Multicultural counseling is a term used to describe a specific type of counseling practice that acknowledges how various aspects of a patient's cultural identity might influence their mental health. The approach centers on the idea that demographic factors such as race, ethnicity, and gender identity play a critical role in how someone experiences the world and relates to others.
Multicultural therapy is a form of talk therapy that aims to address the concerns of clients whose race, ethnicity, religion, gender identity, sexual orientation, income, disability status, or other social factor(s) falls outside of the majority or outside the dominant social group. The approach centers on the idea that demographic factors such as race, ethnicity, and gender identity play a critical role in how someone experiences the world and relates to others, and attempts to factor those realities into their treatment. Multicultural therapy also acknowledges that negative issues that arise for minority groups—such as oppression, stereotyping, racism, and marginalization—are relevant for mental health and illness and should be afforded special recognition during therapy.
Members of minority groups, especially racial minority groups, are generally less likely to seek therapy than those from the majority, in part because many members of minority groups feel that therapists (many of whom identify with the majority, even today) would be unable to understand their lived experiences and fully address their needs. Multicultural therapy, therefore, aims to create a therapeutic environment where individuals from those groups will feel safe, respected, and able to articulate their challenges without feeling misunderstood.
Though therapist and client may not necessarily share the same race, ethnicity, or other relevant factors, a competent multicultural therapist will show significant awareness of the effects such factors may have on a client’s life. Multicultural counseling can take many forms, but in general, there may be more emphasis on the individual client’s unique background, experiences, and needs than in some traditional therapy settings that take a more universal approach. It may also address different cultural views of mental health treatment and help clients overcome internalized stigma or negative associations with seeking care. While the approach is primarily a form of talk therapy, it may be combined with therapies that involve other activities, such as art or music, if these interventions can help clients communicate better.
When It's Used
Members of any minority group—including racial or ethnic minorities, gender minorities, immigrants, and refugees—as well as others who feel marginalized by majority or dominant social groups, can benefit from multicultural therapy. Clients who seek multicultural therapy do so for a variety of concerns; while some are struggling with diagnosable mental health conditions such as anxiety or depression, others come to therapy for help with relationship or intimacy problems, occupational stress, poor body image or self-esteem, or cultural norms that may be interfering with psychological well-being. Sometimes, different facets of someone’s identity may lead to internal conflicts that can be resolved in multicultural therapy; for example, someone who identifies as a gender minority may struggle to reconcile their identity with the religious or cultural views of their family of origin.
The theory underlying multicultural therapy is not tied to a specific modality and can be applied to cognitive behavior therapy, couples counseling, family therapy, and other types of therapy appropriate for children, adults, individuals, or families, as long as the therapist understands the difficulties that affect the development of marginalized clients and the unique problems they face. When therapy is eclectic, the influence of the client’s culture must be weighed throughout every aspect of the therapeutic process.
What to Expect
How a multicultural therapy practice unfolds depends on the therapist’s preferred modality or modalities, as well as the client’s specific demographics and cultural needs. Typically, at first, time is spent developing trust and mutual respect as the client comes to understand the therapeutic process and the therapist comes to understand the client’s difficulties, needs, and expectations. The therapist can then begin to help the client understand which aspects of their problem(s) may be rooted in the relationship between their culture and the majority, dominant culture, and which may stem from something else. Together, the therapist and client work to find appropriate solutions.
In 2017, the American Psychological Association (APA) released updated guidelines for multicultural competency that may influence the course and practice of multicultural therapy. These include, among others:
The therapist should recognize and understand that a client’s identity is complex and may be shaped by multiple factors (race, gender, disability status, and others).
The therapist should recognize and acknowledge that they themselves may hold beliefs that can influence their interactions with others of different cultures, including those of their clients. Therapists should thus make a concerted effort—through continued education, individual therapy, or the like—to move beyond ingrained biases. At times, the therapist and client may discuss these attitudes and beliefs and how they may be influencing the therapeutic alliance.
Therapists should be attuned to historical context and understand how different cultural factors have affected power and privilege over time, and how those influences may manifest in a client’s present-day life.
Therapists should take a strength-based approach to build resilience and minimize the effects of trauma in clients’ lives.
How It Works
Psychology, as a field, has been historically dominated by white men, and many of its early approaches did not extensively take into account race, ethnicity, gender identity, and other demographic factors that can influence someone’s experiences and relationships. Though minority groups are still underrepresented in the mental health professions, in recent years, there has been increasing awareness within the field that what works for the dominant social group may not work for others and that improved cultural competency could better ensure that all therapy clients receive care that is more aware of their lived reality and better tailored to their needs.
Multicultural therapy, therefore, recognizes that psychosocial development is not necessarily the same for people of different cultures and backgrounds and it is essential that counselors and therapists who work with varied populations are knowledgeable about, sensitive to, and comfortable with cultural differences. Otherwise, it is impossible to establish the trust necessary to work with clients of different races, religions, sexual orientations, geographic locations, ages, socioeconomic backgrounds, and family types.
Competent multicultural therapists take special care to reflect on their own biases, lack of awareness, or lack of understanding of the issues affecting specific groups of people. At times, there may be a need for the therapist to refer the client to a different therapist, perhaps even one who shares the same culture. In multicultural therapy, the quality of the relationship established between the therapist and the client is key to success.
What to Look for in a Multicultural Therapist
A multicultural therapist will be a licensed mental health professional, social worker, or therapist with additional training in cultural competency and multicultural counseling, generally through graduate work or continuing education. Developing cultural sensitivity and competency is an ongoing process, so it is important to look for a therapist who also has experience in multicultural therapy as well as one who seems attuned to your particular background and needs.
In addition to training and experience, it is important to find a therapist who communicates an awareness of your particular culture, beliefs, and practices, whose goals and expectations for treatment are in line with yours, and with whom you feel comfortable discussing personal issues. Though it isn’t required, many clients prefer to seek a therapist who shares their race, ethnicity, gender identity, and/or other relevant factors. (Psychology Today 2022)