¶ … Krentzman and Townsend (2008) indicates that multicultural competence means "having the beliefs, knowledge, and skills necessary to work effectively with individuals different from one's self; that cultural competence includes all forms of difference; and that issues of social justice cannot be overlooked" (p. 7). Although improved cultural competency is widely regarded as being an important element of high quality health care services, it is not a "magic bullet" for mitigating existing inequities in the provision of such care (Larson & Ott, 2010). Nevertheless, developing cross-cultural competencies is viewed by many health care providers as an essential first step in improving access and the quality of health care services in Australia today (Sharma & Phillion, 2011). Therefore, in this context, the term "multicultural competence" is used to describe the relationship between a counselor and a patient in cross-cultural settings (An introduction to cultural competency, 2012). The focus of cultural competence is the ability of health care providers to provide health care services that result in positive clinical outcomes through the integration of culture into the clinical context (An introduction to cultural competency, 2012). These issues represent more than merely being aware of cultural differences. In this regard, the Royal Australasian College of Physicians (2012) reports that, "Recognition of culture is not by itself sufficient rationale for requiring cultural competence; instead the point of the exercise is to maximize gains from a health intervention where the parties are from different cultures" (An introduction to cultural competency, 2012, para. 3). The term "cultural competence" is defined by the Royal...

3). More precisely, multicultural competence in counseling can also be defined as the successful "integration and transformation of knowledge about individuals and groups of people into specific standards, policies, practices, and attitudes used in appropriate cultural settings to increase the quality of health services; thereby producing better health outcomes" (An introduction to cultural competency, 2012, para. 3).
From this perspective, cultural competence represents an essential element for the provision of timely and informed health care services for patients from diverse cultural populations by customizing these services according to patients' unique cultural, social and linguistic needs (An introduction to cultural competency, 2012). In sum, given the overwhelming need to develop effective cross-cultural competence, it is not surprising that a majority of health care organisations have attempted to develop a culturally competent workforce.

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The importance of developing effective attending behavior skills is part of a larger skill set that typically subsumes understanding and executing attending behavior skills that are related to fundamental counseling skills (Koltz & Felt, 2012). For instance, according to Koltz and Felt, "These skills are often known as the micro-skills and include: attending behaviors, reflection of feeling, paraphrasing, summarizing,…