After reading the article on Multicultural Counseling, please discuss how you might utilize the various domains of the RESPECTFUL cube to accommodate clients from diverse cultural gr

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Article 4

Adapting Counseling Skills for Multicultural and Diverse Clients

Paper based on a program presented at the 2009 American Counseling Association Annual Conference and Exposition, March 19-23, Charlotte, North Carolina.

Ireon LeBeauf, Marlowe Smaby, and Cleborne Maddux

Multicultural counseling takes place when a counselor and client are from differing cultural groups. Because significant demographic changes are taking place in the United States, multiculturalism is becoming increasingly important. In fact, multiculturalism has been called the “fourth force” in helping (Pederson, 1991, as cited in Skovholt & Rivers, 2007, p. 15). The other forces include psychodynamic, humanistic/existential, and behavioral counseling theories and methods. Knowledge and skills related to all four of these forces are critical for understanding behavior in the counseling process and for effective counseling in a multicultural context. Therefore, seven divisions of the American Counseling Association (ACA) have endorsed the multicultural counseling competencies developed by the Association for Multicultural Counseling and Development (AMCD; Sue & Sue, 1999).

However, whether or not mental health practitioners in the therapeutic setting subscribe to, or even understand, the principles and dynamics of what it means to be culturally competent remains a largely unanswered question (Tackey, 2001). Counselor education faculty often urge students to celebrate diversity, but the average

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student is not equipped with knowledge of the components of the RESPECTFUL Counseling Cube (D’Andrea & Daniels, 2001). These include religion and spirituality (R), economic class background (E), sexual identity (S), psychological maturity (P), ethnic and racial identity (E), chronological stage (C), trauma (T), family background (F), unique physical characteristics (U), and geographical location (L).

The evolution of counseling skills training has moved from an ill-defined process to more clearly delineated approaches. Five pioneers have made important contributions to this evolution. These include (a) Carl Rogers, (b) Robert Carkhuff, (c) Norman Kagan, (d) Alan Ivey, and (e) Stanley Baker. These influential individuals were responsible for (a) Person-Centered Therapy, (b) Human Resource Development, (c) Interpersonal Process Recall, (d)Microcounseling, and (e) the Meta-Analytic and Narrative Review Approach, respectively. (The latter is based on a narrative and meta-analytic review of three of the other approaches.) Elements from the training approaches of the first four of these individuals and from Baker's meta-analysis have been used to develop the Skilled Counselor Training Model (Smaby & Maddux, in press).

The Skilled Counselor Training Model (SCTM)

The Skilled Counseling Training Model (SCTM) is a skills- based training program that promotes attainment of skills through the use ofmodeling, mastery, persuasion, arousal, and supervisory feedback (Smaby, Maddux, Torres-Rivera, & Zimmick, 1999). In the SCTM, skills are divided into three stages: exploring, understanding, and acting (Smaby et al., 1999). For each stage, theModel illustrates (a) a purpose, (b) two counseling processes, and (c) six counseling skills.

The Exploring Stage

The purpose of the exploring stage is to help clients determine where they are in relationship to the problems they are

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facing. The attending process is a component of this stage and includes eye contact, body language, and verbal tracking. The questioning and reflecting process, also a component of the exploring stage, includes open-ended questioning, paraphrasing, and summarizing. The exploring stage should be marked by high levels of client talk and minimal counselor interruption. During this stage, the counselor should communicate acceptance, empathy, and positive regard. At the conclusion of the exploring stage, clients should feel fully and completely supported to explore issues from their own viewpoints (Smaby & Maddux, in press).

The Understanding Stage

The purpose of the understanding stage is to help clients recognize where they are in relationship to where they want to be with regard to the problems they are facing. During this stage, the counselor should confront the client concerning inconsistencies in behavior and attitudes. The counseling process of interchangeable empathy includes the skills of stating feelings and content, self disclosure, and asking for concrete and specific expressions. The additive empathy process includes the skills of immediacy; identifying general problem situations, actions taken, and feelings; and caring confrontation. Thus, when the understanding stage concludes, clients should have a fresh perspective or be able to generate new viewpoints regarding their life challenges (Smaby & Maddux, in press).

The Acting Stage

The purpose of the acting stage is to help clients identify what they need to do to get to where they want to be with regard to problems. The decision-making process includes the skills of deciding, choosing, and identifying consequences. At this point, the counselor should define clients' situation as consisting of a choice to (a) change ineffective coping behaviors or (b) continue to allow these

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futile patterns to be problematic (deciding skill). The counselor should then outline the thoughts and feelings that previously prevented clients from implementing change (choosing) while exploring the positive values that are important to clients as a result of the decision (skill of identifying consequences). The contracting process includes the skills of reaching agreements; setting deadlines; and reviewing goals and actions to determine outcomes.

If the counselor has employed sound exploring stage and understanding stage skills, it is rare that clients will opt for no change, because it is obvious that this would be self-defeating. However, if clients do opt for no change, the counselor should revert back to previous stage skills and attempt to build a relationship that will result in positive client outcomes (Smaby & Maddux, in press).

This article will describe how to use the RESPECTFUL Cube and the Skilled Counselor Training Model (SCTM; Smaby & Maddux, in press) in multicultural counseling relationships.

Using the RESPECTFUL Cube to Assess Potential Conflicting Views Between a Counselor and a Client

The first step is to identify how a counselor's attitudes related to the 10 domains of the RESPECTFUL Cube can conflict with views of clients. This exercise is designed to help counselors become more aware of their own beliefs and biases about clients who are from diverse groups and backgrounds. In this exercise, counselors use the 10 domains of the RESPECTFUL Cube to evaluate themselves on each issue.

For each of the 10 domains or issues, counselors should write a short statement about their views and how these views could be a source of contention with clients who have different views of these issues. Counselors should then use these 10 written statements as a basis for planning to modify how they interact with clients who may hold differing views.

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Adapting the SCTM Skills for Addressing the RESPECTFUL Cube Domains

The second step in this exercise is to adapt skills of the exploring, understanding, and acting stages to various domains of the RESPECTFUL Cube. The following section describes how exploring stage skills can be adapted for ethnic and racial identity when working with American Minority clients.

Adapting the Exploring Stage Skills to Clients From Different Ethnic/Racial (E) Backgrounds

Clients from various racial backgrounds may have different perceptions of the exploring stage skills of eye contact, body language, verbal tracking, open-ended questioning, paraphrasing, and summarizing. It is imperative that the counselor consider how these skills will affect rapport with diverse clientele.

When beginning to counsel American Minority clients (Asian-American, American-Indian, African-American, and Latino- American), it is important to assess the level of acculturation of the client. For example, if the level of acculturation is minimal, direct eye contact, demonstrative body language, and continuous verbal tracking may be perceived as impolite by Asian American clients. The counselor will need to maintain a heightened awareness of how these skills are affecting the counseling session and reduce the use of these skills accordingly (Smaby & Maddux, in press).

Native American clients who maintain strong ties to their tribal groups may perceive persistent eye contact, direct questions, repetitive paraphrasing and summarizing as being invasive and authoritative. Such clients may prefer more oblique and circular questioning, analogies, stories related to the issues or problems of concern, and the use of silence. It is also important for the culturally competent counselor to have a working knowledge of and respect for clients' tribal customs and/or belief systems (Smaby &Maddux, in press).

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Like some otherAmericanMinority clients,African-American clients are likely to suffer from cultural mistrust of counselors. This cultural mistrust can often be traced to past racist and discriminatory practices. Clients who present cultural mistrust often appreciate an acknowledgement and acceptance of their frustration with the system. The counselor should also attempt to create an environment where African-American clients are able to express themselves freely without prejudice or judgment (LeBeauf, 2008).

Acculturation stress and economic issues often play a major role in contributing to mental health issues in Latino communities. When counseling Latino clients, it is important to recognize the profound impact that immigration laws and racial discrimination have had in Latino communities. Casual rather than persistent eye contact along with genuine empathy-based paraphrasing may also be helpful in building rapport with Latino clients. Also, recognizing the important roles of the nuclear and the extended family in counseling can be important to Latinos, who often consider themselves closely tied to family and community (Smaby & Maddux, in press).

Adapting the Understanding Stage Skills for Addressing Sexual Identity (S)

Issues of gender and sexual orientation are often overlooked by counselors in training. The understanding stage of the SCTM focuses on skills of stating feelings and content; self-disclosure; asking for concrete and specific expressions; immediacy; identifying general problem situation, action taken, and feelings; and confronting in a caring way (Smaby & Maddux, in press). The following examples are how the skills of the understanding stage of the SCTM can be useful in understanding issues of gender and sexual orientation in counseling.

Understanding Stage Skills With Females and Males Distinctive communication styles characteristic of each

gender should be considered. For instance, a female may find the

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understanding stage skills of stating feelings and content, self disclosure, and asking concrete questions to be blunt and lacking dimension. Females may prefer a conversational style of counseling that allows them to express more personal and emotional feelings. In contrast, males may find the use of these skills beneficial to their progress in session, but may struggle to identify their emotions.Also, the understanding stage skills of asking for concrete and specific expressions; immediacy; identifying problem situations, action taken, and feelings; and confronting in a caring way may be considered by males to be overly intrusive and emotionally charged (Smaby & Maddux, in press). In either case, the counselor needs to monitor clients' personal communication styles and adjust use of the understanding skills accordingly. If the counselor senses intimidation, withdrawal, or anxiety by the client, the counselor should provide ample time and space to allow clients to express themselves in a way that is comfortable.

Understanding Stage Skills With Lesbian, Gay, Bi-Sexual, or Transgender Clients

The use of understanding stage skills with Lesbian, Gay, Bisexual, Transgender or (LGBT) clients may be considered too intrusive or direct, and may result in clients feeling vulnerable or attacked. Culturally competent counselors using these skills should consider softening their delivery and tone. It is also important that counselors recognize that the mental health problems manifested by members of the LGBT community may not be due to LGBT identity itself (Smith, Foley, & Chaney, 2008). Counselors should also consider the dual discrimination of persons of color who are also members of the LGBT community and who experience challenges related to racism and heterosexism. In order to be effective in the therapeutic setting with LGBT clients, the counselor must consistently communicate genuine empathy and support.

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Adapting Acting Stage Skills for Addressing Economic Class (E), Chronological Age (C) and Psychological Maturity (P)

Economic Class Clients affected by poverty may be reluctant to participate in

counseling. These clients often struggle with basic life needs and may view acting stage skills of deciding, choosing, and identifying consequences as impossible for them. Thus, clients with lower incomes may require assistance in obtaining housing, food, and healthcare. Once these lower-level needs are met they may be more able to focus on strategies to improve their psychological functioning (Smith et al., 2008). Conversely, clients with higher levels of income may find the skills in the acting stage helpful, but may also feel the need to design their own interventions. For example, in regard to contracting, clients may decide what steps are needed to improve a situation without suggestions from the counselor.

Chronological Age Acting stage skills may be difficult for children who are age

2 years and under due to their more limited cognitive and emotional development. Exploring stage skills may be much more appropriate. However, acting stage skills can be adapted for use with children ages 2 to 7 years. This can be achieved by proposing tentative hypotheses regarding decision-making and contracting as a way to nurture the development of higher-order thinking and expanding viewpoints. Children between the ages of 7 and 11 years may be able to engage in acting stage skills if they are presented in a concrete fashion. However, like younger children, they will require suggestions and assistance in contracting and decision-making skills. Play therapy, art therapy, and media may be useful tools in working with children and adolescents in counseling. Counselors should also consult with parents and caregivers to assist young children in their counseling journey (Smaby & Maddux, in press).

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Psychological Maturity Psychological maturity as it relates to the acting stage skills

are based on clients' stage of cognitive and emotional development. For example, in Kohlberg’s theory, those whose moral reasoning is at stages one or two obey rules of behavior based upon their fear of punishment or trading favors. Children at this stage may not fully benefit from acting stage skills due to egocentricity. On the other hand, children who have progressed to moral reasoning levels at stages three and four (good boy/good girl or law and order) may be able to view perceptions of self and others as important to good relationships and rule-following as necessary and important for the betterment of all. A counselor can deliver acting stage skills by suggesting tentative hypotheses that can be confirmed or denied by children. Children at the highest level of Kohlberg’s theory of moral reasoning (social contract or golden rule) may be able to initiate acting stage skills and the counselor should allow such children to use their higher levels of maturity as springboards for developing effective coping strategies (Smaby & Maddux, in press).

Summary and Conclusions

The RESPECTFUL Cube identifies 10 domains that act as cultural lenses through which counselors experience their clients. Thus, counselor educators need to help counselors-in-training to assess how differing views of these domains by diverse clients may affect the counseling process. Secondly, counselor educators need to help counselors-in-training learn to adapt the 18 counseling skills of the SCTM by using the RESPECTFUL Cube domains. These domains can be used as a guide to accommodate clients from diverse cultural groups. It is time for the counseling profession not only to recognize multicultural and diversity issues, but to develop systematic and practical approaches for helping counselors address and adapt counseling practices with culturally diverse clients.

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References

D’Andrea, M., & Daniels, J. (2001). RESPECTFUL counseling: An integrative model for counselors. In D. Pope-Davis & H. Coleman (Eds.), The interface of class, culture and gender in counseling (pp.417-466). Thousand Oaks, CA: Sage.

LeBeauf, I. (2008). Racial disparities in new millennium schools: Implications for school counselors. [Electronic version]. Journal of School Counseling, 6(10). http://www.jsc.montana. edu/articles/v6n10.pdf

Skovholt, T. M., & Rivers, D.A. (2007).Helping skills and strategies. Denver, CO: Love Publishing.

Smaby, M. H., Maddux, C. D., Torres-Rivera, D., & Zimmick, R. (1999). A study of the effects of a skills-based versus a conventional group counseling training program. Journal of Specialist in Group Work, 24, 152-163.

Smaby, M. H., & Maddux, C. D. (in press.) Counseling skills: Assessing mastery, transfer, and client outcomes. Pacific, CA: Brooks Cole.

Smith, L., Foley, P. F., & Chaney, M. P. (2008).Addressing classism, ableism, and heterosexism within multicultural-social justice training. Journal of Counseling and Development, 86, 303-309.

Sue, D. W., & Sue, D. (1999). Counseling the culturally different: Theory and practice (2nded.). NewYork: John Wiley & Sons.

Tackey, N. D. (2001). Eliminating bias in performance management [Electronic version]. British Journal of Administrative Management, 27, 12-18.