Multicultural Counseling and Psychotherapy
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Multicultural Counseling and Psychotherapy

A Lifespan Approach

Leroy G. Baruth, M. Lee Manning

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eBook - ePub

Multicultural Counseling and Psychotherapy

A Lifespan Approach

Leroy G. Baruth, M. Lee Manning

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Multicultural Counseling and Psychotherapy, 6 th ed, offers counseling students and professionals a distinctive lifespan approach that emphasizes the importance of social justice and diversity in mental health practice. Chapters include case studies, reflection questions, and examinations of current issues in the field. Each chapter also discusses the ways in which a broad range of factors—including sexuality, race, gender identity, and socioeconomic conditions—affect clients' mental health, and gives students the information they need to best serve clients from diverse backgrounds.

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Part I Overview

1 Introduction to Multicultural Counseling and Psychotherapy


Questions to Be Explored

  • What is multicultural counseling and psychotherapy, why should counselors understand clients’ many differences, and why should counselors plan culturally appropriate counseling intervention?
  • What clients comprise the U.S. populations? How can counselors define culture in its “broadest” terms, especially since clients have several different cultures?
  • What diversities challenge mental health counselors in a pluralistic society, e.g., culture in all its forms, race, ethnicity, worldview, social class, spirituality, generational differences, gender, sexual orientation, disabilities, and lifespan developmental differences? How does White privilege result in the lack of privilege for many others? What is social justice and how can this specific action toward social justice contribute to the welfare of all people?
  • What are the important tenets of multicultural counseling?
  • What counseling considerations deserve consideration when planning individual, group, family, and rehabilitation counseling?


America’s doors have been open to people of diverse cultural, ethnic, and racial origins for many years. Some people entered the country with hopes of realizing the American dream. Others came to escape oppressive conditions in their home countries. Still others were brought against their will and were expected to conform culturally. Then there were those who already inhabited the land that is now the United States. Through experiences commonly associated with daily living and working together, it was thought that this diverse range of people would acculturate or adopt “American” customs and values and, as in a “melting pot,” assimilate into mainstream society. For any number of reasons, however, many people opted to hold on to their cultural heritages, traditions, and customs; they wanted their cultural characteristics and values recognized as different, rather than as inferior or wrong.
Considerable evidence suggests that the melting pot metaphor does not provide an accurate description of the many cultural groups living in the United States. For example, some groups have failed (or have elected not to try) to forsake cherished cultural characteristics in order to become “Americanized.” Asians and Hispanics, 1 regardless of their generation, often reluctantly give up ethnic customs and traditions in favor of “middle-class American habits” that appear to them to be in direct contradiction to beliefs they acquired early in life. African Americans have fought to overcome cultural dominance and discrimination and, through efforts such as the civil rights movement, have sought to understand and maintain their cultural heritage. In essence, the United States is a nation of diverse peoples, and although cultural groups can be described with some accuracy, cultures are not monolithic in nature. This need to recognize and respect individual differences and similarities within cultures becomes clearer when one considers the generational differences and social class differences among the African American, American Indian, Asian American, European American, and Hispanic American cultures. The knowledgeable counselor can use these differences in working with a multicultural clientele.

Clients: Today and in the Future

The range of the U.S. multicultural society and the role it plays in shaping people’s lives will continue to become apparent to counseling professionals as increasing numbers of clients from diverse cultures seek mental health services. Undoubtedly, counselors and psychotherapists will increasingly counsel clients with differing customs, traditions, values, and perspectives toward life events and the counseling process. Will counselors, regardless of their cultural background, be able to provide effective counseling services for clients of differing backgrounds? The attitudes and skills that counselors bring to the multicultural counseling situation will depend significantly on their knowledge of cultures, their counseling effectiveness with clients, and their willingness to perceive cultural characteristics as differences rather than deficits.
For purposes of this text, we have chosen to concentrate on five cultures: African American, American Indian, Asian American, European American, and Hispanic American. The first determining factor was population numbers, particularly the estimated growth increases associated with them. To date, these cultures have shown significant increases and are expected to continue to do so, either by increased birth rate or by immigration. The numbers are currently sufficiently large that counselors—in schools, private practices, mental health institutions, or other settings of service delivery—will likely encounter clients from these cultures. Second, most available research data were drawn from these five groups. Third, these cultural groups have needs that warrant counseling, but individuals often are reluctant to seek counseling. Fourth, few counselors have sufficient knowledge of clients’ cultural and other differences (especially the African, Asian, Hispanic, and American Indian cultures) and how these differences affect the process of providing effective, culturally responsive counseling intervention.

African Americans

Whether termed African Americans, Black Americans, or Afro-Americans, the majority of this group can trace its origin to regions of Africa. The term African American appears most popular as a replacement for Black or Black American because it recognizes cultural ties with Africa. It also includes groups who indicate their race as “Black,” “African Am.,” or “Negro” or provide written entries such as African American, Afro-American, Kenyan, Nigerian, or Haitian.
The term African American continues to be debated. The term is being questioned by some Blacks who have long lived in the United States, just as their ancestors did. Also, it is being questioned by some people with roots in sub-Saharan Africa. Others simply prefer the term Black. It will take a number of years to determine which term will actually be selected to designate Black people and their culture. While correct names or labels are important, it is more important to understand the African American culture and its diversity.

American Indians

Ancestors of the people who are now known as Indians, Native Americans, or Native American Indians have continuously occupied North America for at least 30,000 years. Rather than emigrating from other lands and facing cultural assimilation into the majority culture, American Indians faced an influx of outsiders to their land who expected them to relinquish cherished cultural traditions. Again, the U.S. Census Bureau categorizes American Indians or Alaska Natives as any of the original peoples of North and South America (including Central America) who maintain tribal affiliation or community attachment. The American Indian people have been categorized into one group (see Chapter 7).

Asian Americans

Risking violation of sacred family traditions, many young Asians headed for the promised land of America around the turn of the twentieth century. Asian Americans were often forced to accept the lowest-paid menial jobs and were denied the rights of citizenship and ownership of land. As discussed in Chapter 9, Asian Americans and Pacific Islanders in the United States include the following Asian cultures: Chinese, Filipino, Japanese, Korean, Asian Indian, and Vietnamese. Hawaiians, Samoans, and Guamanians are known as Pacific Islanders. The recent influx of another group of Asian Americans from Southeast Asia has further contributed to the diversity of the Asian cultures. Many Indochinese started their journey from rural and poor areas to refugee camps and finally to American towns and cities. Originating from such countries as Vietnam, Cambodia, Laos, and Thailand, these people differ from the most populous Asian groups (Japanese and Chinese). Southeast Asians are a diverse group. For example, refugees from Southeast Asia can include Blue, White, and Striped Hmong; Chinese, Krom, and Mi Khmer Cambodians; Chinese Mien, Thai Dam, and Khmer Laotians; and Lowlander and Highlander Vietnamese. Each group has its own distinct history and culture. However, a discussion of all the many Asian groups currently living in the United States is beyond the scope of this text.

European Americans

As discussed in Chapter 11, 53 categories of European Americans live in the United States. Although ambiguous, the term White ethnic originally referred to Southern and Eastern European immigrants, rather than to Americans of British or German ancestry. In later years, the term has referred to a broader range of people. European Americans have not received notable attention in the discussions of multiculturalism and diversity. It is also important to mention that European Americans are a diverse people in terms of thought, emotions, and group loyalty. European Americans emigrated from widely diverse places, such as Western and Southern Europe as well as Eastern Europe and the former Soviet Union. People of Greek, Italian, Lebanese, Near Eastern, Arab, Polish, Irish, French, and German descent are well known in the United States, whereas those from the Netherlands, Portugal, Spain, and Switzerland are less well known.

Hispanic Americans

The Hispanic American culture includes Mexican Americans, Chicanos, Spanish Americans, Latinos, Mexicans, Puerto Ricans, Cubans, Guatemalans, and Salvadorans. All are recognized as Hispanics and share many values and goals. The soaring Hispanic population in the United States has been driven largely by waves of new immigrants—legal and illegal—as well as by more accurate counts by census takers. Hispanics are a large, young, rapidly increasing, highly diverse group of people. Hispanic is widely used to cover a disparate array of people from various nationalities. In fact, Hispanics should be considered an aggregate of distinct subcultures, rather than a homogeneous cultural group. For example, although Hispanics have cultural similarities, each Hispanic subgroup has its own distinct social and cultural practices. This increasing population is currently influencing mainstream American culture in such areas as communication, employment, education, and the arts. Chapter 13 describes the Hispanic population in more detail.

Understanding Diversity Among Clients in a Pluralistic Society

Culture, Subculture, and Intraculture

Culture can be defined as institutions, communication, values, religions, genders, sexual orientations, disabilities, thinking, artistic expressions, and social and interpersonal relationships. It should not be thought of as an abstract or relatively fixed set of attributions, shared traditions, country of origin, or even shared agreement about norms for living, common beliefs, and the like. Culture is fluid and emergent as people constantly recreate themselves, their narratives, and their contexts and, in turn, are themselves changed. Culture is always a matter of intersections—of class, race, ethnicity, gender, age, and experiences—which themselves are diverse and changing (Gallardo & McNeill, 2009; Robinson-Wood, 2009). Although counselors need to have an understanding of culture and its effects on counseling, an inclusive perspective of culture recognizes that client differences exist. Acquiring an objective picture of others’ cultural backgrounds requires an understanding of the many differences that make up an individual. One cannot group all Asian Americans into one cultural group or assume that all European or Hispanic American women are alike.
Subculture can be defined as a racial, ethnic, regional, economic, or social community (e.g., gang, drug, gay, elderly) that exhibits characteristic patterns of behavior sufficient to distinguish it from others in the dominant society or culture. A subculture provides its members with a history, social values, and expectations that may not be found elsewhere in the dominant culture. Therefore, meaningful communication between people who appear similar may be hampered because of differing subcultures.
Intraculture can be defined as a client’s educational background, socioeconomic status, acculturation, and urban and rural background. A client may be a member of several subcultures and intracultures, each influencing the process and outcome of counseling intervention. For example, a client may be disabled, gay or lesbian, first generational, and socioeconomically poor.


Race refers to the way a group of people defines itself or is defined by others as being different from other groups because of assumed innate physical characteristics. It is based on characteristics such as skin and eye color and shape of the head, eyes, ears, lips, and nose. Despite large numbers of people moving from one geographic region to another and increasing numbers of interracial marriages, the concept of race continues to play a role in distinguishing people. However, race contributes little to understanding clients’ culture, ethnicity, sexual orientation, and lifespan differences. Considered as a single entity, racial identity does not reveal an individual’s nationality, communication, or religion. Cultural groups that are defined by nationality, geography, communication, and religion seldom correspond with racial categories, at least not to the extent necessary to provide culturally relevant information. Therefore, although counselors should be cognizant of their clients’ race, they will learn more about their clients’ strengths, weaknesses, and challenges when other, more individual, aspects are identified.


Ethnicity is the most distinguishing characteristic of Americans because we are categorized primarily based on our cultural identity or nationality. Robinson-Wood (2009) maintains that ethnicity refers to a connectedness based on commonalities (e.g., religion, nationality, region) in which specific aspects of cultural patterns are shared and transmission over time creates a common history and ancestry. Ethnicity refers to commonality in which unique cultural aspects refer to a nationality and country of origin. For others, religion describes either ethnicity or values and lifestyles. Characteristics associated with ethnicity include (1) a shared group image and sense of identity derived from values, behaviors, beliefs, communication, and historical perspectives; (2) shared political, social, and economic interests; and (3) shared involuntary membership with a specific ethnic group. Because of interracial marriage, many Americans have multiple ethnic and racial identities. Some persons of mixed lineage prefer to assume identities; for example, they label themselves as “White,” “Black,” “Indian,” “Latino,” “Asian,” or merely “American.” Still, the effects of ethnicity and race are pervasive and influence people’s opinions and actions.


This section defines worldview and discusses overall aspects of the term. Worldview may be defined as one’s individual experiences and social, moral, religious, educational, economic, or political inputs shared with other members of one’s reference group, such as culture group, racial or ethnic group, family, state, or country. Increasing attention has focused on the notion that different counseling and psychotherapy approaches reflect different worldviews. It is important that counselors understand worldviews when planning professional int...

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