TPC-Journal-V2-Issue2

The Professional Counselor \Volume 2, Issue 2 119 as a White middle-class activity that often fails to recognize the economic implications in the delivery of mental health services” (p. 97). While the counseling relationship can be very powerful and a catalyst for change, the authors are aware of and respect the counterintuitive aspects of the commoditization of this relationship. In line with the Western capitalistic framework it makes sense to charge for the services and time provided, and seems natural to translate these intimate exchanges into intimate economies. However, as the authors re-examine this phenomenon under the lens of globalization, they believe counselors should be wary of this aspect as the counseling profession develops in communities where capitalism is not the dominant world view and where the private sector of the home and family are more valued. Not only could these economic exchanges affect how the counseling relationship is viewed and experienced, but also how counseling is accessed. In the following section we will further address the access and structural limitations of counseling. Access and Structural Limitations Scholars have reported the fact that individuals from culturally diverse backgrounds are not as likely to seek counseling and that when counseling is used, these clients tend to terminate more rapidly (Atkinson, 2004; Sue & Sue, 2003). Atkinson outlined many reasons for the under-utilization of services and discussed cultural mistrust, social stigma associated with mental illness or counseling seeking behavior, the counseling process all together, and limited access (Atkinson, 2004). Counselors are increasingly aware of how inequity, discrimination and oppression adversely affect the lives of clients, and how these injustices can be systemically perpetuated by well-meaning individuals in privileged groups (Arredondo & Perez, 2003; Crethar, Torres-Rivera, & Nash, 2008). Many social justice and advocacy efforts continue to fight on the local, state, and federal level for services to be more accessible for all. Atkinson (2004) reported that many low-income ethnic minorities must rely on public and nonprofit mental health services since they often do not have insurance that covers these types of services. Structural barriers such as transportation, hours of operation, and child care, as well as emotional barriers such as fears about being judged, also can create limitations for people with fewer resources to access counseling (Anderson et al., 2006). Toporek (2009) noted that there is a history of inadequate service for marginalized populations and “oppression, discrimination, inequitable policies, and lack of access and resources create environmental barriers that permeate mental health and well-being” (p.12). By ignoring these structural barriers and avoiding advocating for change in these greater systemic arenas, counselors end up colluding with the oppressive system (Toporek). Given that these limitations are present in the U.S., the concepts of access and affordability are extremely important when discussing counseling in international spaces as well. We caution that services offered without issues of access taken into account may leave those people with the greatest need without services. If counseling is structurally established internationally with a similar economic model, and if there is limited structural support for public sponsored programs, then we risk providing services only to those with the most means. As advocacy efforts are attended to in the U.S., counselors will need to attend to similar systemic barriers internationally as well, by addressing social and socio-economic factors that may create limitations. While considering these structural limitations for clients, it also will be important to consider how counselors are paid for their services if counseling is to grow as a profession in international communities. While the U.S. relies on private pay, insurance, governmental and private nonprofit agencies, and sliding scales, for countries that do not have a managed care system, counselors may need to advocate for their role to be added as an official job position in their vocational system. Implications for the Counseling Field Given the potential impact globalization can have on the counseling field and the international communities counselors will serve, an expansion of the multicultural competencies that include an international or more global perspective of counseling is needed (Chung, 2005). Sue and Sue (2003) encouraged counselors to broaden their understanding of multicultural counseling methods of treatment to include informal or natural systems of support, alternative healing