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MHSC8036 FOUNDATION COUNSELLING THEORIES AND APPROACHES

Assessment: 2000-2500 Word Reflective Written Assessment
This reflective written assessment will require you to use a real or hypothetical
case. Cover the following:

1. Identify two aspects of the real or hypothetical client’s cultural identity
(referencing Hay’s 1996 ADDRESSING model) that were of significant
importance to the case.

2. What are two multicultural challenges presented by the real or
hypothetical case and how did you address them?

3. Give two examples of how the Best Practice Principles of Multicultural
Counselling and Therapy (Ivey, D’Andrea, Ivey and Simek-Morgan 2002)
were applied or could have been applied with this real or hypothetical
case.

4. Reflect on the personal challenges you may encounter when working
with clients from different cultural backgrounds. Your reflection need
not be confined to this case. Discuss how these challenges might
impact your professional practice.

Cultural diversity is among the fundamental aspects of counseling practice. For therapy to be effective, counselors ought to be highly sensitive to the cultural identities, beliefs, and values of the client, all of which play a crucial role in shaping and influencing their experiences and worldviews. Hay’s (1996) ADDRESSING model will be used as a comprehensive framework to facilitate understanding of various dimensions of cultural identity. This essay is based on a real case of Vikam.

Vikram, a 25-year-old Indian Singaporean man, has been grappling with intense familial pressure to marry, stemming from his parents’ traditional Indian Hindu cultural beliefs. In this culture, marriage is highly valued, either through arranged marriage or by finding a partner independently. Over the years, his parents have encouraged him to find a girl to marry, even expressing openness to his finding someone outside of the traditional arranged route. However, Vikram has been reluctant to comply, leading to escalating tension within the family.

During one of his therapy sessions, Vikram revealed the core reason behind his hesitation: he is not attracted to women. He does not wish to marry a woman, whether through arrangement or personal choice. When Vikram opened up to his parents about his disinterest in women and marriage, it led to a heated confrontation. His parents, steeped in traditional values, were both furious and confused, unable to comprehend why he would reject such an important cultural expectation.

Vikram further disclosed in therapy that he identifies as gay and has been exploring his sexual orientation over the past two years. He is currently in a relationship with another man and is considering a live-in relationship with his partner, which goes against the familial and cultural norms his parents hold dear. Upon learning of his relationship, his parents insisted that he end it immediately and instead allow them to arrange a marriage for him, believing that once he marries a woman, his emotions will change. They view his sexual orientation as a temporary confusion, hoping that through marriage to a woman, Vikram will “correct” his feelings and align with their expectations.

In this reflective essay, I will begin with an overview of the importance of cultural identity in counseling and the role of the ADDRESSING model in understanding clients from diverse backgrounds. Although I share the same cultural heritage as Vikram (Hindu Indian), I personally do not adhere to the religious beliefs that Vikram’s family holds, as I identify as an atheist. This sets up a reflective approach to how my differing belief system may shape the counseling dynamic while maintaining cultural sensitivity.

Using this ADDRESSING model, we will examine two fundamental dimensions of Vikram’s cultural identity namely: sexual orientation and ethnicity. Besides, it shall shed light on two multicultural challenges presented by the case and identify culturally sensitive solutions that I adopted to address them. In addition, the essay shall apply two Best Practice Principles of Multicultural Counselling and Therapy and later on, provide personal reflections on potential challenges when working with clients from diverse backgrounds.

Cultural Identity Using the ADDRESSING Model

Applying the ADDRESSING model to Vikram’s case, I will focus on his sexual orientation and ethnicity, the two most critical aspects of his cultural identity. This model provides critical insights into the challenges faced by clients both internally and within their families, as well as a comprehensive framework that enhances the understanding of the several layers of a client’s cultural identity. Developed by Hays in 1996, this model evaluates nine key cultural influences, including Age, Developmental or other Disabilities, Religion, Ethnicity, Social Status, Sexual Orientation, Indigenous heritage, National origin, and Gender (Graham et al., 2013). The use of this model in counseling plays an essential role in helping therapists and practitioners explore the intersectionality between these aspects and how it contributes to the worldviews and experiences of the client. In Vikram’s case, the shared cultural background between him and me allows me to comprehend the deep-rooted significance of various concepts, including dharma (duty), family honor, and traditional marriage in Indian culture. These concepts aid in shaping family dynamics associated with expectations around marriage and family continuity.

Sexual Orientation

According to Chin et al. (2019), the dimension of sexual orientation of the ADDRESSING model refers to an individual a person is attracted to regardless of how they identify themselves in terms of gender. This attraction can assume various forms, including being attracted to individuals of the opposite gender (heterosexuality), being attracted to individuals of the same gender (homosexuality), being attracted to both genders (bisexuality), and other variations, including asexuality (Moleiro et al., 2015; Hays, 2016).

Vikram’s sexual orientation is a key aspect of his cultural identity and a major contributor to his internal and external conflict. His identification as gay plays a crucial role in making him experience substantial tension between his personal desires and the traditional expectations of his Indian Singaporean family. In the Indian culture, where his roots can be traced back, individuals from his community adhere to the concept of dharma, which is associated with one’s duty, ethics, morality, and righteousness, all of which affect familial expectations around marriage and societal roles (Srivastava et al., 2013). For Indian parents, including those of Vikram, marriage is more than a personal milestone as it expects males, including Vikram to fulfill and uphold family honor and lineage. Besides, in Indian culture, particularly among traditional Hindu families, marriage to a woman is very crucial as it fosters the continuation of the family line, an essential component of dharma.

In addition, in Indian culture, Khandaan ki Izzat, or else family honor is of substantial cultural significance. Vikram’s family views his sexual orientation of preferring men over women in sexual relationships despite being a man as a direct threat to their reputation and social standing. In the same light, his parents perceive his homosexuality as a deviant behavior against the norms prescribed by his culture and Hindu religion, which emphasizes heterosexual marriage as the foundation of family life. In the same light, the pressure to marry a woman notwithstanding his orientation sheds light on the cultural expectations that the client is mandated to adhere to societal norms in order to preserve his family honor, even at the cost of his happiness (Mishra & Basu, 2014).

Ethnicity

From Hay’s ADDRESSING model, ethnicity refers to the cultural heritage of an individual, including shared language, traditions, values, beliefs, customs, and religion. This dimension influences how people from a common ancestry perceive themselves and how they are viewed by others (Lewis et al., 2023).

Vikram’s ethnicity as an Indian Singaporean plays a crucial role in shaping the client’s experiences within his family and community. Traditional Indian values around Shaadi or rather marriage are deeply rooted within the worldview of his parents (Mahajan et al., 2013). In Indian culture, marriage is more than a personal decision as it is viewed as a social institution that carries expectations of fulfilling familial duties, especially for men who are expected to be the bearers of the family name. Besides, the cultural practice of arranged marriages is a reflection of the community’s emphasis on the importance of collective decision-making over individual choice. In this case, although Vikram’s parents seem to be more modern enough to allow him to enjoy the option of choosing his partner, they are still bound by the cultural expectations that his partner must be a woman. Moreover, for Indian diasporic communities, including that of Vikram, it is highly important for them to maintain cultural traditions because this is viewed as a means of preserving identity in a foreign land. For the client’s parents, this suggests that since they live in Singapore, it is essential to uphold their cultural heritage and values, including resisting Vikram’s sexual orientation due to the fear of Log Kya Kahenge or what will people say (Goel et al., 2023). This is a crucial cultural sentiment that prefers societal approval over individual happiness.

Together, Vikram’s sexual orientation and ethnicity play a crucial role in compounding his internal conflict, in that, although he is seeking to honor his cultural roots, his sexual identity conflicts with traditional values that his family has upheld. The intersectionality of his ethnicity and sexual orientation suggests that the larger Indian community perceives his sexual identity via the lens of his cultural heritage, and this contributes immensely to magnifying the expectations placed upon Vikram. For instance, the fear of Log Kya Kahenge is not limited to his immediate family as it extends into the broader Indian Singaporean diaspora where it is crucial to maintain reputation and adhere to social expectations. As such, identifying as gay is considered an affront to the cultural norms, a belief that adds shame and guilt on the client’s family. Such added pressure insinuates that ethnic identity and sexual orientation of Vikram are not isolated experiences but interconnected ones, resulting in worsening of internal and external conflicts that faces a gay man. Moreover, in Singapore, Vikram is considered both a sexual and ethnic minority, meaning there is a high likelihood of experiencing minority stress. This stress faces individuals as a result of stigmatization of their identities within their social settings (Frost & Meyer, 2023). In Vikram’s case, his sexual orientation is viewed as non-adherence to cultural expectations, resulting in increased psychological and emotional strain. Failure to meet cultural expectations and familial duty of marrying a woman can also make Vikram feel isolated, exacerbating his stress levels.

Besides, while the focus of this assessment was on Vikram’s sexual orientation and ethnicity, the other dimensions of ADDRESSING model lack impactful contribution to this case. For instance, age has no meaningful relevance considering the fact the client is at his mid-20s, which is considered an appropriate age for marriage in Indian culture. In the same light, developmental disabilities are not present in this case and the dimension of religion, while significant for client’s family, it lacks significant influence on his worldview. In addition, factors such as social status, despite having a probable influence on the pressure Vikram feels, fails to drive his internal conflict directly. Similarly, gender and indigenous heritage are not central focus in this case because they do not influence what is happening to the client. However, national origin seems to have some limited influence in this case as Indian diaspora in Singapore is held together by its traditional values.

Multicultural Challenges

In this case, multicultural challenges stemmed from differences in values, beliefs, norms, and cultures. They included cultural differences in understanding family duty and marriage, as well as navigating heteronormative cultural assumptions and client expectations.

Challenge 1: Navigating Religious and Cultural Expectations

As an atheist, I unfortunately do not hold similar religious views to Vikram’s family. However, this does not mean that I do not understand the weight and significance of religious traditions and cultural expectations of the Hindu Indian culture. Concepts such as dharma (duty) and khandaan ki Izzat (family honor) are the building blocks of the family’s worldview, and they contribute substantially to shaping the internal conflict that Vikram is experiencing. His family believes that by marrying a woman, their child is upholding their honor, and this guarantees the continuity of the family line. Besides, despite not personally aligning with these religious views, I do understand that dharma in this context is not limited to a personal obligation, but rather, it is both a moral and cultural responsibility that emotionally burdens the client.

Solutions in Navigating Religious and Cultural Expectations

Reflections

To address this challenge, I adopted the concept of cultural humility, whereby I acknowledged that my personal worldview was somehow different from that of Vikram. Following this realization, I actively engaged in learning about the Indian concepts of Dharma and the importance of marriage within its community. So as to adhere to the concept of cultural humility, I redesigned my interventions to focus on assisting the client explore methods he can adopt to fulfill his duty not only to himself but to also his family while upholding his identity. (Stubbe, 2020). In addition to cultural humility, I engaged in open conversations with Vikram, a technique that helped me explore how marriage and family honor impacted him on a personal level. Here, instead of having a general view of these concepts as external pressures, I prompted the client to consider reflecting on the level of significance and satisfaction he would gain if he fulfilled his familial duty while also assessing how such expectations conflicted with his sense of identity. By undertaking the above exploration, Vikram gained the ability to verbalize his emotions and was able to enjoy a space to articulate how deeply the expectations were undermining his self-concept and decision-making. I also adopted cognitive restructuring, a CBT technique to address the cognitive dissonance between Vikram’s sexual orientation and his family expectations. Through the use of cognitive restructuring, I challenged some of the client’s automatic thoughts associated with his duty and family honor such as “I will bring shame on my family if I don’t marry a woman” (Crum, 2021). Here, we went through alternative viewpoints, including the idea that it was possible to give honor to his family in ways that are in alignment with his authentic-self without necessarily conforming to societal expectations of marriage.  For instance, he could become more supportive and present in his family, being more respectful, and showing love to his parents in ways that showcases adherence to family unity and loyalty without needing to conform to traditional marriage expectations. We also agreed that he should have open dialogue and honest conversations regarding his identity with his family to allow them to understand his perspective.

Challenge 2: Maintaining Cultural Sensitivity Despite Personal Beliefs

I also faced challenges maintaining cultural sensitivity despite personal beliefs. Personally, how I view sexual orientation and identity is to some extent influenced by a more progressive understanding of LGBTQ+ rights. Besides, I reflected on how my atheist views could influence my biases during counseling sessions. For instance, it might be easier for me to reject the religious or societal pressure Vikram faces since I don’t personally adhere to those values. However, as a counselor, my role requires me to ensure that my personal belief system doesn’t overshadow Vikram’s experience. In addition, despite holding these views, it was important to note that the client came from a cultural setting that viewed heterosexual marriage as the norm and homosexuality as temporary confusion and a moral failing (Srivastava & Singh, 2015). These differences created tension between what Vikram expected during the therapeutic relationship and my approach as his counselor.

The solution to Maintaining Cultural Sensitivity Despite Personal Beliefs

Reflections

In order to address this challenge, I integrated psychoeducation into my approach to understanding Vikram’s cultural framework. Here, instead of trying to impose my own understanding of LGBTQ+ issues onto the client, I used the concept of cultural evolution to introduce, in a gentle manner, the idea that cultural beliefs, especially those around sexuality as ever-evolving issues. I also familiarized myself with the concept and importance of Log Kya Kahenge (what will people say) in Vikram’s life, and this allowed me to encourage him to reflect on how societal norms adapt as an understanding of sexual orientation evolves. Besides, I adopted the Social Matrix model as proposed by Kliman (2010) to understand how societal norms of heteronormality and expectations influence how Vikram views his sexual orientation, as well as perceive the broader social pressure at play (Aggarwal et al., 2022).  Besides, I employed cultural humility throughout the session to avoid overshadowing the experiences of the client. Specifically, I had to acknowledge that while I might not find it difficult to dismiss and ignore the societal and religious pressures the client was facing, I am mandated as a counselor to provide a therapeutic setting where client’s values, beliefs, and struggles are considered and honored. This allowed me to explore the complexities brought about by the conflict that Vikram was facing while making sure that my personal beliefs created no interference.

Best Practice Principles of Multicultural Counseling

In Vikram’s case, two Best Practice Principles of Multicultural Counseling and Therapy, including cultural competence and self-awareness played an essential role in promoting culturally sensitive and effective therapy between the client and myself (Gopalkrishnan, 2018).

Cultural Competence

Despite not adhering to the same religious beliefs, I focused on cultural competence by recognizing the importance of religion and familial duty in Vikram’s life. I understood that religious traditions form a core part of his family’s identity and could not be dismissed, even though they contradict Vikram’s personal truth. I made sure to respect these values while also supporting Vikram’s need for authenticity.  According to Gopalkrishnan (2018), cultural competence refers to the ability of a counselor or therapist to not only gain an understanding of but also integrate the cultural background of the client into the therapeutic process.

Ivey et al. (2002) stress that cultural competence is not limited to understanding the client’s cultural background as it mandates counselors to adapt therapy to the unique cultural nuances of the client while avoiding engaging in stereotypes that have the potential of distorting the therapeutic process.  In the case of Vikram, what being culturally competent meant for me was to recognize the significance of shaadi or marriage as well as the concept of family honor in his family’s worldview. Here, I made sure that I integrated approaches that were respectful of these deeply held values in the therapeutic process while still supporting his need for authenticity. Following this, I acknowledged that marriage I Indian culture is more than a personal decision because it is intertwined with familial and social expectations. Learning about the value of familial duty and marriage in the client’s context played a crucial role in allowing me to frame our discussions in ways that placed respect for his parents’ beliefs while asserting his identity.

Besides, I avoided making assumptions about Vikram’s sexual identity and how he navigated cultural expectations of his family. For instance, despite knowing that traditional Indian families prioritize heterosexual marriage as the cornerstone of family honor, I made a conscious effort of refraining of making assumptions about how the client personally felt about these expectations. Alternatively, I asked open-ended questions and prompted Vikram to assess his feelings about marriage, duty, and sexual identity, a process that allowed him to define these experiences in his terms.

I ensured my therapy sessions were culturally sensitive by paying special attention to non-verbal communication and cultural cues from the client. This was informed by the recognition that direct confrontation about LGBTQ+ issues and traditional values has the possibility of being ineffective, considering Vikram’s cultural background. As such, I had to approach these topics with cultural humility, and this was characterized by the use of metaphors and language that matched with his cultural understanding and respected his emotional experiences such as dharma and khandaan ki Izzat.

Self-awareness

Self-awareness is another best practice principle which is emphasized by Ivey et al. (2002) when dealing with clients from different cultural backgrounds. It often involves recognizing one’s cultural biases and assumptions (Meyer & Young, 2021).  While working with Vikram, I recognized the need to be self-aware of my atheist worldview and how it might create bias. For example, I might instinctively want to validate Vikram’s rejection of religious and cultural norms, but my role as a counselor requires me to explore both sides of his conflict—his sexual identity and his family’s cultural beliefs. I engaged in self-reflection to ensure that my atheist views did not inadvertently affect the therapeutic process, and I considered seeking supervision to check for any unintentional biases. These discussions played an essential role in helping me reflect on my own biases and consider the role my beliefs, including my atheist views and my perception of LGBTQ+ issues could play in shaping our therapeutic relationship. Consulting with supervisors and peers contributed significantly to allowing me maintain an approach that is not only neutral but also client-centered.

As a counselor, I was also mandated to be mindful of this by refraining from imposing Western-like individualistic values on the client’s situation where the collective happiness of the family is given more priority over individual desires. In the same light, I acknowledged the risk of being over-empathetic with Vikram’s struggles because such actions have the potential to shift the focus away from understanding the cultural framework of his parents. Being self-aware enabled me to create a balanced therapeutic setting where the client felt supported in his identity without compromising the respect for his family values, and this facilitated culturally sensitive dialogue that considered the intersectionality of the client’s cultural background and personal identity.

Personal Reflection

Reflecting on how my shared cultural background but differing beliefs affected my approach to counseling Vikram, I realize that:

On one hand, my Hindu Indian heritage allows me to have a deeper understanding of the cultural and familial expectations Vikram faces, especially the emotional conflict that arise from family honor (khandaan ki Izzat) and personal authenticity. Family duty or dharma and family honor are of great importance in our shared culture as they not only guide individual behavior but also dictate how the family and broader Indian community both from Indian and diaspora view an individual. This recognition allowed me to empathize with the pressure Vikram was feeling to observe these expectations as we are introduced to them from an early age, influencing all major life decisions, including around marriage and sexuality.

On the other hand, my atheist beliefs allow me to tend more towards rejecting these cultural norms specifically because I feel as if they are conflicting individual self-expression, which in this case is Vikram’s sexual orientation. Being outside of these religious and cultural frameworks mean that there is a possibility of viewing culturally pressures around dharma and family honor as not only outdated but also restrictive. This is especially the case when they result in repression of an individual’s sexual identity. Nonetheless, as a counselor, I am mandated to refrain from imposing my personal views on the therapeutic process. Following this, I had to suppress my own beliefs and focus on the client’s values while recognizing that for Vikram, reconciling his sense of duty with his sexual identity was not a choice between two paths, but instead, a complex conflict that carried the weight of generations of tradition.

Working with Vikram played an essential role in improving my personal growth. Specifically, it deepened my understanding of cultural humility. Here, I was reminded that multicultural counseling presents complex challenges that require counselors to balance empathy with cultural sensitivity. For instance, although I was allowed to empathize with Vikram’s personal struggle to live an authentic life as a gay man, I had the responsibility of respecting the cultural framework that made it challenging for him to do so. Gaining an understanding of ikram’s conflict had crucial requirements, among them listening to his personal narrative and fully appreciating the emotional value cultural and familial expectations have in shaping his decisions. In addition, the experience I had with Vikram’s case reinforced criticality of self-awareness in my own practice. Here, I was able to realize that my worldview which is mainly influenced by my atheist beliefs and more individualistic perspective had the capacity to unconsciously affect the way I approach my counseling. This has reminded me of the importance of taking part in regular reflection and supervision, all of which are essential in identifying potential biases in good time.

Critical Analysis

I critically analyzed how my own belief system as an atheist might lead to unconscious biases. For instance, I may feel less connected to the religious pressure Vikram faces and more aligned with his need for personal freedom. However, I actively mitigated these biases by practicing cultural humility and competence throughout the therapeutic process. Reflecting on the power dynamics in the counseling relationship, I noticed that my shared cultural background with Vikram could create a sense of understanding, but our differing religious beliefs also presented potential challenges. I considered whether I found myself more aligned with Vikram’s desire for authenticity, or whether I struggled to fully grasp the weight of his family’s religious expectations. This reflection highlighted the importance of being aware of how power dynamics can shift based on shared or differing beliefs.

Conclusion

In conclusion, this case highlighted the complexity of working with clients from shared cultural backgrounds, especially when personal belief systems differ. I learned that being culturally competent requires recognizing the client’s worldview, even when it conflicts with my own beliefs. This experience has shaped my counseling philosophy, emphasizing the need for self-awareness, supervision, and cultural humility as essential components of multicultural counseling. Moving forward, I will continue to reflect on my personal beliefs and how they may affect my practice, ensuring that the client’s unique cultural context remains at the forefront of therapy.

References

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Chin, G., Anyanso, V., & Greeson, J. (2019). Addressing diversity in mindfulness research on health: A narrative review using the addressing framework. The Cooper Rowan Medical Journal, 1(1). https://doi.org/10.31986/issn.2578-3343_vol1iss1.1.2

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