Nitisha Shrestha

Roll no. 11
Psychotherapy and Counseling in Multicultural Setting
Date: 2078/07/05

Summary of UNIT I.

Multicultural Psychology is the study of how culture influences the way people think, feel,
and act. It considers internal factors such as personality, and external factors such as the
impact of family, community when trying to understand how culture impacts affect,
cognition, and behavior. There has been divided point of view where one perspective known
as relativism suggest that culture and abnormal behaviors are intertwined and disorders can
be understood only in the cultural framework within which they occur and another view
know as universalism suggests that although culture play a role in determining the behavior
and manifestation of abnormal behavior there are cross cultural similarities in underlying
psychological mechanisms. Culture plays a role in influencing the expression of behavior.
Most psychotherapy is bound to a particular cultural framework. It is necessary to examine
the approaches and use it considering the cultural norms, values, and beliefs of clients. The
effective way of therapy may differ according to culture.

There is a need of professional ethics to make sure that professionals provide culturally
competent services. There are codes of ethics established by various organizations that
recognizes the inherent importance of culture and the interdependence between individuals
and their culture. However, many values and ethics established by different organizations are
vague. There are controversies regarding whether multiculturalism must be inclusive or
exclusive, use of traditional approaches and techniques to people of different cultural
background. There is a necessity to improve the awareness, knowledge and skills while
working with clients from diverse cultures. This chapter helps to reflect on the meaning of
multicultural psychology, the effect of culture on manifestation of abnormal behavior,
provide knowledge on values that underlie ethical practices, and professional ethics in
international context. The chapter also makes us question regarding the uses of traditional
psychotherapy within Nepali culture. This chapter provides a theoretical awareness of ethical
issues and rules in multicultural context. There are different cultures and the chapter helps us
to realize and become aware regarding misconceptions.
Summary of UNIT II- Multicultural Context: Theories and Relevant Concepts.
Multicultural competence refers to refers to ability of a person to be able to become aware
about his or her own assumptions, values, and preconceived notions, attempt to understand
the worldview of a client who belongs to an entirely different culture and provide a culturally
appropriate and sensitive intervention strategies. A culturally competent professional must
foster a high level of awareness, knowledge, and skills when working with client. There are
models that have been developed. There are two major models and eight secondary models
where major models are more elaborated. The models have played a key role, however, they
have shortcomings too. There needs to be clear definitions of construct with clear
relationships among variables and the validation should be proved through continuous
research to test the effectiveness of the models.

The conceptualization of multicultural competence can help to enable students and

practitioners to integrate skills, knowledge, and awareness while working with a client and
during case conceptualization as well as assessment. There might be utility of the models,
however their validity needs to be ensured through research. The in-depth knowledge, skills,
and awareness and the models can provide guidance on how to operate. It keeps informed and
makes us conscious about macroaggression that we could display towards other people.

Summary of UNIT III- Assessment in Multicultural Setting

There are guidelines for assessment and interventions with culturally diverse population.
DSM-IV diagnostic criteria were mostly developed from a Western worldview. Although
DSM-V includes culturally bound syndromes, but there are limited and incomplete
descriptions. Culture does influence the meaning, expression of symptoms. There is a need
for increase in the range, variety, and evaluation of interventions. There are cultural
assessment and interview protocol that can guide professional to understand the worldview of
client. The Cultural Interview Assessment Protocol (Suzuki, 2007) presents with eleven
categories which includes evaluation of client’s attitude towards helping, cultural identity,
level of acculturation, family structure, level of racial identity development, experience with
bias, immigration issues, existential issues, counselors characteristic and behaviors,
implications of Cultural factors between counselor and client, and summary of cultural
factors and implications of diagnosis, case conceptualization, and treatment. This chapter also
deals with multicultural issues in projective assessment.
Most cross cultural researches yield mixed results and there is lack of clarity on the
applicability of projective techniques for people from culturally diverse background. This
chapter brings a readiness for case formulation of a client. During every counseling session,
intake interview is first and foremost step. The guidelines provided in the book can help to
learn more about client and make counselor aware about client’s ethnic backgrounds, cultural
values, and norms. In addition, it can help to provide valuable research data to identify
problems and difficulties in different communities.

Summary of UNIT IV- Counseling and Psychotherapy with Specific Groups

There are many behaviors that people display which are associated with survival and should
not be pathologized. However, Western approach unintentionally pathologies cultural values
(Sue & Sue, 2010). It is important that counselor or therapist have knowledge and be
sensitive when dealing with diverse clients. A person’s experience differ on basis of race,
ethnic background, socioeconomic status, cultural values. This may make different cultural
groups be more receptive to certain counseling styles or communication approach. People
from different cultural group face different kinds of problems and difficulties. In addition, it
differs on basis of gender, immigration status, sexual orientation, as well as developmental
stage. When working with individual it is important to be aware about the stereotypes, living
conditions, cultural values imposed on the client, environmental adversity, all of these factors
should be taken into account.

Counselor needs to provide community counseling services that can reach to minority
populations. The chapter consists of topics that alerts us about counseling different groups
and the difficulties. It teaches to be cautious and helps us learn and have basic understanding
regarding culture-specific or group-specific values and adversity and dangers of
overgeneralizing or stereotyping. Hence, therapists must be able to shift their therapeutic
styles to meet developmental needs, and cultural dimensions of their clients.
Summary of UNIT V- Case Analysis

The case studies involve special circumstances with ethnic population and multicultural
populations. There are various clinical case descriptions that have actually happened. These
are the cases that different professionals came across during their service. The cases provided
awareness on cultural factors that brings issues in the treatment of patient and how the
therapeutic technique must be provided on basis on client’s cultural background and
personality trait. There are clients and counselors who come from different background. It
provides awareness about how in some circumstances having client and counselor from
different cultural background can be more effective.

The case analysis allows us an opportunity to analyze, interpret, and contemplate varying
cases and reflect on what we could do if we were in similar circumstance or were we in the
professional’s position.

References

Sue, D.W., & Sue, D. (2010). Counseling the Culturally Diverse: Theory and Practice (5th
edition). John Wiley& Sons, Inc.

Suzuki, L.A., & Ponterotto, J.G. (2007). Handbook of Multicultural Assessment: Clinical,
Psychological, and Educational Applications (3rd edition). Jossey-Bass.