Every day, modern medicines work miracles, overcoming slowly age barriers and fighting away even diseases that were considered incurable some time ago. From the point of Christianity, the spiritual side of the medical intrusion should be taken into consideration in order not to create imbalance between an individual in need and religion. Christian counselling concepts refer to such counselling which is designed according to the word by God (including His supernatural power and divine revelations). These concepts apply a holistic approach to all aspects of being an individual – body (physical), soul (emotional, rational, volitional), and spirit (more relational and personal) (Litchfield, 2001).
Nowadays, the United States is becoming more diverse due to the fact that individuals from different parts of the world come to major cities, rural areas, and suburbs. According to the latest Census Bureau numbers, today Hispanics constitute about sixteen percent of the whole population, African Americans constitute about thirteen percent, and Asians make up about five percent. Because of this continuously growing multicultural population, mental health workers and counselors have to take their clients’ ethnic, cultural, religious, and even economic backgrounds into consideration while applying theoretical approaches in their practices. A lot of traditional theoretical practices work very well with multicultural populations (Perilla, n.d.). In order to succeed in this, one should pay careful attention to the concepts mentioned below.
First of all, it is necessary to receive a good education. Most states require social workers and counselors to possess at least a master’s degree. Moreover, in order to accept insurance, social workers and counselors must be licensed, which is a difficult process that usually requires from one to two years of supervision in the majority of states. Social workers and counselors should possess a good knowledge of the population with which they will work. In case they plan to work with a multicultural population, it is vital to understand their clients’ world perception with which they will have to deal, also taking into consideration language and cultural differences. It is very important for social workers and counselors to avoid imposing their own principles and values on multicultural clients whose values can differ greatly.
The next step will be to choose a therapeutic technique or approach or prefer an integrative approach. The integrative approach is the one which includes various aspects of two and more therapeutic approaches. Those therapeutic approaches that are effective in multicultural counseling comprise reality therapy (which can be also called choice therapy), cognitive behavior therapy, post-modern approaches such as narrative therapy, solution-based therapy, feminist theory, and family systems therapy. Getting to know different therapeutic approaches gives one methods, techniques, and procedures to work on.
It is better to choose a therapeutic approach or the one that is based on evidence. Cognitive behavior therapy is one of the most widespread therapeutic approaches based on evidence. Such techniques and approaches are easily accepted by various insurance companies, whereas other techniques which did not have enough evidence are often rejected. The overwhelming majority of multicultural clients do not have enough resources to pay for any therapy at once in cash. It is vital for each counselor to take into consideration a client’s economic situation when deciding on billing issues and insurance.
I will once again stress the importance of this step: Take your client’s social, cultural, economic, and ethnic background into consideration. Nonetheless, with the focus on therapies, such as choice-based therapy and cognitive behavior therapy, on the present and not on the past, a sensitive social worker or counselor is able to understand that a person’s background can affect dramatically their interpretation of the present. A responsible counselor will allow their clients to tell how their multicultural background is influencing their interpretations, choices, and overall well-being. Post-modern approaches (for example, narrative therapy) together with the feminist therapy state that the client’s multicultural background should not be taken into consideration; however, it is a fundamental part of the therapeutic process.
The most important piece of advice will be the ability to learn how to treat each client as an individual and not to look at them as a group of cultural or ethnic people only. Nevertheless, some special considerations should be taken into account from time to time during counseling multicultural clients; however, all clients, with the multicultural background or not, should be treated as individuals. Problems of each client must be assessed individually. Counselors should not adhere to prejudiced, narrow-minded stereotypes when dealing with multicultural clients. When some multicultural clients can express a desire to discuss their ethnic and cultural backgrounds, others can feel that their own ethnic and cultural backgrounds have no or little effect on their current health issues.
Now I will do some more research on the therapies mentioned about while enumerating the most important points of the effective counseling.
Reality therapy (or choice therapy as it is widely known) is an approach to counseling and psychotherapy developed by William Glasser in the 1960s. Reality therapy is considered to be a form of cognitive behavioral therapy; however, it differs from conventional psychoanalysis, psychiatry, and medical model schools of psychotherapy, as the main focus falls on responsibility, realism, and right-and-wrong, rather than on the symptoms of mental disorders. Reality therapy supports the idea that an individual suffers from a socially universal human condition but not from a mental illness. The basics of reality therapy lie in the unsuccessful attainment of major needs that an individual’s behavior shifts away from the predetermined norm. Since fulfilling these major needs is a part of a person’s present life, this type of therapy does not take into consideration a client’s past. Neither does reality therapy deal with various unconscious mental processes. Because of this, reality therapy differs greatly from other forms of psychotherapy (Reality therapy, n.d.).
Reality therapy in the field of problem-solving and counseling stresses the importance of here-and-now actions of the patient and the ability to choose and form a better future. As a rule, clients try to discover what they really want in life and how they typically choose to behave in order to get what they want. According to William Glasser, the social constituent part of psychological disorders has been highly overemphasized in the widespread rush to categorize the population as mentally ill or sick. Reality therapy attempts to regard the client apart from their behavior. Just because an individual is experiencing distress which is the result of some social problems does not make this person sick; it just throws them off balance in dealing with their psychological needs (Reality Therapy, n.d.).
Cognitive behavior therapy (CBT) is that type of psychotherapeutic treatment that allows patients to understand the feelings and thoughts that influence their behaviors. Cognitive behavior therapy is widely used to cure a wide range of disorders, including addiction, phobias, anxiety, and depression.
Cognitive behavior therapy is mainly focused on giving clients the opportunity to deal with a very specific problem. While undergoing the course of treatment, individuals learn how to identify and then change disturbing or destructive thought patterns that have a negative impact on their behavior (Christian CBT Counseling, n.d.).
The concept of cognitive behavior therapy expresses the idea that our feelings and thoughts play a vital role in our behavior. For instance, an individual who spends a lot of time thinking about runway accidents, plane crashes, and other air catastrophes can find themselves trying hard to avoid any possibility of air travel. The aim of cognitive behavior therapy is to show patients that due to the fact that they cannot control each aspect of the world around them, they can take control of their attitudes towards everything that happens in their environment (Christian CBT Counseling, n.d.).
In recent years, cognitive behavior therapy has become especially popular with both treatment professionals and mental health consumers. Because this type of therapy is comparatively a short-term option of treatment, it is frequently more affordable than other types of therapy. Cognitive behavior therapy is also spiritually supported and has proved to help individuals effectively overcome a wide range of maladaptive behaviors (Christian CBT Counseling, n.d.).
According to the British Association of Behavioural and Cognitive Psychotherapies, behavioral and cognitive psychotherapies are a variety of therapies based on principles and concepts which are derived from psychological models of human behavior and emotions. They comprise a lot of different treatment methods for emotional disorders, including the field of structured individual psychotherapy which can give a good self-help material.
There are a number of different approaches to cognitive behavior therapy that are commonly used by counselors or mental health professionals. These types include: Rational emotive therapy (resolves behavioral and emotional disturbances and problems, giving people the opportunity to lead more fulfilling and, therefore, happier life), multimodal therapy (treats not only thoughts and actions, but also other psychosocial areas of functioning), and cognitive therapy (allows fighting difficulties by means of recognizing and altering dysfunctional thoughts, behavior, and emotional reactions) (McMinn, 2010).
The form of psychotherapy which uses narrative is narrative therapy. It was developed by Michael White and David Epston during the 1970s and 1980s. Narrative therapy has quite a specific meaning and it is different from narrative psychology or even any other therapy that applies stories. This therapy refers to practices and ideas which are traced by a narrative therapist. A narrative therapist helps their clients to develop richer narratives. During this process, narrative therapists ask many questions to generate vivid descriptions of those life events which are not included in the plot of their client’s problematic story (About Narrative Therapy, n.d.).
As a new story takes shape, the teller tries to select only that information which will allow the story to be truthful and coherent. David Epston considers such stories as both shaping and describing people’s perspectives on their lives, future, and histories. Such stories can be oppressive or inspiring, depending on the individual’s problem or experience. Oppressive stories are often also called problem-saturated stories. They can exert a powerful negative impact on the way clients see their capabilities and life experience (for example, “I have always been an unhappy person” or “I am hopeless”) (About Narrative Therapy, n.d.).
Therapists and counselors who are interested in narrative practices and ideas collaborate closely with their clients in trying to avoid these oppressive stories and discovering some hidden stories which include the desired accounts of patients’ lives (their hopes, commitments, desires, intentions, values, and dreams). Counselors should listen carefully to the narratives of people’s lives, religions, and cultures and try to find clues of capabilities and skills which might help people to live in peace with their ideal way of being.
Therefore, in the narrative therapy approach, the focus falls not on experts’ solving problems, but on people who discover through conversations their preferred, hopeful, and previously unseen and hidden possibilities that are deep within them (About Narrative Therapy, n.d.).
Solution focused brief therapy (SFBT) aims at the preferred result of the therapy and does not focus on the issues or symptoms that brought the patient to undergo the therapy. This technique pays all attention only to the present events and wishes of the client and does not focus on their past. The therapist encourages the individual to imagine their future as they would like it to be, and then the therapist and the individual collaborate on steps which can help to achieve those goals.
What is more, solution focused brief therapy involves dissecting and reviewing the client’s vision and determines what resources, skills, and the individual’s abilities will be developed and applied to achieve their desired results. It was developed by counterparts at the Brief Family Therapy Family Center in Milwaukee, USA, Insoo Kim Berg, Steve De Shazer (Hibma, n.d.).
The most widespread as well as effective questions that can be asked during this kind of therapy include the miracle question (imagine the beautiful future), scaling questions (establish goals), exception seeking questions (at times the same problem can be not as serious as at some other times), coping questions (resources to fulfill the goals), and problem-free talk (allows the client to relax and, therefore, find out solutions to their problems faster) (Hibma, n.d.).
Feminist therapy focuses on giving women the power and letting them discover how to eliminate the stereotypes that are connected with some traditional roles of women in society which can block their growth and development. Feminist therapy developed during the women’s movement at the end of the 1960’s (Mahaney, 2007).
Feminist therapy tends to focus more on strengthening women’s power in such areas as communication, assertiveness, self-esteem, and relationships. One of the main aims of feminist therapists is to build equal relationships of support and care. Therapists believe that their clients are the only possible experts in their own problems and can help them develop the means that are needed to reach their true potential as a valuable and unique individual. There are six major tenets (equal relationship, power, enhancement of strength, non-victim blaming, education, and validation and recognition of feelings) of feminist therapy theory that include five main principles.
It is vital to understand that feminist therapy can also be applied to men and not just to women. Moreover, there is a concept in feminist therapy which states that what is personal is political, meaning that all personal experiences have their roots in political contexts, situations, and realities (Mahaney, 2007).
According to Gerald Corey, the five main principles are:
- The personal is also the political which implements changes in society, as I have already mentioned;
- Counseling relationships are unrestricted and encourage equality between the client and the therapist. The individual should be well aware of the fact that they have the power to alter and define themselves, and the therapist is just a tool that provide new information and some insight;
- Experiences of women are respected, and they should always remain in touch with intuition;
- Definitions of a mental illness and distress are reformulated. Resistance and pain are viewed as a positive confirmation of the wish to live and fight away distress and not being viewed as a weak person;
- Feminist therapists apply an integrated analysis of oppression which presupposes that they recognize that both women and men are subjected to stereotypes, and that these negative experiences have a strong impact on their perceptions and beliefs (Mahaney, 2007).
Family system therapy is a field of psychotherapy that deals with couples and families in intimate relationships to foster development and change. It views change in frames of the interaction systems between family members. Family therapy considers relationships as a vital factor of psychological health.
Different schools of family system therapy share a belief that, despite the origin of the issue and despite the fact whether individuals consider it a “family” or “individual” problem, involving family members to find proper solutions is very beneficial. Such involvement is widely accomplished by the direct participation of members in the therapy session. The knowledge of the family therapist, therefore, includes the ability to have an impact on conversations in such a way that the strengths, support, and wisdom of a wider system are triggered into action (Kane, n.d.).
Conceptual frameworks that were developed by family therapists, particularly by family systems theorists, have been used in a wide variety of human behavior, including the study of greatness and organizational dynamics.
The most widespread techniques and methods used are communication theory, media and communications psychology, psychotherapy, psychoeducation, relationship education, systemic coaching, reality therapy, systems theory, and attachment-focused family therapy (Kane, n.d.).
In conclusion, I would like to say that each of us should be well aware of our own values, religious, political, cultural, and social views in order to avoid unconsciously imposing these personal perceptions on clients with a different set of beliefs. Self-awareness is significant for mental health professionals and it can keep each of us from trying to alter our client’s views or values. When you do not feel good helping or working with a certain client, you should recognize it in order to make it easier to overcome this feeling and, probably, eliminate your own psychological problems.
If you see that you cannot treat a person appropriately, refer this client to a more broad-minded counselor. Not all counselors and clients will be able to find a common understanding. If you recognize that you do not have the capacities or skills to help a certain person, it is vital to let them know that in your opinion this person can be much better served by another mental health professional or counselor.