Counseling the Culturally Diverse. Laura Smith L.

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of gods signifies wisdom; and in U.S. culture, it is generally considered to be a juvenile, quasi‐obscene gesture of defiance, mockery, or contempt. Head movements also have different meanings (Eakins & Eakins, 1985; Jensen, 1985). An educated Englishman may consider the lifting of the chin when conversing as a poised and polite gesture, but to European Americans it may connote snobbery and arrogance (“turning up one's nose”). Most European Americans perceive squatting (often done by children) as improper and childish. In other parts of the world, however, people have learned to rest by taking a squatting position. On the other hand, when Americans put our feet up on a desk, it is believed to signify a relaxed and informal attitude. Yet, Asians and Latinx Americans may perceive it as rudeness and arrogance, especially if the bottoms of the feet are shown to them.

      The Importance of Nonverbals

      Nonverbal behavior provides clues to conscious deceptions or unconscious biases (Utsey, Gernat, & Hammar, 2005). There is evidence that the accuracy of nonverbal communication varies with the part of the body used: facial expression is more controllable than the hands, followed by the legs and the rest of the body (Hansen, Stevic, & Warner, 1982). The implications for multicultural counseling are obvious. Therapists who have not adequately dealt with their own biases and stereotypes may unwittingly communicate them to culturally diverse clients. Studies suggest that women and Persons of Color are better readers of nonverbal cues than are White males (Hall, 1976; Jenkins, 1982). The reason for this may be survival: for marginalized group members to survive and thrive in a predominantly White society, they must often rely on nonverbal cues as much or more than on verbal ones.

      Nonverbals often occur outside our level of awareness, yet they influence our evaluation of others and our behavior toward them (Locke & Bailey, 2014; Garrett & Portman, 2011). Acculturated within a society whose communication styles correspond to European American middle‐class norms, mental health professionals may assume that certain behaviors or rules of speaking are universal and possess the same meaning for everyone. This may create major problems for therapists and clients of varying cultural backgrounds. The cultural upbringing of many cultural minorities dictates characteristic patterns of communication that may place them at a disadvantage in therapy. Counseling, for example, usually involves frequent initiation of communication by the client. In other words, the client is often expected to take a major responsibility for initiating conversation in the session and breaking silences without waiting to be directed; the counselor listens, responds, and generally plays a less active role. However, many cultures—for example, American Indians, Asian Americans, and Latinx Americans—may function according to cultural traditions that weigh against this communication pattern. Members of cultural groups such as these may have been raised to respect elders and authority figures and not to speak until spoken to. Clearly defined roles of authority may have been established in the traditional family. Such clients may see therapy as an authoritative process in which a good therapist is direct and active; this client, if asked to initiate conversation, may become uncomfortable and respond with only brief statements. Therapists in turn may interpret this behavior negatively, when in actuality it is a sign of respect.

      SCIENTIFIC EMPIRICISM

      Counseling and psychotherapy in Western culture and society have been described as being linear and analytic in attempting to model themselves after the physical sciences. As mentioned in Table 3.1, Western society tends to emphasize the scientific method, which involves objective, rational, linear thinking. In using linear thinking, we follow set steps in a particular order in the belief that this well‐defined progression leads inevitably to one proper conclusion. Accordingly, we often see descriptions of good therapists as objective, neutral, rational, and logical (Utsey, Walker, & Kwate, 2005), language that calls to mind this linear paradigm. Therapists are frequently trained to rely heavily on the use of linear problem solving, as well as on quantitative evaluation that includes psychodiagnostic tests, intelligence tests, personality inventories, and so forth. In other words, theories of counseling and therapy are analytical, rational, and verbal in nature, and they stress the discovery of cause–effect relationships.

      Experiments, linear thinking, and problem‐solving are not inherently problematic, of course; when applied within an appropriate context, they are useful tools. Rather, the problem is that the life experiences and feelings of diverse human beings and communities are often not the appropriate context. Moreover, an emphasis on symbolic logic contrasts markedly with the philosophies of many cultures that live according to a more nonlinear, holistic, impressionistic, and harmonious approach (Sue, 2015). For example, American Indian worldviews emphasize harmonious aspects of the world, intuitive functioning, and a holistic approach—a worldview characterized by creative activities and understandings rather than analytical frameworks. Thus, when American Indians participate in therapy, a distinctly analytic approach may clash with their basic philosophy of life (Garrett & Portman, 2011) and lead conventional linear‐thinking therapists to erroneous conclusions about them.

      DISTINCTIONS BETWEEN MENTAL AND PHYSICAL FUNCTIONING

      Many traditional cultures—among them, American Indians, Asian Americans, African Americans, and Latinx Americans—hold varying concepts of what constitutes mental well‐being, mental illness, and adjustment to life. For example, Chinese and Latinx cultures do not always make the same Western distinction between mental and physical health as do their White counterparts (Guzman & Carrasco, 2011). Thus, problems of well‐being that mainstream American culture would consider to be psychological may be referred to a physician, priest, or minister (i.e., not a psychotherapist) within some cultures. Similarly, culturally diverse clients may enter therapy expecting the therapist to treat them in the same manner that a doctor would, and to offer them immediate solutions and concrete tangible forms of treatment (advice, medication, consolation, and/or confession). Conventional therapists sometimes interpret these expectations as resistance or as unrealistic wishes for a “cure,” when they are more accurately understood as a cultural worldview in which one's emotional well‐being is understood to be inseparably bound up with other aspects of the self.

      As we've just seen, the worldviews and traditions of many communities of color have elements that lie outside the taken‐for‐granted assumptions that underlie conventional Western models of therapeutic theory and practice. The practice of family counseling offers a useful opportunity for exploration of still more of these elements, as the family unit itself takes on different meanings and significance across diverse cultures.

       Dior Vargas, a 28‐year‐old Latina mental health activist, recalls a therapist in college—her second one—who she stopped going to after realizing she was “culturally incompetent.” “She wasn't aware of how close‐knit Latino families are. That they are a part of my decision‐making process. My therapist didn't understand that, she would say: ‘No, you need to stand up to your mother.’ That felt very disrespectful to me. Maybe sometimes you do, but the way she said it made me very defensive.” (Hackman, 2016, para. 5)

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