Theory and Practice of Counselling

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

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Theory and Practice of Counseling - PSY632
Lesson 10
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
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
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
­ 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.
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
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
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:
Work and leisure
Activity 1: Assessing Your Personal Characteristics
Personal presence
Compassion & empathy
Flexibility & willingness to receive feedback
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.
Table of Contents:
  1. INTRODUCTION:Counseling Journals, Definitions of Counseling
  3. HISTORICAL BACKGROUND 1900-1909:Frank Parson, Psychopathic Hospitals
  4. HISTORICAL BACKGROUND:Recent Trends in Counseling
  5. GOALS & ACTIVITIES GOALS OF COUNSELING:Facilitating Behavior Change
  7. ETHICAL & LEGAL ISSUES IN COUNSELING:Keeping Relationships Professional
  8. EFFECTIVE COUNSELOR:Personal Characteristics Model
  9. EFFECTIVE COUNSELOR:Humanism, People Orientation, Intellectual Curiosity
  10. EFFECTIVE COUNSELOR:Cultural Bias in Theory and Practice, Stress and Burnout
  11. COUNSELING SKILLS:Microskills, Body Language & Movement, Paralinguistics
  14. LISTENING & UNDERSTANDING SKILLS:Barriers to an Accepting Attitude
  15. LISTENING & UNDERSTANDING SKILLS:Suggestive Questions,
  16. LISTENING & UNDERSTANDING SKILLS:Tips for Paraphrasing, Summarizing Skills
  17. INFLUENCING SKILLS:Basic Listening Sequence (BLS), Interpretation/ Reframing
  18. FOCUSING & CHALLENGING SKILLS:Focused and Selective Attention, Family focus
  19. COUNSELING PROCESS:Link to the Previous Lecture
  20. COUNSELING PROCESS:The Initial Session, Counselor-initiated, Advice Giving
  21. COUNSELING PROCESS:Transference & Counter-transference
  24. CLASSICAL PSYCHOANALYTIC APPROACH:Psychic Determination, Anxiety
  25. NEO-FREUDIANS:Strengths, Weaknesses, NEO-FREUDIANS, Family Constellation
  26. NEO-FREUDIANS:Task setting, Composition of Personality, The Shadow
  27. NEO-FREUDIANS:Ten Neurotic Needs, Modes of Experiencing
  28. CLIENT-CENTERED APPROACH:Background of his approach, Techniques
  29. GESTALT THERAPY:Fritz Perls, Causes of Human Difficulties
  30. GESTALT THERAPY:Role of the Counselor, Assessment
  31. EXISTENTIAL THERAPY:Rollo May, Role of Counselor, Logotherapy
  34. TRANSACTIONAL ANALYSIS:Eric Berne, The child ego state, Transactional Analysis
  35. BEHAVIORAL APPROACHES:Respondent Learning, Social Learning Theory
  36. BEHAVIORAL APPROACHES:Use of reinforcers, Maintenance, Extinction
  37. REALITY THERAPY:Role of the Counselor, Strengths, Limitations
  38. GROUPS IN COUNSELING:Major benefits, Traditional & Historical Groups
  39. GROUPS IN COUNSELING:Humanistic Groups, Gestalt Groups
  40. MARRIAGE & FAMILY COUNSELING:Systems Theory, Postwar changes
  41. MARRIAGE & FAMILY COUNSELING:Concepts Related to Circular Causality
  42. CAREER COUNSELING:Situational Approaches, Decision Theory
  44. DIAGNOSIS & ASSESSMENT:Assessment Techniques, Observation
  45. FINAL OVERVIEW:Ethical issues, Influencing skills, Counseling Approaches