EFFECTIVE COUNSELOR:Cultural Bias in Theory and Practice, Stress and Burnout

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Theory and Practice of Counseling - PSY632

Lesson 10

EFFECTIVE COUNSELOR

As described below, this lecture will focus on personal characteristics, daily stresses, and psychological

health of an effective counselor.

Personal characteristics

Values

Cultural biases

Daily world of a practitioner

Psychological Health Model

Personal Characteristics Model

Influence of Counselor's Values on Client's Values

Values are principles that guide our life. Counselors' values influence how they work with clients and bring

their value conflicts to counseling. Counselors must understand their own values and the values of others.

In fact, no one set of values is superior to others. Every person has a set of beliefs that determines the

decisions they make, their ability to appreciate the things around them, their consciences, and their

perceptions of others. Values serve as reference points for individuals. They provide a basis for determining

which course of action an individual should take, e.g., respecting elders. Counselor's conflict with certain

values can also cause relationship difficulties with the clients. For religious counselors, issues of

contraception, abortion, divorce and intentional single parenting create value conflicts.

Using the Schwartz Universal Values Questionnaire (Schwartz, 1992), Kelly (1995) surveyed a national

sample of nearly 500 American counselors. The prevalence of values as reported by the counselors were as

under: benevolence, 5.27; self-direction, 5.08; universalism, 4.89; achievement, 4.63; hedonism, 4.14;

security, 4.07; stimulation, 3.59; tradition, 3.17; power, 2.09 .

Some counselors recommend neutrality in counselor so that clients move from an external to an internal

locus of control

Williamson (1958) called for an abandonment of neutral position by suggesting that this could easily lead

the client to believe that the counselor can accept unlawful behavior. Some maintain that the counselor

should remain neutral while counseling and communicate no value orientation to the client. In such

circumstances, a counselor or therapist would strive to appear nonmoralizing, ethically neutral, and focused

on the client's values. If topics such as pro-choice versus pro-life, religion, euthanasia, or gay, lesbian, and

bisexual orientation were to arise during the counseling or psychotherapy process, the counselor or therapist

would not take a position. Such a situation could lead to the client's feeling that the counselor supported

behavior that is completely unacceptable by any social, moral, or legal standards. The reason for such

neutrality is the belief that it is important for clients to move from an external to an internal locus of control

during the counseling or psychotherapy process. Values introduced by the counselor or therapist would be

detrimental to such an objective.

Patterson (1958) points out that the counselor's values definitely influence those of the client, affect ethics

of the counseling relationships, the goals of counseling, and the methods employed in counseling. Patterson

cites evidence for the assertion that, no matter how passive and valueless the counselor appears, the client's

value system is influenced and gradually becomes more similar to the counselor's value system. However,

Theory and Practice of Counseling - PSY632

Patterson suggests, counselors are not justified in consciously and directly imposing their values on their

clients.

In an experiment using the Study of Values test, Cook (1966) found that in 3 value-similarity groups, medium

similarity group improved more than those in either high similarity or low similarity groups. He found that

differences in the counselors' and clients' value systems affected counseling outcome. He found that when

clients were grouped by how similar their values were to the values of the counselor, clients who were in a

medium similarity group improved more than those in either high similarity or low similarity groups. These

findings suggest that when the counselor or client perceives his world as being too similar to or too

different from that of the other, it has an adverse effect upon their interactions.

Belkin (1984) suggests that the primary value to which counselors must commit themselves is freedom.

Freedom is an ideal that propels the individual to certain types of actions. Freedom allows the individual to

determine what direction in which to move. It allows the individual to be creative, to make choices and be

responsible for them. Freedom also commits the client to assuming responsibility for his action and its

consequences. He suggests that the primary value to which counselors must commit themselves is freedom.

Research indicates that social class bias influenced psychiatric residents' diagnosis of patients (Lee, 1968;

Fitzgibbons & Shearn, 1972). The professional background of the therapist had an important influence on

whether the therapist judged a patient schizophrenic or not (Fitzgibbons & Shearn, 1972).

Cultural Bias in Theory and Practice

It is widely acknowledged that current theories are derivatives of Western culture and are not universally

applicable to cross-cultural counseling situations (Corey, 2001; Schmidt, 2002).

Examples of cultural differences are abundant (Argyle, 1985). This is manifested in different behaviors of

people, for example, calling others by first name, direct or indirect gaze, etc. Christopher (1996) addresses

diversity issues through the concept of moral visions. Argyle studied 22 social relationships in 4 cultures:

Britain, Italy, Hong Kong, and Japan. Addressing the other person by first name was highly endorsed in

only three Japanese relationships, a much lower figure than in the other three cultures. Looking the other

person in the eye during conversation was highly endorsed in virtually all British and Italian relationships,

but in under half of Japanese and Hong Kong relationships. Christopher points out those different cultures

provide different moral visions. The ideal person in traditional Confucian China was first and foremost

characterized by absolute loyalty and being a dutiful son or daughter. In contrast, in the American culture,

attributes such as authenticity and autonomy are reinforced.

Most Western counseling or psychotherapy theories are moral visions that presuppose the importance of

individualism. For example, behaviorist, cognitive-behavioral, and reality theories emphasize utilitarian

individualism. They stress rationality, control over emotions, enhanced human liberty, the importance of

achieving self-defined goals, and opposition to irrational authority. Humanistic theories, such as person-

centered and Gestalt theories, promote the importance of turning inward, of making contact with inner

experiencing, and of identifying and expressing feelings. Such emphases may not be congruent with the

moral visions of clients from other cultures. Eye contact by young people is a sign of disrespect among

some Native American Groups (Ivey, 1994).

Current theories are derivatives of Western culture and are not universally applicable; they emphasize

autonomy; and turning inward. Western values include emphasis on youth, assertiveness, independence and

competition, whereas the corresponding Eastern values emphasize maturity, compliance, interdependence

and cooperation.

Awareness of cultural differences and the ability to build bridges across them are important counseling

skills. Income, educational attainment and occupational status are currently three of the main measures of

Theory and Practice of Counseling - PSY632

social class; you bring your skills at understanding people from different social classes and of forming

counseling relationships with them. One skill may be handling resistances and messages resulting from

clients' social class insecurities.

Usher (1989) provided some helpful guidelines for assessing the cultural bias inherent in theories of

counseling and psychotherapy:

· Assumptions about Normal Behavior

· Person-centered and REBT's emphasis on Individualism and independence:

o Pedersen (1987) argued that "what is considered normal behavior will change according to

the situation, the cultural background of a person or persons being judged, and the time

during which a behavior is being displayed or observed". A number of theories (e.g.,

person-centered and rational-emotive behavior theory) emphasize the welfare and

centrality of the individual and deemphasize the importance of obligation and duty to

family, organizations, and society.

· Dependence on Abstract Words:

o Would all clients understand the concepts of self-actualization or fictional finalism? Many

clients are not receptive to abstractions or conceptualizations.

· Neglect of Client Support Systems:

o In some cultures, talking with family members or friends may be more acceptable than

talking with a trainee professional who is usually a total stranger.

· Focus on Changing the Individual:

o Linear thinking emphasizes cause-and-effect relationships, whereas the nonlinear or

circular thinking characteristic of some cultures does not separate cause and effect

counselors and therapists who use Western theory as the sole basis for practice assume that

their role is to make the client more congruent with the system. Such a role can be quite

problematic when Western culture-bound paradigms, such as the DSM, are used to assess

the behavior of clients who are culturally different. Their current problems cannot be fully

understood without consideration of their history.

The Daily World of the Practitioner

· A complex relationship exists between elements of the therapeutic process and the demands experienced

by the counselor on a daily basis (Moursund & Kenny, 2002).

· The demands inherent in just about any work environment are tremendous. Concerns about having

enough clients, students, supervisees, research funds, publications, involvements in professional and

community organizations, collected fees, malpractice, and liability insurance are just a few examples of

the kinds of demands that converge on counselors and therapists, e.g., school, college, university, mental

health center, hospital, private practice, rehabilitation clinic, etc.)

· Freudenberger (1983) notes that the very nature of the therapeutic personality often makes it difficult to

say no and many people engaged in counseling and psychotherapy find themselves overextended, tired,

and overly involved with work.

Common Individual Stressors

Striving for perfection

Excessive need for approval

Self-doubt

Physical and emotional exhaustion

Assuming too much responsibility for clients

Ruminating about cases

Theory and Practice of Counseling - PSY632

Stresses association with working in organizations

Excessive demands of agencies

Constant paperwork

Dehumanization and erosion of ideals

Stress and Burnout

How stress paves the way to burnout

Stress at work tends to impact your personal life

Working intensely with people opens you up to your own wounds -- it reactivates earlier conflicts

and pain

Constant stress that is not managed results in physical and psychological exhaustion

Burnout

There are internal and external causes of burnout.

Chronic burnout can lead to becoming impaired.

You are challenged with recognizing signs of burnout before you become an impaired practitioner.

Warning Signs for Burnout

Kaslow (1986) notes that when two or more of these indicators appear periodically and with gradually

increasing frequency, intensity, and duration, a counselor or therapist has entered a warning zone and

should seek personal counseling and psychotherapy, take a vacation, cut back on obligations, and so on,

until he or she re-experiences perspective and balance:

Not wanting to go to work

Constantly complaining about disliking one's practice or feeling overwhelmed by it

Viewing life as dull, heavy, and tedious

Experiencing an increasing number of negative counter-transference reactions to patients or students

Being extremely irritable, withdrawn, depressed, or intolerant at home

Suffering frequent illnesses of inexplicable origin

Wanting to run away from it all or having periodic suicidal ideation

Psychological Health Model

· The capacity to give and receive love as a criterion for psychological health has been endorsed by

many theorists like Adler (1978), Allport (1961), Erikson (1968), Freud (1930), Fromm (1955),

Maslow (1970), and Sullivan (1953).

· Jahoda (1958): proposed 6 criteria for mental health: a positive attitude toward self, continual

movement toward self-actualization, purpose in life, ability to function independently, an accurate

perception of reality, and mastery of the environment.

· Basic self-esteem has been viewed as essential by Allport (1961), Erikson (1968), Jung (1954),

Maslow (1970), Rogers (1961), and Sullivan (1953).

· Personal autonomy and competence are emphasized by Fromm (1955), Horney (1950), Maslow

(1970), and Rogers (1961).

Kinnier's Criteria for Psychological Health

Following a survey of psychological literature, Kinnier (1997) proposed 9 criteria for psychological health.

To determine what criteria for psychological health had been identified by theoreticians and researchers,

Theory and Practice of Counseling - PSY632

Kinnier (1997) proposed that these criteria are believed to apply to counselors and therapists as well as to

their clients.

· Self-acceptance

o Self-esteem seems to be a prerequisite for developing other important

components of psychological health. Psychologically healthy individuals

experience strong feelings of self-acceptance and self-love. Individuals who love

and respect themselves have the capacity to love and respect others and possess

the foundation for becoming self-actualized.

Self-knowledge (introspective)

Psychologically healthy individuals know themselves well and stay aware of their feelings,

motivations, and needs. They are introspective and committed to understanding

themselves.

Self-confidence and self-control

They have appropriate skills for assertive behavior, but do not unnecessarily impose their

views or will on others. Such individuals have an internal locus of control, believe that they

can exert reasonable control over their lives, and feel capable of achieving their goals.

A clear perception of reality (enough societal consensus)

Perceptions of the people, events, and objects around us are always subjective, but there

are usually enough societal consensuses about the nature of reality to provide beneficial

comparisons with our own point of view. Psychologically healthy individuals have a clear

perception of reality and an o ptimistic view of life.

Courage and Resilience.

Danger and risk surround the daily lives and decision-making opportunities of most

individuals; therefore, failures, crises, and setbacks are inevitable. Psychologically healthy

individuals are aware of this reality, adapt well to challenges and changed circumstances,

and can bounce back from disappointments.

Balance and moderation

Psychologically healthy individuals work and play, laugh and cry, enjoy planned and

spontaneous time with family and friends, and are not afraid to be both illogical and

intuitive. They are rarely extremists or fanatics, and usually they do not do anything in

excess.

Love of others: Capacity to give and receive love (Adler, 1978; Fromm, 1955)

A number of theoretical orientations believe that the ability to give and receive love, the

desire to develop close ties to another person or persons, and the need to belong to

another person, family, or group are fundamental to mental health.

Love of life

People who are active, curious, spontaneous, venturesome, and relaxed have traits that

promote their capacity to partake of and enjoy life.

Purpose in life

Individuals vary in their choice of the most meaningful aspects of life. Work, love, family,

intellectual or physical accomplishment, or spirituality may become the primary focus.

The Multidimensional Health and Wellness Model

· Systemic models of wellness suggest that all the identified dimensions of wellness interact and that they

must all be evaluated (Skovholt, 2001), as components of a lifelong paradigm to promote health and

well-ness. Health has been defined as the absence of illness; wellness goes far beyond the absence of

illness and incorporates a zest and enthusiasm for life that results when the dimensions of wellness have

been addressed, developed, and integrated. A person can be "well" even when undergoing treatment for

physical illness because the physical dimension is just one dimension of the wellness model. Little

emphasis has been placed on the importance of counselors or therapists helping themselves, and even

Theory and Practice of Counseling - PSY632

less attention is given to counselors' or therapists' wellness behaviors

· In 1984, Hettler proposed six dimensions of wellness--intellectual, emotional, physical, social,

occupational, and spiritual

· Later revision (Myers et al., 2000) indicated the following Wheel of Wellness as a basis for working

holistically with clients:

· Spirituality

· Self-direction

· Work and leisure

· Friendship

· Love

Activity 1: Assessing Your Personal Characteristics

· Sensitivity

· Personal presence

· Compassion & empathy

· Flexibility & willingness to receive feedback

· Integrity

· Modeling

· Insight

Use this list as a catalyst for honest self reflection. Reflect on how well you know yourself, and assess your

current level of interpersonal functioning.

Activity 2

Conduct an interview with a mental health professional. Before the interview develop a list of questions

that you are interested in exploring. Write up the salient points and conclusions of your interview in your

Counseling Journal.

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