Counseling the Culturally Diverse. Laura Smith L.Читать онлайн книгу.
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.
Relatedly, in the mental health fields, the predominant way of asking and answering questions about the human condition tends to involve the scientific method. The epitome of this approach is the experiment. In graduate school, we learn that reliance upon controlled experiments allows us to impute cause–effect relationships. By identifying independent and dependent variables, and controlling for extraneous ones, we are able to test our cause–effect hypotheses. Although correlational studies, historical research, and other approaches may be of benefit, we are assured that the experiment represents the ultimate approach to knowledge creation. Other cultures, however, often value different ways of asking and answering questions about the human condition, and different ways of representing knowledge (as do qualitative, feminist, and participatory researchers within American scholarship).
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.
PATTERNS OF CULTURAL ASSUMPTIONS AND MULTICULTURAL FAMILY COUNSELING/THERAPY
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)
Family counseling or therapy may be conducted as marital or couple counseling, parent–child counseling, or work with more than one member of a family. Family systems therapy possesses several important characteristics (Corey, 2013; McGoldrick, Giordano, & Garcia‐Preto, 2005):
It highlights the importance of the family (versus the individual) as the unit of identity.
It focuses on resolving concrete issues.
It is concerned with family structure and dynamics.
It assumes that these family structures and dynamics are historically passed on from one generation to another.
It attempts to understand the communication and alliances via reframing.
It places the therapist in an expert position.
Many of these qualities would be consistent with the worldviews of Persons of Color. The problem arises in how they are translated into concepts of what “the family” is, or what constitutes a “healthy” family. Some of the characteristics of healthy families assumed by therapists may pose obstacles to therapy with various culturally diverse groups. They tend to be connoted with value orientations that are incongruent with the value systems of many culturally diverse clients (McGoldrick et al., 2005). According to conventional family systems theory, healthy families:
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