TPC-Journal-V2-Issue2

The Professional Counselor \Volume 2, Issue 2 117 Impact of Globalization on Counseling Heppner (1997) suggested that counseling “can play an important role in building a global village that helps people improve their well-being, alleviate distress and maladjustment, resolve crises, modify maladaptive environments, and increase their ability to live more highly functioning lives” (p.7). While we recognized the importance of considering cross-cultural understanding as counselors take on an international role, we must continuously ask who will define more highly functioning . Leung (2003) acknowledged the ethnocentric bias of Euro-American assumptions inherent in traditional counseling theories. For example, regarding attachment theory, You and Malley-Morrison (2000) confirmed the traditional definition of healthy attachment did not transfer to Asian cultures. The researchers found Korean students to score higher on the preoccupied attachment compared to American students. With an ethnocentric view, counselors might mistakenly believe they should promote the “higher functioning” secure attachment style; however, in Asian collectivistic cultures where there is greater value placed on others than the self, attachment styles present differently due to different interpretations and meanings associated with parent-child interactions (Rothbaum, Rosen, Ujie, & Uchida, 2002; You & Malley-Morrison, 2000). It also is important to understand how globalization can impact the counseling field at the macro level as well as at the micro level where individuals are affected in ways that are relevant to counselors. In the following section, we examine three ways in which globalization may have an impact on the counseling field and on the people living in international communities. First, we will explore how globalization impacts the transfer of Western values transnationally; which in turn influences the local cultures’ ideas and experiences of mental health and wellness. Second, we will consider the commoditization of the helping relationship and how it translates internationally. Finally, through the globalization lens, we consider the issues with access and the structural limitations of international counseling. Global Mental Health and Wellness Early studies suggested that mental health services which were rooted in White middle-class value systems led to the misdiagnosis of racial/ethnic minorities (Adebimpe, 1981; Mukherjee, Shukla, & Woodle, 1983), decreased quality of care for racial/ethnic minorities (Ridley, 1989; Sattler, 1977; Sue 1977), and higher rates of premature termination among racial/ethnic minority clients (Ridley, 1989; Romero, 1985; Sue 1977; Yamamoto, James, Bloombaum, & Hattem, 1976). Given these documented dangers of ethnocentrism within U.S. borders, and because the local is transformed by the global in the process of globalization (Tomlinson, 1999), it is important to examine how the Western ideas of mental health and illness impact local-international communities. There are several ways in which the local is transformed by the global regarding the mental health and wellness of individuals in international communities. First, the spread of Western notions of mental health can change how symptoms are conceptualized and manifested in local-international communities. Watters (2010) examined how the U.S.’s influence over the rest of the world does not simply impact the economic realms of individuals’ lives, but he also explored how the mental illness landscape of the world is changing as well to reflect Western ideas. For example, he interviewed Dr. Sing Lee, a Chinese eating disorder researcher, who explained that prior to the early 1990’s the local version of anorexia nervosa in Hong Kong presented differently in clients than those from the Western version. He called the local version nonfat phobic anorexia because the girls who exhibited the symptom of restricted eating did not also express the symptom of fear of being overweight, like the Western version of the disorder required. However, between 1998 and 2007 there was a significant increase in the number of cases that conformed to the traditionally Western fat phobic version of the disorder compared to the previous decade (Lee, Ng, Kwok, & Fung, 2010). The authors stated that their findings indicated “that the clinical presentation of eating disorders in Hong Kong has gradually conformed to the frequency of occurrence of eating disorders as found in Western communities” (p. 313). Scholars have attributed this trend to the influence of the West. Watters (2010) suggested media coverage of Western mental health clinicians’ perspectives of the diagnostic symptoms of anorexia, which included the fear of gaining weight may have contributed to the shift in the presentation of symptoms. Watters suggested interviews with experts could have introduced an idea of a mental illness that was not present before, providing a new culturally acceptable symptom for psychological disturbances to be expressed by young women and girls in China. Pike and Borovoy (2004) similarly