comfort with asking questions
• Disclosure Preferences
Aboriginal & Torres Strait Islander Clients
Mental Health Policy Implementation
• Pervasive trans-generational impact of colonisation
• Several reviews of Australian Indigenous mental health policy
implementation suggest that much of the work done in this area has been
ineffective
• Attributed to:
–Silos within government agencies and services
–Boundaries between different health professionals
–Services and organizations that are inappropriate and unresponsive
to needs of individuals, families and communities
–Assumptions and attitudes of practitioners, especially non-
Indigenous practitioners
• Influenced by:
–Colour or cultural blindness
–Overt racism
Working with Aboriginal & TSI Clients
• Number of national and community-based ethical guidelines, protocols
and principles of practice available
• Encourage practitioners to familiarize themselves with local:
–History, customs and ways of working
–Mental health issues
• APS has produced a set of guidelines when researching or delivering health
services to Indigenous people
• Australian Health Ministers Advisory Council has developed the national
“Cultural Respect Framework for Aboriginal and Torres Strait Islander Health
2016 –2026”
–Sets out principles and examples of practice
Cultural Respect Framework 2016 – 2026
CRF has identified 6 focus areas:
Whole of organisation approach and commitment 1.
Communication 2.
Workforce development and training 3.
Consumer participation and engagement 4.
Stakeholder partnership and collaboration 5.
Data, planning research and evaluation 6.
Working in Partnership
• Practitioners need to work in partnership with Indigenous Australians
• Very different model from conventional individualistic Western way of
working that has important implications for practice
• Recognize that the individual “Client”, their family, community and
Indigenous co-workers are equally experts in the process
• Development of an effective partnership takes time, trust and personal
relationship
–who you are is more important than what you are
• Have regard for Indigenous protocols in community contexts
–E.g. a process of vouching is required – one or some of the
community members will attest to the person wishing to enter the
community
• Work in collaboration with cultural consultants
Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual
(LGBTQIA) clients
Sex and Gender
• The terms sex and gender are often confused:
• Sex refers to biological differences
• Gender refers to roles, behaviours and attitudes expected of people based
on their biological sex
Sex and Gender . . . cont
• Assumption that women have achieved equality
• Therefore, sometimes make the mistake of assuming marginalisation is not
like to be an issue that women will bring to counselling
• Most practitioners are now female: it is assumed women have the skills to
counsel women effectively
Sex and Gender . . . cont
• Both men and women are influenced by gender role socialisation
experiences.....
• If we don’t examine this, can lead to accidental
discrimination/incompetent counselling
• Examine client beliefs + what the client feels is expected of them by those
around them cultural influence
Sexual Orientation
• Terminology: LGBTQIA = Lesbian, Gay, Bisexual, Transgender, Queer,
Intersex, Asexual
• In order to change therapeutic strategies, one must be open to changing
assumptions about sexual orientation
• Therapists need to become conscious of their own faulty assumptions
• Therapists are challenged to confront their personal stereotypes regarding
sexual orientation
Socioeconomic Status
Socioeconomic Status
• SES is considered a cultural variable and another factor for consideration
• SES effects many dimensions of a person’s life:
Self worth 1.
Access to mental health care 2.
Exposure to violence 3.
4. Sense of personal power
Socioeconomic Status
Social class transcends other cultural dimensions such as:
1. Race
2. Religion
3. Gender
4. Ability status
Ethical Considerations
• Ethical responsibility to provide professional services that demonstrate
respect for the cultural worldviews, values & traditions of culturally diverse
clients
• Important for counsellors to confront own ethnocentrism, race-based
assumptions and stereotypic thinking
• If counsellors are focused on the values of the dominant culture and
insensitive to variations among groups and individuals, they are at risk of
practicing unethically
• Become familiar with cultural considerations contained in the Code of
Ethics of your professional association
Week 3 Lecture
Wednesday, 14 March 2018 1:27 PM
Document Summary
Lecture 3 culture & diversity dr michelle delaney. Overview: frameworks for viewing cultural difference, multiculturalism, aboriginal and torres strait islander clients, lesbian, gay, bisexual, transgender, queer, intersex, asexual (lgbtqia) clients, ethics. Ethnicity: ethnicity: sense of identity that stems from common ancestry, history, nationality, religion, and race, ethnic minority group: groups who have been singled out for differential and unequal treatment and who regard themselves as objects of collective discrimination. Cultural & biological transmission: people learn about norms and beliefs using various forms of cultural transmission, parallels notion of biological transmission, with genetic mechanisms perpetuating certain features of a population over time across generations. Cultural transmission: a group can perpetuate its behavioural features among subsequent generations employing teaching and learning mechanisms transmission, parallels notion of biological transmission, with genetic mechanisms perpetuating certain features of a population over time across generations. Cultural transmission: a group can perpetuate its behavioural features among subsequent generations employing teaching and learning mechanisms.
