Multicultural theories and frameworks

Multicultural therapies like ethnic family therapy recognize the multiple worldviews and diversity of values among clientele. Moreover, multicultural therapies avoid problems associated with decontextualization and the ignorance of politics and power structures in people's lives (Comas-Diaz, 2014). Therapists working in a diverse environment do need to develop cultural competence to serve their communities. Cultural competence requires self-awareness and recognition of one's own worldview, biases, and attitudes. Likewise, cultural competence leads to effective means of helping people whose worldviews and backgrounds are different from the therapist. Without branching too much into related social sciences like sociology, anthropology, and social work, multicultural psychological therapies do draw from other disciplines in order to form a more cohesive vision of cultural competence. No person develops in isolation of his or her culture or background. Therefore, it is critical to include dynamics of oppression, experiences of racism or stigma, issues related to the immigrant experience, biculturalism and struggles with identity into the therapeutic relationship. The therapist must also recognize the dynamics that develop during the therapeutic relationship, ensuring that competence is expressed through mutual respect and humility. As Comas-Diaz (2014) points out, multicultural therapies are rooted in cultural competencies and are becoming increasingly integrated into public policy and the policies of institutions. For these reasons, multicultural therapies can be powerful methods of intervention and can improve the therapist's relevance and efficacy.

Multicultural therapies can "enhance the relationship between self and other," and this is as true for the client's interpersonal relationships as well as the relationship between therapist and client (Comas-Diaz, 2014, p. 541). As such, they will resonate with the worldviews of most therapists, save for the ones who either lack interest in or inclination toward self-awareness. Some multicultural therapies are feminist in outlook because of the means by which feminist theory informs structures or patterns of oppression. Whereas feminist-informed therapies can help heal dysfunctional gender dynamics and bring to light issues that are related to race, class, gender, and power, ethnic family therapy more closely examines family genomes when working with clients. Genomes reveal psychological dynamics that have been inherited socially in families, extended families, communities, and cultures.

One of the great challenges of multicultural therapies is the relevance of ethical relativism. When therapists are caught between values such as gender equity vs. religious values governing a client's patriarchal society, there may be a conflict of interest. To navigate through the tricky waters of ethical relativism and the therapist's role, therapists can find assistance in many of the professional organizations tailored especially for multicultural therapies. The American Psychological Association operates the Ethnic Minority Affairs office, too. In situations in which universal norms of social justice can be applied, the therapist can take comfort in knowing that legal and ethical communities will be on their side. Other situations might warrant the therapist carefully considering alternative approaches to dealing with difficult subject matter like the perceived or actual subjugation of women. Some therapists might not be willing to apply relativistic ethics, making some approaches to multicultural therapy irrelevant and inconsistent with core values and worldviews.

Central to multicultural therapies is the importance of identity. This will be an especially salient issue when therapists work with bicultural individuals, persons with weak or fractured ethnic identities, new immigrants, and interracial couples. There are several formal methods and theories that can be helpful to the therapist. Cultural identity development showcases the relevance of conformity, cognitive dissonance, introspection, and other parameters of identity formation. Counseling white clients may require the introduction to concepts like white privilege, in order to help the person reimagine their role and status in the society vis-a-vis their nonwhite neighbors. Denial and self-awareness are important for both client and therapist. This is why not all therapists or clients will resonate with multicultural approaches.

Another challenge for therapists working with a multicultural framework is countertransference. As Comas-Diaz (2014) points out, over-identification, us vs. them, distancing, survivor guilt, cultural myopia, ambivalence, and even anger are some of the common pitfalls (p. 553). When the therapist cultivates self-awareness, he or she will be better prepared to recognize these features and work to eliminate them or discharge the client from service. The therapist invariably learns as much as the client through difficult sessions or clients that challenge the therapist's social norms or personal worldview.