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Culturally Sensitive and Responsive Counseling When you begin work with couples and families, you likely will conclude after only a few cases that all couples and families are different in at least a few ways. Members of these couples and families individually belong to many different population subgroups, with each group exerting cultural influence. Based on conflict resolution traditions or power distance index of a certain culture, for instance, you may need to modify the theoretical approach you take with a client with that background. Keep in mind that the classroom study of theory and intervention integration cannot provide a description of how to modify or tailor your theory to all the potential relational and cultural presentations you will see. It should, however, provide you with a solid foundation and a toolbox with which to work. As an evolving marriage, couple, and family counseling student, you must rely on your wisdom, developed by reflecting on the work you have done to date, and on continuing to read current evidence-based research. Through such reflections, you will develop ways of altering aspects of your theory-in-action to enhance the potential therapeutic benefits of your services to future clients. To prepare for this Discussion, select a cultural consideration (related to race, ethnicity, religion, gender, sexual orientation, etc.) and think about how this consideration may impact the application of your theoretical orientation. Then, reflect on how you might modify interventions in client work in which this consideration is present.
Culturally competent counseling is an ethical mandate of the counseling profession and has the potential for increasing the effectiveness of the counseling process (Lee, 2008). According to Lee (2008), “In order to be culturally competent counselors, individuals must be open-minded and recognize that valuing and respecting cultural differences requires a commitment to life-long learning and being able to make sound ethical decisions within diverse cultural contexts” (p. 2).
Client centered, and strengths-based counseling strives to work within the client’s cultural context to address risks and protective factors (Berliner et al, n.d.). Berliner and colleagues (n.d.) Most minority-focused treatments, according to Berliner and colleagues (n.d.), involve some amount of modification tailored to the specific client group being targeted; modifications that generally have the goal of increasing the acceptability and meaningfulness of the treatment program. The modifications can be informal and woven into treatment delivery or are full models specifically designed for a particular racial or ethnic group (Berliner et al, n.d.).
While working in a rural substance abuse treatment facility, I had the opportunity to work with Native American clients referred to the facility by a near by Native American Health Center. Roger’s client-centered approach, being warm and genuine, non-directive, and allowing the client plenty of time to think and respond, worked best with this population. The facility used a Twelve-Step approach to recovery and provided The Red Road to Wellbriety: In The Native American Way (2006) as an alternative to The Big Book of Alcoholics Anonymous (2001). The Red Road to Wellbriety: In The Native American Way (2006) was written by Native Americans and blends the teachings of the Native American Medicine Wheel with the 12 Step Tradition.
When working with Native Americans it is important to understand that “In many Native communities, the contemporary status of American Indian mental health remains significantly caught up in a history, culture, and spirituality challenged by the devastating context of European American colonialism” (Nebelkopf et al, 2011, p. 266). In working with Native Americans, Moghaddam, and Momper (2011) it is important that staff “acknowledges that recovery clients may maintain ties with mainstream religion, be acculturated into mainstream society, bear the historical stress and trauma of boarding schools and missionary work, and may have minimal information about their tribal origins and traditions” (p. 9). For a cognitive-behavioral counselor, a modification would be to utilize a trauma-focused approach in recognition of the historical trauma that has been passed through the generations. Another modification is to incorporate cultural elements of the client’s spiritual selves (Moghaddam, & Momper, 2011). At the facility where I worked we had a sweat lodge built. Research indicates that the blending of Indigenous traditional healing practices and a Western treatment model can lead to a reduction in intergenerational trauma symptoms and substance use disorders (Marsh et al, 2018).