ARGUMENT AND MENTAL HEALTH

Are Counselling and Therapy Culture Bound?

Some theorists argue that current theories of counselling and psychotherapy fail to account for the complexity of multicultural or pluralistic societies, which have rapidly grown in numbers within the last 100 years. Most theories, they explain, make assumptions about the nature of mental health problems and intervention through counselling or other means that are based on Western cultural values and expectations. Because of this, counselling theories are seen by some critics to be culture bound (i.e. limited by cultural assumptions), and cannot be easily adapted to the counselling needs of people from other cultural backgrounds. 

Assumptions made by culturally different counsellors and clients have resulted in culturally biased counselling and reluctance of people from other cultures to use existing mental health services (D.W. sue & Sue, 1999; Pederson, 2000). Multicultural specialists have asserted that the theories of counselling and psychotherapy represent different world views, each with its own values, biases, and assumptions about human behaviour. 

Some counsellors have criticised traditional therapeutic practices as irrelevant for people of colour and other special populations such as the elderly. Most Western models of counselling originated in Euro-European culture and are grounded in the beliefs and values of the white middle or upper classes that made up the initial clientele for psychotherapists or counsellors. However, as these treatments have become much more accessible to people from all walks of life and different cultural backgrounds, the danger of imposing white middle class European-American values on clients is very real, and can have major repercussions. 

For instance, implicit in contemporary counselling theories is an emphasis on individualism and on individuation (psychological and emotional separation from the mother or primary caregiver) as the foundation for maturity. In modern Indian society, however, attachment to the mother remains quite deep and persistent, and is, in fact, considered a hallmark of good character. One can see that an emphasis on individuation, which may be expressed as “think for yourself”, during counselling can be meaningless at best, and at worst, may result in profound inner conflict for a client from a more group-focused (or reciprocal) culture.  Counsellors who assume that individuality and self-assertion are highly desirable goals might actually be working against the mental health of the client. 

The problem also relates to sub-cultures such as the elderly, urban and rural Australian Aborigines, or Afro-Americans. Although they operate within, and are part of the wider culture, their particular needs, values and goals may be different, and they may require a more flexible counselling approach that considers their variation from the dominant culture. For instance, depression might take quite different forms among the elderly or among black youth than among young or middle-classed Europeans, Australians or Americans, and might not respond to standard intervention.  

What is needed is a “theory of multicultural counselling and therapy” that takes into account the different values, attitudes and perceptions of clients form different backgrounds. More inclusive theories are needed to:

1. Make counsellors more aware of their own cultural “values, biases and assumptions about human behaviour” and how they can affect their ability to understand and assist their clients

• Prepare counsellors to deal with clients whose world view and perception of their situation is different to their own, and who may be seeking different outcomes than expected. 

Therefore, the counsellor’s primary task is to listen carefully to clients to find out what they want and need, what outcomes they desire, and how best to deliver appropriate assistance. To do this, the counsellor must be prepared to continually monitor his or her thoughts, words and actions for existing cultural biases and assumptions and learn to keep an open mind.