Family counseling techniques in multicultural therapy practice

Relevance of Family Counseling in Multicultural Counseling

Therapy clients from ethnic minority groups are often less likely to use counseling services compared to those from majority groups. This is because as stated by Harper, Terry, & Twiggs, 2009(Waldegrave (2009)

, the majority white group often has values that view counseling as an ethnocentric activity and therefore those from ethnic minority groups are alienated from these services as a result of this. Multicultural counseling has gained popularity in psychotherapy as a way to accommodate the differences that exist between these ethnic groups. Family counseling as a method has also been shown to be second most effective technique after cognitive behavioral therapy )

. The utilization of family counseling as a technique in multicultural counseling has not been studied widely, which is the rationale for this article. An understanding of the relevance of family counseling to multicultural counseling will help counselors appreciate family counseling as a method and understand how to apply it in their future sessions. The Bible in the Book of Genesis states that when we accept others, we view them in God's image (Gen. 1:26-27). The Bible in the book of Romans 15:7 reiterates the same message saying that we should accept one another. Rom 3:23 adds to this and says that we need to accept those individuals who are in need of redemption. Therefore, counselors must ensure they accept differences existing between individuals and respect this through multicultural competence.

Origins of multicultural counseling

Multicultural counseling has its origins in the mid 1970s during the period of the American Civil Rights Movement. During this time, it emerged that people from a particular ethnic group did not request counseling at all. Even when they did, they attended a single session and never came back again. This raised questions as to why clients from these minority groups did not request counseling and when they did, could not persevere the sessions Hildebrand, L., Gray, & Hines, 2008()

The major reason for this cited in literature is that, at the time, counseling was majorly ethnocentric Day-Vines et al., 2009.

Many scholars argued that approaches that were used by counselors had distinctive values that mainstreamed ideologies common in the majority white group Ponterotto, 2009.

These approaches led members of minority groups to feel that counseling was not relevant because their cultures were different.

Application of multicultural counseling in practice

Roy Moodley, 2010(Marbley (2011)

states that multicultural counseling has been applied in practice since the early 1990s when it became greatly appreciated by psychotherapists. Scholars agree on the three major competencies that skilled counselors need to develop in order to embrace multicultural counseling fully )

. These are increased awareness of their assumptions and values, striving to understand the view of different cultural groups and to develop appropriate techniques and strategies of counseling.

Increasing awareness of their values and assumptions

Practitioners need to engage in a cyclic process of multicultural self-awareness. This means that they need to be able to think about themselves, identify values that are dominant in their culture and find alternative values based on differences in the cultures. In this process, counselors should understand the cultural relevance of their names, values and beliefs that they hold in their culture, cultural standards that they uphold in their professional and their unique abilities that influence how they relate with culturally diverse individuals. This will enable the counselor to understand where they currently stand in terms of multicultural ideologies Diller, 2010()

Understanding the view of different cultural groups

Marbley, 2011(Marbley (2011)

argues that the counselor needs to gain knowledge and understanding of the different cultural groups that they expect to serve and how these groups differ. Acts 17:26 states that we are all one race and that we should coexist. This presents the case for unity of the whole human race and urges counselors to understand human diversity. The counselor should begin by developing an empathic understanding of members of cultural groups different from that of the counselor in order to understand how the members of these minority groups feel as a result of being from different backgrounds )

. The next thing is for the counselor to identify strategies, techniques, and guidelines that they might decide to follow to be able to hand these clients from different cultural groups.

Develop appropriate strategies and techniques

After gaining cultural self-awareness and developing an understanding of the different cultures of clients, counselors should then begin to develop strategies and techniques of counseling that are tailored towards the needs of clients from different cultural groups Aga Mohd Jaladin, 2013.

These strategies should be culturally appropriate. These strategies should include nonverbal behavior that has been found to be effective in ensuring the success of counseling activities. However, non-verbal behavior should be coupled with active listening to ensure that the counseling is effective.

Multicultural perspective of family counseling

Family therapy or counseling encourages change within the family by focusing on the individual family members or the family as a whole. In family counseling, the therapist acts as an agent for change and facilitates the change process within the family or individual with the help of the problem. To facilitate this change, the counselor should be sensitive to multicultural issues that exist in a family. These may include the cultural values, morals, beliefs, gender, customers, practices, and expectations. Often, the counselor needs to understand the ability of family members to access social amenities when understanding problems and generating solutions. Impoverished families often are not able to access these social amenities, which creates different cultural context factors for understanding how to handle the case.

The structure of families also depends on the culture of the family members. Family structure influences how family members interact with each other. For example in Asian families, mothers are the authority figures in the eyes of children because they often are completely in charge of these children. The same may not be the case for other ethnic groups. Some families have little or no structure such as family members interact with a lot of ease and there is no particular hierarchical pattern for their interaction.

Hays and Erford (2013)

also suggest that the clinician should understand the history of each member of the family, their cultural values, how they define themselves within the family and the influence of culture on the individuals. Harper et al. (2009)

argue that by ignoring the cultural perspective of each family and how their structure differs renders the strategies and techniques to be used by the counselor ineffective. This is because instead of solving the problem that brought the individual or family to therapy, the counselor may exacerbate the problem. The therapist needs to consider how the family's culture influences their structure, the level to which each family member follows the culture, additional considerations that need to be addressed in order for the counseling to be effective and culturally sensitive, and culturally acceptable changes that need to be made in order for the strategies to be effective. It is only when the counselor has identified the cultural aspects that have an effect on the counseling strategy that the appropriate therapeutic strategy and technique reflective of this understanding can be applied.

Subsystems

Brooks (2008)

supports this and states that families have structures and subsystems that exist within these structures. The most common subsystems are often the spousal, sibling, and parental subsystems. These three subsystems often dominate the culture and create the relationships between the family members. The counselor should identify the types of subsystems in the structure of the family. Whether these are functional or dysfunctional is also essential. The influence of these subsystems on the culture of the family members, in terms of their beliefs, values, and practices, should also be evaluated. Waldegrave (2009)

argues that, in family therapy, subsystems are an essential component.

In this type of family therapy that considers the importance of family structure, referred to as structured family therapy, it is important to understand that these systems, even in one family, may vary depending on the time, place, and events. A quintessential example is when the spousal subsystem in a family changes when one parent is away on business or holiday. Similarly, other subsystems may also change. Within the configuration of each family, each family's subsystem may experience periods of health and lack of functionality. It is important to understand that the culture of the family may influence these subsystems.

Flexibility in multicultural family counseling

When initiating and conducting family therapy, it is important for the counselor to be flexible to effectively understand and develop a therapeutic relationship with the family Godart et al., 2012.

If a counselor is rigid and unwilling to accept change, he or she may end up being inconsistent and ineffective with their therapy strategies resulting from using stereotypical subsystems or subsystems that are not consistent with the family's dominant culture. This form of rigidity leads in lack of empathy and a genuine concern for the emotional health of the family. It leads to creation of prejudices, biases, and stereotypes before commencing treatment Hays & Erford, 2013.

These create barriers to the effectiveness of treatment.

The flexible counselor will be able to recognize these prejudices, biases, and stereotypes, and avoid them by creating a therapeutic alliance with the family to create a safe, convenient, and effective counseling environment. This will also increase the acceptability of therapy by clients because clients will not feel the prejudice and biases of the counselor. An example explained by Ponterotto (2009)

is that persons from families that embrace the extended family culture may feel the session is not helpful if the counselor focuses on the individual family members exposing their personal feelings without regarding the family's culture and subsystems.

For the counselor to be flexible in their work, there is a need to ensure the culture of the family is contextually considered within the family subsystem. The counselor must be able to understand how communication within the family goes on as a result of these subsystems. It is through this process of self-reflection that the counselor develops strategies and techniques that enhance the relationships of the individuals in these subsystems Marbley, 2011()

Boundaries as part of family subsystems

Boundaries are an important component of family culture and subsystems. Culturally competent counselors should be able to appreciate the boundaries within family culture and how individuals function within these boundaries. The counselor should diagnose and consider the boundaries present in the family members since they define the health or lack of functionality in family subsystems. As put forth by Chung & Yoo, 2013(Godart et al. (2012)

, boundaries within family subsystems protect the differentiation within the subsystem. Each subsystem within the family has specific tasks and roles for its members. These predicate the freedom of the members of the subsystem thus creating boundaries )

For family therapy to be successful, the counselor must actively understand how the family functions and what boundaries exist in for each family member. Boundaries help to present the family structure in the ideal way to include essential family actions such as socialization, support, and nurturing.

First and second order change

Once family boundaries are defined clearly, problems within a family are minimized. If problems are present, family therapy may not be successful. This is because the family members may not be able to create healthy solutions since the counselor on their part is using ineffective techniques in a repetitive manner. Cornish, Schreier, Nadkarni, Metzger, and Rodolfa (2010)

state that this lack of respect for boundaries in families results in arguing and yelling and is referred to as first order change. First order change does not resolve the problem neither does it make it worse. Second-order change, on the other hand, occurs when the first-order resolutions are changed resulting in the problems being resolved.

Effective techniques that the counselor may choose to use include motivational interviewing. This strategy will help the family to use second-order strategies to clarify subsystems and boundaries. Counselors often use this strategy when they understand that the family is using first order change strategies and techniques. In families with rigid or diffuse boundaries, there are difficulties in creating second order change Aga Mohd Jaladin, 2013.

The counselor, through cultural competency, should be able to determine whether it is difficulties arising from boundary rigidity that brought them to therapy or there are other underlying issues. This is the only way through which second-order change can be created for the family. As stated by Hays and Erford (2013)

, in cross-cultural marriages, diffuse boundaries that exist between the couple are their parents are often a source of conflict.

Applying cultural competence to family therapy

A culturally competent therapist should be able to ask and answer questions relating to the level of acculturation of the family. This should be coupled with whether the level of acculturation creates a boundaries problem. The counselor should understand how culture defines boundaries existing within the family, and whether the family deviates from their cultural boundaries from time to time Ponterotto, 2009.

Other essential questions for the counselor to answer during the sessions is whether the family is willing to depart from their culture or for those deviating from their culture, to conform to their beliefs, and whether the family can embrace these changes while staying within their boundaries Hays & Erford, 2013.

After these questions are answered, the counselor should use his cultural competencies to apply family therapy to create second-order change in the family.

During the counseling sessions, the greatest mistake for the counselor to make would be to impose their beliefs on boundaries to the family members. This shows that the counselor is not respecting the family culture and boundaries and has no intention of creating functional and healthy boundaries. Often, a culturally sensitive therapist should pursue more information about a culture from other members of the same culture or through other research Aga Mohd Jaladin, 2013.

Other ways to collect this information is through questionnaires with family members and open-ended discussions during counseling sessions. These will reveal the culture, structure, boundaries and subsystems that exist within the family. This information together with the cultural sensitivity of the counselor will help them to create a safe and conducive therapeutic environment to facilitate positive second-order changes.

Subsystems, boundaries, and changes existing within families are the three most important factors in family therapy. For a counselor to exhibit cultural competence, they should be able to pursue knowledge and understanding of the family culture Marbley, 2011.

This should be done through research of the culture, open discussions and questionnaires for the family members to complete. These will reveal the family structure, boundaries, subsystems, and changes that exist and which the counselor should be culturally sensitive to.

Often, conventional counseling techniques and strategies may hinder deliverance of effective multicultural counseling techniques. This is majorly because conventional counseling reinforces beliefs of problems stemming from individuals Aga Mohd Jaladin, 2013.

The major aspect in family therapy is the relationships that the family members have with each other. Though the individual is an important component of family therapy, their environment of interaction is most important because it define the three most important components of family therapy -- subsystems, structure, and boundaries Harper et al., 2009()

Multicultural counseling advocates for flexibility of the counselor or therapist. It is important for the therapist to recognize their thoughts, feelings, behaviors, social interactions, cultural, and political beliefs. These should then be compared with those learnt from the client and their family and then the counselor should change their counseling techniques and strategies to reflect what they have learnt about the client.

Conclusion

Society needs counselors to have multicultural competencies. In family therapy as well, increasingly multicultural counseling competencies are of importance because of trying to achieve success with ethnic minority groups or groups from ethnic backgrounds different from that of the counselor. The need for counselors to work together and empower themselves with the skills, knowledge, and strategies to counter challenges they need to meet the demands of diverse clients. The three multicultural competencies -- self-awareness, cultural knowledge, and skills -- are important for counselors to mitigate the challenges of multicultural counseling in family therapy. Counselors need to be open-minded about the other cultures and avoid validating the other culture's practices, beliefs, and values against their own Aga Mohd Jaladin, 2013()

Developing multicultural competencies is an active process that takes time. Through practice and action, counselors can develop these multicultural competencies and perpetuate social justice to foster therapeutic relationships with their clients. Cultural competence is a commitment for counselors and should be an important aspect of all family therapy sessions. There is an need for counselor to understand how to ask questions with cultural sensitivity and apply strategies that respect different cultural practices, values, and beliefs.