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Module
Title
Task
CULTURAL ISSUES
ESSAY
Weighting
Student No
100%
Tutor
JANET BEE
Met
LEARNING OUTCOMES FOR THIS TASK
Not Yet
Met
LO1 Identify concepts and issues in cultural diversity.
LO2 Demonstrate an understanding of cross-cultural issues for counselling.
LO3 Critically analyse theoretical approaches to counselling culturally diverse
groups.
1st marker
Name
JANET BEE
Date
Areas for further development
The work is over the prescribed word count: Y/N

10-20% over 
more than 20% over
(Please note – if your work is over length the mark indicated below will be reduced by the
appropriate penalty, subject to confirmation by the Module Board).
2nd marker
Name
LISA KMITA
Date
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marking has been carried out appropriately. The second marker is commenting on the marking
standards of the first marker and is not expected to provide feedback to students (which is
provided by the first marker).
Comments by moderator (if
appropriate)
Agreed Internal Provisional
Mark
Name:
Date:
NB any penalty for over length or late submission has not yet been applied
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PLEASE NOTE THAT THIS MARK IS PROVISIONAL AND IS SUBJECT TO VERIFICATION BY THE EXTERNAL EXAMINER AND
THE MODULE BOARD OF EXAMINERS.
IF THE WORK WAS SUBMITTED AFTER THE DEADLINE OR IF THE WORK EXCEEDS THE WORD COUNT, THE PRESCRIBED
PENALTY WILL BE APPLIED PRIOR TO VERIFICATION OF THE MARK BY THE MODULE BOARD OF EXAMINERS.
Concepts and issues in cultural diversity
Demonstrate an understanding of cross cultural issues
Critically analyse theoretical approaches to counselling adverse groups
The intent of this essay is to examine the concepts and issues in cultural diversity by
focusing on how society has changed, and then discuss the possible challenges these
changes pose to today diverse society, and offer a critical analysis of theoretical approaches
when counselling culturally diverse groups. The academic study of culture diversity is both
complex and wide ranging and therefore this essay will focus on minority groups (e.g.
Asians), immigrants and refugees.
The essay will show how the importance of self-awareness, knowledge and skills for the
counsellor impacts on the client as well as the counsellor and demonstrates that cultural
diversity has a greater meaning for the counsellor (Pederson, 1987).
A counsellor has to have a clear understanding of the cross-cultural issues that may be
experienced in counselling, in terms of possible barriers and issues that may arise. Often
these barriers and issues can be more to the fore when dealing with minority groups,
immigrants and refugees. The essay will consider the ethical frameworks for counselling
and look at how cultural diversity influences boundaries within. Furthermore, it will consider
how diversity may not necessarily be a barrier but could be valuable to the counselling
relationship.
Due to global migration being accessible to many individuals in the 21st century, society is
now culturally diverse (Lago, 2006). This comes with its own challenges, diversity has
provoked much controversy in most countries experiencing this demographic change
(Harley, Alston & Turner-Whittaker, 2008). According to Pederson & Ivey (1993) it is
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imperative for counsellors to understand the different aspects of diversity that exist and the
complexity of culture. Palmer & Woolfe (2007) also suggested that someone raised in a
predominantly white area will lack knowledge of differing ethnic cultures and concerns that
impact on other races and cultural issues therefore, impacting on the counselling
relationship.
Aluede & Maliki (2005), Patterson (1996) and Pedersen (1991) argue that all counselling is
somewhat culturally diverse, due to the fact each client counsellor have unique life stories,
which will in variably contrast. As these differences are real and all counsellors need to try
to be fully aware of their own subconscious biases and assumptions in order to develop an
effective and suitable counselling relationship for each client. This argument is supported by
Wheeler (2006) that suggest we no longer look at cultural diversity as race or colour in
today’s society it is so much more, it can be seen as a much broader concept. NelsonJones (2002) argument concurs with this view, advancing the idea that people identify as
gay, lesbian, and bisexual and more people living with chronic illness and disabilities, need
to be included. However, Sue (2001) argues that counselling is can be viewed as
monoculture and multicultural, the former based on traditional counselling theories, holding
to the whites definitions of values, beliefs and practices. Whereas, multicultural recognises
and takes into account diversity, pluralism, and integration therefore challenging the
counsellor to use appropriate strategies.
Diversity and culture are somewhat difficult to understand and/or often misunderstood
(Mishra & Kumar, 2014; Palmer & Laungani, 1999). In simple terms diversity means ‘being
different’ but can be argued as being much more. It can be looked at in terms of ‘cultural’ or
‘ethnic’. Whereas, ethnic diversity focuses on various ethnic groups (Mishra & Kumar,
2014). Culture is what we are born into and shapes us, learnt and passed on from
generation to generation, is often determined by language, religion, lifestyle and birthplace.
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Nevertheless, it can be changed by an individual’s life experiences and events (Palmer &
Laungani, 1999).
According to Sue & Sue (2003) it includes more than just ethnic diversity, as different
aspects of culture lie within different ethnic groups, therefore cultural diversity includes
religion, sexuality, race, ethnicity, gender and age and more. Harley, Alston & TurnerWhittaker (2008) highlight that cultural diversity can be defined in greater depth, it includes
family development & dynamics, psychological and sociological dynamics corresponding to
self-identity, develop self-advocacy, competency, adjustment and attitude, multicultural
awareness and ethical practice, diversity issues such as cultural, disability, gender, sexual
orientation and ageing, current issues in a diverse society and personal development.
Harley, Alston & Turner-Whittaker (2008) state that the cultural diversity is important to the
world of counselling, for the counsellor to be effective in cross-cultural counselling they need
to have cross cultural competencies. As stated by Lee (2013); Pederson (1991); Sue & Sue
(2003) in order for the counsellor to be multicultural in practise and be competent they must
have a working knowledge and cultural understanding. Consequently, this then enables the
counsellor to reduce the challenges and barriers they may be faced with.
Historically, Sue (2001) described three characteristics that are needed by counsellor to be
competent working with the culturally diverse and diverse clients. These are defined as selfawareness, knowledge and skills.
Firstly, considering self-awareness Middleton, et al., (2011) states it is imperative for the
counsellor to have an exceptional awareness of one’s own cultural identity, attitudes,
assumptions, beliefs, biases and world view. We all have a world view that effects how we
look at and evaluate things, coming up with appropriate actions based on our evaluation of
experiences and upbringing (Arthur, 2019). Ivey, Ivey & Simek-Morgan (1997) defines world
view as the way you think about your world and what it means to you, one’s conceptual
framework. Sue (2001) states it is not enough for the counsellor to be aware of their view of
the world but, it is imperative that they have a world view of their clients. Without this view of
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themselves and their client the counsellor is at risk of encapsulation, according to Wrenn
(1962) and Pederson (1994) this can lead to the counsellor imposing their own experiences,
values, beliefs and bias on the client, this in turn has the potential of harming the client.
A study by (Roysircar, 2004) into cultural self-awareness for trainees highlights that being
introspective about their own culture and exercising a critical approach about their own
beliefs and biases, in turn allows for the counsellor within the therapeutic relationship to be
more sensitively aware, understanding that the client is culturally different.
Therefore, to be a valuable counsellor in a culturally diverse arena, being aware of one’s
own core beliefs and having the ability to review them, will in turn effect how the counsellor
behaves and understands others (Wills, 2008). Consequently, if the counsellor is unable to
understand their own cultural beliefs, how can they begin to understand others (Palmer &
Laungani, 1999).
To help trainee counsellors, or even experienced counsellors get a better understanding,
assessment tools have been developed to help with cultural self-awareness (Palmer, 2002).
Roysircar (2004) argues it helps to start talking about their own cultural heritage. This in turn
helps them to see that family is at the root of their culture, understanding where their beliefs
and attitudes have come from. Nevertheless, it does emphasize their possible lack of
knowledge of themselves and in order to better understand they will have to seek out their
own identity (Palmer, 2002). Part of this self-awareness is remembering that at the core of
awareness of one’s self is a set of white cultural values and beliefs by which the clients will
be judged.
Secondly, having a good cultural knowledge within counselling means that the counsellor
recognises and appreciates that their clients bring different things to the relationship. The
counsellor needs to understand how their particular culture relates to them and how it has
helped shape them into the person they are. Cultural knowledge is paramount in developing
a strong therapeutic relationship, because if the counsellor does not understand their
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personal culture and biases then the relationship will be effected and the counselling
becomes insensitive and ineffective (Sue, Zane, Nagayama Hall, & Berger 2009). However,
Tsang, Bogo & George (2003) argues cultural knowledge is much more, that in order for
cross-cultural counselling to be effective, it is necessary for the counsellor to be more than
knowledgeable in the process of just helping their client’s, furthermore, to accurately
understand the cultural specifics and universal aspects of human problems. Sue (2001)
emphasises that it is therefore, imperative for the counsellor to have a clear understanding of
their client’s particular culture in order to deliver effective counselling. Without it, it can lead
to misunderstandings, misinterpreted and could even offend the client.
For example, Wang & Kim (2010), when looking at the cultural value system of American
Chinese, their culture is passive and calm rather than assertive and verbally articulate. This
is seen as wisdom and self-effacement. However, this humility and modesty may make it
difficult for the counsellor to draw a response from Chinese clients. In turn, an inexperienced
counsellor could interpret this as resistance, whereas culturally they may be reserved, and
their way of dealing with conflict is to be silent and withdraw (Sue & Sue, 2003).
According to Pedersen (1987), to become culturally competent it is imperative to have more
than knowledge and skills, a continual process of learning and relearning is necessary.
Roysircar (2009) has argued that cultural competence should be an ethical constraint, with
cross cultural skills given the same level as other therapeutic skills. Sue & Sue (2003)
identified other areas that can improve the counsellor’s skills, such as role-play and working
with counsellors from other cultures. D'Ardenne & Mahtani (2010) also suggest this can be
achieved by getting to know the client’s history and heritage, this can be done either by
questioning the client or by research. Although, as argued by (Lago, 2006) if questioning is
not done sensitively, this can be seen in some culture as interrogative or even rude in some
cultures.
Highlighting that sometimes counsellors may have a lack of cultural appropriate skills, as
they are all trained with generalised skills, the core conditions, active listening, empathy and
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genuineness. There are more specific skills needed to counsel the culturally diverse
(Ponterotto, 1988); Ponterotto (1988); and Sue & Sue (2003) identified specific cultural skills
needed, specifically they need to able to determine effective ways to communicate, as some
clients may communicate in different ways, also their ways of thinking and processing
information may be different. Engage in multiple verbal non-verbal responses,
understanding that certain responses maybe interpreted as appropriate, but being mindful
that in certain cultures it may be seen as inappropriate or even offensive. The cultural
counsellor need to use resources outside the field of counselling, in some cultures healers
for example, are seen as ‘Gods’, however, they need to be mindful of the ethical
implications. Finally be able to change forms of treatment to fit cultural diverse clients. Lago
(2006); Pedersen (1991); and Sue & Sue (2003) point out that this is difficult for counsellors
with a lack of training or experience in this, that, there is not easy method or approach to
help with identifying the best approach to use with certain clients. Identifying one dilemma of
culturally diverse counselling is by having the ability to determine which approaches and
interventions to use with different cultural groups. Nelson & Jones (2002) argued that there
is the possibility that some counsellors, focus on the individual and discount the impacts of
family and community values. Researchers have found that the best way for counsellors to
become culturally competent it is the responsibility of educators and supervisors to help
increase individuals self-awareness, understanding, skills and knowledge (Palmer 2002).
Furthermore, as stated by Sue & Sue (2003) reading and research is not always enough, to
fully understand and stand in the shoes of the client we have to live it. It has been
suggested that meeting people from different races and cultures will not only enhance their
knowledge but enhance their self-reflection, their world view. It has been argued that
because of the exposure to many different orientations empowering them to challenge
earlier assumptions and biases becoming more flexible about their own values and beliefs
(Palmer & Laungani, 1999). Sue & Sue (2003) argue that counsellors that practise without
adequate training or competence with culturally diverse clients are likely to practise
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unethically, which also borders on violation of human rights. Furthermore, without cultural
awareness of their clients the counsellor may interoperate the information wrongly, this in
turn may result in giving the client an unfair, impartial service (Sue & Sue, 2003).
For example, according to Lawrence (2016) limited information is likely to influence
judgement, inferences and interpretations on the part of the counsellor. Counsellors must
remember that in the cultural value system of American Asians tend to show little or no affect
in the counselling session. Often perceiving the white counsellor as the ‘expert’ someone
who has all the answers and will therefore tell them what to do. The counsellor taking a
more active role and the client being passive (Wang & Kim, 2010).
Leong, Wagner and Kim (1995) argue that it is important for the counsellor to assess the
American Asian client’s acculturation when conceptualising the client’s problems and
treatment. For the counsellor to work on assumptions of their clients’ heritage can be as
damaging as ignoring it. This in turn leads the client to see the counsellor as insensitive and
the therapy ineffective often seeing the client leaving therapy prematurely.
Moving beyond self-awareness and knowledge to consider skills needed to counsel the
culturally diverse clients Alberta & Wood (2008) suggest the practical skills model to build on
the basic core skills. Sues (2001) early model identifies was found to be narrow whereas
Constantine (2002) argues that a broader conceptualisation was needed to fully understand
the skills needed. They devised a six factor model, which they stated, was necessary to be
able to understand multicultural counselling better. However, although studies into
assessing professional counsellors and trainees that multicultural competencies comprise
more in line with the findings of Constantine (2002) rather than the three dimensional model
by Sue (2001) the models do not address how the counsellor actually works (HolcombMcCoy, 2004; Holcombe-McCoy & Myers, 1999)
Chung & Bemark (2002) argue that cultural skills are more than the self-report scales, that
what is more important, is for the counsellor to have skills assessing the client, treatment
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suitable and to use the interventions that would best suit their client’ needs. Counsellors are
faced with many challenges surrounding skills, adapting their basic skills to incorporate the
culturally diverse and become culturally competent (Ahmed, Wilson, Henriksen Jr., &
WindWalker Jones, 2011). Ahmed et al., (2011) argued that training programs need to be
reviewed to include cultural diversity, develop competencies as core, and a continual
education program. Despite many training programs being revised to include cultural
diversity, there are still many counsellors who have not received effective training (Palmer,
2002). Consequently, the lack of adequate training is seen as a barrier, Pedersen (2008)
argues that training programs that lack a balance can fail the counsellor, for three reasons.
Firstly, an overemphasis on awareness makes counsellors aware of their inadequacies,
Moreover, trainees don’t know what to do with this new found awareness. Secondly, the
trainee can overdose on knowledge and lose sight of how it fits with the skills. Thirdly, when
skills are over emphasised without a balance of awareness and knowledge they will not
know if they are making things better or worse.
Another skill that is imperative to the multicultural counsellor is the awareness of potential
barriers and what to do with them, in order to prevent harm to the client or breakdown of the
therapeutic relationship, resulting in the client leaving counselling (Bradley & HolcombMcCoy, 2004).
Considering the barriers that the counsellor may be faced with, it is stated by (Salami, Salma
& Hegadoren, 2018) that communication is one of the most important aspects of the
therapeutic relationship especially when considering Immigrants and refugees. Although,
Salami, Salma & Hegadoren, (2018) suggest that the counsellor not only needs to aware of
language but many other obstacles that hinder the cultural diverse accessing therapy. Nonverbal gestures, body language and personal space need to be considered as well.
Language can be a big obstacle in the counselling process. Where it involves the counsellor
and client communicating without a common language, and therefore making the counselling
process ineffective (Memon et al., 2016). Clients that feel there is a language barrier often
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feel disadvantaged because it can lead to miscommunication, misunderstandings,
misinterpretations and even misdiagnosis. This can be due to mispronunciation or that when
words are translated into another language, they can mean different things (Pedersen,1987).
Salami, Salma & Hegadoren, (2018) state that often immigrants and refugees choose not to
learn the majority language in fear of losing their identity. Immigrants and clients that are
bilingual may often find a lack of language or communication skills as a stressor (Salami,
Salma & Hegadoren, 2018). Language barriers will stop ethnic minorities seeking
counselling, they may choose to consult family, friends or spiritual leaders to address life
stressors (Memon et al., 2016). Often Immigrants and refugees feel a personal
responsibility to manage their own stresses due to stigma attached to mental health issues.
Mental health among these cultures can be seen as a taboo, therefore, they feel they have
to hide their problem from their community. It is said that Immigrants and refugees often
suffer in silence. Access mental health services is a major concern to immigrants and
refugees as with a lack of western ethics they often worry that information will be passed
back to authorities with the risk of deportation (Salami, Salma & Hegadoren, 2018).
Counsellors sometimes choose to use an interpreter, another barrier associated to
language. This raises a plethora of issues within the therapeutic relationship and it can be
argued that the communication barrier can still exist. For example, if a phrase is used by
either the client or the counsellor that does not translated into the other language accurately
then the full meaning or intent may be lost or misunderstood, this can also be attributed to
the interpreter (Pederson, 2008). Furthermore, the use of an interpreter can raise issues
around confidentiality (BACP, 2018). This can be seen more often than not when
immigrants and refugees may often choose a family member to be an interpreter, bringing
with it more challenges, loss of confidentiality and an added pressure on family (Salami,
Salma & Hegadoren, 2018; Yakushko, Watson & Thompson, 2008).
Body language is also a key point and can effect communication, facial expression and
gestures can mean different things within different cultures, Wang & Kim (2010) state that
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eye contact is also another facet of the communication model that can be misinterpreted.
Particularly with Chinese clients who avoid eye contact it could be interpreted by the
counsellor as untruthfulness or low self-esteem, as part of their culture it is perceived as
being polite and being respectful (Wang & Kim, 2010).
Furthermore, Bradley & Holcomb-McCoy (2004) point out that in some cultures even words
such as yes and no can mean different things entirely to elders of their culture, therefore, this
can be misunderstood by the counsellor. Also direct eye contact with them is seen as rude,
closed body language can indicate anger or being withdrawn within the therapeutic
relationship, touch and body space (Lago, 2006). Herring (1990) states non-verbal
communication is more culturally bound, backed up Patterson (1996), who believes that the
therapeutic relationship can soon be derailed by a simple gesture such as a thumbs up. In
the western world where it means ‘ok’ within other cultures it has insulting connotations.
The therapeutic relationship is one of the most researched aspects in the field of counselling.
Patterson (1996) argued that the competent counsellor is able to form an effective
relationship no matter what the culture of the client is. The core conditions should facilitate
the client’s disclosure and empathy, by entering their world may be the factor that in an
effective therapeutic outcome, however, Ibrahim (1991) points out that in some culture
empathy can be seen as offensive. A good therapeutic relationship is important in all
counselling approaches, this relationship is equally important when working with culturally
diverse clients but may cause challenges for both the counsellor and the client (Devine,
1989). A challenge to consider is the one of stereotypes, not just on the part of the
counsellor but also on the part of the client (Rosenthal & Levy, 2012). These stereotypical
assumptions are often made on limited information, therefore stereotyping a client is more
likely to occur in the early stages of therapy (Coastigan, 2004). For example an Asian lady
having marriage difficulties, stereotypically it could be assumed that divorce would not be an
option, therefore it was not explored. However, for her, divorce was an option therefore this
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showed a generalised stereotype had been applied that did not fit the client (Coastigan,
2004).
Research has shown that these early impression are difficult to alter, leading to
unsuccessful, ineffective counselling (Strohmer and Leierer, 2000). Consequently, it may be
argued that this could be a major challenge to working empathetically and the ethics that
govern counselling may be called to question when working cross-culturally (Sue, 2001).
While the ethical code of practise may fit with the western society, it is less likely to fit all
cultures. Considering the ethical framework, it does not hold the same meaning with
culturally diverse clients and can prevent an effective therapeutic relationship being formed
(Lawrence, 2010). When looking at the guidelines, for ethical and professional practice in a
culturally diverse setting it highlights how restricted the counsellor maybe. They will have to
negotiate boundaries, advice giving and providing solutions whilst struggling with their own
values conflicting with their clients. Although, some cultures welcome advice and
suggestions as part of the helping relationship (Arredondo & Arciniega (2001). Klukholm &
Strodtbeck (1961) point out that certain groups vary in how they perceive time. For example
Puerto Ricans exhibit time values different to other cultures. It has been said by others that
they are ‘poor disorganised planners’ and last minute. Additionally, lack of disclosure by the
counsellor can be interpreted as cold and lacking in sincerity to certain clients (Sue & Sue,
2003).
Considering all the aspects the counsellor may have to experience with culturally diverse
clients, if they find themselves unsure of the clients’ race, culture or stereotyping they need
to take it to supervision. In the knowledge that their supervisor has adequate experience to
give the right guidance (Palmer, 2020; Pedersen, 1997). It is the place of the supervisor to
facilitate development and understanding especially exploring the best interventions and
theories to deal with cultural diversity (Palmer, 2002).
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A lack of cultural diversity understanding may hinder effective counselling (Lago, 2006).
From a Humanistic perspective. Sue & Sue (2003) and Sue, Zane, Nagayama Hall & Berger
(2009) acknowledge that the core conditions, unconditional positive regard, respect and
acceptance of the individual, empathy for the clients problem and allowing the clients to
explore their own core conditions and reach their own solution. However, self-actualisation
make take a different form for culturally diverse clients, considering that to them their family
may be more important to them rather than within the western world where independence
may be at the fore (Quinn, 2012). Quinn (2012) concludes that if the counsellor can exhibit
a genuine, accepting way they are then likely to move forward providing the person-centred
adapted mechanisms to facilitate change for the client. Patterson (1996) argues that due to
cultural diversity, existing models of counselling should not be easily disregarded in an
attempt to become more culturally diverse. This is backed up by research that found that
Roger’s mechanisms assist the process of client outcome when the person centred
approach is delivered by an experienced counsellor, however, it was found to be nonpredictive when delivered by a non-person centred counsellor (Constantine, 2007). As
Rogers (1984) states it is important for the counselling to be non-directive, giving the client
the opportunity to tell their own story and within culturally diverse counselling stereotyping
should not come into play. The client must be encouraged to express and explore their inner
feelings. With the counsellor using reflection and paraphrasing to help the client look at their
inner experiences.
When working with a cultural diverse client, the counsellor must always respect the client
and beware of some fundamental aspects that need to be considered, as previously
discussed there may be a plethora of potential barriers to consider.
Palmer & Laungani, (1999) argues that person centred counselling does not meet the mental
health needs of certain culturally diverse clients. On the other hand, Cooper et al., (2007)
suggest that person centred counselling is intrinsically culturally diverse when delivered by
an experienced counsellor. Wilkins (2003) makes a similar argument that when person
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centred therapy is delivered correctly it is ‘culture free’. To the contrary Moodley (2007)
however, takes the view that, maintaining the ‘culture free’ position is unsupportable. Person
centred counselling is completely culture bound.
Moodley (2007) suggested that although counsellors have been engaging in cultural issues
for decades, one of the limitations is the lack of culturally diverse counsellors and clients. In
summary, having examined diversity, the foremost consideration is that cultural origins can
influence the therapeutic outcome. It has become clearer that there are many fundamental
factors to that must always be considered.
In Conclusion counselling in today’s diverse society diversity issues are important for both
the counsellor and the client in order to achieve a therapeutic outcome. Diversity impacts on
the counsellor and client in similar ways, yet but different. In order to minimise the impact on
the client it requires the counsellor to be sensitive and critical thinking to assess their own
knowledge and understanding before understanding the client (Sue & Sue, 2003). They
must also overcome their own personal views and beliefs, otherwise this may have a
negative outcome on the therapeutic relationship (Pedersen, 2008). Counsellors have to
overcome many obstacles in counselling the culturally diverse. However, diversity is not
necessarily always a barrier, it may in fact be valuable to some clients, for some clients that
may be having an issue with their own value and belief system having a counsellor with
different values and beliefs can be useful (Pedersen, 2008).
In order to be an effective counsellor working across many different cultures they have to
acknowledge the larger picture, considering their own cultural views and start to understand
the issues and concerns of the client. They need to be aware of their own stereotypes and
bias they bring to the therapeutic relationship. To realise that there is a gap in research and
training, particularly in Britain. It had been suggested that training program review the
curriculum so that cultural diversity plays a bigger part. Continuing developments in training
for working with culturally diverse clients would now appear to be looking towards a bigger
picture (Palmer, 2002).
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References

Alberta, A. & Wood, A. (2008) A Practical Skills Model for Effectively Engaging
Clients in Multicultural Settings. The Counseling Psychologist, 37(4), 564-579.

Aluede, O. & Maliki, A. (2005) The Imperativeness of Multiculturalism to Counselling
Practice in Nigeria. Studies of Tribes and Tribals, 3(2), 117-121.

Ahmed, S., Wilson, K., Henriksen Jr., R. & WindWalker Jones, J. (2011) What Does
It Mean to Be a Culturally-Competent Counselor?. Social Action in Counseling and
Psychology, 3(1), 17-26.

Arthur, N. (2019) Counselling in Cultural Contexts, 1st edition. Cham: Springer.

Arredondo, P. & Arciniega, G. (2001) Strategies and Techniques for Counselor
Training Based on the Multicultural Counseling Competencies. Journal of
Multicultural Counseling and Development, 29(4), 263-273.

BACP (2018) Ethical Framework for the Counselling Professions [Online].
Lutterworth: BACP. Available from: <https://www.bacp.co.uk/events-andresources/ethics-and-standards/ethical-framework-for-the-counselling-professions/>
[Accessed 10.02.20].

Bernal, G., Jiménez-Chafey, M. & Domenech Rodríguez, M. (2009) Cultural
adaptation of treatments: A resource for considering culture in evidence-based
practice. Professional Psychology: Research and Practice, 40(4), 361-368.

Bradley, C. & Holcomb-McCoy, C. (2004) African American Counselor Educators:
Their Experiences, Challenges, and Recommendations. Counselor Education and
Supervision, 43(4), 258-273.

Constantine, M. (2002) Racism Attitudes, White Racial Identity Attitudes, and
Multicultural Counseling Competence in School Counselor Trainees. Counselor
Education and Supervision, 41(3), 162-174.

Constantine, M. (2007) Racial microaggressions against African American clients in
cross-racial counseling relationships. Journal of Counseling Psychology, 54(1), 1-16.

Cooper, M., O'Hara, M., Schmid, P. & Bohert, A. (2007) The handbook of personcentred psychotherapy and counselling, 1st edition. Hampshire: Palgrave McMillan.

D'Ardenne, P. & Mahtani, A. (2010) Transcultural counselling in action, 1st edition.
London: Sage.

Devine, P. (1989) Stereotypes and prejudice: Their automatic and controlled
components. Journal of Personality and Social Psychology, 56(1), 5-18.
15
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
Harley, D., Alston, R. & Turner-Whittaker, T. (2008) Social Justice and Cultural
Diversity Issues. Rehabilitation Education, 22(3), 237-247.

Herring, R. (1990) Nonverbal Communication: A Necessary Component of CrossCultural Counseling. Journal of Multicultural Counseling and Development, 18(4),
172-179.

Holcomb-McCoy, C. & Day-Vines, N. (2004) Exploring School Counselor Multicultural
Competence: A Multidimensional Concept. Measurement and Evaluation in
Counseling and Development, 37(3), 154-162.

Hook, J., Davis, D., Owen, J., Worthington Jr, E. & Utsey, S. (2015) "Cultural
humility: Measuring openness to culturally diverse clients": Correction to Hook,
Davis, Owen, Worthington, and Utsey. Journal of Counseling Psychology, 62(1), iii-v.

Ivey, A., Ivey, M. & Simek-Morgan, L. (1997) Counseling and psychotherapy, 4th
edition. Boston: Allyn and Bacon.

Kim, B., Atkinson, D. & Umemoto, D. (2001) Asian Cultural Values and the
Counseling Process. The Counseling Psychologist, 29(4), 570-603.

LaFromboise, T. (1985) The Role of Cultural Diversity in Counseling Psychology. The
Counseling Psychologist, 13(4), 649-655.

Lago, C. (2006) Lago, Colin. , Database: eBook Collection (EBSCOhost), 2nd
edition. New York: McGraw-Hill Education. Available online:
http://eds.a.ebscohost.com/eds/detail/detail?vid=2&sid=a6a68eba-81bb-41e2-8cc2f026b577dcac%40sdc-vsessmgr03&bdata=JnNpdGU9ZWRzLWxpdmU%3d#AN=233994&db=nlebk
[Accessed 3/2/2020].

Lawrence, D. (2016) Diversity and ethical practice. Therapy Today, 27(6). Available
online: https://www.bacp.co.uk/bacp-journals/therapy-today/2016/july-2016/diversityand-ethical-practice/ [Accessed 3/2/2020].

Lee, C. (2013) Multicultural issues in counseling, 4th edition. Alexandria, Virg.:
American Counseling Association.

Leong, F., Wagner, N. & Kim, H. (1995) Group counseling expectations among Asian
American students: The role of culture-specific factors. Journal of Counseling
Psychology, 42(2), 217-222.

Memon, A., Taylor, K., Mohebati, L., Sundin, J., Cooper, M., Scanlon, T. & de Visser,
R. (2016) Perceived barriers to accessing mental health services among black and
minority ethnic (BME) communities: a qualitative study in Southeast England. BMJ
Open, 6(11), e012337.
16
40005229

Middleton, R., Stadler, H., Simpson, C., Guo, Y., Brown, M., Crow, G., Schuck, K.,
Alemu, Y. & Lazarte, A. (2011) Mental Health Practitioners: The Relationship
Between White Racial Identity Attitudes and Self-Reported Multicultural Counseling
Competencies. Journal of Counseling & Development, 83(4), 444-456.

Mishra, S. & Kumar, C. (2014) Understanding Diversity: A Multicultural

Moodley, R. (2007) (Re)placing multiculturalism in counselling and
psychotherapy. British Journal of Guidance & Counselling, 35(1), 1-22.

Nelson-Jones, R. (2002) Diverse goals for multicultural counselling and
therapy. Counselling Psychology Quarterly, 15(2), 133-143.

Patterson, C. (1996) Multicultural Counseling: From Diversity to Universality. Journal
of Counseling & Development, 74(3), 227-231.

Palmer, S. & Laungani, P. (1999) Counselling in a multicultural society, 1st edition.
London: Sage Publications.

Palmer, S. & Woolfe, R. (2007) Integrative and eclectic counselling and
psychotherapy, 2nd edition. London: Sage Publication.almer, S. (2002) Multicultural
Counselling. London: Sage Publications.

Pedersen, P. (1987) Handbook of cross-cultural counseling and therapy, 1st edition.
London: Praeger.

Pedersen, P. (1991) Introduction to the Special Issue on Multiculturalism as a Fourth
Force in Counseling. Journal of Counseling & Development, 70(1), 4-4.

Pedersen, P. (2008) Counseling across cultures. Los Angeles: Sage Publications.

Pedersen, P. & Ivey, A. (1993) Culture-centered counseling and interviewing skills,
1st edition. Westport, Conn.: Praeger.

Ponterotto JG. Racial consciousness development among white counselor trainees.
Journal of Multicultural Counselling and Development 1988; 16: 145–156.

Quinn, A. (2012) A Person-Centered Approach to Multicultural Counseling
Competence. Journal of Humanistic Psychology, 53(2), 202-251.

Rosenthal, L. & Levy, S. (2012) The relation between polyculturalism and intergroup
attitudes among racially and ethnically diverse adults. Cultural Diversity and Ethnic
Minority Psychology, 18(1), 1-16.

Roysircar, G. (2004) Cultural self-awareness assessment: Practice examples from
psychology training. Professional Psychology: Research and Practice, 35(6), 658666.
17
40005229

Roysircar, G. (2009) Evidence-Based Practice and Its Implications for Culturally
Sensitive Treatment. Journal of Multicultural Counseling and Development, 37(2), 6682.

Salami, B., Salma, J. & Hegadoren, K. (2018) Access and utilization of mental health
services for immigrants and refugees: Perspectives of immigrant service
providers. International Journal of Mental Health Nursing, 28(1), 152-161.

Sue, D. (2001) Multidimensional Facets of Cultural Competence. The Counseling
Psychologist, 29(6), 790-821.

Sue, D. & Sue, D. (2003) Counseling the Culturally Diverse, 4th edition. New York,
NY: John Wiley & Sons.

Sue, S., Zane, N., Nagayama Hall, G. & Berger, L. (2009) The Case for Cultural
Competency in Psychotherapeutic Interventions. Annual Review of Psychology,
60(1), 525-548.

Strohmer, D. & Leierer, S. (2000) Modeling Rehabilitation Counselor Clinical
Judgment. Rehabilitation Counseling Bulletin, 44(1), 3-9.

Tsang, A., Bogo, M. & George, U. (2003) Critical Issues in Cross-Cultural Counseling
Research: Case Example of an Ongoing Project. Journal of Multicultural Counseling
and Development, 31(1), 63-78.

Wang, S. & Kim, B. (2010) Therapist multicultural competence, Asian American
participants' cultural values, and counseling process. Journal of Counseling
Psychology, 57(4), 394-401.

Weinrach, S. & Thomas, K. (2004) The AMCD Multicultural Counseling
Competencies: A Critically Flawed Initiative. Journal of Mental Health Counseling,
26(1), 81-93.

Wheeler, S. (2006) Difference and Diversity in Counselling, 1st edition. London: Red
Global Press.

Wills, F. (2008) Skills in cognitive behaviour therapy counselling and
psychotherapy, 1st edition. London: Sage Publication.

Wilkins, P. (2003) Person-centred therapy in focus, 1st edition. London: SAGE
Publications.

Yakushko, O., Watson, M. & Thompson, S. (2008) Stress and Coping in the Lives of
Recent Immigrants and Refugees: Considerations for Counseling. International
Journal for the Advancement of Counselling, 30(3), 167-178.
18