A Relational-Cultural Framework: Emphasizing Relational Dynamics and Multicultural Skill Development

Kristopher G. Hall, Sejal Barden, Abigail Conley

Increases in diverse clientele have caused counselor education to enhance its focus on multicultural pedagogy, using the Tripartite Model (TM) to impart multicultural learning. While knowledge and awareness are important, it also is important to enhance skill development in counselors-in-training. Counselor educators have a unique opportunity to blend knowledge and awareness with skills learned in counseling techniques courses by incorporating microskills training in the multicultural classroom. Additionally, other theories, such as Relational-Cultural Theory (RCT), can be used as a framework to merge the TM and microskills. This article includes an overview of RCT, a brief history on microskills training and a case study to integrate the two concepts for use in counselor training. The reader should begin to see how microskills, RCT and the TM can serve to enhance skill development in the multicultural classroom.

Keywords: microskills, multicultural, Relational-Cultural Theory, counselor education, pedagogy

Counseling as a profession espouses the need for counselors to be culturally competent, as evidenced by the inclusion of diversity training in preparation standards (Council for Accreditation of Counseling and Related Educational Programs [CACREP], 2009) and in ethical standards (American Counseling Association [ACA], 2005). According to the 2009 CACREP standards, an institution must provide instruction that includes “an understanding of the cultural context of relationships, issues, and trends in a multicultural society” (Section II, Code G.2, p. 10). Although the importance of multicultural competence is supported in preparatory and ethical standards, current pedagogical practices may be ineffective as graduates of counseling programs frequently report feeling unprepared to effectively work with culturally diverse clients (Bidell, 2005; Bidell, 2012; Rock, Carlson, & McGeorge, 2010). Therefore, counselor educators need to consider how to more effectively meet the challenge and responsibility of cultivating cultural competence for counselor trainees by focusing on increasing skill development (Cates, Schaefle, Smaby, Maddux, & LeBeauf, 2007; Dickson & Jepsen, 2007; Hays, 2008).

Priester et al. (2008) conducted a content analysis of 64 introductory master’s-level multicultural course syllabi to understand the content of contemporary multicultural courses. The authors collected the syllabi by examining counseling program Web sites and contacting the instructor of record. Results indicated high emphasis in multicultural knowledge across syllabi, with over 84% of the syllabi highly emphasizing knowledge and moderate emphasis on self-awareness, with 41% of syllabi emphasizing self-awareness and a significantly lower emphasis of skill acquisition, and with only 12% of syllabi emphasizing skill development. Findings highlight relatively high emphasis on knowledge when working with culturally diverse groups and markedly lower levels of skill acquisition, potentially perpetuating the issue of counselor graduates not feeling adequately prepared. Although knowledge and self-awareness are critical components in developing cultural sensitivity, it is imperative to teach counselor trainees skills that will aid them in therapeutically connecting with their clients (West, 2005).

Counselor preparation programs are responsible for training students how to work with clients from all backgrounds; however, multicultural pedagogy has been found to be lacking in key areas (Braden & Shah, 2005), including focusing primarily on obtaining multicultural knowledge and awareness related to working with diverse groups, while failing to reinforce training in discrete skills (Priester et al., 2008). Knowledge alone does not lead to behavior or attitude change among counselor trainees and may actually reinforce culturally insensitive practices (Alberta & Wood, 2009; Arredondo & Toporek, 2004), creating a significant gap in education; while counselors-in-training are taught effective practices for personal multicultural development, they may not be given the necessary skills to use their new knowledge with diverse clients. Therefore, it is imperative to introduce new theories and integrate current theories into counselor education curricula to ensure that students are receiving well-rounded instruction in relation to multicultural competence.

To this end, the purpose of this paper is to highlight the use of RCT (Miller, 1986) as a vehicle to develop skills and integrate existing emphasis of knowledge and awareness in multicultural courses. The authors will begin with a brief overview of multicultural pedagogy and current approaches to multicultural instruction, followed by an introduction to microskills and a brief overview of RCT. The manuscript will close with a case study which integrates the concepts of the TM, microskills, RCT, implications for the field of counseling and conclusions.

 

Multicultural Pedagogy

 

As counseling professionals have become more aware of the complexity and interactions of culture on counseling relationships (Daniel, Roysircar, Abeles, & Boyd, 2004), several models have been developed that make recommendations for what constitutes a culturally competent counselor (Buckley & Foldy, 2010; Collins & Arthur, 2010; Sue, 2001). Although these models were pioneered by recognized experts in the field of multiculturalism, many authors agree that the central model in the field remains the TM, developed by Sue, Arredondo and McDavis (1992) (Holcomb-McCoy & Myers, 1999; Mollen, Ridley, & Hill, 2003). The TM has influenced major counseling bodies such as ACA and CACREP, standardizing multicultural content in counselor training ethics and accreditation (Holcomb-McCoy, 2000). Additionally, the TM has largely influenced current literature on multicultural pedagogy, placing considerable emphasis on teaching multicultural knowledge, skills and awareness to counselors-in-training (Hipolito-Delgado, Cook, Avrus, & Bonham, 2011). Essentially, the TM asks that counselors (a) have the necessary cultural knowledge of the population they will be assisting; (b) be aware of any cultural biases that the counselor may have regarding the client’s culture and biases their client may have due to the counselor’s perceived culture; and (c) have the necessary skills to assist clients of that particular culture, including understanding when to refer to more knowledgeable colleagues.

The TM has been refined on three occasions (1992, 1996, 2001), but past refinements have failed to address some of the major limitations of the model (Arredondo et al., 1996; Sue, 2001; Sue et al. 1992). Criticisms of the model are based on the lack of supporting literature to ground the three-dimensional model, difficulty measuring the factor structure of the model, and lack of relevance for practical application (Constantine, Gloria, & Ladany, 2002). Furthermore, although the TM provides a helpful framework in conceptualizing multiculturalism, it fails to highlight the importance of the therapeutic alliance when working with clients from diverse backgrounds. Extensions and applications of the TM include the development of the multicultural competencies (Sue et al., 1992). While the multicultural competencies highlight the importance of considering culture when developing the relationships, they fail to offer requisite skills that are necessary when developing relationships with culturally diverse clients. For example, the authors espouse using the model to “promote culturally effective relationships, particularly in interpersonal counseling” (Arredondo et al., 1996, p. 55); however, the competencies emphasize only that diverse relationships should be considered, not how they are to be achieved. Given that the TM is the preeminent model in which most multicultural courses are grounded, emphasis on relationships between the client and counselor and relationships between minority clients and majority society is minimal, highlighting the need for alternate conceptualizations and models that emphasize the therapeutic alliance (West, 2005).

Researchers suggest that often counselors teach clients how to best operate within the majority culture, failing to address the significance of contextual factors (e.g., socioeconomic status, education, literacy) that may be related to client distress (e.g., Comstock et al., 2008). When contextual factors are overlooked, the counselor and client are at increased risk for perpetuating cultural misunderstandings and negative attitudes toward counseling (Hartling, Rosen, Walker, & Jordan, 2000). Specifically, failing to attend to contextual factors may lead to disconnection, feelings of being misunderstood, and potential for weakening the therapeutic alliance, which increases the likelihood for treatment withdrawal (Duffey & Somody, 2011). In sum, there is heightened importance for multicultural pedagogy to increase focus on the relational and contextual factors when working with clients from diverse backgrounds. Therefore, it is imperative to teach counselors-in-training specific skills regarding how to be attentive to contextual factors.

Researchers (Roysircar, Gard, Hubell, & Ortega, 2005; Sodowsky, Kuo-Jackson, Richardson, & Corey, 1998) have found that exposure to varied multicultural experiences—both inside and outside of the classroom—increase various aspects of multicultural competence. Sodowsky et al. (1998) assessed multicultural competence while controlling for social desirability, race and attitudes of social inadequacy and locus of control. The authors found that multicultural training variables including minority client load, number of research projects, and multicultural training courses significantly contributed to overall multicultural counseling competency. In another study, Roysircar et al. (2005) used a mentoring program in which counseling students in a multicultural course were exposed to middle school students in an English as a Second Language course to develop trainee multicultural awareness. Counseling students in the study reported increased multicultural awareness as a result of the exposure to different cultures (Roysircar et al., 2005). It can be inferred from these studies that the inclusion of multicultural experiences during counselor training can contribute to student development in regard to the TM.

In sum, counselor educators have adapted to CACREP requirements through the application of several teaching models for multicultural competency including didactic (Abreu, 2001; Kim & Lyons, 2003) and experiential (Platt, 2012; Tomlinson-Clarke & Clarke, 2010) models for teaching multicultural competence. However, the efficacy of many of the existing models is unknown. Therefore, it may be helpful to employ a common standard across counselor education curricula to ensure that counselors-in training are receiving similar emphasis on the development of multicultural knowledge, awareness and skills. This common standard already exists in the microskills training that are used in counseling techniques courses.

 

Microskills

Microskills training is the primary pedagogy used in counselor education training. Counselors-in-training are taught the building blocks of counseling through discrete skills used to simplify abstract concepts (Mollen, Ridley, & Hill, 2003). The training model was developed as a result of work began by Truax and Carkuff (1967), who noticed that beginning and highly experienced counselors were equally skilled in facilitating therapeutic change, an anomaly given an experienced counselor’s increased time in the field. The authors concluded that counseling students were being taught the importance of the relationship in counseling, but not how it is achieved; therefore experienced counselors had the knowledge base but lacked the ability to demonstrate respective skills. Ivey (1971) continued the work of Truax and Carkuff and coined the term microskills or “communication skill units of the [counseling] interview that will help [the student] interact more intentionally with a client” (Ivey & Ivey, 2003, p. 22). Microskills has been the preeminent method of counselor training for over 40 years, with over 450 studies completed on microskills training, highlighting the strong empirical base supporting its utility in counselor education (Ridley, Mollen, & Kelly, 2011). Although microskills are well researched and supported, the need to adapt these core counseling skills when working with diverse clients is not clear. Therefore, we, the authors, propose integrating RCT with microskills training to best meet the needs of diverse mental health clients.

 

Relational-Cultural Theory: A Fresh Perspective

 

Counselors are faced with an increased challenge to find ways to relate to diverse clients and build strong therapeutic alliances (Constantine, Hage, Kindaichi, & Bryant, 2007; Owen, Tao, Leach, & Rodolfa, 2011). While it is not feasible for counselors to understand the idiosyncrasies of every culture, it is possible to increase attention to cultural and contextual factors when building the therapeutic alliance (Vasquez, 2007). Furthermore, researchers have suggested that successful counseling must include empathic relationships that are culturally sensitive in nature and that employ techniques grounded in mutual empathy, defined as a mutual exchange of empathic experiences during the counseling session (Comstock, 2005; Duffey & Somody, 2011; Fuertes et al., 2006). Therefore, it is imperative for counselor educators to focus on emphasizing culture and empathy, and how to build therapeutic alliances when teaching counselor trainees to be culturally sensitive. An overview of RCT will be explored as a framework for incorporating the strategies of multicultural pedagogy, strong therapeutic alliance and mutual empathy into counseling with diverse clients.

 

Overview of RCT’s Basic Tenets

Similar to multicultural theories, RCT is grounded in feminist theory. The theory was developed at the Stone Center for Women in 1977 through weekly meetings with Jean Baker Miller, Irene Stiver, Judith Jordan, and Janet Surrey (Jordan, 2008; West, 2005). Miller’s (1986) book, Towards a New Psychology of Women, solidifies the ideas presented at these meetings and establishes a formal introduction of RCT. Theoretical underpinnings of RCT are grounded in the notion that primary counseling theoretical orientations placed unnecessary blame on the clients for their problems and did not account for the importance of relationships and contextual factors (West, 2005). Therefore, RCT was developed as a theory that emphasizes relationships and external factors, as opposed to focusing on internal pathology and mental illness. RCT states that individuals develop through mutually empowering relationships with others, asserting that the relationship, not autonomy, is the key to growth (Duffey & Somody, 2011). Furthermore, RCT highlights the importance of mutuality and authenticity between client and counselor, both gaining from shared experiences and leaving with a deeper understanding of themselves and the other person’s perspective (Duffey & Somody, 2011).This mutual growth experience begins with the formation of relational images (West, 2005).

Relational images, defined as internal relational schemas or beliefs about an individual’s relationships, are formed from experiences throughout the lifespan (Miller & Stiver, 1997). Positive or negative images form related connections or disconnections within the individual, resulting in the formation of relational images (Miller & Stiver, 1997; Napier, 2002). As individuals move throughout the lifespan, relational images are either confirmed or denied by various experiences. When an event is mutually empowering, it is referred to as a connection (Miller & Stiver, 1997). Conversely, when a person’s experiences are in conflict with their relational images or when they are not mutually beneficial and empowering, they experience disconnections (Napier, 2002). Continuous damage to relational images may lead to negative beliefs including self-blame, isolation and immobilization (Jordan, 2001). Counselors may be at risk of weakening the therapeutic alliance by reinforcing disconnections or by neglecting the cultural context of the client’s concerns (Duffey & Somody, 2011).

Disconnections are an expected occurrence and are necessary for growth (Jordan, 2008). However, constant disconnections can damage the client’s relational images, possibly leading to counseling as a result of feelings of shame, confusion and decreased self-worth (Napier, 2002). When clients successfully move through disconnections, they may experience relational growth or relational resilience. Relational resilience refers to the ability to alter relational images and rebound from disconnection. Clients who experience relational resilience are more able to reconnect to others by increasing mutuality in relationships such as mutual support and growth (Duffey & Somody, 2011). In summary, RCT suggests that all persons seek connections, but internalized feelings may cause them to continually disengage as a mode of self-protection, resulting in a relational paradox; therefore, counselors can use the therapeutic alliance to reframe disconnections and reconstruct relational images (Miller & Stiver, 1997).

Counselors are well-positioned to facilitate dialogues with clients regarding relational disconnections, by discussing reasons and causes for disconnections and enabling the client to avoid placing complete responsibility or blame on their internal self. RCT suggests that the best way to realign and strengthen new relational images is through the therapeutic alliance (Jordan, 2008). The therapeutic alliance gives the client the opportunity to establish positive connections and repair relational distortions (West, 2005). By establishing a strong therapeutic alliance, the counselor provides an environment in which the client is able to begin reconnecting with his/her true self and demonstrating this behavior outside of counseling (Banks, 2006). Freedburg (2007) suggested that clients benefit when they can see their counselor as a fully dimensional human being, encouraging the client to carry the skills learned in therapy back into the real world. Therefore, the client must see the counselor as a mutually engaging human being who sees the client in a way that others have not.

In addition to emphasizing the therapeutic alliance, the use of mutual empathy in RCT encourages counselors to allow themselves to be affected by their client and share their experiences with clients when appropriate (Duffey & Somody, 2011). Mutual empathy also can be taught and reinforced during clinical internship/practicum. RCT suggests that counselors express their connections with their clients and invite feedback about how this has impacted the client (Comstock et al., 2008). During training counselor educators can illuminate instances where mutual empathy could be implemented in the counseling session. Additionally, RCT can be taught in conjunction with the ideas regarding authenticity in counseling. One-way empathy is considered a barrier that blocks authenticity due to creating a more contrived relationship, whereas counselors should instead strive for a relationship based on mutual respect, maximizing possibilities for relational equality and desires for emotional connectedness (Freedburg, 2007). Abernethy & Cook (2011) state that authenticity in counseling with RCT opens up both the client and the counselor to connect in a safe environment. This safe environment is important for multicultural understanding, as researchers (e.g., Comstock et al. 2008) have indicated that minority clients tend to feel disconnected in therapy due to feelings of being misunderstood by majority culture.

The goal of RCT in therapy is to first change negative self-images through mutual empowerment and mutual empathy (West, 2005). The counselor seeks to understand the reasons for relational disconnections and assist the client in repairing their distorted views of the relational process (Miller & Stiver, 1997). For example, a client’s thoughts may change from “I could not make connections, so I am wrong” to “I could not make connections, so the connection is wrong.” Change is achieved through genuine and authentic connections between the client and the counselor, grounded in mutual empathy and mutual exchange of ideas on the direction of treatment and goal setting (Duffey & Somody, 2011; West, 2005).

 

RCT and Counselor Training

RCT is a practical model which counselor educators can use to integrate multicultural knowledge with skill development through the use of mutual empathy to enhance the therapeutic alliance. Given that relationships between the clients and counselors have been found to be one of the most important aspects of the therapeutic alliance and a consistent predictor of client outcomes, it is clear that there is primacy for the therapeutic alliance when teaching multicultural counseling (Baldwin, Wampold, & Imel, 2007; Castonguay, Constantino, & Holtforth, 2006). RCT emphasizes that individuals grow through their relationships with others and that the primary therapeutic goal is for the client to move out of perceived isolation (Duffey & Somody, 2011). By infusing RCT into multicultural courses, trainees may be better suited to form strong therapeutic alliances and demonstrate culturally appropriate forms of empathy when working with clients from diverse backgrounds. By encouraging counselor trainees to pay increased attention to contextual factors and relationships that may be impacting the client, trainees may have more insight and ability to empathize with their clients (Comstock, 2005; West, 2005). West (2005) suggests that by acknowledging external relationships and contextual factors, clients may feel more engaged in the counseling process, helping to reinforce the therapeutic alliance.

 

Integrating RCT, the TM, and Microskills Training

 

Microskills exist as the basis of counselor skill training and are widely used throughout the profession. These skills are carried through the counseling curricula into other courses, reinforcing and developing these basic skills to proficiency. Additionally, counselor educators have attempted to integrate the TM into multicultural training, following accreditation (CACREP, 2009) and ethical code (ACA, 2005) revisions. RCT can be used as a vehicle to blend both microskills and the TM to reinforce and simplify multicultural teaching strategies. Below is an overview of the ways that the TM, microskills and RCT can be combined for multicultural training.

 

Knowledge

The knowledge portion of the TM encourages multiculturally competent practitioners to gather information regarding the cultural and environmental histories of their clients (Arredondo et al., 1996). This information gathering allows practitioners to create a well-informed picture of client issues for accurate assessments and goal setting. RCT also espouses cultural knowledge through its belief in the client worldview. Client worldviews are important as they give detail to how clients interpret life events and how they form the basis of connections and disconnections (Jordan, 2001).

Understanding worldview can be achieved through targeted, open-ended questioning, which was first introduced during counseling skills courses. Rodriguez and Walls (2000) introduced the concept of culturally educated questioning, in which practitioners use knowledge-based questions to gather information relevant to treatment. Information from previous questions is used to build on more focused questions for a deeper understanding of the client. This concept can be tied into RCT by teaching counseling students to ask future clients questions specific to RCT concepts, including significant relationships and power structures.

 

Awareness

Multicultural awareness entails understanding how the counselors’ cultural history may impact their clients (Arredondo et al., 1996). It is important for practitioners to understand how their multicultural makeup (e.g., race, gender, age) may have a bearing on the counseling relationship due to the client’s experiences with these factors outside of counseling, as cultural mistrust has been identified as a barrier to treatment in minority clients (Duncan & Johnson, 2007; Whaley, 2001). RCT encourages practitioners to be aware of the power-over structures, which may exist within the relationships presented by the client (Jordan, 2008). Power-over structures include culturally relevant systemic issues that may affect client functioning, creating constant disconnection due to an effort to assimilate into majority culture (Jordan, 2008). It is important for counselors to be aware of how their role as the counselor and the hierarchical nature of the counselor-client relationship may affect the therapeutic alliance. Therefore, counselor educators can remind students of the importance of the relationship development from the onset of the counseling experience.

 

Skills

From a microskills perspective, counselor educators can remind students of the necessity of relationship building with clients as a foundation for therapeutic engagement. Rogers (1951) asserts that the counseling relationship is a key component for client growth and should be attained before interventions are begun. Young (2012) asserts that students should begin by establishing liking, respect and trust, which leads to client communication and openness. As reinforcement, RCT encourages practitioners to engage in authenticity with clients to create deeper engagement and to demonstrate positive connections that can be repeated outside of counseling (Jordan, 2008). Through the development of the relationship, clients and counselors work to decrease the hierarchical nature of the relationship. Counselor educators use microskills training to teach counselors-in-training to use empathy as a method for connecting to clients and to understand issues from the client’s frame of reference (Ivey & Ivey, 2003). RCT goes a step further with its emphasis on mutual empathy, a technique to allow the client to see, hear and feel that their story has affected the counselor (Jordan, 2001).

Mutual empathy has many similarities to the widely accepted definition of empathy; however, a few key differences exist. Mutual empathy requires that the counselor allow themselves to be affected by the client because detachment may interfere with therapeutic healing (Duffey & Somody, 2011). Mutual empathy is demonstrated by continually checking in with the client through empathic exchange, enabling the counselor to better understand the client’s worldviews and inviting the client to react to the mutual exchange. Allowing the client to react to the exchange constitutes the difference between mutual empathy and empathy, with the counselor inviting the client to engage in empathic exchange instead of the counselor simply making empathic statements. Counselor educators can reinforce this behavior in the classroom by teaching students to request client reactions to certain empathic statements. The act of mutual empathy can create a more meaningful relationship by encouraging both client and counselor to fully participate in the exchange and feel the impact that each participant has on the other (Freedburg, 2007). For example, after making an empathic statement, trainees can be requested to respond based on the empathic statement from the client in order to demonstrate mutual empathy.

In conclusion, infusing central tenets of RCT in multicultural pedagogy through the use of microskills may be an effective way to prepare counselor trainees to meet the demands of working with clients from all backgrounds. RCT’s synthesis of multicultural knowledge and focus on obtaining skills provides trainees with universal tools for developing strong multicultural competence at every stage of the counseling process. By focusing on the relational aspects of counseling through the use of microskills, trainees will be able to demonstrate culturally sensitive counseling. We provide a brief case illustration to highlight core tenets of RCT in practice.

 

Case Illustration

 

James (pseudonym) is a 22-year-old college student at a large university and has entered counseling with feelings of “constant anger” and “frustration” toward his family, friends and professors. James states that his actions are pushing others away, resulting in feelings of isolation. He describes spending much time in his bedroom in order to avoid conflict and reports feeling increasingly depressed. When he does engage with others, he finds that conflict often arises, causing him to either minimize the importance of the issue or withdraw from the offending individual in an effort to refrain from lashing out. James reports that while there are important things he would like to say during these moments, he relents because he does not want to heighten conflict.

Through the course of counseling, James describes varying degrees of emotional connection to his family and friends. He currently lives with his older sister and another roommate in a home owned by his parents. James is of Colombian descent and moved back and forth between his home country and Miami between the ages of 9 and 16. His parents are married, although his mother lives in Miami while his father lives in Colombia in order to maintain the family business. Both of his siblings are pursuing what he considers “successful” careers; his older brother is in law school and his older sister is in medical school. James has one year left to complete his undergraduate degree and is currently studying accounting. His relationships with his parents and siblings are important to him; however, he admits to hiding information, including his visits to therapy and feelings regarding friends and familial issues, as he fears reprisal or invalidation. He also consistently compares himself to his older siblings and feels that he does not live up to his potential within his family. Lastly, James has a fairly large social network, belonging to a coed fraternity for the past 2 years. Although he interacts with several members of the organization, he consistently feels misunderstood or ignored.

 

RCT Counselor Response

RCT is a broad and flexible framework, which can be employed in a multitude of ways. For the purposes of this article, the authors take a closer look at using worldview/cultural context, authenticity, disconnections, and mutual empathy in order to understand a different way to relate to James. The authors also demonstrate how each of these facets can be incorporated with microskills training.

Worldview/cultural context. In order to set the stage for client conceptualization, the initial focus of the relationship should be the client’s cultural context. Exploring the client’s worldview will give the practitioner an opportunity to understand the client’s cultural context and allow the client to feel heard, which is essential to RCT and the therapeutic alliance. After a few sessions, the counselor notes that James operates in many different areas, creating a rich worldview for the counselor to explore.

It is important at this stage to employ culturally educated questioning to enhance the counselor’s multicultural knowledge regarding the client. The counselor asks open-ended questions that are tailored to gather specific information about the client’s worldview as more information is shared between the client and counselor. Through exploration of his worldview, James indicates that his primary identification is a student, which colors all of his other worldviews and affects the primacy of other responsibilities contained within his other cultural contexts. James’s secondary identification is being a fraternity member. However, due to his studies, there are times when he is forced to forgo fraternity events so that he can be prepared for classes. The stress caused from his failing grades and inability to meet fraternal obligations adds to his anger issues. James also discusses his Colombian heritage and the importance of family, giving insight to his decision making. Exploring James’s daily activities, cultural groups and relationships helps build initial rapport and creates an early therapeutic alliance, while also giving insight into possible stressors for James. This alliance is carried through to other parts of the session, as the client feels comfortable giving detail, knowing that his particular worldview will be encouraged and respected.

Connections and disconnections. James feels unheard by his fraternity brothers and inferior to his family members. Deeper investigations into these relationships reveal that James’s peers and family members are not able to accept and understand his feelings, creating an empathic disconnect. The results of this disconnect cause James to become aggressive when he cannot get his point across. Using RCT, the counselor and James analyze the disconnection in each of his familial relationships and how they affect his current functioning and relationships with others. For example, James’s relationship with his brother is often very tense, causing him to retreat from conflict or release his anger in a nonproductive fashion. These behaviors are repeated when James comes into conflict with others, such as his fraternity brothers.

Next, the counselor helps James identify positive, mutually beneficial connections with others in his social circle. When asked what is different about these relationships, he shares that he feels open to discussing his emotions with these individuals and that his feelings are valued. To help build the therapeutic alliance, the counselor directly asks James what can be done to build a similar, mutually beneficial connection within their counseling sessions. James responds that he wants to feel safe and respected so that he can share his views without judgment. The counselor then seeks to create this type of environment using the tenets of mutual empathy and authenticity.

Counselors should be aware of power-over structures, which can alter how relationships are perceived. When counselor educators teach students to employ multicultural awareness, it is important to remind students of how existing societal structures may determine how students form relationships with members of society. RCT asks that counselors analyze client relationships and how they contribute to functioning with regard to positive and negative aspects of various relationships. Counselors can inquire about the important relationships in their clients’ lives and whether these relationships are mutually beneficial.

Mutual empathy and authenticity. While less emphasized in multicultural courses, counselor educators who teach counseling technique courses have the opportunity to reinforce multicultural skill development. Empathy development is taught as a foundational skill in counseling techniques courses, which begins during the initial phases of relationship development. Using RCT, counselor educators can teach the advanced skill of mutual empathy to help deepen the relationship between client and counselor.

In order to move from disconnection to connection, the counselor attempts to create a supportive environment using the RCT concepts of mutual empathy and authenticity by reaffirming the client’s story and attempting to accurately reflect the client’s emotion. When the client shares something that was particularly difficult, the counselor reflects feeling and shows appreciation for the client’s strength in addressing a difficult issue. In order to demonstrate mutual empathy, the counselor shares how he has been affected by James’s disclosure and asks how he feels about that action. James affirms being heard and respected, qualities that are necessary for mutually beneficial connection. For example, after James shares a particularly difficult story regarding feeling frustrated by others making decisions for him, the counselor re-affirms his story through empathic response, but then uses mutual empathy to ask how it feels to hear that his frustration is understood. Using RCT allows the client to feel that he is truly understood, and evidence of a more robust therapeutic alliance is seen through James’s increased willingness to share and explore themes.

 

Implications for Counselor Educators

 

Counselor educators have done much to incorporate multicultural development into counseling curricula. Through CACREP and ACA standards, counselor educators have received a blueprint for developing multiculturally competent practitioners. Counselor educators also have an established method of training through microskills, which are used to help students learn the building blocks of counseling. However, at this time very few counseling theories have sought to bridge both multicultural development and microskills training.

The purpose of this article is to provide a tool for counselor educators to help integrate the TM, (awareness, knowledge, skills) into classroom instruction using microskills training. The TM and RCT have concepts that mirror each other and that, when combined, can create a practical framework for students in progressing toward multicultural competence. When microskills training is used as a vehicle for instruction, students will have a tangible and discrete set of skills to use with diverse clients which may increase self-efficacy, improve the counseling relationship and improve treatment outcomes. Using RCT in multicultural coursework provides counselor educators with an educational tool to better apply the TM and meet the need to increase the emphasis of skills in multicultural courses.

Counseling using RCT principles includes bringing meaning to the client’s relationships and exploring his or her relational images (Jordan, 2001). Additionally, Jordan (2010) states that clients must be aware that they are having an impact on their counselors. Counselor educators have the ability to combine elements of RCT with microskills to enhance multicultural development in students. By linking knowledge, awareness and skills with the RCT elements of emphasis on worldview, power-over structures, and mutual empathy, counselor educators give students tangible skills that can be employed with multicultural clients. Funneling these two concepts through microskills gives counselor educators an available and proven framework to structure student learning.

 

Suggestions for Future Research

 

Like all theories, RCT is not without shortcomings. Because RCT is based on relational focus and views on openness between counselor and client, RCT may not be suitable for all counseling relationships. For example, Jordan (2010) states that RCT may not be effective with clients who have sociopathic personalities, due to such clients’ avoidance of authentic interactions. If a client is not willing to honestly engage the counselor, mutuality is lost. RCT also requires a level of authenticity that some counselors may not be comfortable with, specifically those with boundary issues. Counselors trained in other theories are taught to keep certain levels of relational distance between themselves and the client. However, Walker (2004) makes note that RCT practitioners strive for a level of relational clarity while avoiding language that implies separateness and objectification.

Currently, research is sparse in the area of using RCT as a method of instruction, most likely because RCT has not yet been operationalized, making it difficult to teach. Previously, the theory has been described as a way of being or an understanding, instead of a direct set of techniques that can be imparted to students. Oakley et al. (2013) have suggested using RCT in a brief model of treatment, stating their intention to develop a manual, which may help counselor educators in teaching the elements of RCT. Researchers should continue to focus on finding ways to clarify the process of RCT; its strong focus on relationships, worldviews and advanced techniques such as mutual empathy could create stronger counselors.

 

Conclusion

 

In summary, it is essential for counselors-in-training to be aware of how to put the TM into action. Current multicultural pedagogy primarily emphasizes learning in the knowledge and awareness domains, rarely making skill development a focus during counselor training. Given the changing demographics and increased growth of the minority population in the United States, training counselors to be effective with working with all clients is imperative. Counselor educators are in the unique position to prepare students for multicultural engagement before they begin practice. The infusion of RCT into counseling techniques courses gives counselors-in-training exposure to a different perspective, which incorporates the multicultural competencies with relationship building skills. RCT, with its emphasis on mutual empathy, relationships and contextual factors, enables counselors to gain a greater depth and breadth of minority client experiences, potentially strengthening the therapeutic alliance.

 

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Kristopher G. Hall is a doctoral student at the University of Central Florida. Sejal Barden is an Assistant Professor at the University of Central Florida. Abigail Conley is an Assistant Professor at Virginia Commonwealth University. Correspondence can be addressed to Kristopher G. Hall, University of Central Florida, College of Education and Human Performance, 12494 University Boulevard, Orlando, FL 32816, kristopher.g.hall@knights.ucf.edu.

 

Professional Identity of Counselors in Mexico: A Commentary

Viviana Demichelis Machorro, Antonio Tena Suck

The authors conducted an exploratory study using cultural domain analysis to better understand the meaning that advanced students and professional counselors in Mexico give to their professional identity. More similarities than differences were found in the way students and professionals define themselves. The most relevant concepts were empathy, ethics, commitment, versatility, training and support. Students gave more weight to multiculturalism and diversity, whereas professionals prioritized commitment and responsibility at work. Prevention did not appear as a relevant concept, posing challenges for professional counselor training programs in Mexico.

Keywords: professional identity, multiculturalism, ethics, prevention, counselor training, Mexico

In the field of professional counseling, it is important to consider the benefit of developing a strong professional identity. Initiative 20/20: Vision for Counseling’s Future, represented by influential organizations such as the American Counseling Association (ACA), the Council for Accreditation of Counseling and Related Educational Programs (CACREP), and the National Board for Certified Counselors (NBCC), identifies principles that must be developed in order to strengthen the counseling profession (ACA, n.d.). These principles include sharing a common professional identity and presenting the counseling profession in a unified way. CACREP (2009) recognizes the relevance of promoting professional development in counseling programs; the organization’s standards were written to ensure that counseling student development is congruent with professional identity, as well as the necessary knowledge and skills to practice counseling effectively and efficiently.

In Mexico, steps have been taken toward developing such standards. The Mexican Association for Counseling and Psychotherapy (AMOPP), founded in 2008, has stated in its mission and objectives the promotion of counselor identity and stimulation of professional development (AMOPP, 2014). However, the process of defining professional identity for counselors has complex aspects that imply a great challenge for the Mexican counseling guild (Calva & Jiménez, 2005; Portal, Suck, & Hinkle, 2010).

First, there are few Mexican university programs that train counselors. The only such Mexican graduate program is the master in counseling (maestría en orientación psicológica) at Universidad Iberoamericana, which started in fall 2003 and was awarded CACREP accreditation in 2009. This program prepares students in prevention, evaluation and intervention using an integrative approach that includes theories and techniques, promotion of multicultural sensibility, and a focus on vulnerable populations (Universidad Iberoamericana, n.d.-a). Most students in this master in counseling program have a bachelor’s degree in psychology, which makes for a mixed psychologist/counselor identity that is not easy to separate, and that is likely experienced as a psychological specialty by faculty, students and the general public.

In contrast to countries like the United States and Canada, where a bachelor’s degree is awarded first and students professionalize afterward at the graduate level, in Mexico, students professionalize at the undergraduate level, which promotes professional identity at this point. Thus, in Mexico the possibility of studying for an undergraduate professional program in counseling does not exist, which contributes to the difficulty of counseling being recognized as an independent profession.

There are plenty of reasons to study the professional identity of counselors in Mexico. First, counseling awareness within the community could be increased, making counseling accessible to a population that needs quality mental health services. The Mexican Poll of Psychiatric Epidemiology (ENEP) of the National Institute of Psychiatry reveals that 28.6% of the population presents some type of psychiatric disorder at some point in life, mostly anxiety (14.3%), followed by the use of illegal substances (9.2%) and affective disorders (9.1%). Nevertheless, despite this high incidence of mental health problems, only 10% of the population that presents with a mental disorder receives the attention it needs (Medina-Mora et al., 2003).

Secondly, there is limited professional literature in Mexico regarding professional counseling. Searching behavioral science databases revealed only one reference in a Mexican book regarding psychologists’ professional identity (Harsh, 1994) and no articles about counselors’ professional identity. If the professional identity of counselors in Mexico were more defined, it could help prospective students who are interested in studying counseling. It also could help practicing counselors form a solid base to serve as a platform to strengthen and enrich their professional behavior and clarify their professional identity. Neukrug (2007) has stated that when counselors find out who they are, they will know their limits and relationships with other professions. Therefore, the authors explored the professional identity of counselors in Mexico to better understand their definitive characteristics.

Professional identity, according to Balduzzi and Corrado (2010), is the definition one makes about self in relation to work and an occupational guild. It begins with training, during which professional identity can be promoted or obstructed, and includes interactions with others as well as modeling. Counselors begin to develop professional identity as they are trained (Auxier, Hughes, & Kline, 2003; Brott & Myers, 1999), integrating personal characteristics in the context of a professional community (Nugent & Jones, 2009). Brott and Myers (1999) studied how professional identity is developed among school counseling graduate students in the United States and reported that counselors develop an identity that serves as a reference for professional decisions and assumed roles. These researchers used grounded theory to explain the identity development process of counselors in training. First, students go through a stage of dependence to attain the stage of independence at which the locus of control is internal and the counseling student has the opportunity for self-evaluation without external evaluation. In this advanced stage, experience is integrated with theory, joining personal and professional identities.

To analyze the development of professional identity in counseling students in the United States, Auxier et al. (2003) developed their research from a constructivist model that assumed reality is socially developed, determined by the place where it is elaborated and based on the participants’ experience. They developed the model of “recycling identity formation processes” (p. 32). This model explains that for constructing an identity, a person needs to go through (a) conceptual learning via classes and lectures; (b) experiential learning by practices, dynamics and internship; and (c) external evaluation from teachers, supervisors, coworkers and clients.

Nelson and Jackson (2003) wanted to better understand the development of professional identity among Hispanic counseling students in the United States. They conducted a qualitative study and found seven relevant topics: knowledge, personal growth, experience, relationships, achievements, costs, and perceptions of the counseling profession (Nelson & Jackson, 2003). Although the results were congruent with other findings, such as the need to be accepted and included, relationships such as those available from caring faculty or the support of family and friends were identified as meaningful factors that contribute to formation of a professional identity.

Similarly, du Preez and Roos (2008) used social constructivism to analyze the development of professional identity in South African students between the fourth and last year of their studies as undergraduate counselors. Participants elaborated on visual and written projects regarding their professional development training. Through an analysis of this work, four professional identity themes were identified: capacity for uncertainty, greater self-knowledge, self-reflection and growth (du Preez & Roos, 2008).

Skovholt and Ronnestad (1992) explained that identity development implies progress of attitudes about responsibility, ethical standards, and membership in professional associations. According to the Skovholt and Ronnestad (1992), a counselor’s identity differs from other professional identities because a therapeutic self is shaped by a mixture of professional and personal development. The researchers explained that professional identity is a combination of professional self (e.g., roles, decisions, applying ethics) and personal self (e.g., values, morals, perceptions) that create frameworks for decision making, problem-solving patterns, attitudes toward responsibilities, and professional ethics.

In one of the few quantitative investigations on the topic, Yu, Lee and Lee (2007) used the concept of “collective self-esteem” (p. 163) as a synonym for collective and professional identity. They conducted a study to learn whether the collective self-esteem of counselors influences or mediates their work satisfaction and how they relate to clients. The researchers found that “job  dissatisfaction is negatively related to greater levels of private collective self-esteem, and in turn, greater private collective self-esteem is positively related to better client relationships” (p. 170). Based on their conclusions, it is important to study the professional identity of counselors in Mexico, who must work from a place of job satisfaction and good client relationships in order to successfully address their clients’ social needs.

Hellman and Cinamon (2004) performed a series of semi-structured interviews for 15 professional school counselors with a consensual qualitative research (CQR) strategy to classify counselors through the stages of Super’s (1992) career theory: exploration, establishment, maintaining and specialization. The classification was made according to the perceptions the researchers described about counseling, professional identity, work patterns, and resources and barriers at work. In the beginning stages of their career, counselors describe school counseling as a job or a role, but later they consider counseling a profession. Furthermore, counselors start by depending on external recognition, specific techniques, and highly structured programs. As they become more experienced, counselors gain self-confidence and rely more on their professional judgment.

In general, researchers have described subjective experience to explain the development of professional identity. Furthermore, findings suggests that counselors in their identity development gain more self-knowledge, confidence in their abilities and judgment, knowledge and involvement in their profession and its standards, and a combination of personal and professional characteristics and experiences.

Method

Cultural domain with free listing was chosen as the data collection technique. Cultural domain is “the set of concepts chosen by memory through a reconstructive process that allows participants to have an action plan as well as the subjective evaluation of the events, actions or objects, and it has gradually become one of the most powerful techniques to evaluate the meaning of concepts” (Valdez, 2010, p. 62). It has been accepted in Mexico and applied principally in social psychology and education to define and delineate several concepts such as psychologist (García-Silberman & Andrade, 1994); love, men and women (Hernández & Benítez, 2008); parenting (Medina et al., 2011); the rich and poor (Valdez, 2010); family (Andrade, 1994, 1996; Camacho & Andrade, 1992); and corruption (Avendaño & Ferreira, 1996), among others. This methodology was chosen because “professional identity” is a subjective concept to which different meanings are granted based on personal experiences; the idea was to show the concepts related to the meaning counselors give to their identity.

In this study, the authors posed the following question: What meaning do Mexican counselors give to their professional identity? The dependent variable was professional identity and the attributive variable was level of preparation (student or professional). The study was transversal (data recovery at a unique time frame) and descriptive.

Participants

The participants in the study included advanced students in at least their third semester in the master’s counseling program at Universidad Iberoamericana and professional counselors who graduated from the program at least one year ago. Fifteen of 17 advanced students (88.23%) participated, including 3 men and 12 women with an average age of 29.40 years. Twelve of 29 graduates (41%) participated, including 1 man and 11 women, with an average age of 42.75 years.

Survey Development and Procedure

Each participant was asked to list 10 words or brief terms to describe the concept counselor professional identity. Afterward, participants were asked to rank each word from 1–10, assigning 1 to the characteristic word considered the most relevant and 10 to the word considered least relevant. Advanced counseling students were given the survey in their classrooms and graduate counselors were sent the survey via e-mail. The surveys were analyzed following Valdez (2010), obtaining the definitions with the semantic weight (M), for both students and professionals, considering the frequency with which the words were mentioned, as well as the assigned rankings. The authors used a mathematical procedure called el valor M total [Total M Value] (VMT; Valdez, 2010), which entails multiplying the frequency of occurrence times the weight of each defining word. Next, a cross-multiplication was done, considering the highest VMT as 100% in order to obtain the semantic distance between each concept and the stimulus concept (i.e., counselor professional identity). This procedure is referred to as FMG (Valdez, 2010).

Results

For the students, the defining terms for the stimulus counselor professional identity, listed in the order of the frequency and relevance with which the participants used and ranked them, were as follows:

empathic, understands, sensitive, ethical, honest, sincerity, fair, prepared, knowledge, trained, updated, flexible, adapts, support, help, backup, listening, human, warm, congruence, authentic, mental health, well-being, trustable, integrative, responsible, commitment, intervening, implementing, action, professionalism, respect, tolerance, multicultural, contextualized, diversity, observer, acceptance, non-judgment, structure, organizes, collaboration, design, planning, creativity, patience, goal recognition, positive view, growth, development, contention, service attitude, dedication, different, brief, social commitment, interdisciplinary, reflective, analyzes, guides, communicates, open, wide view, curious, scientific, relationship, psychotherapist, therapist, educates, prudent, diagnoses, prevention, dynamic, specialized, assertive, personal, practical, resilient, facilitator, personal therapy, strategic and consultant.

Consensually, the researchers separated these concepts into semantic categories, taking into account terms that are synonyms or that have a very similar meaning, leaving 57 definitions. Similarly, those concepts with more semantic weight were detected, resulting in the Semantic Association Memory (SAM) group according to Valdez (2010), which refers to the 15 categories with the most relevance (M total). This process is done considering frequency and weight. This group includes 17 categories since the last 3 present the same value. Table 1 shows terms that counseling students used to define counselor identity, weighted in order of relevance.

Table 1

Counseling Students’ Identity

 

For graduated professional counselors, the defining terms for the stimulus counselor professional identity, listed in the order of frequency with which participants used and ranked them, were as follows:

empathic, commitment, dedicated, responsible, ethical, serves vulnerable populations, social service, prepared, experienced, updated, supervised, studious, research, listening, authentic, genuine, congruent, support, assistance, orientation, guidance, honesty, integrity, integrative, trustable, educates, informative, professional, versatile, adaptable, flexible, active, guide, creative, discipline, work, therapeutic relationship, curious, healthy, motivated, reflective, framing, intelligent, strength, ecological, humble, sensitize, acceptance, verbal, focused, aware, systemic, problem-solving, catalyze, assertiveness, decision-making, practical, positive, growth, development, fair, influence, self-knowledge, respectful, tolerant, reflects, cheerful and certified.

Once more, the defining words were classified into semantic categories, obtaining 48 definitions, as well as detecting those with the most semantic weight, resulting in a SAM group with the 15 most relevant categories. The authors derived these categories by considering higher frequencies and weight. The participants indicated that being empathic was the closest concept to counselor professional identity. The authors established empathic as FMG = 100, and cross-multiplied the other concepts to obtain their distance. Table 2 shows terms that professional counselors used to define counselor identity, weighted in order of relevance.

Table 2

Professional Counselors’ Identity

 

The resulting defining concepts also were divided into two categories: (a) the way counselors work and (b) the way counselors are. The authors believe it is important to understand how counselors actually perceived their role in their work (e.g., professional behaviors, attitudes, approaches, roles, and functions) and also the way they identify themselves personally (e.g., characteristics and abilities; see Table 3).

Table 3

Counselors’ Roles and Characteristics

 

Discussion

It is possible to distinguish professional identity with common themes that begin during counselor training and continue as a process (Auxier et al., 2003; Balduzzi & Corrado, 2010; Brott & Myers, 1999). More similarities than differences were found comparing students and graduates.

For students and professionals, empathy occupies the most relevant place when describing counselor identity. It is interesting to observe how counselors, students and professionals prioritize values and concepts that come from a humanistic approach (e.g., empathy, authenticity, being genuine, congruent, warmth). This finding coincides with what Hansen (2003) expressed in that the counseling profession has its roots in the humanistic model, which is an undeniable part of its identity. This is also congruent with the values that the Universidad Iberoamericana promotes with students.

Ethics appear predominantly in both sets of participants, likely since professional identity and ethics are closely related (Nugent & Jones, 2009; Ponton & Duba, 2009; Skovholt & Ronnestad, 1992). Responsibility and commitment, as well as training and preparation, appear to be important defining words for counseling students and graduates, indicating that these concepts are considered fundamental. Furthermore, students and graduates consider flexibility as one of a counselor’s professional identity characteristics, which relates to versatility in counselor roles and functions. Attending to the vulnerable population and social commitment were prominent for graduates, which fortunately matches well with the mission of counseling at their university (Universidad Iberoamericana, n.d.-b).

According to the data, the concept of prevention does not emerge as a direct priority that Mexican counselors believe distinguishes them. Students mention this concept, but just once and with low relevance; however, it does not reveal itself at all as a defining term for professionals. This finding does not correlate well with actual course descriptions within the counseling master’s degree program (Universidad Iberoamericana, n.d.-a); therefore, changes in the program curricula may be needed. Students identified multiculturalism and diversity in the description of their professional identity; however, graduates did not. This distinction could be related to the recent teaching of this topic in Mexico and is expected to increase in the new generation of graduates.

It is important to note the limitations to this preliminary descriptive study. The sample was limited to 27 participants and no in-depth interviews were done in order to more comprehensively understand student and counselor perceptions. There is no basis for suggesting that the results can be generalized to other counselor populations, given that the study was specific to the particular context of one program at a private university. It is imperative to continue the study of counselor professional identity in Mexico with more participants and in-depth interviews.

There are several implications for Mexican counselor educators in regard to the development of counselor professional identity. First, there is the understanding that counselors are models in their professional activities including writing, affiliations and certification. It is imperative that educators invite students to get involved in national and international associations; promote practice, research and writing; and exalt the relevance of counselor certification.

Prevention—on the one hand a historic activity of many counselors—has proven to be a less important to Mexican counselors. To enhance this concept, the university curricula design may need to emphasize this topic in the thematic content of the program’s courses. Practica and internships might as well include prevention strategies in the student’s roles and functions. Furthermore, an elective course about prevention program design and implementation could be offered. On the other hand, it may be that prevention is a good idea, but not actually practiced by professional counselors because people tend to not pay for preventive services.

In summary, counseling students and graduates in Mexico share a common professional identity self-described as empathic, ethical, committed, versatile, trained and supportive. Efforts should be made to continue enhancing counseling core values as the profession continues to grow in Mexico, as well as internationally.

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Viviana Demichelis Machorro is a doctoral student at Universidad Iberoamericana in Mexico City. Antonio Tena Suck is the Director of the Psychology Department at the Universidad Iberoamericana in Mexico City. Correspondence can be addressed to Viviana Demichelis Machorro, Universidad Iberoamericana, Departamento de Psicología, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, 01219 México Distrito Federal, viviana.demichelis@amopp.org.