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Chapter Ten: Professional Practice in Multicultural Contexts
Chapter Overview
The multicultural perspective is foundational to the practice of contemporary clinical
mental health counseling. Culture and social context are fundamental elements in human
development. Multiculturalism tolerates and even supports alternative views of mental health,
taking into account not only differences in race and ethnicity but also differences in nationality,
education, sexual orientation, religion, age, geographic location, and socioeconomic influences.
This acceptance is a logical consequence of being ecologically minded. Thus, mental health
professionals who embrace the multicultural perspective are able to work with persons of
different backgrounds without assessing recognized differences between themselves and their
clients in terms of being right and wrong, superior and inferior.
This chapter introduces the implications of diversity and multiculturalism for the profession
of mental health counseling. First, the chapter describes the current multiracial, multicultural
face of America and the necessity for skilled mental health counselors to demonstrate
multicultural competence. Second, foundational principles for respectful counseling of diverse
populations are discussed. Competent counselors must be aware of numerous barriers to
effective cross-cultural counseling and significant influences of their personal cultural self. In
addition, a working knowledge of the implications of racial/cultural identity development theory,
within- versus between-group differences, and the convergence of multiple identities helps
counselors recognize and work with the diversity in various groups of people. Finally, the
client. Third, MSJCC sees advocacy efforts directed toward exosystems and macrosystems of
clients’ ecological context as appropriate and, sometimes, necessary targets for mental health
counseling interventions. Thus, clinical mental health counselors conceptualize treatment by
matching therapeutic structure, strategies, and processes to the unique concerns, strengths and
resources, and ecological contexts of their clients.
Learning Objectives
By the end of this chapter, students should be able to:
• Understand and describe the historical development and progression of multiculturalism in
clinical and mental health counseling
• Define and describe the importance of key definitions and concepts in multiculturalism
• List and describe potential barriers in multicultural counseling
• List and describe the foundational principles of multicultural counseling
Key Words/Terms
• Race- a biologically based classification system of people groups based on viable
physical characteristics
• Ethnicity- a group of persons who identify with one another by virtue of sharing common
ancestry, religion, language, skin color, and/or culture
• Institutional racism- takes place when social policies and laws have the intentional or
unintentional consequence of positioning one racial/ethnic group in positions of privilege,
power, and advantage over other groups
• Discrimination- biased treatment of a person based on the view one holds of the group to
which that person belongs
• Confirmation bias- a human tendency to search for information that confirms one’s
preexisting conceptions
• Acculturation- the gradual physical, biological, cultural, and psychological changes that
take place in individuals and groups when contact between two cultural groups takes
place
• Unresolved-relational pattern characterized by couples who had not addressed, were in
conflict over, or did not know what to do about their cultural differences.
Lecture Outline for Chapter Ten
Professional Practice in Multicultural Contexts
I. Diversity and Multiculturalism in America
A. Minorities becoming majorities
B. Differences in education, socioeconomic status
C. Conceptualizing race and ethnicity as such broad constructs obscures the extent to
which within-group and individual differences operate
II. Multiculturalism as the Fourth Force in Counseling
A. Freud and the psychoanalytic perspective, behaviorism, and humanistic
psychology are recognized as the first three forces, respectively.
B. Contemporary trends and the composition of American society have led the
counseling profession to view the multicultural orientation as integral to the work
or mental health counselors.
C. Historically
2. Civil Rights movement
4. In 1973, the American Psychological Association’s Vail Conference and
5. Considered further unethical to deny treatment based on untrained staff
D. Ethics
2. Preamble to ACA Code of Ethics, “Association members recognize
diversity and embrace a cross-cultural approach in support of the worth,
dignity potential, and uniqueness of people within their social and cultural
contexts.”
E. Counselor Education
1. CACREP identifies social and cultural diversity as one of the common
core areas
3. Graduate students gain important knowledge and skills on relating the
4. Academic programs called on to design recruitment and retention
strategies for the employment of faculty members who reflect the diverse
backgrounds in society
III. Key Definitions and Concepts
A. Race- a biologically based classification system of people groups based on viable
physical characteristics
1. Racial differences based on differences of physical appearance is one of
2. Race may carry popular meaning as a social construction and status
variable, but counselors must avoid using the term and its implications in
ways that support any form of prejudiced attitude or discriminatory
practice
B. Ethnicity- a group of persons who identify with one another by virtue of sharing
common ancestry, religion, language, skin color, and/or culture
1. Used in this manner, can use interchangeably with race
2. More narrow sense of the word focuses on the setting apart of groups of
persons on the basis of national origin and distinctive cultural patterns
C. Culture- a way of living that encompasses the customs, traditions, attitudes, and
overall socialization in which a group of people engage that are unique to their
cultural upbringing
D. Prejudice- an attitude, judgment of feeling about a person that is generalized from
attitudes or beliefs held about the group to which the person belongs
E. Racism- the use of power and position, overtly or covertly/intentionally or
unintentionally, to treat others differentially on the basis of perceived racial
differences between or among groups of people
1. Individual racism- occurs when a person holds attitudes and beliefs of his
2. Institutional racism- takes place when social policies and laws have the
intentional or unintentional consequence of positioning one racial/ethnic
group in positions of privilege, power, and advantage over other groups
F. Discrimination- biased treatment of a person based on the view one holds of the
group to which that person belongs
2. Self-awareness and honesty are necessary attributes if mental health
counselors are to recognize the operation of discrimination in their private
or agency practices
G. Cross-cultural counseling- any counseling in which two or more of the
participants are racially/ethnically different
IV. Barriers to Effective Multicultural Counseling
A. Resistance
1.Mental health professionals resist assimilating multicultural training in
overt and subtle covert ways
2.Three forms
3.Overcome by counselors-in-training being very honest with themselves,
B. Cultural Encapsulation
2. Demonstrate insensitivity to persons of other cultural backgrounds who
hold alternative perspectives
4. Become trapped in what may be described as a cultural tunnel vision
C. Misapplication of Traditional Theories and Techniques
1.Current standards for clinical mental health counseling encourage infusion
2. Fundamental presuppositions undergirding traditional models of
counseling
a. Individualism
b. View of normalcy
i. Normal and abnormal behavior held from Western, Euro-
American perspective
c. Functional agnosticism and antireligiousness
d. Personal happiness as a legitimate goal of counseling
e. Insight and process of change
3. Systematic barriers within counseling delivery systems
4. Language barriers and miscommunication
5. Mistrust
a. Fundamental attribution error- the general tendency for people to
underestimate contextual influences and overestimate dispositonal
influences in explaining the behavior of others
b. Culture and the operation of the fundamental attribution errors can
V. Foundational Principles in Multicultural Counseling
A. Activation of Schemas and Confirmatory Bias
1. Incoming stimuli cue schema used to differentiate people according to
observable characteristics
3. Confirmation bias- a human tendency to search for information that
confirms one’s preexisting conceptions
B. Between- Versus Within-Group Differences
1. Mental health professionals must possess baseline knowledge of the
differences in and implications of the cultural backgrounds of their clients
C. Racial/Cultural Identity Development
2. Dissonance
4. Introspection
5. Integrative Awareness
D. Racial and Ethnic Identity Development (REID)
E. Acculturation- the gradual physical, biological cultural, and psychological
changes that take place in individuals and groups when contact between two
cultural groups takes place
F. Multiple Identities
2. Three dimensions:
a. A dimension—characteristics into which people are born
3. Multiple Heritage Identity Development Model (MHID) (6 Stages)
a. Not linear or age-related
b. Neutrality—lack of difference recognition
4. Interracial or intercultural relational pattern to manage differences,
societal stereotypes, and social contexts
a. Integrated Couples
VI. The Culturally Competent Counselor
A. In the early 1900s, the leadership of the Association of Multicultural Counseling
and Development (AMCD) looked to progress multiculturalism
B. AMCD directed its Professional Standards Committee to prepare a set of
Multicultural Counseling Competencies
1. Sets competencies in three specific domains
C. Challenges to implementation
1.Problems operationalizing and measuring cultural competence
3.Adaptations of counseling intervention strategies are not well researched
4.Thus, the profession lacks empirical foundation to guide training of
competencies and to measure impact of culturally competent service
provision
D. Multicultural and Social Justice Counseling Competencies (MSJCC) (2016)
1.Conceptualized as a two-dimensional framework: privileged/marginalized
clients and privileged/marginalized counselor
2.Four competencies
a. Counselor self-awareness
b. Attunement to client’s worldview and experiences
c. Influence of privilege and marginalization acknowledged
d. Apply culturally relevant counseling and advocacy interventions
VII. Conclusion
A. Importance of attending to the ecological context of culturally diverse clients
B. “Culturally sensitive talk” as strong as our “walk”?
C. Profession of counseling is a unique culture that reflects a particular view of
wellness and mental health as well as the process through which each may be
obtained
D. Recognize that the interaction of culture takes place beyond the individualistic
level
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